Extra, extra!

Two of our recent web-only items worth looking at. First, Joseph Becker writes here about some of the more controversial provisions of the National Defense Authorization Act of 2012. One of these forbids the transfer of Guantnamo detainees to the U.S. mainland for trial.

Reasonable people may differ about the dimensions of the threat posed by Al Qaeda, but there is a touch of paranoia in the insistence that Guantnamo detainees not be moved to the mainland. As President Obama noted, hundreds of terrorists have been tried in federal courts with satisfactory results. That is to our credit. Of the prisoners confined to the island, however, only a handful have been tried at allby military commission. Pursuit of justice on the island has not been energetic. Were the Guantnamo inmates, now reduced to 171, carriers of leprosy or smallpox, a rational case for their exclusion from the mainland could be made. But the irrational fear that they would wreck the federal prison system or break out to carry on with their terrorism here is a discredit to the nation. The many successful prosecutions of detainees in domestic courts are proof to the contrary, if proof were needed.

Second, in a follow up to Unagidon's response to a piece by Hadley Arkes in First Things, Arkes replies to Unagidon and Unagidon answers. After correcting Unagidon on a point of information, Arkes acknowledges that the Affordable Care Act -- known to its detractors as "Obamacare" -- follows logically from a piece of legislation from the 1980s, signed by Ronald Reagan, that requires hospitals to treat anyone who shows up in an emergency room even if he or she has no health insurance and can't afford to pay for treatment out of pocket. Arkes writes:

[Unagidon] is perfectly right that we are brought to the point of the mandate, the requirement to buy insurance, as a result of the Emergency Medical Treatment and Active Labor Act (EMTLA), the Act that barred hospitals from turning away patients. That Act would saddle hospitals with massive bills from people who could not pay them. The result, wholly predictable, was to push some hospitals to the point of bankruptcy unless the federal government stepped in to fund the obligation it had enjoined. We take matters yet another step when we forbid insurance companies to refuse new policies on the basis of pre-existing conditions. That kind of move virtually obliterates the logic of insurance. The policy can be absorbed by the insurance companies only if the government will guarantee the supply of clients by forcing people to buy the insurance they sell.[...]And that brings us to what Unadigon seems to regard as his culminating point: If Arkes believes that hospitals should be allowed to deny care to sick and injured people without health insurance (or without enough money to pay for services out of pocket), he should say so outright, for this is one of the consequences of his argument about contracts.Surely, it has not passed the understanding of Catholic intellectuals that one may be committed to the principle that all men are created equal, that one could seek the broadest provision of medical care, that one could have a special concern for the protection of the weak and the poorand yet not be persuaded that the best way to achieve these ends is through a system of medical care dominated by the government, and engaging at critical points the monopoly powers of law in refusing treatment to patients. To argue over these kinds of questions is not to be at odds over the moral postulates that should move us and govern our judgments. It is entirely false of Unagidon to suggest that, because I have deep reservations about a system of medical care controlled by the government, I wish to deny medical treatment to the sick and injured. It all rather recalls H. L. Menckens line about the people who seem to think that if we are reluctant to buy the Cancer Salve, it must be because we want Uncle Julius to die.

To which Unagidon replies:

I believe that Professor Arkess contention that the unfunded government mandate imposed by the Emergency Medical Treatment and Active Labor Act (EMTLA) led to higher costs, which in turn led to the government becoming involved in a national medical payment scheme (i.e., the Patient Protection and Affordable Care Act), is not quite correct. What actually happened is that after World War II healthcare gradually became an expected part of labor compensation. From then on, it began to be seen as a right. Workers began to demand it, and the general public demanded it for non-workers in the form of Medicare, Medicaid, and finally EMTALA. In my earlier response to ArkessFirst Things article, I outlined the failure of the market to provide universal coverage and to control costs. I know that Arkes opposes EMTALA and other government intrusions into the insurance market, and I can only assume that he would like to see these things rolled back. If they were rolled back, then the market for medical services would consist entirely of people entering or not entering into voluntary contracts with private-insurance companies and health-care providers.But medical coverage (and Arkes is right that medical coverage is not really insurance in the traditional sense) has become one of a constellation of rights that developed in the twentieth centuryand not just in the United States. Let me borrow Arkess H. L. Mencken quoteif we are reluctant to buy the Cancer Salve, it must be because we want Uncle Julius to dieand add that this is in facttrue if the Cancer Salve actually cures cancer. Access to modern medical care cures ills; lack of access can cost people their lives; and the current market system does not provide adequate access. This is the situation that we find ourselves in. The real question people like Arkes should be asking is whether or not natural-law theory allows us to understand health care as a right.

You won't find either of these features in the magazine, so visit our homepage while they're both still front and center.

Matthew Boudway is senior editor of Commonweal.

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