Bart Stupak has described himself as a “devout Catholic” and “pro-life Democrat.” Until his despicable sell-out last Sunday, many Catholics and pro-lifers were prepared to believe him. Christopher Badeaux at The New Ledger lays the blame for Stupak’s betrayal at the feet of the American Catholic bishops. “For essentially my entire lifetime,” Badeaux writes, “the Democratic Party has made as one of its governing planks that women have an inherent right to murder their children. Catholic Democrats have not, with a tiny handful of exceptions, bothered to even murmur a protest; the most prominent among them have taken up that position as their own.” Meanwhile, “the men who are supposed to stand against evil every waking moment of their lives appear more concerned about the environment, about immigrant rights, about the death penalty.” The bishops’ emphasis on these secondary issues, coupled with their failure to discipline pro-abortion Catholic politicians, has made them in Badeaux’s view “enablers” of those who, like Stupak, feel justified in compromising on abortion in the interests of pursuing what they take to be other social and political goods.
This is not entirely fair; the bishops have loudly, repeatedly, and consistently condemned abortion, and the United States Council of Catholic Bishops called on Congress to vote down the new health care bill if it failed to prohibit public funding of abortion. The bishops do not seem to be less concerned with abortion than with other issues. Still, Badeaux’s complaint seems to me to have merit – not with respect to every individual bishop, to be sure, but certainly with respect to the USCCB itself. For that body has also loudly, repeatedly, and consistently taken positions on several other matters of public controversy (such as the issues Badeaux mentions) in a fashion that has likely led many Catholics to think – quite mistakenly – that said positions are binding on Catholics and of equal weight with opposition to abortion. And that in turn has likely helped to generate a false impression that where opposition to abortion and the pursuit of some other political end come into conflict, a Stupak-like “trade off” can be justified.
Consider the health care issue. As I have said, before the health care bill vote, the USCCB urged Congress either to alter the bill to prevent federal funding of abortion or to vote the bill down. (The USCCB also objected to the bill’s failure to extend coverage to illegal immigrants.) But the letter in which this request was made also emphasized that “for decades, the United States Catholic bishops have supported universal health care,” that “the Catholic Church teaches that health care is a basic human right, essential for human life and dignity,” and that it is only “with deep regret” that the bishops must oppose passage of the bill “unless these fundamental flaws are remedied” (emphasis added).
Needless to say, the impression these words leave the reader with – whether the bishops intended this or not – is that, were abortion (and coverage of illegal immigrants) not at issue, the moral teaching of the Catholic Church would require the passage of the health care bill in question, or something like it. In fact the teaching of the Church requires no such thing. Indeed, I would argue (see below) that while the Church’s teaching does not rule out in principle a significant federal role in providing health care, a bill like the one that has just passed would be very hard to justify in light of Catholic doctrine, even aside from the abortion question. Nevertheless, as I say, the bishops’ language would surely leave the average reader with the opposite impression. And as the bishops themselves remind us, they have “supported universal health care” for “decades,” in statements that also would leave the unwary average reader with the impression that Catholic moral teaching strictly requires as a matter of justice the passage some sort of federal health care legislation. On the day Obama signed the bill into law, Cardinal Francis George, a bishop with a reputation for orthodoxy, urged vigilance on the matter of abortion while declaring that “we applaud the effort to expand health care to all.”
Now, suppose you are Bart Stupak, or some other Catholic in government. You are ideologically prone to favor statist solutions to social problems, and under constant pressure from your fellow Democrats to support them in any event. You are not a theologian, and must rely on what prominent churchmen say on matters of current public controversy in order to determine what the Church’s teaching requires of you. They tell you that the Church teaches that abortion is tantamount to murder, and if you are remotely serious about your Catholic faith – as Nancy Pelosi, Arnold Schwarzenegger, the late Ted Kennedy, Rudy Giuliani, et al. manifestly are not, but Stupak and his ilk at least appeared to be – then you will dutifully oppose legalized abortion. But these same churchmen also tell you – or seem to, anyway, if you are a layman not versed in moral theology – that it would be a grave injustice not to vote for an expansive federal health care bill if ever you have an opportunity to do so. Now you are confronted with a situation in which you have to choose between what seem to be two grave moral imperatives: to prevent federal funding of abortion, and to vote for what might be the only significant federal health care bill likely to come your way for the foreseeable future. Your conscience tells you to do both if you can, and there is in any event enormous political pressure on you to vote for the bill. Obama’s promise of an executive order, manifestly flimsy though it is, provides just the way out you need.
Is this how Stupak reasoned? I cannot claim to know, of course; and both this video clip from last year and his statements since the vote make it hard to believe his prolonged public hand-wringing was entirely in good faith. But perhaps such a rationalization passed through his mind. It has surely passed through the minds of many other Catholic politicians, particularly those who like to claim that their advocacy of socialized medicine and other left-wing causes shows them to be no less loyal to the teaching of the Church than Catholic pro-lifers are.
It is in any event important to remind ourselves of what the Church actually teaches, and what she teaches is not at all what such liberal Catholics think it is. To be sure, in line with statements made by popes John XXIII and John Paul II, the Catechism of the Catholic Church does indeed speak of a “right to medical care” as among those the “political community” has a duty to uphold (2211). But does this entail that universal health care must be funded by and/or administered by the federal government, or indeed by any government? No, it doesn’t. Consider first that the same documents that affirm a “right” to medical care also affirm “rights” to “food, clothing, [and] shelter” (John XXIII, Pacem in Terris 8) and “to private property, to free enterprise, [and] to obtain work and housing” (the Catechism again). But no one claims that the Church teaches that governments have a duty to provide everyone with a government job, or free food, clothing, shelter, or other kinds of property at taxpayer expense, or a guarantee of entrepreneurial opportunities.
