The old ideas–by today’s standards 2 years qualifies as old–keep proving relevant again and again. Here I explore the notion of social justice in what will most likely spill over into a multi-part series on the topic.
The notion of social justice so prevalent with the passage of Social Security in 1937 and again with the civil rights movement in the 1960s seems to have reemerged as a buzz word in the last few years in certain health policy circles, especially those with a commitment to the uninsured and underserved populations and those interested in the idea of health disparities. What ethical basis justifies the pursuit of social justice and what are the political implications of doing so?
From basically every ethical point of view, be it utilitarian, Kantian, or communitarian, social justice is a desirable goal. However, we are not always clear about what constitutes social justice. Recently, there has been a major focus on the topic of health disparities, especially along racial lines. A major distinction must be made, however, between inequalities and inequities. An inequality simply means that there is a difference, while an inequity means that there is an unjust difference. Social justice should concern itself only with the latter. For example, there might be an underlying genetic cause of disease-specific differences between blacks and whites (e.g., sickle cell disease). That there is a difference is an example of an inequality, but because the difference is genetically determined, we would not consider this an inequity. However, if blacks and whites tend to have the same incidence of heart disease, but blacks die more often, this suggests at the least possibility of disparities in treatment on the basis of race, as highlighted by Vicente Navarro. This, being unjust, would make the resulting gap in mortality rates an inequity.
In the face of inequities, with whom does the burden lie for taking corrective action? Is it an individual responsibility, a community responsibility, a corporate responsibility, a government responsibility, or some combination of the above?
It does not look like it can solely be left up to the people. As mentioned in Alan Wolfe’s book Does American Democracy Still Work?, ballot initiatives, seen by many of the general public as the ultimate expression of democracy, might actually be unjust if the majority votes against items that would benefit racial and ethnic minorities. So, it would seem that there is actually a role for government to play in not always listening to the majority and rather seeking to contradict mass opinion and support the “right thing to do.” At the same time, however, Wolfe suggests that the disinterested “referees” of politics (e.g., Supreme Court Justices) have disappeared, leaving no one to advocate for social justice without imparting their partisan views on the issue.
Should one party or another be the clear proponent of social justice as a part of their party’s political ideology? It would seem that the traditional liberal view would be more conducive to social justice: Intervening where the market has failed, using government programs to subsidize and support the less fortunate. Yet, what about the recent compassionate conservative movement? Appealing to all things in the name of Christ, it would seem that the right should extend a helping hand of charity to the poor. Yet this conflicts with their views of the role of both government and the market, and thus, they do not do nearly as much for the less well off as you might expect from their “compassionate” label. On this point, it becomes very clear how manipulative the conservative populist democracy really is in appealing to the people.
As Wolfe points out, however, we have moved away from being party-centered towards being candidate-centered. So, the question of which party should champion social justice seems to be less relevant than the individual candidate’s decision to advocate for social justice. In this situation, it seems that there can be three stances: the candidate supports social justice because it is the “right thing to do,” the candidate supports social justice because for one reason or another it promises to earn him or her a certain number of votes, or some combination of the two.
What is, or at least should be of greatest concern is that the general political ignorance of the public allows for policies to be implemented that have the real effect of reducing social justice in society without appearing to do so prima facie. Specifically Wolfe writes “Conservatives know what they want. The public has little idea what it wants. Under such circumstances, unjust action are easier to undertake because a public that admires justice in the abstract has little notion that it is supporting injustice in the concrete.” Thus, the prospects for social justice appear rather dim unless citizens become proactive and educate themselves on matters of policy.