Freedom from Fear in the Health-Care Debate

There comes a moment when we can say a word or speak a concept so often that it loses meaning and simply becomes sound. The concept becomes exhausted, thin, one-dimensional. Such was the case with the word and the concept of freedom during the debate in the House of Representatives on final passage of the Affordable Health Care for America Act.

The opponents kept saying that health-care legislation would take away our freedoms and lead to a "government takeover" of health care in the United States. Some dressed this argument in patriotism and in pathos. They sounded an alarm to be wary of a behemoth of federal government, a beast standing in our doctor's doorway. They counted the number of times the word "shall" appeared in the legislation, and reminded us of the coercive power of the state to take us to jail if we break the law. I find these arguments specious.

Freedom is complicated. It is more than the ability to do what we want without interference. It exists in both positive and negative ways. The late political philosopher Isaiah Berlin writing in an essay "Two Concepts of Liberty" defines negative freedom as non-interference and positive freedom as the source of interference that compels us to do this or that. As long as individuals live in society, freedom is not absolute. The common good puts limits on individual freedom. These boundaries and requirements do not mean that custom or law has usurped our freedom.

Berlin says: "You lack political liberty or freedom only if you are prevented from attaining a goal by human beings." The health-care legislation requires citizens to buy health insurance. If we do not, we can be fined. My question is: what goal does such a mandate prevent us from attaining? Berlin references Jean-Jacques Rousseau and the concept of the equality of sacrifice.

When we all buy health insurance, we get a tangible benefit in return. We lose the freedom not to buy health insurance, but we gain the benefit of freedom from denial of coverage for pre-existing conditions. We cooperate with our fellow citizens to help pay for health care for all. If we are able to choose not to buy insurance, our fellow citizens would have to pay the cost for our care when we need it. Be assured; we will all need care at some point.

Berlin also reminds us that to instead offer freedom to people who need food, clothing, shelter and health care "is to mock their condition." People need their health in order to make use of freedom. The positive freedom is the freedom that comes not through coercion, but from a willingness to fit our freedom into a greater good and to understand why we ought to do it.

In 1941, President Franklin D. Roosevelt articulated four freedoms: freedom of speech and expression; freedom of religion; freedom from want, meaning "a healthy peacetime life"; and freedom from fear. God has not given us the spirit of fear. We ought not to fear our own government. In a republic, our vote is a check on the power of government. The paradox is by giving up a portion of our freedom, we will gain greater freedom.

Dr. Valerie Elverton Dixon is an independent scholar who publishes lectures and essays at She received her Ph.D. in religion and society from Temple University and taught Christian ethics at United Theological Seminary and Andover Newton Theological School.

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