Health care policy is one of those issues that should bring out the anti-democrat and anti-libertarian in normal conservatives. Democracy is clearly inadequate to the task: we have no choice but to rely upon experts, a managerial class, an "elite", and to hope they get it right. Libertarianism is unconscionable in that it denies the natural role of the state in fostering the common good.
With the passing of Obamacare traditionalist conservatives have a problem. We must oppose it for multiple grave reasons, but we cannot adopt the language of radical individualism, talk radio, or Ayn Rand without selling our souls. Last week I heard Dennis Prager practically shout at one of his callers: "I don't want a leader!" And there you have it, what has become the battle cry of the so-called American "right" - Non Serviam! - the drunken slogan of an ungovernable people. Prager went on to claim that the Old Testament did not place leaders over the Jews, nevermind the prophets, patriarchs, priests, judges, and eventually kings. Note well how libertarian ideology destroys the rational faculties of an otherwise intelligent man.
Language matters. Language changes us. We end up believing our own rhetoric. And here's the twist: our enemies end up believing it too, and they will one day use it against us.
So here are a few things I think we need to keep in mind:
1. "Coercion" is not a four-letter word. Laws are coercive. Taxes are coercive. The exercise of state power is by definition coercive.
2. Taxation is not "theft". Redistribution is not "theft". The state has legitimate power and authority to do both.
3. That Obamacare was passed along strict party lines means nothing. The problem is that it is bad legislation, not that it is partisan legislation. It has happened in the past, and will happen in the future, that good legislation is passed along strict party lines.
4. That a majority of Americans appear to oppose Obamacare also means nothing. The majority of Americans have not read the 1,700 page bill, and even if they had, most would not understand it. Good legislation should be passed even when opposed by an ephemeral "majority".
5. The state has an obligation to facilitate the common good, and that might include spending money on health care.
6. All people have a right to basic health care. That means someone has a duty to provide it. Traditionally, that has been the role of the Church and all Christians, with the supplemental help of the state. With Obamacare we are reaping the rewards of disestablishment.
Zippy has argued that, even though conservatives cannot embrace libertarianism as an ideology, it should nevertheless be the practical disposition of American conservatives given the wickedness of the present regime. I'm highly sympathetic to that line of thought. A libertarian regime would indeed be preferable to the secular totalitarianism which now threatens us. Still, I think we need to maintain a larger perspective. Christian civilization has more than one enemy, and the enemy of my enemy is not always my friend ...
Comments (56)
Jeff, I'm going to hang onto that point of agreement as a miser hangs onto his gold.
Posted by Lydia | March 27, 2010 9:42 PM
Lydia - LOL. Please do. There just isn't anything more I could add to what has already been said against this bill, again and again, without boring most everyone who reads this site.
Posted by Jeff Culbreath | March 27, 2010 10:13 PM
You could have been the first Catholic on this site to propose a concrete, affordable plan to make this "right to basic health care" a practical reality without walking all over the basic economic liberties of medical professionals.
That, in and of itself, would have been the post which sparked a thousand new comments on this site...
Posted by Mike T | March 27, 2010 10:21 PM
It would also be interesting to see a post describing how a society which is increasingly driven by government and economically unproductive jobs would sustain such a right. We all know that liberals believe that wealth, that thing which actually makes that "right to basic health care" theoretically possible, grows on trees which bear fruit biweekly. Conservatives are supposed to be hard-headed enough to realize that there are such things as economic hard rules which shouting "si, se puede" till we have permanently shifted the CO2 balance in the atmosphere cannot even budge.
For many young Christian men like me, this is yet another boot up our ass that prevents us from having a traditional household. See, your "right to basic health care" puts a crosshair over my paycheck which will make the difference between my wife being able to home school and us having to send our kids to an atheism-inducing liberal school in metropolitan DC.
You're damn right I resent that.
Posted by Mike T | March 27, 2010 10:33 PM
I mean, politically I'm an authoritarian all the way down. But that doesn't mean that just anyone ought to have authority.
Safety nets are another matter. (Though even with safety nets it is crucial be careful that the safety net does not undermine subsidiarity).
Posted by Zippy | March 27, 2010 10:39 PM
There seem to be some errors, or at least unsupported arguments, in Jeff's piece.
The biggest one is:
What a non-sequitur! The second sentence doesn't follow logically from the first: It is an unsupported assertion. Unsupported assertions are okay when they're items everyone already agrees with. But your second sentence in that quote is not a point of universal agreement, unless by "basic health care" you only mean "medical services to prevent death or disability in the event of an emergency."
Universal Agreement
All people have a right to whatever health care they can afford, because everyone else has a moral obligation not to prevent them from obtaining that health care.
Everyone agrees on that.
All people have a right to emergency health care to prevent loss of life or debilitating injury, because everyone else who spots a bloodied accident victim or a heart attack in progress or some other emergency situation is morally obligated to help rescue that person if they are able, and especially if they are doctors.
Everyone agrees on that, too.