Why not? Because the term “right” is simply not used in Catholic moral theology in the crude manner in which modern American liberal politicians like to use it, viz. as expressing a legally enforceable demand on the part of an individual that he be provided with some benefit by government (either in the form of a service funded by the taxpayer or in the form of coercion of those who might otherwise “discriminate” against him). Rather, the theory of rights enshrined in traditional natural law thinking and the traditional Catholic moral theology informed by it is very complex and nuanced, and includes a number of crucial distinctions that must be borne in mind in any analysis of what the magisterial documents of the Church entail. There is, for example, the distinction between objective right – some thing or act one might in some sense have a claim to – and subjective right – the moral power he might have to claim that thing or act he has an objective right to. There is the distinction between natural rights – rights we have simply by virtue of being human – and positive rights – those that exist only given a certain man-made legal framework. There is the distinction between a connatural right – a right one has independently of any conditions – and an acquired right – a right one has given the fulfillment of certain conditions. There is the distinction between an affirmative right – a right to have some good provided to one – and a negative right – a right merely not to be impeded in the pursuit of some good. There is the distinction between a perfect right – a right which is a precondition of the possibility of everyday moral life – and an imperfect right – a right which is not strictly necessary to make everyday moral life possible but which nevertheless considerably facilitates it. Among perfect rights, there are those which must be enforced via the power of the state (e.g. the right not to be killed unjustly) and those which are not appropriately enforced in this way (e.g. the right to be treated with respect by one’s children). Among imperfect rights, there are rights to things strictly due to us (e.g. gratitude from those we have benefited) and rights to things that are not strictly due to us (e.g. to be treated pleasantly by those we come into contact with in day to day life). There are further distinctions to be made, and elaborations and qualifications to be made to the distinctions already made; and a good book on ethics or moral theology of the sort I recommended in an earlier post will spell them out for the interested reader. (Volume I of Cronin’s Science of Ethics is particularly good on this subject, as on so much else.)
The point for present purposes is to emphasize that noting that a magisterial document speaks of a “right” to something by itself does nothing to show that government must provide it. All it shows is that people have a claim of some sort against others – how strong a claim, how that claim is to be respected, whether and to what extent government has a role in ensuring that it is respected, etc. are all further issues requiring careful analysis. This is especially so of something like a “right to medical care,” which, unlike such negative rights as the right of an innocent person not to be killed, involves a positive claim against others that a certain service be provided. Does the right to medical care entail that government itself must provide medical services? Or only that it provide citizens with the means to purchase such services? Must it provide them to all citizens, or only to those otherwise unable to afford them? What level of government is supposed to do this – municipal, state, or federal? Does it require government to force some individuals to become medical doctors, nurses, and the like so that the services can be provided? (They don’t grow on trees, after all.) Or is government involvement really necessary here at all? Is the right in question instead only a right that others provide those who need medical assistance with the means to do so in some way or other – through government if necessary, but through private means if possible? And if so, which persons in particular are supposed to provide this aid – family members and friends, churches and charities, or total strangers too? Merely noting that the Church teaches that people have a “right” to medical care (or to food, shelter, a job, etc.) answers none of these questions.
Now the Church definitely rejects the radical libertarian position that government can never, even in principle, justly intervene to help even the neediest citizens to acquire services of this sort. Catholic social teaching affirms the principle of solidarity, according to which we have, by nature, positive obligations to one another that we did not consent to and that the state as a natural institution can in principle step in to assist us in fulfilling when necessary. But the Church also firmly rejects the leftist tendency to regard governmental action as the preferred or even the only appropriate means of fulfilling our obligations to others. And she firmly rejects too the egalitarian tendency to regard our obligations as extending to all other human beings in an equal way. Contrary to what the libertarian supposes, the individual is not the basic unit of society; contrary to what socialists, communitarians, and many liberals suppose, “society” or “the community” as a whole is not the basic unit either. The family is the basic unit, and it is to our family members that our obligations are the strongest and most direct, with positive obligations to other human beings, though deriving from natural law rather than consent, becoming less strong and less direct the further they are from the family. Hence my obligations to the local community are stronger and more direct than they are to the nation as a whole; and my obligations to the nation as a whole are stronger and more direct than they are to the community of nations.
This approach is enshrined in another central principle of Catholic social teaching, the principle of subsidiarity, according to which the needs of individuals, families, and local communities ought as a matter of justice to be met as far as possible by those individuals, families, and communities themselves. Here are some key magisterial texts on subsidiarity:
As history abundantly proves, it is true that on account of changed conditions many things which were done by small associations in former times cannot be done now save by large associations. Still, that most weighty principle, which cannot be set aside or changed, remains fixed and unshaken in social philosophy: Just as it is gravely wrong to take from individuals what they can accomplish by their own initiative and industry and give it to the community, so also it is an injustice and at the same time a grave evil and disturbance of right order to assign to a greater and higher association what lesser and subordinate organizations can do. For every social activity ought of its very nature to furnish help to the members of the body social, and never destroy and absorb them. (Pius XI, Quadragesimo Anno 79)
Neither the State nor any society must ever substitute itself for the initiative and responsibility of individuals and of intermediate communities at the level on which they can function, nor must they take away the room necessary for their freedom. Hence the Church's social doctrine is opposed to all forms of collectivism. (Congregation for the Doctrine of the Faith, Libertatis Conscientia 73)
By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending. In fact, it would appear that needs are best understood and satisfied by people who are closest to them and who act as neighbours to those in need. (John Paul II, Centesimus Annus 48)
Experience shows that the denial of subsidiarity, or its limitation in the name of an alleged democratization or equality of all members of society, limits and sometimes even destroys the spirit of freedom and initiative… An absent or insufficient recognition of private initiative — in economic matters also — and the failure to recognize its public function, contribute to the undermining of the principle of subsidiarity, as monopolies do as well. (Compendium of the Social Doctrine of the Church 187)
Various circumstances may make it advisable that the State step in to supply certain functions… In light of the principle of subsidiarity, however, this institutional substitution must not continue any longer than is absolutely necessary, since justification for such intervention is found only in the exceptional nature of the situation. (Compendium of the Social Doctrine of the Church 188)
And here are some magisterial texts concerning the priority of the family to society as a whole and to the state:
Inasmuch as the domestic household is antecedent, as well in idea as in fact, to the gathering of men into a community, the family must necessarily have rights and duties which are prior to those of the community, and founded more immediately in nature. If the citizens, if the families on entering into association and fellowship, were to experience hindrance in a commonwealth instead of help, and were to find their rights attacked instead of being upheld, society would rightly be an object of detestation rather than of desire. (Leo XIII, Rerum Novarum 13)
The Church considers the family as the first natural society, with underived rights that are proper to it, and places it at the centre of social life. (Compendium of the Social Doctrine of the Church 211)
A society built on a family scale is the best guarantee against drifting off course into individualism or collectivism, because within the family the person is always at the centre of attention as an end and never as a means. (Compendium of the Social Doctrine of the Church 213)
The priority of the family over society and over the State must be affirmed… The family, then, does not exist for society or the State, but society and the State exist for the family. Every social model that intends to serve the good of man must not overlook the centrality and social responsibility of the family. In their relationship to the family, society and the State are seriously obligated to observe the principle of subsidiarity. In virtue of this principle, public authorities may not take away from the family tasks which it can accomplish well by itself or in free association with other families. (Compendium of the Social Doctrine of the Church 214)
There can be no question, then, that while the Church allows that government can legitimately intervene in economic life and in other ways come to the assistance of those in need, she also teaches that there is a presumption in justice against such intervention, a presumption which can be overridden only when such intervention is strictly necessary, only to the extent necessary, and only on the part of those governmental institutions which are as close as possible to those receiving the aid in question. This surely follows from the principles of subsidiarity and the priority of the family. And it surely rules out not only libertarianism but also the sorts of policy preferences typical of socialists, social democrats, and egalitarian liberals.
