I thought this essay (here) by Bill May was particularly powerful. His reminder of our obligation to take up our cross daily is important as we get ready to begin Holy Week.
Richard M.
Friday, March 26, 2010
On Being a Burden to One's Family, Especially One's Spouse and Children
Health Care Reform (4): The Political Sustainability of the Legislation is Undermined by Its Partisan Approach and Public Opposition
[This is the fourth in a series. You can view the full series on one
page here.]
Understandably anxious about having passed a
narrowly partisan bill – steered through by an unpopular congressional
leadership and signed by an unpopular president over the opposition of most
Americans – President Obama and the Democratic Party now must try to make the
political case to the American people that they knew what was best for us all
along.
Toward this end, hopeful Democratic Party
politicians have taken to citing other major social programs, such as Social
Security and Medicare, as showing how controversial Democratic legislative
initiatives become celebrated historical landmarks. They claim that these legislative programs had also been
passed by Democrats over Republican opposition. In the same way, they argue, the American people will learn
to love the new health care program and reward, rather than punish, the
Democratic Party.
The Democrats are whistling past the political graveyard. This new political spin is a political
myth. What happened this past week
truly was unprecedented. Never
before has a major and potentially transformative social welfare initiative
been enacted by Congress without broad-based bipartisan and embracing public
support. And, as a consequence, whether genuine health care reform will take effect remains uncertain. Building and maintaining solidarity with the disadvantaged, for whom those future uncertainties are most dangerous, has been made far more difficult.
In 1935, when Social Security was enacted,
Democrats did not force through a narrow partisan scheme over Republican
opposition, even though Democrats enjoyed an overwhelming majority in Congress
and had the enormously popular President Roosevelt in the White House. In fact, Republicans voted for Social
Security by a vote of 81-15 in the House and 16-5 in the Senate (here). Republicans had preferred an
alternative measure that would have created a true trust fund whose assets
could not be withdrawn and applied to other government spending (what a
blessing today if that alternative had prevailed). Nonetheless, on the final vote, Republicans stood solidly
behind Social Security.
In 1965, Medicare was enacted with nearly
unanimous Democratic support and the support of nearly half of Republicans in
Congress (70-68 in the House and 13-17 in the Senate) (here). The legislation was promoted and signed
by Democratic President Johnson who stood high in the polls as well, soon after
his landslide victory in 1964.
By contrast, the Patient Protection and Affordable Care Act of 2010 was enacted on a strictly partisan vote by unpopular politicians and over public opposition. In the House this past Sunday, all Republicans and 15 percent of Democratic representatives opposed the bill. The Democratic congressional leadership that cajoled and dealed and wheeled the legislation through to slender passage are held in such low regard by the public that one barely breaks into double digits and the other falls below it, with Speaker Pelosi at 11 percent and Majority Leader Reid at 8 percent (here). President Obama has seen his approval rating plummet over his first year in office. In the latest CNN poll, a majority of Americans now disapprove of the president (here). On the eve of the House vote, a CNN/Gallop reported that nearly 60 percent of Americans opposed the bill (here).
Reply to John Schwenkler
John Schwenkler evidently thinks that my recent comment on "moral incoherence" was directed at him. It wasn't. It was directed at Vice President Joe Biden, Senators Mark Begich, Christopher Dodd, Ted Kaufman, Dick Durbin, Tom Harkin, Mary Landrieu, Barbara Mikulski, John Kerry, Claire McCaskill, Robert Menendez, Kirsten Gillebrand, Jack Reed, Patrick Leahy, Patty Murray, Maria Cantwell, and those Catholics in the House of Representatives and across the nation who share what, if Mr. Schwenkler and I are right, is the morally incoherent position that (1) “we must reform the health care system to ensure that basic care is reasonably accessible to all members of the community,” and (2) “the unborn have no right to legal protection against being killed by abortion.”
I took the opportunity afforded by Michael P.'s posting of Mr, Schwenkler's comment to make the point. Mr. Schwenkler seems to think that I wanted to force him to go through the ritual of acknowledging the bidirectionality of the charge of moral incoherence. I didn't. I hadn't heard of Mr. Schwenkler before reading the comments Michael P. posted. He seems a bit annoyed that I haven't seen his bio on dotCommonweal. But I do not read dotCommonweal on a regular basis, and I read his comment on MoJ, not on dotCommonweal. Anyway, none of this matters, since my post wasn't directed at him and I had no intention of forcing him ritually to acknowledge the bidirectionality of the charge of moral incoherence.
