Thank you Susan for your insights into health care reform. Last month, after reading Michael Pollan's Omnivore's Dilemma, I suggested that one way to control health care costs in the US would be to reform agricultural policy. A couple of days ago, Michael Pollan had an op-ed in the NYT advocating this approach. Here's a taste:
No one disputes that the $2.3 trillion we devote to the health care industry is often spent unwisely, but the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained, as a study released last month says, by our being fatter. Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.
That’s why our success in bringing health care costs under control ultimately depends on whether Washington can summon the political will to take on and reform a second, even more powerful industry: the food industry.
According to the Centers for Disease Control and Prevention, three-quarters of health care spending now goes to treat “preventable chronic diseases.” Not all of these diseases are linked to diet — there’s smoking, for instance — but many, if not most, of them are.
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The American way of eating has become the elephant in the room in the debate over health care.
HT: David Bell
UPDATE: Coincidentally, Susan's Creo en Dios post today also mentions the misuse of food.
My subject line was the unofficial title for the symposium held yesterday at Villanova Law: "Sovereignty's Seductions: Reconciling Conflicting Claims to Govern." The symposium grew out of a conversation my wonderful colleague Ann Juliano and I carried on, over several years, about whether it makes sense to try to decide any important politico-legal issues in terms of "sovereignty." I was skeptical, but Ann, who teaches Indian Law, made lots of good points about why sovereignty is indeed what one should call what tribes should be seeking from the U.S. government. Our goal in convening the symposium was to bring into a common conversation people who talk about sovereignty in a wide range of generally disjointed areas. Because of scheduling difficulties, a couple of the perspectives we had hoped to include (international, theology proper) weren't in the end represented. But that didn't get in the way of a fabulously successful discussion of a topic about which (to paraphrase one of the presenters) "there is still amazingly much to say."
The day was supposed to begin with remarks by Kevin Gover, director of the Smithonian's Museum of the American Indian and former Assistant Sectretary of the Interior for Indian Affairs, but at the last minute illness prevented him from attending. Doug Endreson, a pracitioner of Indian law in D.C. and an adjunct at Columbia Law School (and, like Kevin Gover, formerly my colleague at ASU) started us off with a masterful account of the phases and direction of Indian law in the U.S. Doug emphasized that even during periods when Indian interests have not succeeded in the Supreme Court, many tribes have made huge strides forward in terms of effective self-governance and community prosperity. Kate Struve, of Penn Law, went next, and she offered a rich account the myriad consequences of tribes' frequently having their interests determined in the courts of another sovereign. Hope Babcock, of Georgetown Law, spoke third, and her focus was the use, since John Marshall's trilogy of Indian law cases, of legal fictions to fix the place of Native interests in American law. This presentation offered lots of insights, coming out of Lon Fuller's work, on the broader place of fact and fiction in forming legal doctrine and practice. Where Endreson is optimistice, Babcock is straightforwardly pessimistic. The contrast couldn't have been sharper or better articulated. The fourth speaker was Don Doernberg, of Pace Law, and he developed the fascinating theme that because knowledge is power, putative sovereigns are having a harder time of it in this world of Twitter (where "Twitter" stands for all the instantaneous communication that dominates our lives). The instant availability of knowledge is making government more accountable to the governed, which, Doernberg argued, defeats claims to "sovereignty." Responsible and responsive governors are not the stuff of which Leviathan is made! MOJ's own Greg Sisk went last (but was not least), and he developed a strong account of why the common good calls for -- rather than, as I tend to think, forbids (or counsels against) -- federal sovereign immunity. For me, the principal issue is that when the the governor (I won't call him "sovereign") disobeys the law (and then claims immunity from suit under that law), this is inconsistent with the governor's showing the positive law the respect it deserves (as, by hypothesis, an ordinance of reason, for the common good, promulgated by one who has care of the community). Sisk's way around my objection, as I see it, is to take an ontologically lighter view of the status of the positive law. While I don't assume that judges have the power to craft remedies for violations of the positive law (that is itself a question of positive law, not of the natural law), I do take the (natural law) position that the positive law governs -- that is, its preceptive force holds with respect to-- even the behavior of the one who posits it (unless and until he withdraws it). I hope Greg will add his two or three cents not only the issues but on the tenor and topics of the whole day. Thanks to all who participated!
The five papers will be published in a forthcoming issue of the Villanova Law Review. I look forward to reading them with the care they deserve.
