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The Devil in the Details

In the important and seemingly endless health care debate, a crucial item that has rightly received much attention here is whether the Senate bill provides sufficient safeguards in the matter of not funding abortion on the part of the federal government.Despite the strong counter-position taken by the Bishops Conference, I am sufficiently impressed by the careful analyses of people like Peter Nixon and Matthew Boudway to think that in this prudential judgment of how pro-life principles may be preserved and hopefully strengthened, I can, in conscience, support the Senate bill in this respect.But I think it important to underline that this is a prudential judgment, based in part upon a personal, non-expert, reading of the material, but also on personal trust placed in those who seem to be both extremely knowledgeable and deeply committed to moral principles in keeping with the Catholic tradition. I certainly do not escape responsibility for that prudential judgment. May I also, respectfully, suggest that those who advocate for such a decision, in favor of the Senate bill, also bear an added responsibility for their advocacy.It might be of help, then, if all sides were to acknowledge the fallibility of their prudential judgment, and that it is entered upon with a certain salutary "fear and trembling," since so much is at stake.That said, there are other aspects to the bill that also merit attention, as this story from today's Washington Post indicates:

virtually everything House Democrats want to achieve in their package costs money. For example, Obama and House leaders have promised to increase government subsidies to help lower-income people purchase insurance, to fully close the coverage gap known as the doughnut hole in the Medicare prescription drug program, and to extend to all states the deal cut with Nebraska Sen. Ben Nelson (D), under which the federal government would pay for a proposed expansion of Medicaid.Meanwhile, House leaders want to dramatically scale back one of the most powerful deficit-reduction tools in the Senate bill: a 40 percent excise tax on high-cost insurance policies. Obama has proposed to delay implementation of the tax until 2018 and to limit the number of policies that would be subject to the tax.Obama and House Democrats have proposed to pay for their changes by raising Medicare taxes on the wealthy. They were hoping to reduce deficits further by incorporating Obama's plan to overhaul the federal student loan program to cut out private lenders.Those changes are unlikely to match the long-term savings proposed in the Senate bill, aides and lawmakers said, leaving House leaders scrambling to come up with additional sources of cash. Failure to comply with the reconciliation rules would imperil the package in the Senate and could cause big problems in the House, where the votes of many fiscally conservative Democrats hinge on the ability of health-care legislation to rein in soaring budget deficits.

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I most certainly agree everyone should approach these bills and these issues with a sense of one's own fallibility, as there will likely be problems with any approach that will have to rectified as things evolve. That is a good point to make, and one that is too often lost amid the scrum.On the other hand, there are many aspects about this issue that, if still remaining within the arena of prudential judgments, are not really in dispute. One of them is the cost factor, both human and financial. In fiscal terms, it is clear that doing nothing would be a disaster, for the United States, for American families. And the CBO score of the Senate bill (which is quite conservative in terms of savings projections) shows that it would cost $875 billion over 10 years and reduce the deficit by $118 billion. It would also provide coverage for 31 million uninsured. Could more have been done in terms of savings and coverage? Certainly. Is it perfect? Of course not. But it will save money and insure many more Americans and begin to alter the disastrous course of health care, which would otherwise run off a cliff. I think that is the special sense of responsibility that opponents of the Senate bill might bear. Consider this news:

"The number of uninsured adults and children in California swelled by 25 percent between 2007 and 2009, according to a new report by researchers at the University of California, Los Angeles.""One quarter of the states population is now uninsured, according to the analysis, and less than half of those with insurance receive it through employers."

http://prescriptions.blogs.nytimes.com/2010/03/16/study-finds-1-in-4-uni... who enjoy health care and a certain economic security also need to keep such human realities in mind as they ponder the choice between extracting more savings from health care or continuing with a status quo that will worsen dramatically with each passing year.

DG: "Those who enjoy health care and a certain economic security also need to keep such human realities in mind...." I Second David and move the question.

It seems relevant to me to note that the principle criterion the bishops have insisted on using to judge health care reform legislation is whether or not it is consistent with the Hyde Amendment. The Hyde Amendment permits federal funds for abortion in cases of rape, incest, and threat to the life of the mother. So the Hyde Amendment itself is not consistent with Catholic teaching. The bishops position was a compromise to begin with, and I have not heard anyone critical of that compromise. If the bishops had insisted on something more strict than the Hyde Amendment, there would have been no possibility at all of getting a bill they could approve of. So the bishops made a prudential decision at the outset, not insisting on the Catholic position of "no abortions, ever, for any reason." To maintain that their prudential decision has the weight of Catholic doctrine makes no sense to me. Obviously Catholics are to take very seriously what the bishops say. When bishops say abortion is intrinsically evil, they are speaking as the Magisterium, But when they say federal funding of abortion in health care reform must be consistent with the Hyde Amendment, and when they get into disputes as to whether the House or the Senate versions of the bill are indeed consistent with the Hyde Amendment, they are not speaking with anywhere near the authority as when they proclaim abortion to be intrinsically evil.So it seems to me that, from the very beginning of the debate, even the most faithful of Catholics have never been obligated to adopt the exact position taken by the bishops.