I concluded my post by noting that Ross Douthat would agree with me, but allowing that I didn't know whether Mr. Schwenkler would agree. That was because I know Ross Douthat and I don't know Mr. Schwenkler. In particular, I didn't know whether Mr. Schwenkler would agree with this point in my post:
"The Church ("that very same church") teaches that efforts must be made to ensure that all members of the community, including the poor, have reasonable access to basic health care; but it does not prescribe a government run health insurance or health care system or a particular scheme or degree of government regulation of health care providers or insurers. People can reasonably and responsibly "claim the banner of church teaching" while advocating different policies for the structure (or reform) of the health care system to make sure that as many members of the community as possible have reasonable access to basic care (and insurance against medical catastrophes)."
I gather from what Mr. Schwenkler says in his response to my post that he does agree. That;s great. I'm delighted. But Mr. Schwenkler seems to want to do a bit of boxing with me, so I'm happy to go a round or two with him. Here's where I disagree with him, if I understand him correctly. He blames "conservatives" for their "stunning. inability to propose a coherent and forward-looking agenda of their [read our] own to address this country’s very real need for serious health care reform." He is painting with too broad a brush. Are some conservatives complacent about the need for dealing with the flaws of our health system, including the need to improve access and expand coverage? Sure. And they merit Schwenkler's criticisms (and mine). Are there Randian libertarians out there who think that improving access to health care is none of the government's business? Of course, though most of them, like Ayn Rand herself, are on the Biden-Dodd-Durbin-Harkin-Mikulski side of the abortion question. (It's just that they are less morally incoherent than the pro-choice Catholic senators against whom my post was directed.) But there are conservatives, including dedicated pro-life conservatives, who are thinking and working hard to devise sensible, affordable, liberty- and subsidiarity-respecting ways of reforming the health care system. James Capretta and Yuval Levin of the Ethics and Public Policy Center in Washington, D.C. are two whose work strikes me as particularly insightful and promising. If Republican victories in 2010 and 2012 make it possible to repeal and replace Obamacare, work now being done by people like Capretta and Levin will help to shape the reform of the reform
Thursday, March 25, 2010
Health Care Reform (3): Fantasies About Spending, Revenues, and Economic Forecasts
[This is the third in a series. You can view the full series on one page here.]
My apprehension about the future of this country as it is now being reshaped by the current administration and congressional leadership was well-expressed a couple of days ago by a man who is far more knowledgeable about deficits, government spending, and economics than I ever will be. In the aftermath of the health care legislation vote, Indiana Governor and former federal budget director Mitch Daniels said: “In a life of optimism about America and its future, this morning I am as discouraged as I can remember being.”
If my amateur evaluation set out below is even half-correct, and if the newly-enacted health care legislation actually is translated from paper into full implementation in the coming years, we risk national insolvency, the punishing debt levels of an impoverished third-world nation, an ongoing and permanent recession, sluggish employment, declining standards of living for everyone, fewer opportunities for our children. “The End of the American Dream.” Apocalyptic words. Are they more than the pessimistic ramblings of a conservative suffering a post-health-care-passage hangover? After you read what I ’ve set out below, you can judge for yourself.
In the closing days of the arm-twisting campaign to build a slender House majority for his health care bill, the Washington Post reports that President Obama “draped one arm over [Pennsylvania Democratic Representative Jason] Altmire’s shoulder, turned away from the others and leaned in close to his intended target.” “‘Jason,’ Obama said. ‘We have to do this. It is essential to bringing down the deficit.’”
I’m not sure what unsettles me more about this story. That President Obama would cynically appeal to a Democratic representative from a moderate district reluctant to vote for a new big government entitlement program by snookering him into thinking this health care spending program would reduce the deficit? (To his credit, Rep. Altmire didn't buy it and still voted “no” on Sunday.) Or that President Obama might actually believe that his massive new spending program will reduce the size of the federal budget? If it is the latter, then the Obama White House has become an Orwellian enclave in which “Spending = Saving”.