As an aside, I would add that this strikes me as event that exemplifies some of the distinctive contribution "Catholic law school" can make. I don't make the silly suggestion that this conversation could not have occurred at Rutgers or Iowa. Of course it could have. We had similar conversations at ASU during my eight years there, thanks in part to the presence there of the estimable Michael J. White. But in this case it occurred at Villanova, and it did so in part because of the intellectual space provided for the purpose of introducing Catholic views into the conversation. The symposium grew out of an organic intellectual inquiry and disagreement in which the Catholic view (as I understand it: "God alone is sovereign," as Maritain said) was in dialogue with a view in which God is not available (to be sovereign or anything else). "Catholic law schools" are uniquely positioned, through their faculty members who ask and answer the questions that define and guide the Catholic tradition, to test and try the other views that are on offer in the culture at large. This can happen sporadically in other institutions. It should be a defining feature of and regular occurrence in the life of a Catholic law school. Why is that so controverisal (or, as the case may be for others, negligible)?
Michael Scaperlanda directs us to a recent WSJ op-ed and asks what problems there might be to the author's suggestion of a market-based approach and whether such an approach is inherently at odds with Catholic Social Teaching.
I think the short answer is that if we could obtain a fully competitive private market and provide some back-up for those persons still unable to afford to purchase insurance in the now-more-competitive (and therefore presumably less expensive) insurance market, there would be no reason to complain from the standpoint of Catholic Social Teaching. Let me say a few words about both pieces of that suggestion.
First, I think any hope of achieving a fully competitive market requires doing away with the tax-favored status of employer plans. I suspect the author of the op-ed knows this and waffles on the issue because he knows how politically unacceptable such an idea would be. As we all know from the debates on health care reform, significant numbers of those who are now covered under employer plans don't want to see health care reform that requires them to change their coverage. Changing the tax provisions to put individual purchasers and employer puchasers on the same footing would mean changes in existing plans. I think that is a good thing...in fact I'd like to see employers out of the business of providing medical coverage alltogether, but I don't think that is feasible politically.
Second, I'm far less confident that innovations such as guaranteed renewable contracts "would catch on quickly in a vibrant, deregulated individual insurance market," making it likely that even in a competitive market, some of what the author wants would likely require changes in state insurance laws. That means relying on 50 states having to change their insurance laws. So the change would not be quick in coming.
Third, even in a fully competitive market, there will be some people who can't afford insurance. I'm guessing that many of the same people opposed to government involvement in health care reform would balk at a substantial increase in Medicaid eligibility to cover the working poor who will not be able to afford coverage. Relying on a private market and leaving substantial numbers of people unable to obtain medical care because they can't afford it is not acceptable.
The bottom line is that I don't think one can say that a market-based approach supplemented by some means of providing coverage for those who still can't afford insurance on the private market, is at odds with Catholic Social Teaching. I'm just not convinced we can get there.
This week my family took at small step away from government subsidized big agri-business toward what I hope will be healthier food produced in a more sustainable way by people we will get to know over the years. We joined the Oklahoma Food Cooperative. Over the next several months, we plan on volunteering on a delivery day or two and also visiting some of the farms growing our food.
This op-ed in the Wall Street Journal from last month proposes a market-based solution for health care reform, which gets us closer to universal coverage without massive government regulation. If it works, isn't this solution consistent with Catholic Social Teaching? Although the op-ed doesn't address the poor, don't we have Medicaid for them? And, if Medicaid is inadequate (I don't know whether it is or not), shouldn't we be tweaking and/or expanding Medicaid to work toward ensuring that no one goes without needed health care because of their economic status? In other words, if one problem is affordability and portability and the other poverty, might they need two totally different solutions: one market oriented and the other government interventionist?
For those more in the know, what are the problems with the market solutions proposed in the op-ed? And, are your conclusions based on your prudential judgment? Or, is the market based approach inherently at odds with Catholic Social Teaching?
Thanks to Rick for posting Pope Benedict's prayer during his visit to Ground Zero. I'm drawn particularly to the request for wisdom and courage to work for a world of peace. In my Creo en Dios! post this morning (which you can read in its entirety here), I quote Martin Luther King, Jr.'s admonition that "returning violence for violence multiplies violence" and that only love can drive out hate. King urged that we “must evolve for all human conflict a method which rejects revenge, aggression and retaliation. The foundation of such a method is love."
On this day on which so many of us still mourn the loss of loved ones, let us pray that we may find ways to spread Christ's love to the hearts of all.