The Area Of Disagreement: Relevant Questions
The disagreement is in another area entirely. That area is better delineated by questions such as:
1. If a person eats twinkies every day, and doesn't exercise, and as a result is morbidly obese and in danger of heart disease, are his neighbors morally obligated -- not permitted, but obligated -- to pay for his regular checkups and his cholesterol-reducing medicine? ...and,
2. Are some of his neighbors morally permitted to hire employees with guns to forcibly take money from the rest of his neighbors, to pay for said couch potato's checkups and medicine?
3. Let us say that our neighbor is morbidly obese and needs cholesterol-reducing medicine he can't afford, but not through any fault of his own, so far as we know. If he can't afford his medicine, are we obligated to help him provide it? ...and,
4. If some other neighbors of our obese-through-no-fault-of-his friend are not willing to chip in to help buy his medicine, are we morally authorized to force them to chip in at gunpoint?
There are, after all, some situation where the use of force is morally permissible. But we are not morally obligated to be enablers to everyone who lives unwisely (Item 1). And we are certainly not morally authorized to force others to be enablers (Item 2). And we are morally obligated to help the needy in general (Item 3) but that doesn't mean we're morally authorized to force others to do so (Item 4). That's quite another question entirely!
Government, as you note, is intrinsically coercive, all the time. The government is the paid servant of the people: They are our armed employees.
But that is why government's role in society is best reduced to involvement in only those areas where the use of force is morally justified. And Catholic moral teaching holds that there is a high bar for the authorization of the use of force: This is why the restrictions of the "Just War Doctrine" exist.
Two Examples
Let's say that Tom, Dick, and Harry are three guys living on the same prairie, outside civilization. Tom sees Harry being attacked by savages, and Tom knows he can save Harry's life, if only he had a gun. Dick has a gun, but is unwilling to part with it. Tom steals Dick's gun (planning to return it), uses it to rescue Harry and save his life, but the gun is destroyed in the process, and Tom lacks the money to pay Dick back.
Did Tom do the morally right thing? I think he did.
Now, let's change the scenario. This time, Tom, Dick, and Harry live in civilization; there are no savages, and Tom owns the gun instead of Dick. This time, Tom sees Harry is having trouble paying his rent. Tom, being a swell guy, gives Harry some money, but it's not enough. Tom goes to Dick and says, "Hey, Harry's in trouble, can you chip in?" Dick says, "Hey, I'd love to, but I'm sending my kid to Princeton and the tuition is murderous; I can't do it." Tom pulls out his gun and responds, "No, Dick, you're GOING to give Harry some money."
Is Tom morally justified this time? I don't think he is.
We are morally authorized to use force, and even to take property from our neighbors, to save lives. But a certain degree of emergency is contemplated. When that emergency is absent, so is the justification for the use of force: We are not allowed to go around robbing Peter to pay Paul, even if Paul is poorer than Peter, as a standard operating procedure.
A lot of Catholics like to lean on Aquinas' argument that the poor man may take bread from the rich man's kitchen to prevent himself from starving, even if it's not likely he'll every be able to pay the rich man back. But again, we are there talking about a kind of emergency situation which justifies the use of force to save life. Aquinas did not say the poor man could, as an ongoing regular state-of-affairs, set up a kind of militia or protection-racket to go and take from the rich man on a regular basis in order to store up bread against the possibility of the poor man going hungry at some point in the future. Force is authorized when starvation is at issue: But forcible provision of "hunger-care insurance" is not contemplated.
So, again, we ought to limit government force to areas where it is justifiable. In practice, that will mostly be to combat criminals who would prey upon the weak. There, the moral justification for force is clear, because the criminals are initiating force, and the government is only responding: It parallels the situation with Harry and the savages.
Not so, with the argument to provide health insurance.
Other Hurdles
But let us say, for the sake of argument, that we are morally permitted to forcibly transfer wealth from persons to provide health insurance for everyone. Let us pretend for a moment that that use of force is morally authorized, that it passes the smell test.
Does that mean that a Federal-level health care bill in the United States which obligates taxpayers to pay for "basic health care" for all is morally permissible?
Not necessarily. For now we are within the realm of American law, and the powers of Congress are limited by the U.S. Constitution. That Constitution is the employment contract for our "employees with guns." It states that any powers they legitimately possess are only theirs because we, our employers, had those powers to begin with and voluntarily delegated those powers to our armed employees. (10th Amendment.) Any powers we did not delegate to them are reserved to the states or to the people.
As a matter of historical fact, the power to rule the health care system, or to provide health care, or to require coverage, or anything similar, is not among the powers granted to Congress. It logically must therefore reside in the states, or in the people.
This is actually a very good thing since it's in line with Catholic notions of subsidiarity: A program of this type is more likely to cause evil when implemented by the Federal government than the states or even localities, who will more naturally be able to deal with local issues. Functions should be carried out by the lowest level of organization capable of doing the job. The states themselves may be too high a level, but at least they're preferable to centralizing all the bureaucracy in Washington D.C.!
But putting subsidiarity aside for a moment, we have to admit that Federal encroachment on the authority of the states and the people has produced some nasty results already in the area of health care; e.g. abortion. Were the Constitution being followed with any semblance of attention to the intent of its authors, that would never have happened. It is only by interpreting the Constitution in crazy, anachronistic ways that many Federal programs have avoided their just fate of being declared null and void in the courtroom. Obamacare is in that same category; we can only hope that it will be declared a nullity where they were not.