"But I think it important to underline that this is a prudential judgment, based in part upon a personal, non-expert, reading of the material, but also on personal trust placed in those who seem to be both extremely knowledgeable and deeply committed to moral principles in keeping with the Catholic tradition. I certainly do not escape responsibility for that prudential judgment. May I also, respectfully, suggest that those who advocate for such a decision, in favor of the Senate bill, also bear an added responsibility for their advocacy."Thank you for saying this, Fr. Imbelli.

"On the other hand, there are many aspects about this issue that, if still remaining within the arena of prudential judgments, are not really in dispute. One of them is the cost factor..."If you are of the opinion that the CBO score is an accurate predictor of the cost of the legislation in both nominal, and more importantly, real, dollars as using the term cost and deficit as they are generally understood by FASB and other accounting organizations, for example, I believe there is quite a bit of dispute. And yes, I will stipulate that you do not consider the dispute worthy of your consideration but it exists nevertheless.

MAT, the CBO's estimates are routinely accepted by both parties and are seen as a baseline standard by experts. What other countervailing analyses would you cite? And do you disagree that health care costs and deficits won't go up if nothing is done?

Robert Imbelli, thank you for articulating where I suspect most thinking Catholics find themselves in this debate.David Nickol, thank you for your perceptive thoughts about the Hyde Amendment. Life is imperfect, and in a pluralistic society we ain't gonna' reach perfection anytime soon.Mr. Gibson, I echo your plea that those of us blessed with insurance and an income not overlook the needs of our fellow human beings without.As a Kentuckian, I am so very, very ashamed of Senator McConnell's de facto opposition to providing health care to people in need. Long before this controversy, he was known locally as an obstructionist. Indeed, he is mentor to the like-minded Republican leader of the state senate.If there is a Hell to which God will send sinners, it will not be populated by rapists, murderers, paedophiles, bank robbers, thieves, terrorists, etc. No, such a Hell will be populated by folks who were in positions of responsibility but refused to help their fellow human beings who were without. These once powerful sinners will ask their Maker for that one "drop of water".As a friend suggested years ago, the opposite of love is not hate.It's indifference.

Bob:I am both honored and humbled by your confidence. I also completely agree that given the complexities of the legislation, all sides should hold to their positions with a certain "fear and trembling." There is no question that an expansion of social provision of this magnitude simply has to be paid for. Based on the CBO scoring, I believe the drafters of the bill have done a reasonably good job, although I also think we have more work to do on the reform of care delivery. That, of course, is as much of a responsibility for those of us who work in health care delivery as it is for the federal government.Let me offer a word of comment on the excerpted text in your post, which describes the excise tax on high cost insurance policies as a deficit reduction measure. The policy role of this provision is actually more complex than that.A number of economists have argued that one factor driving health care inflation is the tax treatment of health insurance benefits. Because they are not taxed as income, employees face an incentive to take compensation in the form of health benefits rather than wages. Because health insurance tends to insulate consumers from the true cost of their care, they tend to demand more of it. Higher demand pushes up costs.Now there are reasons to doubt that this simple model works exactly the way it does in textbooks, but I will grant that it probably has an impact at the margin. The rationale for taxing high cost plans is not so much to raise revenue but to change behavior. By encouraging employers to offer less generous plans, the tax will ultimately lead employees to pay more of the cost of their own care. This will make them more price conscious and--so it is hoped--make them less likely to want to purchase health care services that are of minimal value. Thus if behavior change--rather than raising revenue--is the core motivation for the tax, there is a strong argument for a delay in implementation so that people will have time to change their behavior. Organized labor feels strongly about this because they represent members with moderate incomes who have often been willing to forgo real (i.e. inflation adjusted) wage increases in order to preserve benefits (as a former labor union staffer, I can attest to the truth of this). Therefore, it seems reasonable to allow adequate time for labor contracts to turn over and be re-negotiated to reflect the new structure of incentives in the tax code. Even non-union employers would probably appreciate some transition time. We can, of course argue about how long the appropriate phase in period should be.Having said all this, I still harbor some doubts about the underlying theory. If you look at the numbers, consumers are paying a larger share of the cost of their health care than ever before, both in terms of paying more of the cost of their premiums and facing increased cost-sharing at the point of service. I think the effects on health care inflation have been modest at best. There are many reasons for "excess demand" in the market for health services and I am not necessarily convinced that tax policy is one of the most important ones.

