In my younger and more vulnerable years my father gave me some advice that I've been turning over in my mind ever since. "Whenever you feel like criticizing any one," he told me, "just remember that all the people in this world haven't had the advantages that you've had."As a believer in the social gospel, I am often compelled to excuse the societal ills long caustically dismissed as vulgar and worthy of scorn prevalent in the ranks of the less fortunate. Just like Nick Carraway's father, I've asserted, quite haughtily, sad to say, that since the poor haven't had the educational opportunities and certainly not the economic ones from which I have greatly benefited, that I ought to forgive their inferior ways by interjecting my own supposedly superior ones in their place. Well and good, this is until I take a step back and realize that I'm not exactly granting them the right to live their lives in their own way. Free Will, as I've come to understand it, is that God grants us freedom of choice. And as part of that arrangement, the only way we can be truly good is to have complete freedom to choose good over evil. Though this is a belief I still hold fast to, a recent event in my life has left me grappling with myself as to how I apply the concept to outside events and daily happenings.
Recently I attended a funeral of a member of my Father's side of the family. Regrettably, the only time we're ever together in one place these days is when someone dies. The deceased was another textbook victim of the famed stroke belt. A poor diet, combined with a sedentary lifestyle, combined with a pack-a-day smoking habit, combined with inadequate and infrequent medical care led directly to his demise. Had he taken precautions and acted in accordance to the wishes of any doctor worth his or her salt, he likely would still be alive this instant. The family has lost three or four members to the same combination of risk factors in as many years. Certainly, this is nothing noteworthy. Stories such as these are prevalent among southern poor whites and as such they all grow depressing familiar after a time.
The rest of the family shows an unfortunate reflection of the same lifestyle: overweight, undernourished, undereducated, unhealthy, and largely unaware it could be anyway else. Speaking of poor decisions, I note that a second cousin of mine became pregnant out of wedlock at fifteen, married the biological father at sixteen, divorced him at seventeen, remarried him within months, and now has three other children. Establishing the biological father of each of the last three kids would require a blood or DNA test to determine conclusively. And, not only that, she wins the dubious distinction of being the third successive generation of women in her family to have had an unplanned pregnancy before the age of sixteen. Again, I do recognize that this is hardly anything unusual or out-of-place. But when I see situations like these, I must admit that my first reaction is not that of pity. Instead, it is one of a lethal combination of snap-judgment and repulsion. It angrily thunders, Don't you have any more respect for yourself? But after that instantaneous display of Puritanical coldness subsides and calm returns, I try to be compassionate and understanding. Even so, I do recognize fully that both of these opinions are radically divergent from each other and I conclude that I cannot entertain both at once.
Taking into account the big picture, allow me to pose a question. If we are to enact health care reform soon and we are to manage cost while providing the best of care for all, what steps will we take towards reducing free will? Freedom to choose or Freedom to choose to be irresponsible? What will win out? Already insurance companies charge extra to their customers who continue to smoke and to those who refuse to get yearly examinations from a GP. In hot debate at the moment is a provision that would refuse to extend some potentially life-saving operations to those over the age of sixty, believing that their lives are practically over anyway and thus it makes more sense to prolong the life and provide necessary coverage towards someone younger and healthier. But such people, I must strongly qualify, would have medical situations like my relatives--- refusing to take care of their bodies, refusing to follow the advice of doctors, and struggling as a result with health problems they themselves created through their own refusal to take responsibility for their physical well-being. Those unfortunate enough to end up with health problems due to bad luck and worse genes have nothing to worry about. The idea of modern medicine and human means can be seen as a kind of low-grade manipulation of the natural state of affairs, but I think we're going to have to Play God a bit if we are to have a viable system. As for where we're headed when we do, only God knows for sure.