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Pope says universal health care an "inalienable right"

B16's address to the 25th annual conference of the Pontifical Council for Health Care Ministry broke no new ground in Catholic teaching, but summarized the church's position on health care quite firmly -- and also implictly challenged those Catholic conservatives in the GOP who are about to take over the House with a vow to repeal Obamacare.ZENIT has the full text here, and here is my PoliticsDaily write-up:

"It is necessary to work with greater commitment at all levels so that the right to health is rendered effective, favoring access to primary health care," Benedict said in a message on Thursday to the 25th annual conference of the Vatican office that promotes health care ministry."Health justice should be among the priorities of governments and international institutions," he added.The pope said that establishing this goal requires "a true distributive justice that guarantees to all, on the basis of objective needs, adequate care," and he said "the social doctrine of the Church has always evidenced the importance of distributive justice and of social justice in the different sectors of human relations."Benedict's secretary of state and second-in-command, Cardinal Tarcisio Bertone, read the papal statement to the annual conference of the Pontifical Council for Health Care Ministry and then delivered remarks that were even clearer than the pontiff's."Justice requires guaranteed universal access to health care," Bertone said, adding that the provision of minimal levels of medical attention to all is "commonly accepted as a fundamental human right."

WWJBD? What will John Boehner do? Not much, is my view, given that papal statements rarely effect Catholic politicians of either stripe, not even the pope-ier-than-thou Catholics on the right.But I do note that there are conservative pro-life Catholic voices that take a line more in keeping with that of the pope's, notably Valparaiso University law professor Richard Stith and R.R. Reno, who have both taken some heat at First Things for their columns proposing to remedy HCR rather than repeal it.They say that alleged abortion funding in HCR (a position of some dispute, as we know) should be eliminated, and then they'd be good with it, like Benedict. The standard conservative Catholic/GOP position, however, is that the whole principle of federalized health care policy is wrong.Still, I wonder if the Stith-Reno-Benedict position would give Republicans cover if they fail on a full repeal, which they seem likely to do. That could work out well for them, as most Americans still favor HCR, and strong majorities favor almost all of its elements, except the individual mandate.

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Re: ObamaCare and healthcareYou are aware that ObamaCare is NOT about the actual provision of healthcare? Rather, it is all about $$$, it is about compelling healthy young people to pay into "healthcare plans," it is about compelling employers to provide healthcare plans, it is about insurance companies paying claims, and it is about government bureaucrats deciding what will be allowed to be paid for and what will not be allowed to be paid for. In fact, every study done on ObamaCare indicates that the actual provision of actual medical treatment will go DOWN.

Bender,So are you saying we must have a single-payer plan?

Bender, do you live in a no-fault auto insurance state, where everyone (even the good drivers) are forced to buy car insurance? If so, do you think this is a bad idea too?

Isn't the health insurance run on the principle that healthier people are going to pay in, and sick people are going to use, and it'l will be there when and if the healthier people get sick. I thought that was the general principle that insurance ran on, but I'm not in that business.

"Isnt the health insurance run on the principle that healthier people are going to pay in, and sick people are going to use, and itl will be there when and if the healthier people get sick. I thought that was the general principle that insurance ran on, but Im not in that business."Yes, any insurance whatsoever, including both Medicare and Social Security, from the beginning of time.

"most Americans still favor HCR, and strong majorities favor almost all of its elements"A citation would be interesting. Poll after poll actually shows a majority not just against ObamaCare, but for actual repeal.http://www.politicsdaily.com/2010/10/15/repealing-health-care-reform-try..."Rasmussen Reports -- shows that voters in 26 states favor repeal by a significant margin, voters in four others support repeal by margins of four points or less and voters in two states oppose repeal."At the link you'll find a table of 8 different polling organizations. Only three of them have a majority that opposes repeal.

So, then, you guys do not dispute that ObamaCare really is about money and financing, and not about the actual provision of medical care (and it is the latter that is the "fundamental right" -- actual treatment -- and not the forced payment of money).How about having a system that truly promotes genuine healthcare, rather than a system that is focused on money?