So there are plenty of reasons to support national-level health care stuff: 1. We the people have no just authority to use force for such a purpose, and as such have no just authority we can delegate to our employees, the government; 2. It's an illegal usurpation of power by Congress; 3. It violates subsidiarity.
I would add that 4. It's unwise inasmuch as it puts us into huge unpayable debt; 5. It's unwise inasmuch as it creates perverse incentives to live unhealthily or to buy no insurance until one gets sick; 6. It's unwise inasmuch as the aforemention incentives, when acted upon, will bankrupt all private health care and insurance providers, leaving a government single-payer option as the only way to rescue the system; 7. After the system is replaced by a government single-payer option, those same perverse incentives from #5 will cause expenses to rise so far that rationing of care will begin; and 8. Even if there is no rationing of care, all we taxpayers will be paying for abortions, sex-change operations, and the like.
But items 4-8 aren't particularly responses to your original note; I mention them only in passing.
A Final Note
You mention: "That a majority of Americans appear to oppose Obamacare also means nothing."
Well, it doesn't mean much, in a Constitutional Republic. But it doesn't mean exactly nothing.
You see, as I stated above, the Constitution does not grant authority to the Congress to do the kinds of things it is doing. But one could argue that employers (We The People) do have a right to alter the terms of an employment contract with their employees, to give those employees more leeway.
If we start from assuming that the people, in and of themselves, have just authority to forcibly take money from their neighbors to buy, not emergency health care in a life-and-death situation, but regular maintenance health insurance -- and I find myself rolling my eyes at that risible notion, but I'll continue -- I say, if we start with that assumption, then one could argue that the people, in this instance, wished to change the terms of the employment contract to allow the government to wield that authority on their behalf.
Granted, if we were doing things by the book, that would call for a Constitutional Amendment. But stay with me: My point is that if the people really did want Obamacare, it would be slightly closer to being justified by virtue of being an expression of the employer wanting to grant more authority to his employees.
Not justified, really. Just somewhat closer to being justified.
But we don't even have that. The people mostly oppose the bill. That fact means that Obamacare proponents can't even honestly say that their arrogation of power expresses how the people want their Constitution interpreted...which is about their only fig leaf of justification, anyway.
So, as I said, the polls aren't entirely meaningless. They serve as yet another indicator of how credibility-free the whole Obamacare exercise is.
Posted by R.C. | March 27, 2010 11:05 PM
As I think should be obvious, when I said "So there are plenty of reasons to support national-level health care stuff" in my previous piece, I meant to say, "So there are plenty of reasons NOT to support national-level health care stuff."
Sorry for the blunder.
Posted by R.C. | March 27, 2010 11:11 PM
All people have a right to whatever health care they can afford, because everyone else has a moral obligation not to prevent them from obtaining that health care.
Everyone agrees on that.
All people have a right to emergency health care to prevent loss of life or debilitating injury, because everyone else who spots a bloodied accident victim or a heart attack in progress or some other emergency situation is morally obligated to help rescue that person if they are able, and especially if they are doctors.
Everyone agrees on that, too.
I agree with the first but not the second.
No matter the circumstances, no one may presume upon the charity of others even in the greatest extremity.
Private charity is capable of providing for the poor. If not, then too bad.
Health care is no more a right than shelter care, food care, clothes care, education care, computer wifi care etc.
Jeff, you'll have to study up on the Impassivity of God. God has no more problem with you starving to death because you're broke in a land of plenty or dying in a field from untreated cancer than he has a problem with a seven year old girl being snatched from the street and raped and brutally murdered. It is the world He created for us to enjoy, so to speak.
We cannot "fix" this world by stealing other people's money and coveting their goods and services, we have a hard enough time trying to provide for our own families while trying to keep monstrous thieves from stealing the fruit of our labor. The barbarians are always at the door and among us as it is.
Because we once had liberty and could trust in Law (generally), we created wealth which gave us the freedom to be generous and kind.
The State only exists to do what we want it to do, and if what we want is not severely limited then all hell is loosed upon us.
Posted by mark Butterworth | March 28, 2010 12:43 AM
Health care is not a right any more than health is a right.
There is no right to good teeth, or to a dentist's services in trying to get them; no right to being measles free or to a doctor's services when you get them, no right to good eyesight or to having bifocals in order to get it; no right to a cabinet full of aspirin or Zicam when you have a cold or a headache; no right to intestinal surgery if you have appendicitis or to a surgeon's skill when it happens -- and especially at others' expense.
Please, don't go around inventing rights and then cooking up schemes to coerce folks to pay for your inventions or imaginary obligations to supply them via government.
Posted by Michael Bauman | March 28, 2010 1:00 AM
QUOTE:"6. All people have a right to basic health care. That means someone has a duty to provide it. Traditionally, that has been the role of the Church and all Christians, with the supplemental help of the state. With Obamacare we are reaping the rewards of disestablishment."
1. All people have a right to basic health care - this is a claim unsupported my any moral or philosophical argumentation.