Congressional Budget Office Estimates: “Fantasy In, Fantasy Out”
But, someone may protest, the non-partisan, independent Congressional Budget Office (CBO) put its gold seal of approval on the Patient Protection and Affordable Care Act of 2010. We are told the CBO assured Democrats that the latest, “fixed” version of the health care plan would save trillions of dollars. In fact, just a couple of weeks ago while campaigning for his health care agenda in Pennsylvania, President Obama asserted that the legislation “brings down our deficit by up to $1 trillion dollars over the next decade because we’re spending our health care dollars more wisely. . . Those aren’t my numbers. They are the savings determined by the Congressional Budget Office, which is the nonpartisan, independent referee of Congress for what things cost.”
Well, not to mince words, but President Obama was both wrong and disingenuous. Even with the questionable premises underlying the CBO estimate, President Obama’s plan was supposed to save a little more $100 billion in the first decade, not $1 trillion. Not only was President Obama wrong, he was exponentially wrong by a multiplier of nearly ten. (Oh well, a trillion dollars, a hundred billion dollars; potayto, potahto, tomayto, tomahto.) When called on the error, the White House insisted that President Obama meant to refer to the trillion dollars of savings projected for the second decade (although the CBO carefully notes that projections that far into the future are not reliable.)
Moreover, every CBO assessment of the budgetary impact of a legislative initiative is based on a set of assumptions, both those offered by the bill drafters and those made by the CBO in its ongoing economic forecasts. In particular, when bill-drafters promise future congressional steps, however improbable they may be, the CBO must proceed accordingly. Thus, as former CBO director Douglas Holtz-Eakin explained in a New York Times column, when it comes to CBO projections, “fantasy in, fantasy out.”
To spell it out, if the bill drafters tell the CBO to assume that Congress will pay for new spending by making cuts in popular programs and by raising taxes even during hard economic times, the CBO must assume that will happen. “But,” as the Washington Post observes, “that falls apart if a future Congress finds the cuts or taxes too painful to handle and overturns them.”
(As I’ll address in more detail in tomorrow’s post, the likelihood that Congress will have the necessary discipline to stay the course is greatly diminished when one party pushes through a partisan agenda over the unanimous opposition of the other party and against a majority of the citizenry.)
With that understanding, let me outline just a few of the guesstimates and contingencies underlying the supposed deficit-reducing features of the Democratic health care legislation. You the readers can decide whether these suppositions constitute hard-headed, real-world premises by those serious about controlling spending or Disney-esque fantasies.
John Schwenkler responds to Robert George
Stating the Obvious
March 25, 2010, 9:07 am
Posted by John Schwenkler
Remarking on my earlier post, Robert George writes:
… someone “claiming the banner” of Catholicism who says, (1) “the plight of poor people who do not have access to health care is no concern of mine (except, perhaps, as a matter of private charity) and is not a legitimate subject of public deliberation and policy-making, and (2) “the unborn must be protected by law against being killed by abortion,” is being morally incoherent. By the same token, someone who says (1) “we must reform the health care system to ensure that basic care is reasonably accessible to all members of the community,” and (2) “the unborn have no right to legal protection against being killed by abortion,” is being morally incoherent.
Or so it seems to me.
I don’t know whether John Schwenkler would agree. I’m sure that Ross Douthat would.
Well yes, I do agree! But it also seems to me that I shouldn’t really have had to go through that ritual, given that not only does my dotComm bio indicate that I’ve gone through the sort of advanced study in philosophy that enables one to recognize that the charge of moral incoherence can be applied bidirectionally, but I also identified myself as pro-life in the very post Prof. George is discussing. At this point it strikes me that it might be permitted by the rules of the game to demand that Prof. George swear fidelity to Rome on such matters as transubstantiation and the Virgin Birth, but that would likely be taken as mere pertinacity.
Prof. George also reminds us, presumably bearing in mind my stated opposition to the Democrats’ health reform bill, that the question of how best to ensure access to adequate health care is a prudential one:
The Church (”that very same church”) teaches that efforts must be made to ensure that all members of the community, including the poor, have reasonable access to basic health care; but it does not prescribe a government run health insurance or health care system or a particular scheme or degree of government regulation of health care providers or insurers. People can reasonably and responsibly “claim the banner of church teaching” while advocating different policies for the structure (or reform) of the health care system to make sure that as many members of the community as possible have reasonable access to basic care (and insurance against medical catastrophes).