It is important to emphasize that this is not a mere pragmatic consideration. For a central government, or any level of government, to intervene when it is unnecessary for it to do so is not merely not required. It is not merely unwise. It is, in the words of Pius XI, nothing less than an “injustice,”“gravely wrong,” a “grave evil and disturbance of right order.” It is disturbing, then, that the USCCB does not balance its emphasis on the Church’s teaching about the “right to medical care” with equal emphasis on the principle of subsidiarity – a principle which has a longer history in Catholic social teaching than the (very recent) affirmation of a “right to medical care,” and which has a much more sophisticated and worked out theoretical basis in Catholic moral theology and natural law theory than the latter right has ever been given. (Astonishingly, the USCCB’s online summary of the basic principles of Catholic social teaching includes no reference to subsidiarity at all; and its more extended online overview of Catholic social teaching mentions subsidiarity only once, in passing, without explaining what it means.)
In particular, it is disturbing that no consideration of subsidiarity or the rights of the family seems to have informed the USCCB position on the health care bill, which, as I have noted already, seems to allow that the bill is acceptable or even required by Catholic teaching apart from the elements concerning abortion and coverage of illegal immigrants. How does respect for a “right to medical care” justify the federal government forcing every citizen to buy insurance, of a kind the government (rather than parents or individuals generally) decides the citizen needs? How does it justify increasing government power to determine for citizens what sorts of treatments are worth paying for? How does it justify moving towards a de facto monopoly as health insurance companies are transformed into heavily regulated government contractors? How does it justify the bill’s “marriage penalties”? Even apart from considerations of subsidiarity and the independence of the family, it is hard to see how such policies could be justified; in light of those considerations the policies seem positively immoral. Add to that the bill’s staggering increase to the already crushing debt we are facing, the dubious constitutionality of some of its components, the rushed and irresponsible way a transformation of one-sixth of the economy was cobbled together for political reasons without sufficient attention to unforeseen consequences, and the bill’s Rube Goldberg system of bribes and special breaks – as well as the USCCB letter’s admission that the bishops are “not politicians, policy experts or legislative tacticians” and thus without any special competence vis-à-vis the practical side of health care policy – and it becomes mystifying why the USCCB should think that, apart from the matter of abortion, the bill is something to “applaud” (as Cardinal George put it). The bill is not even an improvement on the existing system; it’s not even equally bad. As Steve Burton points out, it takes what is already wrong with the existing system and doubles down on it.
There is a reason why, as then Cardinal Ratzinger once put it, “no episcopal conference, as such, has a teaching mission.” (The Ratzinger Report, p. 60) It is rather the individual bishop who properly has the role of teacher of the faithful, and “it happens… that with some bishops there is a certain lack of a sense of individual responsibility, and the delegation of his inalienable powers as shepherd and teacher to the structures of the local conference leads to letting what should remain very personal lapse into anonymity.” (Ibid.) The result is that “the search for agreement between the different tendencies and the effort at mediation often yield flattened documents in which decisive positions (where they might be necessary) are weakened.” (p. 61) Ratzinger gives as an example the German bishops’ conference in the 1930s: “The really powerful documents against National Socialism were those that came from individual courageous bishops. The documents of the conference, on the contrary, were often rather wan and too weak with respect to what the tragedy called for.” (Ibid.) Needless to say, the tragedy that occurred last week was by no means comparable to the tragedy that followed upon the rise of Hitler and the Nazis. But it was a tragedy all the same. Where abortion is concerned, the USCCB response seems indeed to have been “rather wan and too weak.” Where the bill’s threat to the principle of subsidiarity is concerned, the USCCB has offered no response at all. And the failure to interpret the “right to medical care” in light of subsidiarity has arguably led Catholics of the Stupak stripe falsely to believe that voting for a health care bill like the one in question was a moral imperative as grave as that of opposition to abortion – and, in particular, that such a vote could be justified in light of Obama’s “executive order” stratagem.
Comments (31)
Excellent, Dr. Feser, all the way through. And thank you. I posted a much weaker comment on the subject of "rights" before I knew this was posted.
Posted by Jeff Culbreath | March 29, 2010 2:53 AM
This is the most sensible suggestion I've seen yet for how your church could quickly bring these men to heel...
You may also be interested in this: http://blogs.telegraph.co.uk/news/geraldwarner/100030794/catholic-sex-abuse-scandal-time-to-sack-trendy-bishops-and-restore-the-faith/
Posted by Mike T | March 29, 2010 8:00 AM
Great essay, Ed.
I particularly appreciate the emphasis on the family. The fact that numerous provisions of this bill will weaken the position of middle class families (while, admittedly, lightening the burden of some others) is what most alarms me. Tools that middle class folks have used to escape the absurdities of our current mess and the fetters its clasps upon them (HSAs, physician-owned hospitals, for-profit urgent care centers, etc.) seemed to be marked for destruction, and vaunted compassion of social democracy cares not a whit.