May I also, respectfully, suggest that those who advocate for such a decision, in favor of the Senate bill, also bear an added responsibility for their advocacy.The core position of the USCCB was that health care reform should be "abortion neutral" by maintaining the principle -- as stated in the Hyde Amendment -- that tax dollars must not be spent on abortion (except in cases of rape, incest, and threat to the life of the mother). It seems to me that if it is your judgment, after careful study, that the Senate bill reflects the principles of the Hyde Amendment, you are not in disagreement with the bishops over the principles they set forth. You are in disagreement with them, their spokespersons, and the experts they consult over what the bills in fact say, and how what the bills say could be interpreted. So I don't think there is a special burden on those who advocate for the Senate bill. At this stage of the game, there are no moral issues left for bishops to pronounce on. It's all a question of whether the Senate bill provides federal funding for abortion. Legislators and legal experts are far better equipped than bishops to answer those questions, and in fact the bishops are consulting legislators and legal experts just as much as everyone else. We are beyond the point at which the opinion of the USCCB matters.What has struck me throughout this whole process is how few arguments over matters of morality there have been. From the beginning, it has all been about sticking to the principles of the Hyde Amendment. There has been nothing like the arguments preceding the presidential election on "intrinsic evil," "remote material cooperation," "proportionate reason," and so on. No one has raised the question (which seems to be a legitimate one, to me) as to whether a slight increase in support for abortion could be outweighed by the good done by covering 30 million additional people, providing more services to pregnant women, and so on. I might even go so far as to say the USCCB has given very little moral guidance. I appreciate them sticking up for immigrants, although their support has been all words and no action. I appreciate them being strong advocates for health care reform. But in trying to balance out all the issues involved in this very complex debate, I don't see that they have been much help at all. I have never even seen arguments from the bishops that it is not "stealing" to impose taxes for the common good, or that passing health care reform is not "tyranny."Just as an addendum, in reading comments from "the people" (on web sites where readers are permitted to comment on news and opinion pieces), I have found that objecting to the use of taxpayer dollars for abortion and objecting to immigrants benefitting in any way from health care reform often go hand in hand. So it seems to me a lot of people have taken to heart the bishops' anti-abortion stand but have rejected their pro-immigrant (pro "we're all human beings with a right to health care") stand.

First: Timothy Jost is an expert in the field of health-care law.Second: What is the nature of our special responsibility? Our decision to support the bill is an informed one--a risk, like any political calculation. There is a difference between saying the bill is throughly terrific and pointing out the shortcomings of its critics' arguments. We think the USCCBNRLC is simply wrong on the facts, and making a prudential judgment based on false assumptions. Once their objections are ruled out, from a Catholic perspective, there is no good reason not to support the bill. Balanced-budget amendments have never been part of Catholic teaching. When bishops and priests start objecting to a bill because it costs too much, you know you're no longer having a conversation about Catholic teaching.

"It might be of help, then, if all sides were to acknowledge the fallibility of their prudential judgment, and that it is entered upon with a certain salutary fear and trembling, since so much is at stake."In addition to whatever fear and trembling might take place with regard to how the bills affect abortion, I would hope there's at least a little quaking over whether the final version of the bill--if and when it passes--actually helps the people it's supposed to in time for them to enjoy some measure of better access to care.As one of the uninsured, I'll let you know ...

"In fiscal terms, it is clear that doing nothing would be a disaster, for the United States, for American families." It's hard to read a sentence like that and not laugh out loud. Millions of Americans are not only reasonably satisfied with the current health care system, they believe the changes proposed in this bill may be catastrophic. While everyone, I'm sure, has ideas on how the system might be improved, polls indicate that most Americans would consider "doing nothing" to be far from disastrous. But why bother with the masses when "it is clear" that there's work to be done.A high school teacher would never accept the "it is clear" argument from a student--neither should Commonweal.com bloggers. Next time, put in it italics or underline it--that always makes an argument more compelling."What is the nature of our special responsibility?" Ok, questions like this don't make me laugh out loud--they scare me. When editors of a national Catholic magazine, who stridently advocate such drastic changes in the fundamentals of our health care system--changes opposed by the Church--feel the need to ask such a question.well, excuse me while I pick my jaw up off the floor. Or does the press feel they no longer bear any special responsibility?