2. That means someone has the duty to provide it - there are negative rights and positive rights. Negative rights don't require anyone to provide them - only to not impinge on them.
3. Christians have a moral duty - not a legal duty. Much different things
4. The rewards of disestablishment - no, the rewards of a failed moral education as to the the role of the state and the role of charity.
Posted by Alan M | March 28, 2010 1:17 AM
Let me put my money where my mouth is. I'm a guy with a classic pre-existing condition. Right now, the drug I inject every two weeks costs about $700 a shot. $1400/mn. That's about $17,000 a year.
The day may come when I don't have insurance or the Death Panel says it costs too much, whatever. The day may come when I can't afford it and no one will provide it.
That's my tough luck.
And you can't begin to imagine what happens to my body when I can't keep my condition under control. Agony and suffering doesn't begin to touch the matter.
It's also my tough luck that this current drug may become ineffective in the future. Again, my tough luck. Or that they create a drug that works but I can't afford it.
I simply have no right to try and make other people take care of me. I will just have to suffer and pray to God for mercy and compassion.
And I must say, I have enjoyed a great deal of mercy and compassion in my life. Far more than I could ever deserve if things are put in the balance.
Posted by mark Butterworth | March 28, 2010 1:35 AM
Or, as a matter of basic justice, do not put a crushing burden on the productive.
The biggest issue that Jeff, Maximos, M.Z. and others here have failed to address when waxing eloquent about "rights" with regard to health care is the practical matter of implementing them without permanently jacking the productive minority with such debilitating taxation that they never see most of the fruits of their own labor.
My generation, plus Generation X, are simply too small relative to the Baby Boomer generation to provide it with the "basic health care" it largely believes is its God-Government-granted right. We are also a country that does substantially less manufacturing and substantially more government, non-profit work and other things which are either a drain on the wealth production that might hypothetically enable this "basic right" or are economically neutral toward the same end.
I can speak for a number of young Christian men I know on this matter when I say that as far as I am concerned, I have no moral obligation to support the "abortion generation" in the lifestyle it has become accustomed to having (and didn't save enough money to continue having, or lost through casual divorce).
Posted by Mike T | March 28, 2010 6:35 AM
I'am guessing the line about Coercion was addressed at me for what I said in another post.
The reason I used it in this situation on Healthcare was the goverment is forcing you to buy a product, not just pay taxes, and if you refuse to buy the product you get fined. If the goverment can force you to by products it can force you to do anything.
This is not like car insurance for instance. Everybody needs to go to the doctor. Not everybody needs to drive. If you don't want to drive or can't afford it then you don't need car insurance, but everybody needs Medicine and uses medical faculties so there's no way of getting out of this.
What if a person doesn't want medical insurance but wants to pay for medical care with cash when he needs it, the individual mandate requires people to do something, simply by virtue of existing, it also limits the freedom of health insurance companies to sell goods and services meaning they will have to raise costs (because of the people with pre-existing conditions and the people who just don't take care of themselves, now added on to there books) and pass it on to everyone else.
Posted by The Phantom Blogger | March 28, 2010 7:43 AM
Posted by Zippy | March 28, 2010 9:26 AM
But in the words of the prophet Iron Maiden, "your time will come".
Posted by Zippy | March 28, 2010 10:18 AM
It is only by interpreting the Constitution in crazy, anachronistic ways that many Federal programs have avoided their just fate of being declared null and void in the courtroom
While what I am going to write is not off topic it might seem to some that what I am questioning represents only a tangential point of personal interest for me.
In any event, here goes.
Why is it that only The Judicial Branch is thought supremely authoritative when it comes to issues of Constitutionality?
If we the people have created three co-equal Branches of Government, then it seems to me The Executive Branch and The Legislative Branch have equal authority in declaring any action Unconstitutional.
And, if it did work that way, wouldn't it be the case that the Govt would be more representative of we the people because, in effect, we the people (the true interpreters of the Constitution)would have the power to settle captious Constitutional quarrels via the Franchise.
Written otherwise,when The SCOTUS took their tyrannical Unconstitutional decision on Roe V Wade, Nixon could have declared their decision Unconstitutional and declared it null and void. And so could have The Legislative Branch.
And then we the people could have decided the issue via The Franchise in either returning Nixon to Office or keeping the Legislature the same party.
But, if only The SCOTUS has the authority/power to make that declaration than it is indeed THE Supreme Power in these United States and, because they never stand for election, they, and not we the people, are the sole interpreters of what The Constitution means.
That, to me, seems insane but because I am an autodidactic crank when it comes to these matters I'd appreciate being set back on track if I have wandered too far out into the boonies.
Thank you.
Posted by I am not Spartacus | March 28, 2010 10:28 AM
It is unconstitutional. If the federal government itself will not obey the law, "why should I obey the law?" (Personally I will obey the law regardless but it's a good question that any bright teenager should be expected to ask).
The U.S. constitution does not forbid the individual states from enacting health care, and competition between them could help ensure that they are good health care schemes. For example, Wisconsin's BadgerCare and Minnesota's similar plan would effectively cover the uninsured gap if they were only expanded a little.