Posted by Paul J Cella | March 29, 2010 8:07 AM
I very much appreciated this post. It's shows a level of nuance that is rarely applied to these debates. Two complex questions:
(1) I understand that on the Roman tradition, persons have natural, objective (and perhaps connatural) rights in virtue of their dignity as persons which is then interpreted as meaning that persons have a right to achieve eudaimonia understood in a general Thomistic sense (very crudely: traditional Christian eudaimonism). Does this mean that the *only* objective/natural/connatural rights are those that lead to or promote eudaimonia? This is to say that there is no right to do wrong?
(2) I'm attracted to deontological views which affirm the dignity of persons but interpret this as requiring that they be treated in accord with their own reasoning (some form of Kantianism) when it comes to the right. In other words, people can have even natural rights that do not, by themselves, promote their good. Of course, this does not mean that such rights are wholly independent of their good. Instead, we might understand *as part of their good* being treated with dignity, which in turn would involve having their dignity realized by their fellows. I take it such a view is out of line with the Catholic tradition. Why? Is this because on the Catholic/Aristotelian view the only basic features of practical reason are means and ends rather than rule following, full stop? That is to say that the only reason one could have to follow a rule is because it promotes one's good? Would this apply even to obeying God? That is to say, the reason we are obliged to obey God's commands is because God, loving us and being perfectly good, is either (a) promoting our good with the command or (b) because ultimately God *is* our good and living in harmony with His commands is what happiness consists in?
(2b) I know that you reject contractualist views on the ground that will theories of rights like contractualism cannot make sense of the rights of marginal persons. For now, set that concern aside by assuming (again, for now) that one of the following two responses work: (a) a hybrid view, where the rights of marginal persons are understood in terms of interests until their reasoning reaches that of a properly functioning human adult, (b) applying a will theory and contractualist theory of rights directly to rational souls, such that all rational souls have rights even if they cannot express their reasoning through their material aspects.
Posted by Selfreferencing | March 29, 2010 10:10 AM
Great post, Dr. Feser! I appreciate the thought and time that you have put into this.
Posted by Jay Watts | March 29, 2010 11:14 AM
As I understand it, the critique of the bishops here is that their statements on ObamaCare (1) suggest that the bishops would have supported the bill (and that all good Catholics should have supported it) if it wasn't for certain objections regarding abortion and perhaps immigration, and that (2) some people might conclude from this that it is okay to support ObamaCare despite its provisions regarding abortion.
The problem with this critique is that (1) isn't true, and even if it was (2) doesn't follow from (1). To my knowledge, the USCCB has never said it would support ObamaCare if it included the Stupak Amendment, and when the House bill containing the Stupak Amendment was passed the response of the USCCB was, I believe, rather muted. The bishops did suggest that they would not oppose ObamaCare if it included adequate protections on abortion, but "not oppose" is not the same as "support."
Second, suppose the bishops had said that they would support the bill if it included the Stupak language. Suppose even that they said it was a moral duty of all Catholics to support the bill if it includes that language. Leaving aside the question of whether the bishops should issue such a statement, would it follow from such a statement that Catholics can support the bill even without the Stupak language? Clearly not. Saying "oppose X unless Y occurs" is not even close to the same as saying "support X regardless of whether Y occurs."
Mr. Feser, I'm sure, is aware of this. His counter, if I understand him, is that some people who hear about the bishops' statements might mistakenly conclude that they are saying (1) (even though they are not) and that they might then infer (2) (even though this is illogical). And this is of course true. Any time you make a public statement it is possible that people will misunderstand you and/or draw faulty inferences from what you are saying. A person might read Mr. Feser's post, for example, and conclude that the Catholic Church must be a false church, because it is teaching error. But I hardly think that makes Mr. Feser an enabler of apostasy.
Posted by Blackadder | March 29, 2010 11:41 AM
I thought it was pretty clear what he was saying.
As far as I can tell, he is saying that the muddled language of the Bishops toward their flocks, coupled with their equally strong rhetoric against social issues that are not even remotely as important as abortion have created false dilemmas and false equivalences in the minds of many Catholic laymen. In other words, for laymen like Stupak, this bill should have been dead on arrival because it even opened the door to possible federal funding of abortion, a prospect which is so abhorrent that it would negate any public good done for the poor by the bill (the life of a baby being naturally a higher moral good than providing medicine to the poor).
Posted by Mike T | March 29, 2010 11:57 AM
In addition to that, if you concede that it is possible to support a bill that provides for the funding of abortion on the grounds that it provides a great deal of relief to the poor, then you have to concede such things as the good of preventing terrorism overcomes the evil of torture.
I doubt many liberal Catholics would be consistent there...
Posted by Mike T | March 29, 2010 11:59 AM
Ed,
Thanks so much for this post. I have to admit, both as a member of Cardinal George's flock and as someone who has admired his work over the years, I was deeply disappointed with the USCCB letter. My disappointment stems partially from the talk of healthcare as a "right", without all the qualifiers that you laid out in this excellent post. But I was also deeply disappointed, as I have been for some time, at the Church's strange position on illegal immigration. Take the section of the letter dealing with this issue as it relates to healthcare:
Here is what troubles me -- at a basic level an illegal immigrant seems to me to be violating one or more of the Ten Commandments. Either they are stealing, in the sense that they have stolen a place in this country that could have gone to someone else who was patiently waiting in line or more directly stolen an identity to get around at their job or to buy a home, etc. Or they have coveted their neighbor's house by wanting what the U.S. offers and by deciding to leave their country of birth and again, to not follow the rules to get here. But the Bishops are saying that we as citizens have to ignore all of this and instead of passing and enforcing laws designed to catch those who would violate the rules we put in place to legally become a U.S. citizen, they say we have to allow an illegal immigrant to get the same benefits provided to all citizens. The Bishops says these provisions would leave the families worse off but they don't think about the obvious solution to the problem -- an illegal immigrant can and should return home to stop living in sin.
Why do the Bishops tolerate the violation of immigration laws, especially given the respect that Catholic social thought places on subsidiarity, which in my mind should lead these Bishops to respect national borders and local cultures and encourage all of us to take immigration restriction more seriously?!
Posted by Jeff Singer | March 29, 2010 1:14 PM
Mike,
The bishops opposed the bill. There was nothing muddled about that, and I don't think Stupak, of all people, was confused as to where the bishops came down. If he voted for the bill it's not because they were strong enough in their opposition but that he decided not to listen to them.