"What is the nature of our special responsibility?"It's not up to me to answer that question; but I do have some thoughts. When those who possess teaching authority in the church take a clear position in a public policy dispute, does Commonweal, as a publication that is Catholic in some sense, have a responsibility to present that position in a respectful manner, or at all, even when its editorial board advocates the opposite? I believe it does, particularly in a complex and technical matter like abortion funding in the Senate bill.If that is not part of its responsibility, then in what sense is Commonweal a Catholic publication?Two sets of posts started the recent burst of posting activity on this topic. One was a link to a David Gibson piece in Politico that quoted Professor Jost in a positve manner. No USCCB or other Catholic sources were referenced in either the post or the linked article; reading those pieces, one would have no reason to suppose that the USCCB had taken any sort of position in the matter of the Senate health care reform bill.The second was Matthew Boudway's posts disputing assertions by AUL, which, although pro-life, isn't a Catholic organization. Again, there was no mention that the USCCB had taken a strong position and earnestly desires that position to be communicated to Catholics in the US.That the USCCB even had a dog in this fight was unearthed by commenters here, doing their own research. Once the USCCB position began to appear in the comments boxes, a subsequent set of posts has done its utmost to discredit the USCCB on this topic. Still another set of posts has gone to great lengths to sow disunity in the church by quoting other prominent Catholics who have broken with the USCCB.Who does Commonweal serve? My perception is that on the topic of health care reform, it serves the Obama Administration, inasmuch as this burst of posted commentary, all of which supports the administration's position, coincides with the adminstration's orchestrated blitz on the topic, and given Commonweal editors' and contributors' ties to the Obama campaign in 2008. What all of these posts have in common is that they promote the positions of the Obama Administration, and seek to minimize, discredit or completely ignore the church's positions.I'm disappointed. I believe Commonweal has a responsibility to present the news in an unbiased manner, and, at the least, to give the church's position respectfully, even when you disagree with it. My opinion is that even minimal respect hasn't been accorded the church's posiiton. I'm just one reader, though. Thanks for letting me air my perceptions.

Jim, I'll let others at Commonweal respond, but I think the magazine is Catholic in every sense. Mark Proska, I thought by this point I didn't have to cite chapter and verse of every study in a comment, but the need to reform the system and reduce costs before they submerge us seems to be the one thing agreed on by all sides. I am glad I gave you a laugh. Sounds like you could use one -- and that you have enough health care to cover you if you bust a gut.

"At this stage of the game, there are no moral issues left for bishops to pronounce on. Its all a question of whether the Senate bill provides federal funding for abortion. "David Nickol ==Excellent point. Excellent post. Yes, "my side" can be wrong about whether or not the law will allow payment for abortions, but only time will tell. What irritates the life out of me at this point is that few people consider the fact that the law can always be amended if it isn't working as intended. But if the bill isn't passed, 31 million people will still be out in the rain (not to mention the other millions who won't be covered even if it is passed).By the way, who are these other people who won't be covered? If they're not the immigrants, won't they sue on the basis of discrimination of some sort? (Now there's a moral question: ought the immigrants - or some of them - be covered? And why?)Is this bill scary? Yes. But no bill is much scarier.

Please listen to me about the U. S. government after 23 years working in the Department of Justice. If the health care bill is a matter of trust, it's all over. Very few of these people in power can be trusted. Toward the end of my career, I could no longer hold an intelligent conversation with anyone. Nobody cared because it did not matter to them. Even when they failed their jobs or were even involved in scandals, they were promoted. Nothing mattered! Play the game that you care.I know all of you care, but they don't. A congressman gets a ride on the presidential plane and now he's a "yes" vote. When the public option was on the table, do you think any of those who supported the option would move to that plan? Of course not! And what about fiscal prudence. My experience in teaching and counseling tells me that one of the obstacles to a full spiritual life (real life) is distraction through worry about too much debt. The very spiritual life of this country is at stake. A multi-trillion dollar health care fix cannot be the answer. Maybe the Church has an answer but they are in debt too. Too distracted. Trust! It's not there for that much money. It's a shame.

I only wish that the electorate, commentariat, Catholic ecclesiastics and other flotsam and jetsam had been to worried and vocal about the enormous cost to the country of (1) the self-service Bush tax cuts on the well-to-do and (2) the ill-advised and ever encompassing military incursions into places that are draining our country's coffers, confidence, will, human power and world reputation.Oh, I forgot: abortion was not involved. I guess those there were OK then.Reverse those 2 matters and eliminate the cap on social security contributions and this country will more than be able to fund universal healthcare, medicare and social security for a long, long time.

Poor proofing on my part: mea culpa.