Posted by Steve P. | March 28, 2010 11:13 AM
So no matter what the level of taxation it cannot be theft? The Lord demands 10%, yet the State can demand anything?
Posted by Joel | March 28, 2010 11:16 AM
I do think that Phantom Blogger's point about coercion was well-taken as a response to the "Obamacare is constitutional because it's just part of the income tax" silliness. That point is related to the point about enumerated powers that I made in a different post. Fortunately, Jeff is not defending this federal legislation as federal legislation.
Of course, everyone will guess that I'm by no means as authoritarian-inclined as some of my fellow bloggers here. Even if we were ruled by some benevolent Christian monarch, I would think it an imprudent idea for him to try to control the entire healthcare industry, to pay for all the healthcare of the poor by way of taxes, and the like.
I also think that the answer to high prices and shortages is more freedom of exchange and that in all likelihood a big part of the reason for high healthcare prices now is the removal of the economic connection between provider and patient. If we had lots less insurance, I suspect prices would come down quite a bit. People would also get fewer checkups, but that would be up to them, just as, say, whether or not to buy healthy foods like salad is now up to them. From a purely economic standpoint, the present legislation is thus, from my perspective, going in _precisely_ the wrong direction. As I said on another thread, there are two sets of ideas going around about what is wrong, economically, with healthcare, why it is so expensive, etc., and what the best way is to "fix" it, and I suspect they are utterly incompatible sets of idea. As with the provision of anything else important--food, for example--I'm going to side with those who think we are in the long run doing the poor no favors by royally messing up the whole system in order to increase their demand for a product by giving the perception that it can be provided in huge quantities ex nihilo and for free.
But since I am unlikely to get much agreement from some of my fellow bloggers either on the point regarding centralized power and authority generally or on the economic point about the best way to provide what is needed, I fall back on and am grateful for the agreement on a different prudential point--namely, the madness of the present legislation in terms of _who_ is getting more power and _what_ they are likely to do with it. That seems to me to be a point around which a coalition can be and has in fact been already built and can be sustained.
Posted by Lydia | March 28, 2010 1:00 PM
I should add that _for the sake of_ the poor and _because_ of the importance of healthcare, I think it _especially_ important that it be more freely exchanged. I truly believe that free markets are the best way to keep prices for goods and services lower than they otherwise would be and to keep them widely distributed and available, to, in short, best help and raise up the poor. If we created an entitlement to a luxury item like, say, Merino wool and ended up with wool shortages, at least it wouldn't be that big of a deal. And the appetite for healthcare, especially given the continual urgings and naggings of the elite to access _more_ healthcare, have _more_ checkups and prevention, etc., is far greater than the potential appetite for Merino sweaters. The consequent problems for everyone in a very important area are precisely the economic reasons why I oppose its further socialization and further entitlements in that area.
Posted by Lydia | March 28, 2010 2:28 PM
The biggest issue that Jeff, Maximos, M.Z. and others here have failed to address when waxing eloquent about "rights" with regard to health care is the practical matter of implementing them without permanently jacking the productive minority with such debilitating taxation that they never see most of the fruits of their own labor.
This is a bit disingenuous. The focus of discussion has been on the immorality of even providing benefits. Given that we spend twice as much on health care as nations with universal health care schemes, I'm certainly not going to accept prima facie that we would need debilitating taxation.
And this subtle going Galt thing is absolutely hilarious.
Posted by M.Z. | March 28, 2010 3:13 PM
Well, Culbreath, you just came out and stole all my thunder! No matter, you've probably done a better job of carrying it off than I ever would have.
I'll add just a few points of emphasis.
(a) It is hardly surprising that traditional Catholics and conservatives would readily admit that rule-by-the-few is prudent and necessary sometimes! What I was hoping to do was show some of our dear liberals that they are rule-by-the-few men themselves, when it suits them. One liberal (who, it must be said, has been rather elusive lately) read me a sharp lecture some weeks ago for even daring to treat rule-by-the-few as an open question "in the 21st century."
(b) Jeff is, in my view, too dismissive of the majority. I think a majoritarian doctrine with a specific sort of majority in mind is compatible with the a natural law system like what Thomists have bequeathed to us. Recall, as Chesterton was wont remind his readers, that the monarchy was in many ages assumed to be the vindicator of rightly ordered majority will. Before the triumph of the liberals, with their natural rights levellers' creed, the people's will was to disciplined and refined and applied through the agent of the king. He would embody the virtue and piety of the people, not their passions.
(c) Which is why I would suggest to liberals what I have hinted before: there are other options besides liberal democracy, besides wants-based rule-by-the-many, and they may be worth revisiting, even now in the 21st century.
Posted by Paul J Cella | March 28, 2010 4:51 PM
As I have said before in my infrequent comments here: we live in messy reality; there are no utopias. Whatever libertarian thinking cannot solve, be sure that statist thinking also has its problems. Our task is to choose the more honest stance, and accept its inevitable shortcomings.
First in order is to plainly admit the truth about taxation. It may be inevitable, it may or may not be beneficial, but it most definitely is theft, by any non-convoluted definition.