Posted by Blackadder | March 29, 2010 1:52 PM
An awful lot of words considering that there is no federal funding of abortion in the bill as some Catholic groups recognized.
Health care, national security, education, environment/energy and the economy are first tier issues. Every thing else is secondary or lower.
Any rational consideration of subsidiarity and health care still puts the federal government in a central role. This is due to our failure to make the business cycle illegal. As it seems these cycles are going to be with us, a structure has to be in place that allows for counter cyclical funding and the only entity that can do that is the federal government.
Posted by al | March 29, 2010 2:40 PM
al,
Since we are on the subject of the USCCB, here is what they say about the recent Obamacare bill passed by the House:
There is also the issue of funding for Community Health Centers, which is a new appropriation and not covered by the Hyde Amendment.
Finally, please stop insulting all the readers here at W4 by assuming that you have a monopoly on "rational consideration". I can understand that in your understanding of subsidiarity and health care, the federal government will have a central role. But that's not my understanding, or Ed Feser's understanding, or Steve Burton's understanding (check out his previous post), etc., etc. And it has nothing to do with the business cycle or help for the unemployed. Think outside of the box, as all the trendy management consultants like to intone.
Posted by Jeff Singer | March 29, 2010 3:16 PM
Thank you, Mike T, for the link to the Telegraph broadside - invigorating, bold and fearless - sort of like the Gospel that used to be preached before the episcopal apostasy of the West.
As a convert from mainline Protestantism, I can assure you that the authority of the Church to speak out on ANY ISSUE, including abortion, has been undermined, if not irreparably compromised, by the "child abuse" (ie.homosexual predation) scandal and its consequences. By opening its seminary and chancery doors to the deviant, by tolerating decades of horrific behavior among priests and bishops, by refusing to discipline complicit bishops, by refusing to speak honestly and clearly EVEN NOW about the causes of the scandal, the Church has opened itself to ridicule, calumny, derision, disgust, and pity.
And Stupak? In Michigan, where the Catholic Gov. proudly upholds the right to murder babies; where unions made of up Catholic workers routinely endorse policies of death; where a few miles to the South a putative Catholic university grovels before the abortion President? Where a neighboring state turned its chancery into a haven for the lavendar mafia and whose bishop (finally retired) pens an unctuous panegyric to his own perversions?
And we are surprised at Stupak?
CONTRA NATURAM.
Posted by tonyo | March 29, 2010 3:28 PM
We'll solve that one right after we figure out a way to make war illegal.
Posted by Mike T | March 29, 2010 3:29 PM
I don't think it has to be that way, but the Catholic Church will never be the same again if the Pope were to ever get the stones to do it right. He'd have to start by decimating the ranks of the bishops and priesthood and start actually excommunicating laymen who work firmly against the Catholic Church on issues like abortion.
It is unacceptable that the Catholic Church can excommunicate laymen like this family, but there are so many politicians in the US who are still accepted in as wayward Catholics despite fighting to keep the practice legal in the US.
Posted by Mike T | March 29, 2010 3:45 PM
Jeff, I was hoping someone would post with a primary source instead of the opinion of others and save me the trouble but i guess not. Some Catholics (e.g. the bishops) read it one way and some (e.g. Catholics actually involved in health care) read it the other. Ed writes as if this was a slam dunk when, it seems that folks who are, in general, opposed to abortion can honestly differ on this one.
Further if one adopts the view that Stupak was actually trying to advance the ball for your side but, in the end, was unwilling to kill the opportunity to reform our health care to the advantage of millions, then referring to his actions as "despicable" is simply not called for and likely reflects a certain poverty of analysis on Ed's part.
The implications of the business cycle go beyond unemployment compensation. For example, Arizona is cutting back on insurance for children. States can't run deficits, the feds can and having a certain automaticity to the process is a useful countercyclical activity allowing time and energy to go into other areas. Imagine for a moment what would happen to communities if Social Security and Medicare were state funded and the checks stopped coming in a recession.
"Rational" is appropriate as we have to ask just where most conservatives were over the past decade? If you or any of the folks you mention were on record as being opposed to unfunded tax cuts. off the budget funding of wars, and the funding (lack of) and structure of Medicare D in a TIMELY manner then fine, apologies to that person, otherwise, if the shoe fits...
Posted by al | March 29, 2010 4:07 PM
Let's see if I can find the abortion language. Scroll, scroll, scroll. (Yes, this is a pain, but if you are not willing to do it you have no business commenting as all you are doing is parroting someones talking points. Trust no one, suspect everyone, rarely forgive, never forget.)
"PART I--Health Insurance Market Reforms
Sec. 1201. Amendment to the Public Health Service Act.
`subpart i--general reform
`Sec. 2704. Prohibition of preexisting condition exclusions or other discrimination based on health status.
`Sec. 2701. Fair health insurance premiums.
`Sec. 2702. Guaranteed availability of coverage.
`Sec. 2703. Guaranteed renewability of coverage.
`Sec. 2705. Prohibiting discrimination against individual participants and beneficiaries based on health status.
`Sec. 2706. Non-discrimination in health care.
`Sec. 2707. Comprehensive health insurance coverage.
`Sec. 2708. Prohibition on excessive waiting periods.
PART II--Other Provisions
Sec. 1251. Preservation of right to maintain existing coverage.
Sec. 1252. Rating reforms must apply uniformly to all health insurance issuers and group health plans.
Sec. 1253. Effective dates."
Scroll, scroll, scroll.
"Subtitle L--Maternal and Child Health Services
Sec. 2951. Maternal, infant, and early childhood home visiting programs.
Sec. 2952. Support, education, and research for postpartum depression.
Sec. 2953. Personal responsibility education.
Sec. 2954. Restoration of funding for abstinence education.
Sec. 2955. Inclusion of information about the importance of having a health care power of attorney in transition planning for children aging out of foster care and independent living programs."
Ah, here we are:
SEC. 1303. SPECIAL RULES.
(a) Special Rules Relating to Coverage of Abortion Services-
(1) VOLUNTARY CHOICE OF COVERAGE OF ABORTION SERVICES-
(A) IN GENERAL- Notwithstanding any other provision of this title (or any amendment made by this title), and subject to subparagraphs (C) and (D)--
(i) nothing in this title (or any amendment made by this title), shall be construed to require a qualified health plan to provide coverage of services described in subparagraph (B)(i) or (B)(ii) as part of its essential health benefits for any plan year; and
(ii) the issuer of a qualified health plan shall determine whether or not the plan provides coverage of services described in subparagraph (B)(i) or (B)(ii) as part of such benefits for the plan year.
