Countless discussions have taken place here at Vox Nova about health care, revisiting debates about whether or not it should be provided, in any way, by the government. When I have expressed the view that, under these current (and probably collapsing) political arrangements, the government should see to it that all persons have access to health care, I’ve been charged with “not really being an anarchist.” The reasoning is that if I oppose the existence of the state, this means I should therefore believe that health care should be provided by “private” entities.
This mistaken assumption reveals to some degree the differences between anarchism and libertarianism, the latter of which tends to be the source of criticism of my intuitions with regard to health care. Anarchism has traditionally been more communitarian, where libertarianism is liberalism taken to its extreme. Both anarchists and libertarians oppose the state — actually, its debatable how much libertarians actually oppose the state — but they oppose the state for very different reasons.
Here are a few excepts from an article I found recently on an anarchist approach to social welfare. It might help to clarify some mistaken assumptions, and I am sure it will help to generate discussion. I am of the mind that the approach described here is very “Catholic.”
[A]narchists criticize the State as much for what it represents as for what it is. The State is singled out for particular attack because it is the exemplar of the top-down organization, based on power relationships, hierarchies and institutionalized violence. And it is the existence of power relationships and the systems of domination that they support, that anarchists have consistently attacked, their ultimate aim being the creation of a society—an ‘anarchy’—in which such relationships have been abolished. These power relationships are not embodied solely in the State but permeate the rest of society. In seeing the State as not something unique but rather as the supreme manifestation of a system of power relations, anarchists have recognized that the only way to dismantle the State is to construct other relationships….
[…]
Any definition of society should include an ability to take care of the welfare of its members, not just those members who have a privileged place in the social hierarchy. Welfare should be an intrinsic part of any society, therefore, not simply a functional extra. This requires that society is organized first and foremost to provide welfare. What anarchism calls for is the re-absorption of the provision of welfare into the daily lives of the citizens of the community. Welfare thus becomes not simply a function—something provided by a system or the workers in a system—but part of the everyday life of the community and its citizens.
[…]
The failure of the State to provide social welfare should not be seen as undermining the idea of social welfare itself, but of invalidating the role of the State; welfare is inextricably linked to empowerment, which is why State-provided welfare is always going to have minimal success. At the same time we should be under no illusions as to what the effects on the poor will be of the paring down of what State provision there is in the name of the market: without a viable alternative, the market simply means sink or swim, and to sink means poverty, destitution, homelessness, even death. The attempt to free welfare from the State cannot be left to the free marketeers of the Right. The need for a democratic and participatory alternative to the Welfare State has never been more urgent.
[Millet, Steve. “Neither State Nor Market: An Anarchist Perspective on Social Welfare.” In Twenty-First Century Anarchism: Unorthodox Ideas for a New Millennium, edited by Jon Purkis and James Bowen, 24-40. London: Cassell, 1997.]
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