Bender, I don't understand what you are saying. I don't think anyone has agreed with your point, and I'm not sure what your point is. "All about money?"Flanagan, the mainstream polls I've seen, such as this one by Gallup, consistently show a bare majority at least tend to favor keeping or expanding the law. http://www.gallup.com/poll/144422/four-americans-believe-healthcare-law-... still is the Kaiser survey that shows all of the reform's elements are widely popular with the public except for the mandated purchase of health insurance:http://voices.washingtonpost.com/ezra-klein/2010/11/why_repealing_the_he... Of course, HCR has also been ridiculously demonized by opponents, much like TARP, so it's not surprising that it would not be as popular in general, but is widely supported when its provisions are taken out out of the context of "Obamacare" and presented to respondents.

Also, why is it that no Catholics who oppose HCR are willing to weigh in here and explain why the pope is full of hooey, too?

"So, then, you guys do not dispute that ObamaCare really is about money and financing, and not about the actual provision of medical care (and it is the latter that is the fundamental right actual treatment and not the forced payment of money).How about having a system that truly promotes genuine healthcare, rather than a system that is focused on money?"Bender, this isn't some worker's paradise. This is America. EVERYTHING is focused on money. So what are you getting at?

Benedict is just speaking the common sense of Europeans in general -- of course people should not be left to die on the streets when they fall ill -- of course health care should not be the preserve of the rich. It amazes Europeans that poor Americans are so brainwashed as to consider themselves unworthy of these "socialist" benefits.

I think it's just wonderful that the Pope not only called universal access to health care a fundamental human right, but that he specifically said it's an issue of "distributive justice". I get very frustrated when some Catholics say there is nothing in our religion that requires us to support government-funded healthcare; I'm really glad the Pope says otherwise.

Poor Americans are brainwashed by the money ads that rich health care companies continually run so that what is true seems untrue. The principle of advertising. Say it often enough and it seems so. Brand name. But with real Catholics, lack of support for health care is decidedly ungenerous.

Catholic opponents of what they call "Obamacare" may say that the devil is in the details, but it seems that it is now incumbent upon them to say where the devil is exactly and to propose some form of legislative exorcism rather than a whole sale reversal. I also would say that advocates of a single payer approach should make there case with more force and more broadly than they have.

Actually Christians should not need the Pope to tell them that care for the poor is a moral duty.

Right, Joe, Christians should not need the Pope to tell them that care for the poor is a moral duty,but how heartening to have the Pope spell it out that establishing the goal of health justice requires: a true distributive justice that guarantees to all, on the basis of objective needs, adequate care. And how good to hear him say the social doctrine of the Church has always evidenced the importance of distributive justice and of social justice in the different sectors of human relations.He really got it right this time.

David, I am not willing to say that the pope is full of hooyey because that would be disrespectful but I am willing to say that I disagree with him. First, I disagree with employing the Good Samaritan story to justify national health care. It seems that that story does nothing more than call us to personal sacrifice. It does not call us to tax our unwilling neighbors to make equal sacrifices. Whether one fed the LORD when he was hungry or not is something she should have to answer to Christ for, but not to Ceasar. The government's proper role is to keep the peace and to make sure that people's natural rights are protected. Since Gaudiam et Spes, the Vatican has turned everything into a right. This seems to an impoverished understanding of rights. Rights are those thing which bind your neighbors. Your right to life means I have an obligation not to kill you but from the state's perspective, I should not be force to contribute to your well-being by force. To do so is tyranny. To force someone to work for someone's else interest without his consent is the very definition of slavery. Now, before you yell at me, I absolute do believe that Christians ought to sacrifice for others. But "love your neighbor" is simply too radical for the state to ask of us. It seems strange to me that the same people who think we can't do anything about mother's killing their children in a pluralistic society think we should enforce charity among strangers. I also think the Church refuses to learn from its past entanglements with the state. Government money means government control and whatever winds are blowing in the culture are going to be pumped into the Church. I am amazed that the Church is surprised when the state tries to require funding for contraception and other activities contrary to Catholic teachings. Many of our bishops seem to naively believe that a leviathan state that takes almost half of the nation's resources and employs about a 10th of the population is not a threat to the Church's autonomy. This is despite much evidence to the contrary---a Church that relies on the government for money is not a free Church. Many Catholics would give the huge amounts of money that currently goes into government bureaucracies to Catholic schools and hospitals. I wish the Church would keep that in mind. Carolyn HyppoliteP.S. Lest you imagine that I speak from a state of comfort, I currently do not have health insurance. I also spent much of my childhood without health insurance.

Hello Carolyn- Do you believe you can disagree with the Pope on this and still be a good Catholic? If you do, would you also agree that I can respectfully disagree with the Pope on artificial contraception and the ordination of women ( nd a couple of other things) and also still be a good Catholic? Or not?