"Millions of Americans are not only reasonably satisfied with the current health care system, they believe the changes proposed in this bill may be catastrophic."What is catastrophic is when one loses the healthcare coverage that one has had. This includes unemployment AND when one's employer switches healthcare insurance coverage and the sacred "my doctor" decides that (s)he doesn't want to join the resulting HMO/PPO or just gets sick and tired of the insurance bureaucracy and bows out of all of these plans.It's very easy to be satisfied when your own little self-centered world is OK. However, change can sneak up on your very quickly and painfully and then we'll hear the screaming and hollering about unfairness, etc.There's always the emergency rooms ---- who pays for those expenses?

Don't be frightened, Mark. While I don't speak for "the press," I was not suggesting that journalists do not bear any special responsibility. I was simply asking what was meant by the term. You haven't helped to answer my question.Incidentally, Mark and Jim: as a member of the church, I disagree with your claim that the health-care-reform bill is opposed by "the church." It is not official church teaching that the Stupak Amendment is the only way to keep federal dollars from funding abortion. After all, accepting the Hyde Amendment at all is already to compromise Catholic teaching on abortion. The USCCBNRLC claims its interest here is in maintaining the status quo. Jim: I see you're on lacunae patrol again. You seem to suggest a publication's Catholicity directly correlates with the amount of space it gives to episcopal statements. It doesn't. We are not a news magazine. We are in the business of opinion journalism. That entails different standards than those we expect from a news desk at, say, the New York Times. We take seriously our responsibility to present opposing viewpoints in a fair manner. And, if I may be so bold, I doubt you'll find another publication covering "religion, politics, and culture" that does a better job. You also return to the theme of "presenting the Catholic viewpoint." Do you seriously believe, first, that the opinions of the USCCB are not readily available and, second, that we have disrespected those opinions here? If so, how? You seem to be in a pronouncing mood. Time for you to make an argument.I realize why you might think that my role as an unpaid adviser to the Obama campaign--which concluded with that campaign--might compromise me, but I can assure you that my colleagues have minds of their own. (No other editors were involved. One of our columnists, Cathleen Kaveny, was also an unpaid adviser to the campaign. You'll notice that I am still employed by Commonweal magazine, and have not decamped for a federal sinecure.) Rather than rule my considered opinion and theirs out of court simply because of my one-time role as a volunteer campaign adviser, why don't you consider the possibility that we have done the research and have concluded that on the issue of abortion funding the opponents of the health-care-reform bill are mistaken? As for your charge that we have discredited the arguments of the the USCCBNRLC, why wouldn't we, if we find them unpersuasive?

"Balanced-budget amendments have never been part of Catholic teaching. When bishops and priests start objecting to a bill because it costs too much, you know youre no longer having a conversation about Catholic teaching."Actually, responsible stewardship has been one of the bishops' core goals for health care reform since the very beginning.

Jim: the USCCB's "dog in this fight" was identified and endorsed by Commonweal long ago: health-care reform can't include government funding for abortion. The discussion here hasn't ignored that principle; it has been based on applying that principle. That the bishops are correct in holding that line has been taken for granted. The USCCB is now saying the Senate Bill doesn't meet that standard, but they're mistaken. Pointing out the problems with their argument isn't disrespecting their teaching authority, because their opinion about this particular piece of legislation isn't a matter of teaching authority. It's not "breaking with" the USCCB to think the USCCB has bad information on whether this bill meets their own standards for acceptability.

Actually, responsible stewardship has been one of the bishops core goals for health care reform since the very beginning.Jim,I am confused. From everything I have read and heard, the bishops offered to help get the bill passed if only the Stupak language could be added to it. And the suggestion on how to get Stupak into the bill was through reconciliation and overriding the parliamentarian, since it is not really legitimate to use reconciliation to change something that does not affect federal spending. See A href="http://www.slate.com/id/2247037/entry/2092839/">here and here. One of the USCCB's most recent complaints about the bill is that "affordability credits for very low income families purchasing private plans in a Health Insurance Exchange are inadequate and would leave families financially vulnerable." This does not sound like something that can be remedied without the bill costing even more.

Allow me to suggest that a sine qua non of the special responsibility of the press is to make every attempt to use fair minded words. That includes resisting the temptation to resort to the liberal mind's fatal conceit: If you disagree with me, that is proof of the baseness of your motives.Allow me to further suggest that included in the special responsibility is full disclosure. So Grant, I appreciate your disclosure--better late than never. It is unfortunate that clicking on your name merely indicates that you are an associate editor of Commonweal, with no mention of your former status with the O'bama campaign. While I'm sure you make every effort to navigate ethically through the conflicting interests, might I suggest it was inappropriate for the magazine/blog to not have this information readily available to its paying subscribers.Happy St. Patty's day to one and all!