(B) ABORTION SERVICES-
(i) ABORTIONS FOR WHICH PUBLIC FUNDING IS PROHIBITED- The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is not permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
(ii) ABORTIONS FOR WHICH PUBLIC FUNDING IS ALLOWED- The services described in this clause are abortions for which the expenditure of Federal funds appropriated for the Department of Health and Human Services is permitted, based on the law as in effect as of the date that is 6 months before the beginning of the plan year involved.
(C) PROHIBITION ON FEDERAL FUNDS FOR ABORTION SERVICES IN COMMUNITY HEALTH INSURANCE OPTION-
(i) DETERMINATION BY SECRETARY- The Secretary may not determine, in accordance with subparagraph (A)(ii), that the community health insurance option established under section 1323 shall provide coverage of services described in subparagraph (B)(i) as part of benefits for the plan year unless the Secretary--
(I) assures compliance with the requirements of paragraph (2);
(II) assures, in accordance with applicable provisions of generally accepted accounting requirements, circulars on funds management of the Office of Management and Budget, and guidance on accounting of the Government Accountability Office, that no Federal funds are used for such coverage; and
(III) notwithstanding section 1323(e)(1)(C) or any other provision of this title, takes all necessary steps to assure that the United States does not bear the insurance risk for a community health insurance option's coverage of services described in subparagraph (B)(i).
(ii) STATE REQUIREMENT- If a State requires, in addition to the essential health benefits required under section 1323(b)(3) (A), coverage of services described in subparagraph (B)(i) for enrollees of a community health insurance option offered in such State, the State shall assure that no funds flowing through or from the community health insurance option, and no other Federal funds, pay or defray the cost of providing coverage of services described in subparagraph (B)(i). The United States shall not bear the insurance risk for a State's required coverage of services described in subparagraph (B)(i).
(iii) EXCEPTIONS- Nothing in this subparagraph shall apply to coverage of services described in subparagraph (B)(ii) by the community health insurance option. Services described in subparagraph (B)(ii) shall be covered to the same extent as such services are covered under title XIX of the Social Security Act.
(D) ASSURED AVAILABILITY OF VARIED COVERAGE THROUGH EXCHANGES-
(i) IN GENERAL- The Secretary shall assure that with respect to qualified health plans offered in any Exchange established pursuant to this title--
(I) there is at least one such plan that provides coverage of services described in clauses (i) and (ii) of subparagraph (B); and
(II) there is at least one such plan that does not provide coverage of services described in subparagraph (B)(i).
(ii) SPECIAL RULES- For purposes of clause (i)--
(I) a plan shall be treated as described in clause (i)(II) if the plan does not provide coverage of services described in either subparagraph (B)(i) or (B)(ii); and
(II) if a State has one Exchange covering more than 1 insurance market, the Secretary shall meet the requirements of clause (i) separately with respect to each such market.
(2) PROHIBITION ON THE USE OF FEDERAL FUNDS-
(A) IN GENERAL- If a qualified health plan provides coverage of services described in paragraph (1)(B)(i), the issuer of the plan shall not use any amount attributable to any of the following for purposes of paying for such services:
(i) The credit under section 36B of the Internal Revenue Code of 1986 (and the amount (if any) of the advance payment of the credit under section 1412 of the Patient Protection and Affordable Care Act).
(ii) Any cost-sharing reduction under section 1402 of thePatient Protection and Affordable Care Act (and the amount (if any) of the advance payment of the reduction under section 1412 of the Patient Protection and Affordable Care Act).
(B) SEGREGATION OF FUNDS- In the case of a plan to which subparagraph (A) applies, the issuer of the plan shall, out of amounts not described in subparagraph (A), segregate an amount equal to the actuarial amounts determined under subparagraph (C) for all enrollees from the amounts described in subparagraph (A).
(C) ACTUARIAL VALUE OF OPTIONAL SERVICE COVERAGE-
(i) IN GENERAL- The Secretary shall estimate the basic per enrollee, per month cost, determined on an average actuarial basis, for including coverage under a qualified health plan of the services described in paragraph (1)(B)(i).
(ii) CONSIDERATIONS- In making such estimate, the Secretary--
(I) may take into account the impact on overall costs of the inclusion of such coverage, but may not take into account any cost reduction estimated to result from such services, including prenatal care, delivery, or postnatal care;
(II) shall estimate such costs as if such coverage were included for the entire population covered; and
(III) may not estimate such a cost at less than $1 per enrollee, per month.
(3) PROVIDER CONSCIENCE PROTECTIONS- No individual health care provider or health care facility may be discriminated against because of a willingness or an unwillingness, if doing so is contrary to the religious or moral beliefs of the provider or facility, to provide, pay for, provide coverage of, or refer for abortions.
(b) Application of State and Federal Laws Regarding Abortion-
(1) NO PREEMPTION OF STATE LAWS REGARDING ABORTION- Nothing in this Act shall be construed to preempt or otherwise have any effect on State laws regarding the prohibition of (or requirement of) coverage, funding, or procedural requirements on abortions, including parental notification or consent for the performance of an abortion on a minor.
(2) NO EFFECT ON FEDERAL LAWS REGARDING ABORTION-
(A) IN GENERAL- Nothing in this Act shall be construed to have any effect on Federal laws regarding--
(i) conscience protection;
(ii) willingness or refusal to provide abortion; and
(iii) discrimination on the basis of the willingness or refusal to provide, pay for, cover, or refer for abortion or to provide or participate in training to provide abortion.
(3) NO EFFECT ON FEDERAL CIVIL RIGHTS LAW- Nothing in this subsection shall alter the rights and obligations of employees and employers under title VII of the Civil Rights Act of 1964.
(c) Application of Emergency Services Laws- Nothing in this Act shall be construed to relieve any health care provider from providing emergency services as required by State or Federal law, including section 1867 of the Social Security Act (popularly known as `EMTALA')."