Carolyn:If people could opt out of having health care that they don't pay for, then under free market "principles" opting out of the health insurance/coverage system might make sense. But state laws in the US are pretty consistent in requiring hospitals to treat people who come in through the emergency room (for example) whether they can pay or not. From where I am sitting (in a CFO office of a major health insurance company), the real "socialists" are the ones who don't want health insurance but do want to be treated if their car hits a tree.In the end, requiring people to have health insurance is no different (in structure) from no fault auto insurance. If you don't want to pay for auto insurance, you can opt out of the system by choosing not to have an automobile. Unfortunately, no one can opt out of the health care system by choosing to not have a body. But except for a very small number of religious fanatics (and an even smaller number of people who can really afford to cover any possible claim out of their checking account) I don't think I have ever run into anyone wearing, say, a bracelet that says "If you find me on the side of the road in a pool of my own blood, please leave me there." Since everyone has a legal right to at least some level of treatment right now, the people who either pay taxes or (to a greater degree) pay for private insurance are already paying for people like you. You are in fact in the state of comfort of a free rider. I would imagine that when you do need to go to the doctor, you pay for it out of pocket. But unless you are extremely wealthy, you are sooner of later going to need care that you can't afford and you are merely asking everyone else to pay for it for you in the name of a (in this case) bogus individualism.

"the social doctrine of the Church HAS ALWAYS EVIDENCED the importance of distributive justice and of social justice. . . " (emphasis mine)This time he got it right :-)

" To force someone to work for someones else interest without his consent is the very definition of slavery. "Carolyn H, --So you're against drafting people into the Army?

Irene, I am not willing to call myself a good Catholic....This morning I prayed my rosary half asleep in my bed and then I decided to have a late breakfast/early lunch and ate half a pizza---sloth and gluttony all before noon!. I hardly consider this good Catholic behavior. I do think that the Church has a right to decide which disagreements are allowable, which are not. It seems to me that it's ok for the Church to say that if you don't accept the real presence, you are not one of us. If the Church should decide that I am bound to believe all the quasi-socialist silliness that many of the bishops have been promoting, I would be sad, but the Church must have that right. I still respectfully ask to be persuaded. I have read all the major social encyclicals and I have tried, at times better than others, to be charitable in my personal affairs, which I think I am absolutely bound to before God. I am not persuaded that I am bound before God to accept any particular social arrangement to provide health care that I think is imprudent and incompatible with liberty. I do not believe that I am sinning in doing so but I also do not believe that I make the final call about who is and who is not a faithful member of the community. As for the issues, you raise, I personally think it's ok to disagree about the ordination of women but I think if you go out and have yourself ordained that is sin. Likewise, I think using contraception is clearly sin but I would not say you automatically sin because you have trouble with a particular Church teaching. I am not fond of the good/bad Catholic labels---only God is good. I am much more interested in specifying what actions are sinful and which are not. Peace in Christ,Carolyn

Ann, I am against drafting people into the army. Carolyn

Ann-- good catch. :0

Unagidon, I don't appreciate being called a free loader. I recently decided that I could not afford and did not need health insurance as I am generally in good health. During this time, I have paid what expenses I have needed out of pocket. Of course, it has not been much, mostly dental and allergy treatments, but I do pay for it. Also you said: If you dont want to pay for auto insurance, you can opt out of the system by choosing not to have an automobile. Unfortunately, no one can opt out of the health care system by choosing to not have a body. This is precisely why I think it is wrong to force people to have health insurance. I cannot opt out of a body and I think think I should be taxed for being alive! As for car insurance, my state only requires that I cover damages to the property and bodies of other people. Whether I choose to cover my own expenses is up to me. I decided that since my car is pretty old that I am not going to cover it. But if I should put someone's life in danger I should pay for that; That is just. As for emergency situation, I do agree that you must provide immediate life saving care to people but there might be ways to make people pay for that on the back end. This is slightly off topic but the real problem is the cost of health care is ridicilous and need not be so. My mother had a $15,000 for going to the emergency room after a car accident and getting an ice pack and some pain killers (and some tests). We need to get to the bottom of that,. If an ice pack and pain killers $100 as it should, there would be no need to propose a government health. This insane price tag was paid for by the car insurance company! I suspect that the insurance bureaucracy and government regulations are what makes this problem worse. I once had a doctor tell me that he would sell me some shoe inserts for $200 if my insurance refused to cover it. He was charging my insurance $800! But of course, he knew that I would never pay that price for inserts. If people had to pay more of their health care costs directly, prices would go down; there would be competition. We should start by having insurance cover only serious health problems, not your basic eye exam. Carolyn Carolyn

Carolyn, thanks for your very honest comments. I admire the way you contend with the teachings and pronouncements, as I think too few do so. BTW, my "hooey" remark was a playful way of inviting opponents of mandated universal health care to explain their disagreement with the pope. I'd never say that about the pope, of course. I mean, not to his face...