David - I don't know enough specifics of the bill, or if the bishops have commented on the money part of it. Their advocacy for health care reform is driven by their concern for the poor and vulnerable. So they're also critical that coverage wouldn't be extended to undocumented immigrants.If the bill calls for spending $X but increases revenues by $X * 1.05 (or some other factor that exceeds the annual growth of the federal budget), then it reduces the deficit, even if X = a really big number.

"MAT, the CBOs estimates are routinely accepted by both parties and are seen as a baseline standard by experts. What other countervailing analyses would you cite?"I personally use CBO estimates, among other things, routinely to make very material investment decisions so I literally put my money where my mouth is when I say I have the highest regard for the CBO. At the same time, they produce very specific and technical estimates based on a universe of assumptions which may not correspond to reality so to say that a CBO prediction of economic behavior of a system a decade hence based on very specific usiverse of inputs which do not correspond to naturally occuring financial phenomena is confusing to many people. By way of example, I think many people think when you said the CBO estimates this legislation will "reduce the deficit by $118 billion," that, all else equal, in the absense of the legislation, the net public debt over the next ten years will be $118 billion larger, but that is not what the CBO means. A critique is not really a relevant metric, it is just a matter of understanding what the CBO estimates mean. By way of example, I believe you are aware that the $118 billion is an on-budget estimate only and includes off-budget items as offsets. That is entirely proper within the confines of the financial model they are working with and public law and statute but it does not represent a full picture of the estimated future public borrowings of the US government. "And do you disagree that health care costs and deficits wont go up if nothing is done?"That is too imprecise a question to answer fully, but if you are asking if I personally think health care costs, all else being equal in the absence of this legislation, will increase in the aggregate in real dollars, the answer is yes.

Grant - probably I am on lacunae patrol. I will be the first to admit that you and other Commonweal editors have probably given much more thought to what it means to be a Catholic journal than I have. (I would like to know your thoughts in more detail, not to tear it down but because I'm curious). I doubt that the line between a news journal and an opinion journal is as bright as you make it out to be. DotCommonweal, an organ of the publication, calls our attention to news articles all the time, e.g. 'Catholic nuns come out in favor of ObamaCare.' Commonweal also provides a great deal of reporting - deeper dives into issues. I'm sure a big reason that we subscribe to Commonweal is because of the information you provide.I actually think the bishops have done a terrible job in communicating their position on the Senate bill, and most particularly their reasons for opposing it. They've buried their analysis deep on the web site. Most Catholics are not policy wonks. I wouldn't expect the bulk of your readership to be able to recite the bishops' talking points.I hope your role in the Obama campaign hasn't compromised you. I agree that it didn't curtail your ability to think. I persist in the opinion that in in the last week this forum has veered into cheerleading mode. 'Nuf said by me on that, though. Mark P. - at the time of the election, it was disclosed here that Grant and Kathleen were advisors to the Obama campaign. (Was Margaret also one?).

"Mark P. at the time of the election, it was disclosed here that Grant and Kathleen were advisors to the Obama campaign. (Was Margaret also one?)."But the issue is bigger than that. After all, it's not as if people's political allegiances ended with the campaign. I now know of the former alliances, but only because I happened to be reading the blog when the one comment in a million disclosed it. What about people who did not see the comment, or come to the blog later? How much would it take to simply disclose the former alliances as part of the bio, so that Commonweal can report, we can decide?If a Commonweal article quoted a former Bush advisor who said something favourable about Bush, would the former alliance have been disclosed? If they commissioned an article by a former McCain advisor to present another side of an argument, would the former alliance have been disclosed? If, in an attempt to increase diversity, they brought in a former staffer to Newt Gingrich who was regularly singing his praises on the blog, would the former relationship have been disclosed a bit more transparently?I don't want to see a publication that prides itself on its independence appear to have its integrity compromised, even if only slightly, especially when it would take so very little effort to set things right.

Mark, as one who has differed with Grant on Obama, let me say that your statements are way out of place when you attack integrity. The issue is health care for 30 million people. And on that issue Grant and Commonweal come shining through brightly. Your failure to advocate for those thirty million people might prompt you to question your own motives. Your views are consistently on one side of the fence. So it could be you are talking about yourself with such projections about others.

Would the House Bill have passed without the Stupak Amendment? If the House Bill would not have passed without the Stupak Amendment, why would the Senate decide not to include the Stupak language in their bill?I am wondering if those of you who profess to be Catholic can explain why you would support a National Health Care Plan that would include insurance for elective abortions when you know that abortion, the intentional destruction of a Human Individual in their Mother's Womb is not Health Care. Keep in mind that Roe v. Wade did not require that insurance be available to make it more affordable to obtain an abortion.

