“The moral consensus of a free state is not something mysteriously prior to or above politics: it is the activity (the civilizing activity) of politics itself.” Bernard Crick, In Defense of Politics

Bernard Crick argued in defense of politics as an activity, as something that we do together. But he notes in the paragraph that precedes the above sentence that for people to engage in problem solving through politics, they must first have “a common interest in sheer survival”. To see our common interest, we must see our common humanity.

During the “debate”, if it can be called that, over the unsuccesful attempt to repeal the Affordable Care Act in 2017, I kept wondering, what, exactly, do people think insurance is? The whole concept is about collective risk. It is difficult to purchase fire insurance for your home after your home has already caught on fire. The idea that health insurance is only for people who are “sick” is just empirically false. Some of us, perhaps those of us able to read and write at this moment, enjoy temporary good health. Eventually all of us die. In the process, we are all likely to need some kind of medical care. And none of us would survive to adulthood without the care provided by other people.

Political theory can be very useful for thinking about these kinds of questions, and in this case we can turn to Joan Tronto. She has thought very carefully, over several decades, about the relationship between care and political life.  In doing so, she has thought about the complexity of the ways that care and inequalities are reproduced particularly in the contemporary United States.

What does care have to do with insurance and collective risk? Tronto argues that the traditional way that liberal democratic political theory has thought about humans in political life–as independent, unencumbered individual utility maximizers–gets just about everything wrong. This notion is wrong about being human, it is wrong about the substance of political life, it is wrong about democracy, and it is wrong about how to live a meaningful life. And this notion certainly misleads us about the challenges of the present political moment.

Of course many political theorists have made this argument. But Tronto argues that it is much more useful for those of us who care about democracy to think of humans as care receivers. “Dependence marks the human condition from birth until death.” (Caring Democracy, p. 94)

In the debate over the ACA, the claim was made that it was “unfair” for healthy people to pay for sick people. As if there is such a thing as “healthy people” and “sick people” as a kind of ontology. No. There are people. And it bears repeating: none of us would survive to speak or write or complain about paying for insurance if we had not already been care receivers.

Tronto would argue that those who see themselves as healthy people are claiming a kind of “pass” out of responsibility for others. But her claim goes even deeper: they are claiming immunity from human vulnerability. They are claiming not to be human.

There are no healthy people, only people temporarily enjoying good health.  “We are care receivers, all.” (p. 146) As the twitter hashtag had it, #iamapreexistingcondition.

Sooner or later, we all need health care. We are human.  We are vulnerable.

Perhaps that is just too frightening for some to recognize. But if we are to have a better politics, we need to start with our common interest and our common humanity.