Carolyn,There are many people who do not have the ability or opportunity to decline health insurance. For example, there are young children, any number of people too ill to think clearly about this or any other significant mater, people without much education, etc. A decent society has to figure out how to make sure that these people get the health care they need. One way of doing so is through health care insurance. We know that private health care insurance in the U. S. leaves many millions of people uninsured. Many of these people are in groups of disadvantaged people such as those I've mentioned. Some institution has to make sure that these people do get care. If there is some other institution that can get this job done, then maybe the government wouldn't have to intervene. I know of no such actual or proposed institution, at least here in the U. S. So the government is it. To be effective, it will have to establish appropriate rules, perhaps even requiring that everyone who can do so contribute to the costs. Governments have mandatory programs to provide all sorts of services, e. g. police protection, food inspection, etc. that no other institutions can do with the necessary thoroughness. Unless one can propose a plausible alternative to government action in these matters, then it is a matter of justice for us to support these programs.I recognize that no programs, governmental or otherwise, are going to be flawless. They will all need regular review and modification. But the fact that one can find some flaw in a program is no reason for simply rejecting the program instead of working to improve it.

Benard, There is no doubt that there is much need in the world, but the first thing, I would like to see is all of us think beyond is this knee jerk reaction that just because there is a need, the state must do something as if it is the only institution that can do something. There are many ways of handling these problems. I am from Haiti and when someone had a huge hospital bill in the family, you called up uncles, brothers and cousins and they all dug deep and chipped in. I am not suggesting that Haiti is a model society but this is one aspect of traditional societies that might be worth reviving. I have come across a few protestant health care cooperatives where people pay a reasonable sum on a monthly basis and the fund is used to help members with serious health care needs. Members also commit to pray or each other as issues arise; I like this model. Also, there are all sorts of charities that are eager to provide for the need and I think there might be a few more them if we had not gotten it into our heads that the government will take care of it. Sure, this will all be messy, but where did we get this notion that life is supposed to be neat and completely without risk? I want us, particular in the Church, to focus more on what it means to live in community, that it means freely sacrificing for your neighbors and your brothers without threats from uncle Sam (or the Church). Also, as I said earlier, we all need to be asking why is health so RIDICULOUSLY expensive as opposed to who should pay for it. If it were more reasonably priced, this would not be an issue. My other main point is that such government system is contrary to basic liberty; I value liberty more than security, and I think it is wrong to take money from one person to give it to another even for a good cause. If you want someone to be charitable and I think we all want that, you should persuade her. CKH

Mark, yes in fact the pope did specifically espouse universal care as a human right for all. But I think you are right that he didn't say it had to be government single-payer or a mixed system like that of Switzerland or the Obama plan. As long as everyone is covered with proper care (as they have not been in the US, obviously), and it seems pretty obvious that there would be an important government component to make that work.

"inviting opponents of mandated universal health care to explain their disagreement with the pope."But David, the Pope never espoused universal health care, did he? If I believe that a free market for healthcare would produce the most efficient system, while still believing a safety net be made available (either through funds provided by the government or private charity) to those down on their luck that they may purchase healthcare through this most efficient of systems, am I not completely in sync with the moral principles the Pope says should guide us?