What is it with the attacks on Grant's integrity? This is absurd. Make an argument, if you have one -- and you don't seem to have one -- or let it be. Grant has been perfectly forthright in any of his affiliations. If you don't like his opinions, well, they're his opinions. If you don't like him because of his opinions, well, tough turkey. We treat you -- I'm thinking of Mark Proska and Jim Pauwels -- with due respect without questioning your integrity.Jim P, I've always respected your opinions and even agreed with a few! But as I understand it you are an ordained deacon of the Archdiocese of Chicago. Given your vows and all you have personally invested in that job, one could question the integrity of every assertion you make here, every defense of the bishops or your bishop. You are deeply compromised, if that's the way you want to approach this kind of exchange. I would suggest that you leave aside the questions about the integrity of other Catholics' faith and views, especially when it regards a staff you do not know at a magazine that has been devotedly Catholic longer than you have been a Catholic.

"I am wondering if those of you who profess to be Catholic can explain why you would support a National Health Care Plan that would include insurance for elective abortions when you know that abortion, the intentional destruction of a Human Individual in their Mothers Womb is not Health Care.Nancy --I am not aware of any Catholic on the blog who "would support a National Health Care Plan that would include insurance for elective abortions . .." If you think the current bill provides such coverage, then, of course, you are right to oppose it. But since I think that it does not provide such coverage, I do support it.The disagreement here is not about Catholic moral principles, it is bout what the health care bill means.

Would the House Bill have passed without the Stupak Amendment? If the House Bill would not have passed without the Stupak Amendment, why would the Senate decide not to include the Stupak language in their bill?Nancy,First, they can't. Reconciliation allows only changes that affect the federal budget, and it is universally agreed that a change in the abortion language does not. Second, they don't need to. There is no significant difference between the House and Senate bills when it comes to abortion. Third, in their wisdom, the Founding Fathers gave us a bicameral legislature. They never intended for the Senate to do something just because the House did it, or vice versa.

Ann, the intention of this Health Care Bill is to provide quality, affordable Health Care, AND to make elective abortions more affordable, despite the fact that we all know elective abortion is not Health Care.At the end of the Day, when you have started the Day by denying that the unalienable Right to Life is inherent and cannot be alienated because it is endowed to each one of us from our Creator, Nature's God, (with the capital G) one should not be surprised to find the devil in the details.

David N., the Founding Fathers intended that we Respect and Protect the unalienable Right to Life, Liberty, and the Pursuit of Happiness that has been endowed to each one of us from our Creator.

Nancy,And what is your answer to the first and second points I made?Can you tell us what you object to in the Senate bill? How does it compare unfavorably to the House bill on the issue of abortion?

David G--Perhaps I've been unclear. My issue is not with Grant. After all, he was the one who was kind enough to disclose his former association. I understand it's entirely possible he argued for a fuller disclosure but was overruled by the powers that be. I mean no disrespect when I say that I doubt an associate editor makes the final decision in matters as important as this.I think it would be unwise for any publication to have such an exalted view of itself that it is above dispassionately engaging issues that speak to its integrity. A defensive posture is much less helpful than transparent one. Even now, the matter is easily rectified.

Mark Proska: No I was not an advisor to the Obama campaign. So what?And I am not the editor of Commonweal, which your question presumes.

"... the liberal minds fatal conceit: If you disagree with me, that is proof of the baseness of your motives."Honestly, I would cringe to make such a statement about my many worthy conservative friends in real life and here on the blog. Charity dictates that I make no inferences about what fuels such overgeneralizations. But fairness compels me to mark it and to weigh it in the balance as I consider other opinions from individuals who make statements like these.

"... the intention of this Health Care Bill is to provide quality, affordable Health Care, AND to make elective abortions more affordable, despite the fact that we all know elective abortion is not Health Care."Nancy, I see the possibility of more affordable elective abortions as a possible side effect of the bill, not an intention of the bill. Is there specific language that leads you to this conclusions that I have missed? I would be interested to know about it!Obviously people disagree about whether the bill contains adequate safeguards to prevent federal funding of abortion. They also disagree with about whether the bill contains adequate provisions to help anybody without insurance right now (and I would be one of the latter).

Mark Proska: If you continue to be troubled by the degree of "independence" at Commonweal, you're welcome to write another letter. The Senate bill is the topic here.

"Ann, the intention of this Health Care Bill is to provide quality, affordable Health Care, AND to make elective abortions more affordable, despite the fact that we all know elective abortion is not Health Care."Nancy -That's what YOU think the bill says. It is not what I think the bill says. If it did I wouldn't support it either. I'm not about to pay for abortions if I can help it, and please don't say that I am. It isn't true, so it isn't fair.Nancy says further: "xAt the end of the Day, when you have started the Day by denying that the unalienable Right to Life is inherent and cannot be alienated because it is endowed to each one of us from our Creator, Natures God, (with the capital G) one should not be surprised to find the devil in the details."Ann replies: Watch it, Nancy. You are making a serious accusation there, and it is not founded in fact. You are accusing me of denying the right to life of unborn babies. I most assuredly do NOT deny their rights. To say I do is grossly unfair. You have an obligation to be truthful about those with whom you disagree, and don't you forget it. You owe me an apology.