Second: the legitimate authority of the state, in your view, I assume, derives from Romans 13 and the fact that the state exists everywhere and always. In my view, what is inevitable is not necessarily legitimate. Sin and evil are inevitable but they are not legitimate. The entity of the state is astronomically by far the most efficient stealer, killer, and destroyer (take your pick of what!) on earth. The state, whatever our fantasies about it may be, is evil in practice. This not the place to propose an alternative or at least a way of thinking about the issue, but that is not the point. We must face the facts and reckon with them if we are going to be honest about the fundamental insoluble problems we face on this fallen earth.
As for Romans 13, the letters of the Apostle Paul being the foundation of the Christian theology, it is useless to debate that topic in this forum. It is more profitable to examine the exact meaning of the words of Jesus to "render unto Caesar".
Anyone who is interested in a reasonable libertarian view of the state can safely ignore anything Ayn Rand says. Her harsh and shortsighted ideology leaves the same bad taste in my mouth as that of John Calvin. I recommend instead the lively essay "Anatomy of the State" by Murray Rothbard.
Posted by fironzelle | March 28, 2010 6:01 PM
This post really tries my patience, so I should probably just shut up and let it ride, as I have with pretty much everything else written about health-care by our local reflexive authoritarians, lately. But one can only take so much.
"[In] health care policy...we have no choice but to rely upon experts...and to hope they get it right."
Take out the word "policy" from that claim, and insert the word "sometimes" between "we" and "have," and it might almost be defensible. But, as it stands, it is not only false - it is pernicious.
Look, Jeff. There are mountains of material available on the potential advantages of "consumer-driven" healthcare. Have you ever read a word of it? The fact that you select Ayn Rand (!) and Dennis Prager (!!!) as your examples of "libertarian" thought in this area strongly suggests to me that you have not.
Posted by steve burton | March 28, 2010 6:26 PM
[taxation]...is theft, by any non-convoluted definition...
A fairly common definition of theft is an unjust taking. Needless to say I have difficulty saying how taxation fits in there.
Posted by M.Z. | March 28, 2010 6:52 PM
M.Z.:
The power of taxation is delegated to the Congress in the U.S. Constitution for the purpose of funding the work of the Federal Government: But the early articles of the Constitution spell out what the work of the Federal government is to be, and the 10th Amendment limits the work of the Federal government to just what is spelled out in those early articles, by giving voice to the enumerated powers doctrine.
Taxation may be just when it is executed for the purposes for which the people authorized it when they hired this cavalcade of armed hired hands we call "government." But taxation will become unjust when the collected revenues are used for purposes not contemplated by the framers of the Constitution. (Note: I do not say that this is the only way that taxation can become unjust; I am only saying that it does become unjust when used in this way.)
And that has increasingly been the problem in the United States since the court-packing extortion of FDR ripped constitutional jurisprudence forcibly away from the intent of the framers. We the People had a contract with our employees which authorized them to use our money as a resource for their duties, but only for the purposes we specified in their employment contract (the Constitution).
But what they have done is take rather a lot more of our money than needed for those authorized purposes, and when we look into what they've been doing, we find the extra funds have been used for activities we never authorized. Our current situation reminds me of a quote from the movie L.A.Story, in which Steve Martin finds out that his agent has been having an affair with his girlfriend for three years. Shocked, he exclaims, "I thought he was only supposed to take ten percent!"
So taxation for unconstitutional purposes is an unjust taking inasmuch as it is used for activities for which the government has no just authority.
However in general, apart from that exception, I agree with you: Taxation when used for the common defense and other duties as enumerated in the Constitution is in no way unjust: It is necessary, and it is authorized by the Constitution.
Posted by R.C. | March 28, 2010 8:05 PM
I have repeatedly attempted to bring in various aspects of morality which you and others wouldn't concede, such as the subsidizing of sin, whether it is moral to overburden one group or another and to what extent the public can lay claim to the labor of the medical profession and its supporting industries.
Those countries also tend to rely on medical procedures, drugs and devices invented in the (once free) American system. When you don't do much of your own R&D, of course it's cheap. It's the same reason why the Chinese are able to build cheap products.
A very revealing comment...
There are many ways to starve the leviathan. I choose to starve it by releasing my personal work under the GNU GPL. The GPL is brilliant in that the only people who can profit directly from GPL software are those with the technical skills to modify it.
Posted by Mike T | March 28, 2010 8:07 PM
Suppose you are taxed until you can literally no longer support yourself on your own labor. Suppose you are an elderly individual and your property taxes are raised to the point where you are throw out of your house and watch as it is sold for pennies on the dollar at public auction.
Most of us would call that the moral equivalent of theft.
You, I suspect, would console yourself in the belief that your benevolent provision of a welfare safety net and public housing would repay your sin in enabling those situations.
Posted by Mike T | March 28, 2010 8:12 PM
Germany is still doing major drug research. Most of our drug research is done through federal grants. I'm sure you already knew all of that though. It would be nice if you could actually make a substantially correct claim every now and then. Capitalism is and always has been very poor at R&D. Even the shining examples like Bell Labs are from monopoly exploitation or from government contracting like IBM.