Carolyn,In this case the state IS the only institution that can do something about health care. The private market is riddled with market failure, and a hundred years have shown that the situation is only getting worse (evidenced by the rise of costs and the decline in quality of care).The history of the highly developed economies shows unequivocally that advanced economies turn to government to manage large-scale risks like health care because markets are not up to the task. The market is plagued by asymmetric information, the near-monopolistic powers of a few huge insurers, etc. In short, none of the institutional arrangements for functioning markets are present.Also, your anecdotes from Haiti illustrate perfectly the virtues of risk management through insurance programs. The difference is that the scale and cost of such a system in the US would be prohibitive for the family unit. How many families do you know who could collectively cover cancer services in the hundreds of thousands of dollars?I am also curious to better understand your reasoning against government's capacity to administer a functional health care system. Risk management is one area where the evidence suggests government is in fact both more equitable and efficient than the market. See Hacker for a richer argument:http://www.prospect.org/cs/articles?article=bigger_and_better

Thomas, I am skeptical that we have hundreds of years of data about the failure of the health care market but we do have a few decades of data that indicate a serious and growing problem. I am not convinced that it is a market problem since the government is greatly involved in health care already and there are good arguments that they are making things worse. But this is beyond the question that I have attempted to answer. As you noted I am not against pooling for risk management. I have spoken about the use of rights and the force of the law. I have said nothing about the efficacy of a government system (while much could be said about it). That is a good discussion, the use of rights makes it a moot point. For example, an argument about the efficiency of slavery does now make a viable moral option because it violates fundamental human rights. The pope said that health care is a universal right. If he is right, then the question of whether the government is the best administrator is irrelevant because in my view, it is the duty of government to preserve our universal rights. If health care is a universal right, then the government must step in and assure that every person has health care. I wonder how far this right extend, if I have a headache, is the government bound to provide me aspirin? I am not sure if the pope means the same thing I mean when I say right but it seems to me that if it is a right, then we are only able to quibble about minor details. In fact, a recent comment by a bishop (I can't remember who) seems to me that the bishops are confused about the nature of rights. The bishop said the Church only cares that everyone is covered no matter under what system including a wholly private system. I find this strange because as I understand them, rights must be protected by the government. It seems to me that health care is a great need, like food, shelter, even love, but I believe that assuring that no one ever lacks for these things often involve the creation of tyrannical systems. I make no great claims that I have a plan to assure that everyone, at all times, will have health insurance; I find the suggestion that I should problematic. But I do think we ought to tackle the more realistic question, of why is insurance so expensive and how can we fix that, and how can we assist those who cannot afford even the more affordable health care by being good samaritans. I also brought up another question of rights, which I think is well supported by Leo XIII and Pope Pius (can't remember which right now) and that is whether a woman has a right to the fruits of her labor. And this seems to me a right that the government is bound to protect. (If you want I can talk about what taxes I think are just). A while I read a story about a well-to do- couple who had what the government in Massachussetts considered to be inadequate insurance. This couple had a great deal of savings and prefered a very high deductable insurance with low monthly premiums. Mass. govt. was not impressed and insisted that they buy more insurance or be fined. Since it was cheaper for them to pay the fine, they did. I find this problematic. A government that can tell a couple what to buy and when they have had enough is too powerful.Peace in Christ,Carolyn

Carolyn said: "I dont appreciate being called a free loader. I recently decided that I could not afford and did not need health insurance as I am generally in good health. During this time, I have paid what expenses I have needed out of pocket. Of course, it has not been much, mostly dental and allergy treatments, but I do pay for it."I am sorry that you don't appreciate being called a free loader, but you are, in fact, a free loader. Yes, you may be in reasonably good health and yes, you may be paying cash for the things you do use. But if you have an accident or a catastrophic event (and sooner or later, the odds are that age or fortune will cause one or the other) someone else will be paying for you. On the other hand, you are not paying for other people's catastrophic events now. So like it or not, you are already part of a national risk system that is being paid for by people other than yourself.You suggest that some of the popes spoke about women having the rights to the fruits of her labor. You are now (and will be when you become old) taking the fruits of the labor of other people who are and will be paying for your health care. Unless, of course, if in the interests of the free market you would rather die than take more out of the health care system than you yourself are putting into it. Because this is how the system works today.

Thomas Jacobs --Thanks for the excellent Hacker article at American Prospect. An eye-opener.

unagidon You are just being ridiculous. I am not against getting health insurance not do I plan on never having it but it does seem to me that I ought to have the right to decide that as a healthy 30 year-old woman that there are financial priorities in my life more important than health insurance. And the fact that now the public thinks such a decision by individuals is up for public review is exactly what worries about where we are moving. This is the problem with collectivism. People who know nothing about someone's individual circumstances feel like they have a duty to comment on their financial decisions. Will you be commenting on menu choices next? I don't think I had five serving of veggies today. Do I need to discuss that with American public? CKH

Surely Carolyn is perfectly within her rights in calculating that she can neglect insurance just now? In Japan insurance is mandatory for all, though many neglect it in practice, but in the USA there is no such law. She also makes a good point: "we all need to be asking why is health so RIDICULOUSLY expensive as opposed to who should pay for it. If it were more reasonably priced, this would not be an issue." In Japan, health care is much cheaper than in the US, so even an uninsured person can cope financially with unexpected accidents or infections.