Government officials make everything ambiguous. Some on this blog believe the "wording" is adequate to prevent federal funding of abortions, others believe not. How can the wording on the issue of life be ambiguous in any way? That's what Stupak is saying. Regarding those Americans who do not have health care, from 2004 - 2009 I was responsible for the health and welfare of all federal inmates entering halfway houses in New York City, Boston, and Philadelphia. With the thousands of inmates that arrived, not one inmate was denied health care at a hospital. An inmate might come to the halfway house with a 30-day supply of medication and was even able to get medication after the 30 days if they were not employed. The governments (fed, state, city) are already paying for healthcare.

David G: yes, I am a deacon of the Chicago archdiocese. I am not impartial about the archbishop who ordained me, and I agree that any statements I make about him should be taken in that light.The question of how clergy should insert themselves in politics probably is as complicated as the question of how journalists should insert themselves in politics. Both clergy and journalists are people, which is to say that they are political animals, and should be permitted to form political opinions and express them. The rule of thumb for clergy, undergirded both by good sense and IRS regulations, is that we need to make it chrystal clear that whatever political candidate advocacy statements we say are our own opinion and not in our role as spokespersons for the church. In addition, I'm not to run for public office, and also, I believe, should not actively campaign. I'm not even supposed to have yard signs during election season, which in Chicago is like not having a mailbox. (But what about my wife, who is not a member of the clergy, is a political animal, and shares the same yard with me?) I take it that Grant's argument, at its core, is that because Commonweal is not a news journal, it needn't aspire to the objectivity and appearance of objectivity that a newspaper or a news magazine should. Inasmuch as I'm not in the profession, I don't know if that is the common and traditional view. I could be all wet. If an editor of the Chicago Tribune wants to take a role in a political campaign, I believe that the newspaper would expect her to take a leave of absence. But I think Grant would point out that a newspaper is not an apples-to-apples comparison.If I am all wet about all of this, please let me know.

Jim, so you have compromised your integrity and your faith, according to the criteria you impose on Grant and Commonweal. How then are we to trust what you say? Why should we accept your attacks on the faith and integrity of your fellow Catholics as sincere?

"Charity dictates that I make no inferences about what fuels such overgeneralizations."Jean--No need to make inferences, it's all there in black and white. Check out the 3/17 post at 2:51 pmor 3:22 pmor 7:41 pm(to be continued). Although perhaps it would have been more charitable if I had called it the fatal temptation rather than fatal conceit. I will leave it to the liberals on the blog to identify the conservative mind's fatal conceit--I can't think of one!Mollie--Thanks for the offer, and the link to one of the best letters to the editor I have ever read. Seriously, though, my issue here is not really independence, it's disclosure. I do not think that having former advisors to a presidential campaign on the staff necessarily impairs independence. I do think it is inappropriate that this important fact is not readily available to readers.

Your objection is noted. Move on, please.

Mark,How about disclosure with reference to you. I understand that you are not part of a newspaper or magazine. But you do have allegiances and affiliations which you are clearly not disclosing here. All of us here knew about Grant's affiliation. He does not have to file a notice everytime he writes anything. You refuse to tell us what contacts you have that compromises your statements. Still.I am truly concerned about your affiliation with the bishops and how you have differed with them in any way. Grant has disagreed with Obama and is independent of him. I would like to see where you have disagreed with the bishops. When you make such an accusation as you have then you have to own up to what you are doing. If you will not give full disclosure then one must conclude that you want transparency in others but not yourself. Which may be termed hypocritical.Bloggers are not immune from responsibility and disclosure. Especially when they impugn others. It seems to me you have a credibility problem. Please address that before you continue to attack others. Expecially when you have limited knowledge of that situation.

I think it would be unwise for any publication [ecclesial officer] to have such an exalted view of itself [himself] that it [he] is above dispassionately engaging issues that speak to its [their] integrity. A defensive posture is much less helpful than transparent one. Even now, the matter is [not so] easily rectified.A slight re-write.

Bill--I don't think mere subscriber/commenters can be held to the same disclosure standards as editors, columnists, etc. And, for the record, I am not now nor have I ever been formally associated with any presidential campaign. While I'd be happy to respond in greater detail, we've been ordered to move on.

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