An example of the dishonesty we find. Recall that we have been told that the exchanges are required to have at least one plan that provides for abortion:
"(i) IN GENERAL- The Secretary shall assure that with respect to qualified health plans offered in any Exchange established pursuant to this title--
(I) there is at least one such plan that provides coverage of services described in clauses (i) and (ii) of subparagraph (B);
Note the semi colon, so we continue:
" and
(II) there is at least one such plan that does not provide coverage of services described in subparagraph (B)(i)."
That is it continues the status quo.
Posted by al | March 29, 2010 5:35 PM
Ed, great post all through, but I esp. appreciated this:
This point is important even among non-Catholics. Repeatedly, people wring their hands over the fact that this person or that person did not have his medical bills covered and had a huge and unexpected bill from the hospital, that people are "not going to agree to be excluded forever" from (some degree of) medical care, and so forth, and emphasize the incredible _importance_ of medical care as a reason for the government to guarantee it to all. But all of this neglects the fact that we are asking empirical and economic questions when we ask (as we should) whether it is anything other than madness for the government to try to do any such thing and what is the best way to try to expand the availability of these goods. "X is really, really important" just doesn't entail, "The government should provide X and engage in redistribution of income to guarantee X to everyone." Clean water is also really, really important, but it would be insanity and tyranny to set up a world government to "redistribute" clean water from the United States to Africa! Indeed, those with free market leanings would be inclined to argue that the more important something is, the more important it is that we have stable local governments, the absence of corruption, enforceable contracts, and the like, and that within such a local context the market be free to operate in that field, in order to motivate providers and avoid shortages, inefficiency, misallocation of resources, etc.
Posted by Lydia | March 29, 2010 5:46 PM
"Clean water is also really, really important, but it would be insanity and tyranny to set up a world government to "redistribute" clean water from the United States to Africa!"
True, but a rather inapt analogy. Would it be so insane and tyrannical for the nations of Africa to come together and deal with the issues involving those rivers that cross national borders (Nile, Congo, etc.).
Also, I believe we are not yet on the other side of a world wide financial meltdown caused in part by a reliance on an ideological approach to "free" markets.
Again, every other industrialized nation has managed to do that which some in ours hold to be improper and impossible.
Posted by al | March 29, 2010 5:56 PM
Also, I believe we are not yet on the other side of a world wide financial meltdown caused in part by a reliance on an ideological approach to "free" markets.
At last, something that I can more or less agree with. Especially given that you correctly put "free" in the appropriate quotes. Unfortunately, it comes with this:
States can't run deficits, the feds can and having a certain automaticity to the process is a useful countercyclical activity allowing time and energy to go into other areas. Imagine for a moment what would happen to communities if Social Security and Medicare were state funded and the checks stopped coming in a recession.
Crystal clear. Thank you, Al. This is at least one half of the mentality that gave us the mess referred to above. The federal government cannot run deficits in real terms any more than can states, not without the price of...Yes, you said it, the financial meltdowns that result from pretending that borrowing money to pay for goodies for the folks is a long term rational strategy. And ALSO from the government getting in bed with large corporations and gumming up the system with pretend "fixes" to messes that they created to begin with, thereby helping corporations stick it to the people who cannot locate the information that would tell them that this quick fix will work for 2 years but will kill them in the long run. ARM mortgages with sucker starting rates, anyone?
To be fair, I suspect that the perfect storm of political evil is neither in the spend your way to "freedom" liberals, nor the slash-and-burn corporate conservatives, but the unholy marriage of the two resulting in such heretofore unknown animals as the slash and burn corporate touchy feely liberals (Warren Buffet, for example). At the government level, it has resulted in a year after year of congresses and administrations who cannot see any point in rational monetary / spending policy, because the belt-tightening effects will be blamed on your side (causing your side to lose in the next elections), while the benefits will be felt in the next cycle, to the glory of your opponent's side. No politically sustainable effort is plausible.
By the way, Ed, great post. Whatever the benefits of the idea of collegiality were supposed to come about by working everything through national conferences appear to have taken a second place to letting the "group" take all the heat for hard teachings, and of course the group never will in such case.
Posted by Tony | March 29, 2010 11:40 PM
Wow. I just stumbled onto this great site. Thanks, Ed, for an excellent piece.
I had a recent email exchange with my archbishop on this very subject, asking many of the same questions, and getting a rather soft response. He is one of the more outspoken bishops in America on many social issues, writing often on the topic of Catholic involvement in the public square. I was troubled that the sole contention the bishops seemed to have with the health care bill was with abortion funding while neglecting to address the State takeover of an industry that intimately affects all of us. Here is his response to my direct question of whether the bishops would support the health care bill if abortion funding were removed:
"...The Catholic principle of subsidiarity is very important. But some people say that in a country as technologically advanced as the United States, and with the kind of health care that is available, health care reform isn't really possible without the involvement of the government. What they are arguing is that the principle of subsidiarity does apply, but since smaller bodies can't do it, it's a responsibility that belongs to the federal government.
I don't think the American bishops have taken a stance on this. One thing that does seem certain, though, is that for the most part local governments really haven't managed the issue either because they don't have the will to do so or they aren't able to do so.
You're right, State-run health care would be opposed on principle if there are other ways of handling it. But the question is, are there other ways of handling it.
Some decisions of the bishops are prudential judgments. Others are considered matters of faith and morals. The question of what kind of health care plan works is a prudential judgment and not a doctrinal judgment. So you certainly would be free to disagree with bishops on how they might approach this matter as long as you don't undermine the principles of human dignity and the common good. ..."
My other questions on Catholic rejection of socialism and the big government takeovers of industries were not addressed. We did agree that we live in a time where the battle between good and evil is becoming more and more obvious, and that the Catholic Church is the only institution on earth capable of challenging and defeating the cults of "progress" and death. But I will no longer agree if our bishops take the side of big government, or if they side with a president whose policies are influenced by his life-long involvement in those very cults.
Posted by Innocent Smith | March 30, 2010 3:17 AM
The archbishop's response quoted by Smith strikes me as a voice of reason in a sea of hysteria. It is a prudential question which health care system serves our needs best. It is an empirical question to what extent the principle of subsidiarity works etc.
You may think your opponent in the debate behaves economically unwise or even unconstitutionally, but still, it is not GODLESS to favour a system that, though in many different ways, every other Western Christian country implemented many decades ago.