I believe Unagidon is entirely correct. Except for the super-wealthy and the Amish, people who forego insurance are of course subsidized by the rest of us. Carolyn above had said she doesn't plan on never having insurance, it's just not a priority now when she's healthy. So she's thinking abut timing her participation in the system. If she times it right, she can still get health care when she needs it; she would have ended up paying less in premiums and she would still be taking out more than she pays in. But if she times it wrong, and gets sick while not covered, she won't be able to get insurance. So the option for someone in that situation would be to either forego care, get Medicaid or go into bankruptcy (stick the hospital with the bill). If we're talking about "rights to the fruits of one's labor", wouldn't the latter options also in a sense be taking the fruits of another's labor?That said, I would still be willing to help subsidize the health care of those individuals who had the means but intentionally chose to forego insurance. (And I would vote that others do so, too, through taxes, even they don't want to) Why? because even though they had been irresponsible, I believe, like the Pope, that health care is a basic human right and everyone is entitled to it.

Unagidon, Not the topic here, but would you be able to tell me, under health care reform, will my small non-profit be able to get claims-rated now rather than the horrible community-rated premiums we pay?

Dear Irene,If it has between 51 and 100 then, sort of. (Businesses in that size range start out with a sort of "community rate" which is then adjusted by claims experience; groups larger than 100 are entirely experience rated). If it has less than 50, then no. However, the good news is that the "community" used for the rating (the community is the size of the pool that the risk is spread over) should get much, much larger and that should drive your rates down.

My heart breaks for those poor Europeans who know not the joy of individual freedom but suffer under the tyranny of collectivism when it comes to distributed and even redistributed costs for health care. But let's go further and privatize parks, roads, and other social goods that we use taxes collected from all (or many, to be accurate) to pay for. Let there by turnstiles at every turn. What I don't understand, genuinely, is why health care is a Rubicon for social conservatives who retain some attachment to the commonweal. I don't understand what ideological or theological principle drives the animus against universal coverage as a mandate.

unagidon- Thanks!

Irene, If it makes you guys feel better, I plan on getting health insurance when I can afford it, but since I have chosen to forgo full-time employment for now to pursue my academic interests, a decision that I don't think the American public is responsible for, insurance became an unjustifiable expense. More importantly, my greatest worry remains not my health but my freedom. What ought to be a transaction between my health care providers, my insurance provider, and myself is now a transaction between me and the public--the system and how much I am paying into it. So, unless I decide to become Amish or become super-rich, I cannot maintain that this is a private matter because I am being pushed into a non-consensual arranged marriage with your benevolent, coercive system. With all due respect, I value my autonomy above your concern. And I repeat, a government (a public) that feels compelled to dictate what economic transactions private citizens ought to engage will ultimately insert itself every area of our lives where it feels individuals are too incompetent to make those decisions. Our founders are rolling in their graves. As for letting people die, I have a great deal of confidence in your generosity Irene---a great deal more than you have in my ability to make decisions. I have so much confidence in your genersority that I do not doubt that if able, you are willing to write a check to a local charity hospital to take care of those down on their luck or just plain irresponsible. I have so much confidence in you that I see no need to force that money out of you. I also suspect that if we cut out our Uncle Sam, we will get more bang for your buck.Peace in Christ,Carolyn

If everyone has a right to expensive health care then everyone who is able may have a moral duty to work beyond his or her planned retirement date, perhaps for many more years, in order to pay for a generous set of benefits.As the dismal science suggests, there may not be any free lunches. Early retirement may be a luxury that an expanded welfare state will have to discourage, already in places like France and soon in our own country.

