Health is a Common Good


So how do we get public trust? We earn it.

Anita Sreedhar and Anand Gopal said in their New York Times article that the history of the vaccines in the US is relevant here.  In the US where vaccines have been available for as long as vaccines have been around, when vaccines for smallpox, a very deadly disease, were first introduced, In the US in the early 20th century, efforts to vaccinate people met with some strong (virulent?) opposition. But attitudes of people changed sharply after World War II. In the 1950s the government had a hard time keeping up with the demand and, this may seem shocking to us now, by the late 1970s nearly every state had laws mandating vaccinations for schools and there was very little opposition.  Why was that?  That is the big question. A Public good demanded strong public policy.

 This was the time when big government was appreciated!  That seems like forever ago doesn’t it? Governments in the west brought in ambitious social programs for things like Medicare, Old Age Security and things like that. They called it the welfare state. People loved these benefits of government. In the mid-‘60s in the US there were a number of social programs targeted at helping poor people, even black people. In the US President Johnson declared War on Poverty and pursued what he called “the Great Society.” Specific government programs sought to achieve greater public health among the poor and were very popular. As Sreedhar and Gopal said about some of the organizations created under these programs, “they embodied the idea that public health is effective only when community members share in decision making.” They demonstrated  an appreciation that health care was a common good! And that made all the difference.

As Sreedhar and Gopal said,

“The experience of the 1960s suggests that when people feel supported through social programs, they’re more likely to trust institutions and believe they have a stake in society’s health. Only then do the ideas of social solidarity and mutual obligation begin to make sense.”


The types of social programs that best promote this way of thinking are universal ones, like Social Security and universal health care. Universal programs inculcate a sense of a common good because everyone is eligible simply by virtue of belonging to a political community. In the international context, when marginalized communities benefit from universal government programs that bring basic services like clean drinking water and primary health care, they are more likely to trust efforts in emergency situations — like when they’re asked to get vaccinated.

 When such attitudes are present, and when the common good is respected, and not disparaged, as it has been disparaged now for about 4 decades, people trust the government and their institution’s.  They are not suspicious of them and then don’t sneer at them as they do now. The world is then a different place. I would say, then the world is a better place. And that attitude helped to make the world a better place. As Sreedhar and Gopal concluded:

“If the world is going to beat the pandemic, countries need policies that promote a basic, but increasingly forgotten, idea: that our individual flourishing is bound up in collective well-being.”


The pandemic has made starkly clear how important it is to have a feeling of common purpose and a respect for the common good. We now are starting to appreciate the enormous importance of such beliefs for their absence makes the most important enterprises—public enterprises—impossible.

America, and to a lesser extent Canada, and the world, will have to realize that 40 years of conservative policies that included reductions in basic social services while their incomes stagnated and while the rich people have seen their incomes rise enormously, will exact a terrible price on society. Ripping the social fabric of a country does not come without costs. In fact, it comes with enormous costs. That can even come back to haunt the rich who benefited from the reduced taxes. Perhaps they even gained less than they lost! Sometimes it takes something like a pandemic to make it clear that we need each other. We actually are in this together. If we can’t get the poor to participate in important social programs like vaccinations, we will all be stuck with a hefty bill.

Yes, social programs cost money; so does ripping them to shreds.  We should remember not to be cycnics. For as  Oscar Wilde said, “the cynic knows the cost of everything and the value of nothing.”

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