> On Mon, 13 Jul 1998, David Seedhouse wrote:
>
> > There are people who argue that it is unjust to redistribute income
> > (I'm not one of them I hasten to add).
>
> Yes, and they're not all rich! (But, they are wrong!)
>

Rhonda:

I'm pleased that you want to continue the discussion but I'm
concerned that you seem to want to skirt around some big issues.  I
mean, for example, _why_ are people against the redistribution of
income wrong?  It isn't enough merely to say and feel that they are -
you need to advance reasons.

> And, in response to some of my comments about redistribution of income,
> David wrote:
>
> But not everyone in HP agrees with you.  Surely it is time to
> > become more explicit so that everyone (not least the recipients of HP,
> > many of whom are not concerned about world poverty) knows where they
> > stand.
>
> Of course, not everyone agrees with me. But, this discussion began with
> queries about HP and poverty. So, I am trying to focus on that.
> And, since we are discussing "politics" and HP, we do need to discuss
> disagreement. I can't get anymore explicit about where I stand!!!

On the contrary.  You make bold assertions only.  If you explained
these more deeply you _would_ be more explicit.

>
> David then suplied us with a synopsis of his theory
>
> > `Work for health is essentially enabling.  It is a question of
> > providing the appropriate foundations to enable the achievement of
> > personal and group potentials.
>
> Now, all personal and group potentials? What about the "bad guys"..do we
> want to work for their potentials? I am not being facetious although it
> may seem that I am.
>

Well, I think it is unproductive to focus on apparent weaknesses in a
small piece describing a large body of work.  Obviously I am aware
that there can be distinctions betweeen good and bad potentials and
am at pains to explain this and argue for my preferences in my books.
I would be pretty daft to have overlooked something like this
wouldn't I?

> So, *who* gets enabled and *who* gets to meet his/her potential?
>

The foundations theory is first egalitarian and second liberal and
is quite clear that the foundations should be provided for everyone
regardless of how they live their lives. Only once these foundations
are available for everyone should more specific choices - rationing
medical services for instance - be made.

> Then, David wrote about the four boxes:
> > 1.      The basic needs of food, drink, shelter, warmth and purpose in
> > life.
> > 2.      Access to the widest possible information about all factors
> > which have an influence on a person's life.
> > 3.      The skill and confidence to assimilate this information....
> > 4.      The recognition that an individual is never totally isolated
> > from other people and the external world....
>
> Sherrie has asked about #1..keeping with the theme she started about
> poverty. I would add that you can have all of #2-4 and still NOT be
> "healthy." In fact you could be as mean as a junk yard dog.
> (Obviously, I don't think mean is healthy...at least not for the
> recipients of meanness)

This is silly.  According to my way of thinking if you have good
foundations then you have a good level of health.  I can and have
defended this view.  If you think that this isn't what being healthy
means then you ought to respond in the same way, offering your own
account of what health is.
>
> >It will be immediately obvious that this notion of health does not
> > have traditional medical provision as its focus.
>
> David, most of us have been past the medical focus since the Lalonde
> document..if not before...but POLITICS keep us from living out our
> knowledge.
>

Why?  It hasn't stopped me.  I both write and act according to my
understanding of health.  It has always been difficult and lonely to
do this but I have persevered.  Unless we act out what we believe
nothing will change.

> > `... work for health cannot be fully comprehensive - not all work
> > should be thought to be health work.
>
> Now this is where HP is getting into trouble.."health" has become a
> totalizing concept. But, I think that is perfectly understandable, if
> regrettable, given that HP is, (at least for some of us!),
> part of movement for social change..it will have its contradictions.
>

So you will get contradictory social change - does that make sense
to you?

> >  What a person makes of the foundations he has is
> > up to that person, as long as he possesses at least the essentials
> > of the central conditions.  Given this then an individual must be
> > allowed to become the architect of her own destiny. (1)  (Quotation
> > slightly changed from the original.)
>
> So, a healthy person can be a nasty person too?

Yes, of course.  Health isn't everything.  There are, for instance,
many points where health work must cease - changing a person's
character is certainly one of these.  If a person is 'nasty' to
other people then he or she might rightly be of concern to health
workers, but she is more likely to be stopped by the police.

>If so, Ontario is becoming
> a healthier province!
>
It seems to be increasingly less healthy - but that is because
people's foundations are being dismantled.

> Really, I apologize if I'm appearing a little testy here...but, this is
> one of our core problems I think. If the social cohesion approach is
> correct, and everyone is living out his or her potential, we better hope
> it is the "good guys" who determine what cohesion is!
>

But I didn't say anything about social cohesion.  Provide decent
foundations and you are likely to get an increasingly diverse and
interesting society - maybe more cohesive, maybe not.

> We all know that these issues have been discussed by philosophers,
> theologians, academics, mothers, etc..for centuries. But, when we are
> discussing POVERTY and HEALTH, we have to confront that some people are
> realizing their health potentials and destinies at great cost to others.
> WHAT are we going to DO about that?
>

Try what we can, but you have to admit that the Right have the upper
hand at the moment.  They are more likely to be shifted when there
are thoughtful alternatives to their hardnosed selfishness.  Just
shouting at them that they are wrong is water off a duck's back.

Perhaps it would be helpful to spell out the alternatives?  What
(if anything) can and should health promoters do about social
injustice?

(It would be interesting to hear from people from a different
political persuasion too - how would you answer this question?)

Best wishes



David