Carolyn- I completely respect your right to choose not to have private insurance coverage and I believe you when you say you do not intend to take advantage of any public subsidies. You may successfully accomplish that. Even so, I also believe that there are very few people like you, which makes you statistically insignificant. We need to frame a public policy that addresses the millions of uninsured and underinsured people right now who need or might need government subsidy for health care. I don't personally have a problem with the government paying peoples' health costs directly; but for those who don't think that is a good idea, requiring that people with resources buy insurance is one response.I strongly agree with you that costs need to be lowered, but I also think it is a complete red herring. No matter how cheap you make it, there are still people who won't be able to afford even basic health care, let alone major surgery.And as someone who has worked twenty years in various charities, I would certainly not want to rely entirely on the kindness of strangers. Every charity I ever worked for received government money; charitable donations came nowhere covering the costs of our work. I suspect health care charities are the same.

William, I don't have a special atteachment to health care. It is just what we are debating now. The only thing that is special about it for conservatives is that it is one more thing. It is losing ground. I also think conservatives have a problem that it is being handled at the federal level, which we think is another creative reading of the commerce clause. As for maintaining a link to commonweal, I like to read from a wide variety of sources and I like to keep up with what is going ion the Catholic world. I have read commonweal for years although I rarely comment. I thought David's question to conservatives deserved an answer. I think many of my conservative brothers and sisters have been pretending that there is no gulf between them and the pope on this matter so I wanted to give David an answer. Am I invading your space? As for as the Europeans do, I don't enough about it to comment but I will share another anecdote which I think is telling. Most of my extended family moved to the United States but I have an aunt who moved to Canada. In America, most of my family have achieved some measure of success. We didn't always have health care but most of us do now and until very recently, I had very good insurance. I have an uncle who never graduated from the eight grade who is the successful owner a decent size cab company in Miami. On the other hand, my aunt who moved to Canada, who is the only sister out of four to graduate from high school, spent two decades in Canada living off the public. She never worked a day in Canada. And dare I say, it is the same people who are accusing me of freeloading who create the benevolent systems that cause this life long freeloading. It is just anecdote but I think it is telling. Take it from an immigrant, America is a wonderful, challenging, risky and rewarding place and conservatives want to keep it that way. Let the Europeans be Europeans. I don't begrudge them their vacations. Let the French protest that their precious retirement age will be raised above sixty. But please, let there be one America in the world. Let there be one place where barely literate boat people can achieve great things. Before you balk, may I remind you that I grew up in that community. And I want there to be one place where my uncle's story can happen and that place is not Europe.Peace in Christ,Carolyn

How is Carolyn's position taken not to any absurdist extreme but really just applied consistently not also an argument against any form of mandated paid holidays or labor standards. Presumably the public has a compelling interest in health and safety and in matters of non-discrimination, but aside from that, I see Carolyn as arguing implicitly against a minimum wage, mandated family or medical leave, and other efforts to constrain economic transactions between private employers and employees. There is a principle here that extends far beyond health insurance.

There was a story on the news a couple of months ago about a town in, I think either Kentucky or Tennessee, where property owners were expected to pay an annual fee for fire services. (I'm not sure whether the fee was optional, I think it was). Anyway, one owner chose not to pay the fee, and, guess what, his home caught on fire. The fire department came to the scene (to protect the adjacent properties) but they let the house burn down. The owner was just outraged. I think there are similar scenarios in health care; I think many uninsured people are hoping to stay healthy but fully intend to take advantage of government-funded programs if the need arises (I was once in that boat when I was in school). I also think others (and this is not directed at Carolyn), I think others may fully believe they wouldn't take these subsides, but like the man whose home burned, will feel otherwise if they ever really need medical care.

William, You are right. There are broader implications for my argument. But you are in luck. First, conservatives by nature don't tend to be revolutionary. Unlike FDR, we won't change America over night. Right now, we are more interested in holding line. We are too busy thinking about what aspects of our lives liberals want to regulate to seriously think about making serious roll backs. We also prefer, generally not universally, slow and organic changes. Second, we are pragmatic. Not really interested in fights I can't win. There are all sorts of things that I hate but I can't be bothered to do anything about it. I have a personal life and bigger political fishes to fry. But to go back to your question, why health care? It about 1/6 of our economy so it's a big fish and we think we can win. CKH

Irene, So the man was outraged? So what? Is there more to this story? Did he sue? Did he win? Was someone from his house injured or killed? CKH

"Is there more to the story". Nope, just an example of how a man didn't want to be required to pay a form of insurance for a catastrophic risk, but when the catastrophe occurred, too late for him, he wanted the services.

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About the Author

David Gibson is a national reporter for Religion News Service and author of The Coming Catholic Church (HarperOne) and The Rule of Benedict (HarperOne). He blogs at dotCommonweal.