Indeed they can, and in fact this is a point that I’ve argued at some length. But the fact that there can be health care policies that will do an equal (or better!) job than the Democrats’ of ensuring widespread access to health care does not alleviate the problem I was identifying, namely that of “conservatives’ stunning inability to propose a coherent and forward-looking agenda of their [read our] own to address this country’s very real need for serious health care reform”. Appeals to prudence are fine and good, but absent a political agenda that centers on more than simply saying “No” to the Democrats, mainstream conservatives are in a poor position to complain when they’re accused of incoherently regarding the bishops’ statements on health care with something less than the seriousness with which they treat their views on abortion.
Or so it seems to me.
I’m sure that Ross Douthat agrees; he says just this in the very post I was discussing. And I’ll assume for charity’s sake that Prof. George would, too.
[Original post, plus comments, at dotCommonweal.]
Catholic Teaching and Big Government
I appreciate the comments, both posted to the Mirror of Justice and by email, on my continuing series on what I believe are the serious flaws in the health care legislation enacted this week, as well as my hopeful suggestion that the potential is still out there to do it right (Post 1 and Post 2). (I'll post the third in the series, on the fiscal implications of the health care bill, this afternoon.) I especially welcome my colleague Rob Vischer's direct engagement, asking "is the Church opposed to big government?"
I am tempted to respond simply, well, if the Church isn't yet opposed to big government, it should be! But the better answer is more nuanced than that, even if one believes, as I do, that our Catholic-grounded belief in the dignity of each human person and in the liberty that God bequeaths to all of us should lead to a presumption against government solutions when adequate alternatives are available.
I agree with Rob that the judgment as to the best mix of government and alternative public solutions to problems calls on prudence and that these are judgments on which reasonable, faithful Catholic can and will disagree. (I would add, as well, that this prudential judgment includes the decision about which matters of human relations should be left to individuals, families, neighborhoods, employers and employees, private intermediary groups, etc. rather than calling for public mandates or legal regulation of any kind.) For some things, such as national defense, "big government" appears to be the best solution, or at least is inevitable. For other "big" things, such as interstate highways and government buildings, government is a necessary part of the partnership, in terms of planning and funding, but the actual construction is better accomplished through contracts with private enterprises rather than creating government construction companies staffed by government construction workers. For social welfare programs, again, the right mix is one that deserves thoughtful debate, with those on both sides still being comfortably under the big tent of Catholic social teaching.
I do want to submit, however, that all things being equal (in terms of quality solutions to social problems, effectiveness in administration, cost, etc.), we should presume against "big government" solutions and prefer partnerships with private enterprise and voucher-type programs. And we should do so not only for the most nitty-gritty of practical reasons but as a matter of moral principle. Let me identify five reasons why I think this is right:
Two Cheers for Bart Stupak
Departing for a moment from my series of posts on the health care reform legislation, I wanted to add a word of support for Michigan Congressman Bart Stupak, even though I think he stumbled at the finish line.
I do think he made an error in judgment in accepting President Obama's dubious executive order as justifying withdrawal of his objection to the inadequate abortion language in the Senate version of the health care reform legislation and agreeing to cast his vote for the bill. But, while mistaken in my judgment, he made a call on the fly, his heart was always in the right place, and he has a solid record of principled support for the sanctity of human life. His ultimate vote for the health care legislation is not an act of deliberate betrayal, as he had always been on record as supporting the merits of that proposal. And, for that matter, the Obama executive order may prove to have some value, as it at least puts this White House on the record about use of federal funds, even indirectly, for abortion and about the need for a conscience clause for medical providers opposed to abortion.
Would it have been better if he had stood firm, even to the bitter end? Yes, which is why he gets two cheers and not three from me. But as far as I am concerned, and even with my disagreement over the wisdom of bargain with the White House, Rep. Stupak remains a member in good standing of our diverse pro-life community. At any dinner of pro-life leaders, I would be proud to have Rep. Stupak at my table.
Greg Sisk
Wednesday, March 24, 2010
Is the Church opposed to big government?
By increasing the government's sheer size and role in the provision of health care, does health care reform really violate Catholic teaching as a matter of principle? Greg writes:
My opposition to the unwarranted emphasis on big government solutions in the 2010 health care legislation goes beyond prudential concerns about efficiency and cost to the public, although those factors obviously are important and contribute to the lack of economic viability for the plan . . . . As a matter of principle, grounded in Catholic teaching about liberty, human dignity, and human thriving, I regard this plan as dangerously fostering dependency on government, as suppressing our liberties in making economic and health care choices independent of government guidelines, and as enhancing the power of government employee unions that convert government itself into a special interest contrary to the common good.