Here is the prayer offered by Pope Benedict during his visit to Ground Zero:
O God of love, compassion, and healing, look on us, people of many different faiths and traditions, who gather today at this site, the scene of incredible violence and pain.
We ask you in your goodness to give eternal light and peace to all who died here -- the heroic first-responders: our fire fighters, police officers, emergency service workers, and Port Authority personnel, along with all the innocent men and women who were victims of this tragedy simply because their work or service brought them here on September 11, 2001.
We ask you, in your compassion to bring healing to those who, because of their presence here that day, suffer from injuries and illness. Heal, too, the pain of still-grieving families and all who lost loved ones in this tragedy. Give them strength to continue their lives with courage and hope.
We are mindful as well of those who suffered death, injury, and loss on the same day at the Pentagon and in Shanksville, Pennsylvania. Our hearts are one with theirs as our prayer embraces their pain and suffering.
God of peace, bring your peace to our violent world: peace in the hearts of all men and women and peace among the nations of the earth. Turn to your way of love those whose hearts and minds are consumed with hatred.
God of understanding, overwhelmed by the magnitude of this tragedy, we seek your light and guidance as we confront such terrible events. Grant that those whose lives were spared may live so that the lives lost here may not have been lost in vain. Comfort and console us, strengthen us in hope, and give us the wisdom and courage to work tirelessly for a world where true peace and love reign among nations and in the hearts of all.
I blogged a few days ago about (what I think is) a disturbing family-law opinion, written by a judge in New Hampshire. Bill McGurn has an interesting op-ed, here, about the case, and also about a case in Florida, in which a state court is "considering what to do with 17-year-old Rifqa Bary. Miss Bary fled to Florida from Ohio a few weeks back, where she sought refuge with a Christian couple whose church she had learned about on Facebook. She says she ran away from home because her father discovered she'd become a Christian—and then threatened to kill her. On Thursday, Circuit Judge Daniel Dawson ordered the girl and her family to try mediation and set a pretrial hearing for the end of the month."
I read a few things in which it was suggested that a consistent commitment to religious liberty and parents' rights required those who were troubled by the New Hampshire decision -- or, more precisely, its reasoning -- to side with Rifqa Bary's father. I don't see it (assuming, for present purposes, that Ms. Bary is telling the truth about her father's threat). It is not the business of the public authority to override a fit parent's decisions about religious education; it is the business of the public authority to protect children from potentially lethal violence by angry parents. Thoughts?
UPDATE: My colleague Cathy Kaveny has a different view of the New Hampshire case. In response to her post, I wrote, in the comments:
As Cathy and I discussed, it is clearly the case that the context of the court's opinion -- that is, a dispute regarding custody arrangements -- complicates matters. In this context, courts often have to make decisions about matters that, as a general matter, are probably not courts' business. What is (to me) troubling about the court's decision is the fact that the court concedes that the child is being educated in accord with the relevant standards and that the mother is a fit parent, but nonetheless endorses the conclusion that "the daughter would be best served by exposure to different points of view at a time in her life when she must begin to critically evaluate multiple systems of belief and behavior and cooperation in order to select, as a young adult, which of those systems will best suit her own needs." To me -- and again, I agree with Cathy that the familial-dispute context complicates matters -- this line of reasoning is worrisome, and in tension with religious liberty, even if it were operating merely as a default theory of education. (There is also the different question whether this default theory of education really is attractive, on the merits.)
Some commentators claim that white Americans put prejudice behind them when
evaluating presidential candidates in 2008. Previous research on the question of
white discrimination against black candidates has yielded mixed results, and
suffers from such methodological limitations as hypothetical candidates, local
samples of respondents, and racial attitude measures that fail to account for
social desirability bias. Fortunately, the presidential candidacy of Barack
Obama, combined with a methodological innovation in the measurement of racial
stereotypes in the 2008 American National Election Studies, provides an
unprecedented opportunity to examine more rigorously whether prejudice
disadvantages black candidates. I find that negative stereotypes about blacks
significantly eroded white support for Barack Obama; indeed, the effect of
stereotypes may have been sufficient to cost Obama the popular vote among
whites. Further, racial stereotypes do not predict support for previous
presidential candidates or current prominent white Democrats, indicating that
white voters punished Obama for his race rather than his party affiliation or
policy platform. This finding indicates that white Americans have not put
prejudice behind them after all.
