The Kindness of Strangers

I recently had a conversation with a person who earnestly believes that all entitlement programs are unconstitutional and should be eliminated.
The constitutional arguement is based on the notion that since nothing in the constitution specifically provides for federal social welfare entitlements it is forbidden to provide them. The counter arguement is that not being specifically permitted does not mean that these entitlement programs are forbidden.
An arguement over the finer points of the constitution offers little comfort to the parent of a young child newly diagnosed with a lifelong disability or to the aging parent still struggling to care for an adult disabled child. It offers little comfort to the husband or wife unable to provide a spouse with the best possible care for cancer or heart disease.
That same person who would have all entitlement programs stopped believes with apparently equal sincerity that charitable giving could and should take the place of these programs.
But how realistic is that? And even if it could be done, how palatable would it be for the recipients to live their lives, as Tennessee Williams famously said, depending on the kindness of strangers.
Could it possibly work? I put the question to several people involved in one way or another with either the health care reform debate or with providing assistance to individuals with disabilities. As it turns out, it seems that depending on such kindness is, at best, a stop-gap measure.
Individuals and organizations alike immediately point out that even now, with entitlements or with good insurance, not all needs can be met nor can all those needing help get it. As for resorting to charities, again none of them have proven to be complete solutions either. They are both needed to provide stability for the individuals in need and for the organizations caring for them.
For a healthy person with a healthy family, I'm sure it makes perfect sense to think that privately funded philanthropic organizations and facilities would and could fill the gap. And we all know that in some instances this is indeed the case.
But when we are talking about catastrophic illnesses and injuries, chronic conditions, and permanent disabilities, it is not realistic or kind to expect our brothers and sisters and their families to live out their lives hoping every day that a charity which has no obligation to care for them will do so.
Charity is a wonderful thing and it has a place in a society that considers itself moral. No system of entitlements will ever be perfect. There will always be those who slip through the cracks and there will always be unexpected new challenges to be met. There will always be a need and a place for charity and for the fortunate to experience the joy of sharing their abundance with those less fortunate. But what is moral about having a significant percentage of the population live in daily want and constant fear that because of some illness, accident, or disability they will never be able to move past the need to depend on the kindness of strangers?
That is not what I consider to be a moral society. The 19th century German philospher Arthur Schopenhauer took the position that compassion is the basis of all morality. For those of us who agree with Schopenhauer, it is an immoral society that fails to be compassionate.
A compassionate society incorporates and encourages charity but it does not demand that any of its members sacrifice their security and dignity by depending solely on charity. A compassionate society gladly and unbegrudgingly guarantees and affirms that access to health care and related support is a basic right. Access to health care and related support are not privileges to be dispensed by the wealthy to the poor. They are essential components of a compassionate society. Both the right to have them and the obligation to provide them are shared by all.
Health care and disability entitlements fulfill that obligation.
It is the responsibility of those of us who believe that we have that obligation as a society to a act accordingly.
We can act to improve the delivery of charitable giving or we can act to ensure the continuation and improvement of entitlement programes.
Doing nothing is not an option.