Greg is certainly not alone on this point. More and more I seem to notice conservative Catholics advocating for small government as though it were a principle of Church teaching, rather than a prudential judgment regarding the policy measures that may or may not be most conducive to human flourishing under a particular set of circumstances. I understand that the totalitarian state does violate Church teaching in principle, but that's not what we're talking about here. It simply cannot be true that fostering reliance on the government when it comes to the provision of health care violates Church teaching as a matter of principle (or that supporting government employee unions does). I have no problem with Catholics opposing the European welfare state (a state that was shaped in significant part by Catholics), but I've understood that opposition to be grounded in an empirical judgment that the European welfare state does not work very well, not that the European welfare state is contrary to Church teaching.
As I've argued on MoJ before, I suspect that many (most?) of our opinions on these matters are shaped by our life experiences occupying a whole bunch of identities (we are "bundles of hyphens," to quote Laski) not just as the bearers of some purely distilled essence of a Catholic worldview. I'm not saying the health care debate regarding the role of government is prudential judgment all the way down, but it's close.
The abuse scandal deepens
The New York Times reports on new documents showing that Cardinal Ratziner failed to respond to an American bishop's requests that a priest who admitted molesting 200 deaf boys be defrocked. (The requests apparently were made years after the abuse occurred.) Even apart from the incalculable human costs inflicted by these priests -- and by the Church leaders who failed to take action to stop them -- this scandal is wreaking havoc with the Church's moral witness, and it appears that it will continue to do so for the foreseeable future. I fear that the 2010 edition of these scandals is just ramping up. Two sets of questions come to mind: First, is a pastoral response -- focusing on the spiritual dimension of this crisis and the need to put our trust in Christ -- sufficient, or does there need to be more candid discussion of the extent to which certain of the Church's institutional tendencies and power dynamics contributed to the crisis? Second, if a pastoral response is most appropriate here, should that response include repentance by the Church leadership as a whole, perhaps even including Pope Benedict? I've read commentary suggesting that Pope Benedict cannot admit mistakes given the doctrine of papal infallibility. That's wrong, of course, but it's still a matter not to be taken lightly. Even if the failing is paying insufficient attention to these matters in Munich and during his time heading the CDF, wouldn't that go at least part of the way to defusing the accusation that the Church is primarily concerned with maintaining the perception that its leaders can do no wrong?
Health Care, Abortion, and Moral Incoherence
Calling attention to a recent column by Ross Douthat, John Schwenkler says:
"Claiming the banner of church teaching when it comes to the protection of the unborn while ignoring the demands of that very same church concerning the adequate provision of health care is a gross moral incoherence."
But surely it works the other way round, too, does it not?
Claiming the banner of church teaching when it comes to the provision of health care while ignoring (indeed, openly rejecting) the demands of that very same church concerning the protection of the unborn is a gross moral incoherence.
The Church ("that very same church") teaches that efforts must be made to ensure that all members of the community, including the poor, have reasonable access to basic health care; but it does not prescribe a government run health insurance or health care system or a particular scheme or degree of government regulation of health care providers or insurers. People can reasonably and responsibly "claim the banner of church teaching" while advocating different policies for the structure (or reform) of the health care system to make sure that as many members of the community as possible have reasonable access to basic care (and insurance against medical catastrophes).
With respect to the protection of the unborn, the Church ("that very same church") teaches that each and every member of the human family, irrespective of age, size, location, stage of development, or condition of dependency, possesses inherent and equal dignity and a fundamental right to life. The Church further teaches that it is the duty of government to guarantee that fundamental right and to afford to all, including the unborn, the protection of the laws against homicide and other forms of violence.
So, someone "claiming the banner" of Catholicism who says, (1) "the plight of poor people who do not have access to health care is no concern of mine (except, perhaps, as a matter of private charity) and is not a legitimate subject of public deliberation and policy-making, and (2) "the unborn must be protected by law against being killed by abortion," is being morally incoherent. By the same token, someone who says (1) "we must reform the health care system to ensure that basic care is reasonably accessible to all members of the community," and (2) "the unborn have no right to legal protection against being killed by abortion," is being morally incoherent.
Or so it seems to me.
I don't know whether John Schwenkler would agree. I'm sure that Ross Douthat would.
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