Posted by M.Z. | March 28, 2010 8:26 PM
One thing that always bothers me greatly in people who defend more, mostly, or entirely socialized medicine is the disingenuousness with which they declare that "anyone can still buy additional health care with his own money if he wants to." What, know ye not that this is _already_ not the case, even pre-Obamacare? If a doctor treats any Medicare patients (I believe it's within a two-year period) and accepts Medicare payments, said doctor is not permitted to charge more than the Medicare-approved rates, even for other patients. Most people don't know this. The doctor has to stick within the overall Medicare guidelines for care for _all_ his patients over the age of 65, including those on employer health plans. So _everybody's_ care is rationed, unless you can find a doctor who is not involved in the Medicare system at all, which is unlikely, because most doctors can't make it that way. National Right to Life fought this one for several years explicitly, but a doctor I've interacted with on-line assures me that this is how it is, so evidently they lost that battle.
In general, when the government gets its claws into the healthcare industry, it is _very_ difficult for any sort of ordinary, middle-class people to get around that. Their money is heavily taxed to pay for the socialized and overburdened system, leaving them less money in the first place with which to pay for medical care outside of the system. (Compare the education system in America, wherein people who wish to send their children to private schools must pay double.) But worse, and even worse than the educational situation, in medical care it is extremely hard if not impossible to find doctors, much less whole medical facilities, that operate outside of the system within their country. That's why even the rich in Canada come _here_. It's not like there's all this high-quality, speedy medical care just available to them in Canada if only they are willing to add their own money on top of the state funds. It does not work that way.
I wish people would stop talking like it does. And this is closely related to the justice/injustice issue. Forcing everybody or nearly everybody, forcing all ordinary folks, into a lower-quality, totalizing system _is_ unjust.
Posted by Lydia | March 28, 2010 8:31 PM
Germany is also the strongest export-driven economy, adjusted for its size, in the West. It's rather telling that they, Switzerland and the United States, an export-driven market socialist economy and two fairly free market economies with much smaller social welfare nets in health care, are the drivers behind it.
While we're on the subject of federal involvement in R&D, I'd like to point out that left rarely acknowledges that most of the technology it attributes to "the government" as a sign of the superiority of that system actually came specifically from the military-industrial complex.
Lastly, while we're on the subject of R&D, I'd like to point out two errors of omission on your point:
1) Most product development in technical fields is itself a form of R&D and yields advances.
2) The other half of the equation in medical research are devices, something which I have yet to a see a liberal credit primarily to federal funds.
Posted by Mike T | March 28, 2010 8:49 PM
Jeff's polemic may well be the most foolish thing I've read at this site - on its face. Smarmy self-righteousness masquerading as moral superiority with no cognizance whatsoever of the extended ramifications of such abject ignorance.
Posted by Doren Hagen | March 28, 2010 9:35 PM
You surely haven't read much on this site, because I know I have written far more foolish things than this.
Posted by Paul J Cella | March 28, 2010 9:47 PM
Doren Hagen - lest you think that "smarmy self-righteousness masquerading as moral superiority with no cognizance whatsoever of the extended ramifications of such abject ignorance" is the rule, here, please check out my previous comment, and my latest post.
Posted by steve burton | March 28, 2010 9:54 PM
Several readers have objected to my stating that "all people have a right to basic health care". Personally, I have an inherent aversion to the language of "rights", which too often generates more confusion than clarity. Nevertheless, such language is occasionally employed by the Church, so its legitimacy must be admitted even if sometimes imprudent or unhelpful. Pertinent to this discussion is the encyclical Pacem in Terris of Pope John XXIII (also mentioned in another thread):
Straightaway, we can see from this passage that the Church is not using "rights" in the sense of something that must always and everywhere be guaranteed by the state. The right to life? All men die. Some are even called to die in the line of duty. The right to bodily integrity? Some are born without limbs, others must have them removed. The right to security in the case of sickness? Sometimes illness just has its way.
The Church tells us elsewhere that all children have the right to be born to married parents. But of course, children continue to be born out of wedlock, and the state cannot compel anyone's marriage. Rights exist because duties exist (e.g., the duty of men and women to be married before conceiving children), and those duties are not always, or even usually, the duties of government – except in a supplementary way. Neither are these rights absolute: there is no possibility of government being their guarantor.
But the state can help to foster a society in which these rights are not systematically violated or institutionally neglected.
I think we should look at basic health care in the same light. Leaving aside for the moment the question of how "basic health care" is defined, the state’s role in securing this right is naturally supplementary. When family, community, and religious organizations are healthy and doing their job, state intervention will be minimal. At other times it will be more necessary. But the state’s legitimate role is never an usurpation of the duties proper to subsidiary institutions or a displacement of the institutions themselves.
What we have with Obamacare is another giant leap toward usurpation and displacement. It must be vigorously opposed. But it must not be opposed in such a way that closes the door to genuine reform.
Posted by Jeff Culbreath | March 29, 2010 2:42 AM
I associate myself with Culbreath's remarks.
Posted by Paul J Cella | March 29, 2010 4:30 AM
Mike T., you wrote:
I don't have a plan. Sorry. I just finished cleaning out a chicken coop this evening - literally. Health care policy isn't my strong suit. Which is why I don't have much to say about it other than: 1) The present system needs fixing; 2) Obamacare will make things worse; 3) I don't like the manner in which some people are opposing health care reform.
