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The Good Society 15.1 (2006) 43-50

Civil Society, Philanthropy, and Institutions of Care
Gus diZerega

The word "philanthropy" elicits images of the wealthy using their bounty establishing scholarships or contributing to institutions helping the poor to assist the less fortunate. Or perhaps employing their riches to endow art museums, libraries, museums and public art, enabling others to enjoy values otherwise undersupplied. These philanthropic examples are certainly appropriate, but by themselves they are misleading, for they suggest love of humanity — phil-anthropy — is the exclusive preserve of society's most fortunate. Humankind, upon which the philanthropists exercise their beneficence, constitutes a relatively passive and needy target of their Olympian good will.

I want to offer a different analysis of philanthropy, one that by no means rejects the great merit of actions such as these, but pointing towards a larger, more liberal vision of philanthropy and its place in our world today. In the process I hope to demonstrate philanthropy's underappreciated potential in promoting liberty, equality, environmental sustainability, and even democracy.

Consider this example, taken from a local newspaper: Oasis Health Center serves the health needs of the uninsured poor in and near Brunswick, Maine. While Maine provides health care for children and the very poor, childless adults and in some cases parents whose incomes are barely above the poverty line generally lack affordable medical care. Only when their incomes fall to the official poverty level of $185 a week, does MaineCare cover them. Oasis serves people who earn from that meager amount up to $275 a week.

Staffed by volunteer doctors, nurses, physician's assistants, dentists, optometrists and chiropractors, the center provides urgent care as well as offering diabetes, depression, hypertension, and asthma clinics. Oasis also organizes outpatient support groups. Oasis accomplishes this ambitious program on a budget of under $70,000 annually.

"For each dollar we spend" says Dr. Peter McGuire, "our clients receive about seven dollars in care." In her description of Oasis, Gina Hamilton explains "This is because so many things — time, pharmaceuticals, and space — are donated. The clinic employs only one full-time staffer, and six part-time managers."1 Their physical space is always donated, and two area hospitals cover lab work, x-rays, and other tests without charge to patients. A retired doctor visits physicians in the area, collecting sample medications they have been sent, but will not use. A nurse checks on patients to make sure they suffer no unexpected side effects, as well as serving other post visit needs.

While people sending in monetary donations are clearly practicing philanthropy, so are the volunteers providing medical services, space, and other necessary services. Each of these non-monetary donations could be replaced by a monetary one enabling the center to hire out these services. Limiting philanthropy to money gifts alone underreports its frequency and ignores millions who serve others. Philanthropy needs to be conceived as all actions dedicated to helping provide values to others within a community of relative strangers.

The Oasis example offers us another insight. It is possible that MaineCare could be expanded to cover a wider range of people, incorporating those Oasis presently serves. If this happened, the result would be described as an expansion of public services. Those who created and sustain Oasis practice public policy by other means, outside the framework of government provision. They serve the public within the framework of civil society. Civil society is the larger institutional framework within which philanthropy works. But there is some uncertainty as to what should be included within the term.

Libertarian and most classical liberal theorists argue examples like Oasis illustrate how markets can provide for needs we might think government is needed to serve. And yet, examined closely, Oasis is as subversive to the market liberal's dichotomy of government vs. the economy as it is to the common sequestering of public policy within the realm of government. I believe the so-called classical liberal framework is unable adequately to appreciate philanthropic action at a theoretical level.2

Market Places and Market Orders...


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