Therefore, to call on people to pray for the rejection of Obama's health care plan - as it happened on this site - is among the worst idolatries I've ever come across. Who do you think you are?
Posted by Grobi | March 30, 2010 6:00 AM
It can't be the worst idolatry you've ever seen when it isn't even idolatry to begin with. If praying for deliverance is idolatry, then the Bible contains many examples of, as well as exhortations to commit, idolatry.
Posted by Matt Weber | March 30, 2010 9:04 AM
Gobi,
It's not so much about what the health care plan is today, it's about the future incarnation of that plan and what it will do to limit, not only future generations' choices regarding their medical care, but the morality of those choices given the increasing hostility of the government toward Christians and their "idiosyncracies" such as opposition to abortion and in many cases opposition to articifical birth control which results in large families that are an anethema to the "earth worshipers" in the environmental movement.
To pray for the rejection of the Obama health care plan is for me, rooted in my hope that my grandchildren will have the liberty to make choices for themselves and live a moral and self-governed life which was the intention of the Founders. This bill is an insult to the principle of self-determination modified by obedience to God and His Word. Of course once civil institutions send God packing from civil life, all forms of self-control break down, laying the ground work for a popular appeal to the government who becomes the Golden Calf.
I don't apologize for praying that the obvious consequences of this health care bill and most of President Obama's policies are rejected.
Posted by Gina Danaher | March 30, 2010 9:50 AM
Grobi
My apologies for spelling your name wrong at the beginning of my post.
Posted by Gina Danaher | March 30, 2010 9:52 AM
There's no point in arguing with the likes of Grobi. For myself, I couldn't care less what he thinks.
Posted by Lydia | March 30, 2010 9:57 AM
Many other Western "Christian countries" have begun to implement gay marriage and abortion. The fact that they are ostensibly Christian and have implemented something does nothing to inherently recommend it in this age.
Posted by Mike T | March 30, 2010 10:24 AM
What I wanted to suggest to all of you was not to withdraw your rejection of obamacare, but some kind of rhetorical disarmament.
I am living in Germany, we have universal health care for 60 years or more. There is no tyranny, no Golden Calf, no socialism, no new Hitler here. There is not a single prominent politician, neither from the extreme left nor from the extreme right, neither a liberal, nor a conservative who doubts universal health care in principle. The same holds for France, Great Britain, Spain, Norway etc. etc. Have all Europeans become insane? It would be suidcidal even for the (modest) European libertarian parties to propose the end of the universal system.
O.k. there are problems with the health care system here, too, and yes, Europe and Canada may be dead wrong, and yes there are good philosophical arguments for more subsidiary solutions.
But why do you stylize this debate to a fight between the good and evil forces of the world? Why is everyone wo disagrees with you on a political question (this is not about abortion!) immoral, treacherous or whatever? Christianity is not only about liberty but also about charity. There can be good Christian motives on both sides of the debate. Why do you have to demonize the other, why to pray for his/her failure?
The problem with you, Lydia, is indeed that you didn't care about what other decent people think. I am sorry for you.
Posted by Grobi | March 30, 2010 12:20 PM
Grobi,
No doubt you have noticed that, over time, your eyes become accustomed to darkness. That is also the case politically and philosophically, not just physically. After 60 years of socialized medicine, perhaps that is now the case with Germany.
In America, we're still fighting to save the light before it goes out. In so doing, we still call good and evil by their real names.
Posted by Michael Bauman | March 30, 2010 12:33 PM
Tony, you are correct about structural deficits which should be avoided but the general idea is that we run surpluses in the fat years and deficits in the lean and things more or less balance out over the business cycle. The real screw ups here were the decisions to cut taxes in 2001 and 2003, invade Iraq and do an unfunded Medicare drug bill. All this was independent of the mess in the financial sector.
Had we used the surpluses to pay down debt we would be in a stronger position now even with the financial mess. Had we done the tax cuts and properly regulated the financial sector, we would still have a structural debt problem.
A little more information on Stupak; the Bishops staffed this out of course and it seems they need to get a little more hands on in supervising their staff. Based on their performance with health care, trusting the Bishops to get it right on any specific initiative seems rather foolish.
As the Church's position is in favor of expanding access to healthcare, they might start by asking their point man why he got them in bed with rightwingers who seek to limit that access. Hopefully Stupak and his allies have learned something and will seek their counsel elsewhere in the Church in the future.
"Rep. Bart Stupak (D–Mich.), who opposed healthcare reform up until the last second because of his doubts about its abortion language, took his cues largely from Richard Doerflinger, associate director of the United States Conference of Catholic Bishops' Secretariat of Pro-Life Activities. Plenty of other Catholic groups eventually agreed that the bill's language was actually pretty restrictive, but the bishops never did."
http://motherjones.com/kevin-drum/2010/03/stupak-and-bishops
I'm just wondering Ed, what's the point of all this high faluting philosophical speculation if we still wind up with rookie mistakes like this post?
Posted by al | March 30, 2010 1:11 PM
and yes there are good philosophical arguments for more subsidiary solutions.
But why do you stylize this debate to a fight between the good and evil forces of the world?
How about the obvious ones: there are recent state efforts that have been initiated, and seemed likely to improve matters. The fact that things needed reform did not mean that they needed federal control. There are LOTS and LOTS of federal efforts that could have been made that not require a federal take-over of health-care. The fact that there is a potential federal role for reform does not imply that the federal role is take-over.
The main reason the bill did not limit itself to these less global visions is that the liberals don't want to abide by subsidiarity, they don't accept it as a guiding principle, and they are perfectly willing to plow it into the earth to further objectives that have nothing to do with the common good as such and much to do with state control of society. How do we know this? Look at the rhetoric and the arguments. None of it was designed to show that any major portion of the bill is not only needed, but is the least intrusive, least overwhelming, least disruptive to lower social orders, way of achieving that result. They don't do this because they don't care whether it is or not. (In all probability, many liberals (but not all) actually welcome the fact that the bill takes power out of the hands of individuals, communities, and states, because they don't like those entities having the right to make their own decisions.) In my book, a fully deliberate choice to ignore one of the 4 most basic principles regarding the common good and governance is a choice for evil.
Posted by Tony | March 30, 2010 2:50 PM