Exceptional Citizens: Veterans and Health Care
Brandy Fox, MS, PhD (c), Saint Louis University
Many people argue that rather than a theistic religion, there is a strong civil religion based on patriotism and “support for the troops” in the United States (Marvin & Ingle, 1999, p. 20). This paper will examine one impact our particular civil religion has on national health care policy. This religion has its own unique values that privileges certain groups of citizens over others, particularly military veterans. Because of this, health care for veterans takes on a stronger moral element than other types of health care. In any number of materials related to health care for veterans, buzz words like dignity, freedom, justice, liberty, rights, and the phrase ”sacred promise” are used repeatedly (Damron-Rodriguez et al, 2004, p. 246; Carter, 2017, p. 115; Koblinsky et al, 2017, p. 126; Williams et al, 2016, p. e1577). For example, in his 2014 speech to the American Legion National Convention, President Obama referred to a “sacred trust” between members of the military and the citizens of the country, saying that “upholding our trust with our veterans is not just a matter of policy, it is a moral obligation” (p. 322). This statement reveals how military service changes the fundamental obligation a country has to a citizen, not only practically, but ethically as well.
However, this idea of health care as part of the repayment for service has not always existed. The conceptualization of health care for former military members underwent a shift, moving from a reward for sacrifice to an enticement to join the military. Our civil religion acknowledges a boundary between someone who was once a soldier (outsider) and civilians (insider). Veterans can occupy a liminal space, no longer belonging on the outside, but not exactly re-incorporated into society (Marvin & Ingle, 1999, p. 106). Philosopher Didier Fassin writes about the power differential between those citizens in a liminal state; he describes those in the state of exception as being “defined not in the absolute of a condition, but in the relation to those who have power over them” (2012, p. 4). Veterans are not valued for who they are as people; they are valued because of the service rendered to the sovereign. This service is translated into greater moral worth, which in turn justifies the expenditure of government resources for veterans health, while regular citizens do not have the right to health care. This results in an ethically troubling issue: the requirement to “earn” health care that disproportionately impacts particular segments of society. This “alternative” way to get health care is used to justify the lack of a national health care policy.
However, this idea of health care as part of the repayment for service has not always existed. The conceptualization of health care for former military members underwent a shift, moving from a reward for sacrifice to an enticement to join the military. Our civil religion acknowledges a boundary between someone who was once a soldier (outsider) and civilians (insider). Veterans can occupy a liminal space, no longer belonging on the outside, but not exactly re-incorporated into society (Marvin & Ingle, 1999, p. 106). Philosopher Didier Fassin writes about the power differential between those citizens in a liminal state; he describes those in the state of exception as being “defined not in the absolute of a condition, but in the relation to those who have power over them” (2012, p. 4). Veterans are not valued for who they are as people; they are valued because of the service rendered to the sovereign. This service is translated into greater moral worth, which in turn justifies the expenditure of government resources for veterans health, while regular citizens do not have the right to health care. This results in an ethically troubling issue: the requirement to “earn” health care that disproportionately impacts particular segments of society. This “alternative” way to get health care is used to justify the lack of a national health care policy.