Civilizing the Economy A New Economics of Provision

Health care: not Socialism, nor Libertarianism, but Civicism

Posted Dec 14, 2010 by Marvin Brown in Uncategorized, 5 Comments

For the United States government to require that everyone carry health care insurance is not socialism, but neither is it libertarianism.  What about seeing it as a third form of government that we can call: “civicism.”  Civicism believes that all citizens have certain obligations to each other based on such civic norms as solidarity, moral equality, and reciprocity.

Solidarity may seem rather irritating for libertarians, because they tend to ignore the very essence of citizenship: civic membership.  A bit of reflection, however, should make clear that without membership in a political community, no one could enjoy property rights.  It is a “we” that makes it possible for any “I” to enjoy the benefits of ownership.  At the same time, membership does not negate ownership; it simply places it in the context of civic relationships.  Health care also belongs to these civic relations.

Civic moral equality may be an even greater challenge for libertarians than solidarity, because libertarians tend to divide the world into the haves and the have-nots.  If the government tells them what to do with what they have, they see it as a form of tyranny.  For them, morality is a kind of property management—the management of their personal and private property.   Some would say that socialism is also about property management.  They just want the government to manage it.

The civic view of moral equality, however, begins with the notion of persons as moral actors.  Moral equality means that most of the time, most of us do what we think is right considering the world we think we live in.  Most conflicts, in other words, are conflicts between right vs. right rather than conflicts between right vs. wrong.  This understanding of moral equality serves as the foundation for civic deliberations about controversial policy issues.  All citizens have the right to participate in public conversations about our life together.  This means that everyone’s voice deserves equal representation and equal attention in the conversations about health care.

Reciprocity refers to the foundation for making exchanges, for giving and taking, and for mutual insurance against the risks we all face.  One finds it in almost all cultures.  And yet, in our society, it has been mostly replaced by the notion of market price.  Today, many calculate whether to participate in health care insurance programs in terms of whether the costs outweigh the benefits.  “Is health insurance a good investment for me?  If not, why bother?”

After 250 years of living in an economic legacy that pictures exchanges as based on self-interest, this seems quite normal.  In fact, in terms of human history, it is an aberration.  Human communities, for the most part, have assumed that what one gives will someday be returned.  It is not so much a calculation as an expectation towards oneself and toward others.  Obviously, it rubs against the individualism of the libertarian.  Still, even they can see (if they want to) that we all live today in complex systems and get most of what we have through these systems.  Even a drink of water comes from an elaborate water system.   That is also true of health care.  The fact is that we do depend on one another.   Reciprocity transforms that dependence into one of moral value.  It honors our capacity to provide for and to protect one another.

In the United States, we do have a tradition of civil rights and civic virtue.  It is based on the recognition of the dignity of the individual as a member of the civic community: as a citizen.  Expanding on this legacy could give us a foundation for supporting universal participation in health care insurance.

5 Responses to “Health care: not Socialism, nor Libertarianism, but Civicism”

  1. traditional war – great britain – world war ii – soviet union – share world – guest login – posted sep – conflicts – Heart – world says:

    December 14, 2010 at 4:24 pm

    [...] It was a war to determine the way of life that should exist in Europe, and by extension as the world’s center of geopolitical gravity at the time, the whole planet. Another factor accounting for the enduring appeal of World War II is the personalities of its leading You can also read the following related post: [...]
  2. Peter Mazsa says:

    December 26, 2010 at 11:40 pm

    Cf. the December 2010 issue of
  3. Marvin Brown says:

    December 27, 2010 at 9:44 am

    How interesting that in most discussions of Adam Smith and property rights, writers ignore the significant place of slavery in the historical transition from feudalism to capitalism. Slaves were property, which meant that one did not need to consider their misery. This is aptly illustrated by Adam Smith's treatment of slaves as property in his The Wealth of Nations. John Locke even invested in the slave trade as he wrote his Treatise on property as the basis of freedom. I would invite libertarians to include this in their historical narratives. The fact is that early capitalism belongs to the story of the capture and enslavement of 11 million Africans. When Adam Smith lived in Glasgow, it was a center of this Atlantic trade of slaves and tobacco. His silence about this source of wealth in his book on wealth creation has continued into the present, and needs to be broken.
  4. Peter Mazsa says:

    December 27, 2010 at 10:38 am

    ok but what have you answer to do with overlordship vs property debate?
  5. Marvin Brown says:

    December 27, 2010 at 4:50 pm

    Overlordship seems to imply that some people are subject to others. In a representative democracy, the idea is that all people are citizens, and are represented in government decisions. If power is given to the people, which is the first principle of democracy, then no one is a lord over others, but all have equal representation. As long as we see freedom based on ownership of property, of course, those with property will be able to force those without property to be their subjects. This describes much of our common life today. As I argue in Civilizing the Economy, a true democracy would give membership priority over ownership. If the essential meaning of citizenship is that of membership, then the realization of democracy would mean that property rights are political, not natural. Slavery is not irrelevant here. To see slaves economically rather than politically has its origin in the Anglo-American tradition of economics that is also the origin of libertarianism. Adam Smith's silence about the slave-based tobacco in his account of wealth creation really does reveal the hypocrity of this tradition.

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Marvin T. Brown, Ph.D teaches business and organizational ethics at the University of San Francisco and Saybrook University in San Francisco.

This book is the culmination of 30 years of teaching and writing on business and society from a communicative perspective. Visit for more information.

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