As everyone knows by now, the US Supreme Court voted today to uphold the Affordable Care Act (ACA), thus allowing to stand President Obama's signature legislative action on health insurance. In doing so, the Court also, unintentionally I suspect, ratified a Mencian approach to public policy.
A modern application of Mencius would support ACA. A key point in the Mencian perspective, which is largely absent in the US debate on the issue, is that by extending health insurance to everyone, ACA facilitates the fulfillment of filial duty: sons and daughters can care for their parents more effectively. How terrible is it for a child to face a parent's illness or incapacitation and not be able to secure necessary medical care! Moreover, as Confucius suggests, children have a duty to maintain their own health so that parents will not worry abou them (Legge translation):
Meng Wu asked what filial piety was. The Master said, "Parents are anxious lest their children should be sick." (2.6)
There is, of course, much that is beyond our immediate control when it comes to health, and Confucius here is not blaming the victim, as it were, if some a medical misfortune occurs. But we should take reasonable steps to avoid medical problems that might bring anxiety to our parents. Widely available health insurance, which makes it easier to seek early treatment, does that.
And Mencius would understand health insurance as a government responsibility, to the extent that it creates social conditions conducive for the broadest possible realization of Humanity. In speaking with a bad king, who is ignoring the livelihood and health of the people, Menicus says (Bloom translation):
At present, the regulation of the people's livelihood is such that, above, they do not have enough to serve their parents and, below, they do not have enough to support their wives and children. Even in years of prosperity their lives are bitter, while in years of dearth they are unable to escape starvation. Under these circumstances they only try to save themselves from death, fearful that they will not succeed. How could they spare the time for the practice of rites and rightness? (1A7)
There is a correlation between wealth and access to health care. The poor, if they fall ill and cannot secure the care they need, quite clearly have more difficulty in sparing "the time for the practice of rites and rightness." It is harder for them to do the right thing. And it is the king's - and by modern extension, government's - responsibility to make sure the "people's livelihood" is such that filial and social duties can be performed with the dignity they deserve. All persons should be provided with certain minimal material conditions, as Mencius suggests here (Bloom translation):
Mencius said, "In years of abundance, most of the young people have the wherewithal to be good, while in years of adversity, most of them become violent. This is not a matter of a difference in the native capacities sent down by Heaven but rather what overwhelms their minds.
"Now, let barley be sown and covered with earth; the ground being the same, and the time of planting also the same, it grows rapidly, and in due course of time, it all ripens. Though there may be differences in the yield, this is because the fertility of the soil, the nourishment of the rain and the dew, and the human effort invested are not the same.
"Thing of the same kind are thus like one another. Why is it that we should doubt this only when it comes to human beings?....."
We all start out, according to Mencius, with the same inherent moral capacity, the ability to do right in the world. When people fail to do right, it is not because of some innate character flaw. Rather, the environment surrounding them was not conducive to right action. If each person receives the care they need, if the human effort invested in their growth and development is sufficient, then we can expect the best possible social outcomes.
Not having access to medical care, for oneself or for a loved one, can clearly "overwhelm the mind" of otherwise good people. Thus, there a general social duty, best enacted by government, to create conditions that ease the medical burden for as many people as possible.
Therefore, when contemplating the whole health care mess in the US, remember what Mencius says: think about the barley.