That's just malarky. I imagine that abolishing, say, the federal Department of Education would release enough money to fund the basic medical needs of the uninsured. If not, I'm sure we could find another federal department or two to abolish. But I don't really want the feds involved in healthcare at all, for reasons of both constitutionality and subsidiarity. Perhaps the states could individually, and maybe collaboratively, provide a health care "safety net" for their citizens, preferably working through religious organizations and non-profits. But that would require citizens who care something for the common good, are willing to help people they don't know, and who do not hold that taxation is by definition "theft".
Posted by Jeff Culbreath | March 29, 2010 4:33 AM
And I with yours, Paul. But I have to confess myself the lightest of lightweights on this topic.
Posted by Jeff Culbreath | March 29, 2010 4:40 AM
Paul Cella, you wrote:
Oh, absolutely true. A little intellectual honesty on this would be nice, but don't hold your breath.
I don't think we disagree at all. The Gallup or MSNBC poll "majority" is light years removed from the "rightly ordered majority" of the disciplined, refined, and well informed.
Posted by Jeff Culbreath | March 29, 2010 5:12 AM
Lydia, you wrote:
Yes, indeed. I fall back on this as well. In the case of libertarian-ish conservatives such as yourself, traditionalists can "do business" with you without too much compromise.
Posted by Jeff Culbreath | March 29, 2010 5:33 AM
Oh, really?
$46.7 billion (+12.8%) – Department of Education
Source: http://en.wikipedia.org/wiki/2010_United_States_federal_budget
Read the rest of the budget and you'll see that it isn't even remotely that simple.
Now, if we just means-tested Social Security so that retirees with pensions and significant retirement assets would not qualify...
Posted by Mike T | March 29, 2010 7:18 AM
Given the behavior of the left, I think we have to rule out the state's involvement on a regular basis as its function here is almost invariably predatory on those other institutions. M.Z. has pointed to examples where the Catholic Church could not raise enough funds to pay for the medical costs of its own priests, nuns, etc. as proof that religion has failed here.
To me, that is simply a sign of probable impiety on the part of those Catholic communities. As far as I am concerned, for any church to continue to emphasize caring for the poor over fighting that spiritual malaise is putting the cart in front of the horse. The effect there is self-reinforcing. The church declines, the state picks up the slack. The people see the state doing the church's job and see it as vestigial. The church declines...
Posted by Mike T | March 29, 2010 7:28 AM
Some food for thought on Obamacare, socialized medicine and prices: http://market-ticker.org/archives/2131-So-The-Government-Doesnt-Like-Consequences.html
Posted by Mike T | March 29, 2010 9:01 AM
Just a side note. I was recently reading International Planned Parenthood Federation's statement on sexual rights. I saw the language that they were against "coerced" child pornography, but darned all if I could find anything in it that said that child pornography was wrong in and of itself. It seemed like the phony doctrine of consent in all its glory.
Posted by Scott W. | March 29, 2010 11:18 AM
coerce : to restrain, control, or dominate [did he say "dominate?], nullifying individual will or desire, as by force[ does he mean fines and jail sentences?] power, violence or intimidation. Maybe you have a different dictionary, give it a shot.
And on and on.
The will of the people, or a majority, means nothing, I have to remember that one. It does seem that with a change in regime a lot of so called truths have vaporized. The people didn't read it, neither did Congress. But people are reading it now.
Culbreath's basic line is that because certain things are done, taxes for example, then certain other things can be done, that an A presupposes a B, and regardless of nature and scope, that stated as is, limit is irrelevant, infinity opens it's gaping doors.
And if people have a right to health care, then one would [foolishly]presume that people, other people & not fit for our pity, should have the right to choose and manage their own health care . Guess not, and a strange "right" to health care it is.
This is just a dazzling morality.
Posted by johnt | March 29, 2010 3:38 PM
"...Taxation is not "theft". Redistribution is not "theft". The state has legitimate power and authority to do both..."
Pardon me, but other than it's aesthetic structure and/or appeal, do you seriously think you're telling us something here?
Most people who'd read this know full well that the state has the 'legitimate power and authority' to tax and redistribute. The issue isn't whether or not the state has the power; the question is whether the state has the right. And 'both' can most certainly become 'theft' when the 'power and authority to do both' is abused.
Is yours a legitimate post or simply an intellectual exercise? And I don't mean to sound sarcastic with that question.
Posted by Guest | March 29, 2010 4:53 PM
1. Laws are necessarily coercive, but their legitimacy depends upon the majority consent of the people either directly or through representation.
2. Taxation is not theft if kept under an income-dependent limit, i.e. progressive taxation up to a certain threshold.
3. Partisanship is one thing, scorched earth obstructionism is another. The Republicans gambled everything and they lost.
4. The ephemeral "majority" opposes it in part because it does not contain a public option.
5. Libertarians deny the existence of a common good.
6. With Obamacare, a few religious communities are exempted from buying insurance.
http://www.opencongress.org/articles/view/1448-Amish-and-Other-Religious-Groups-Exempted-from-the-Individual-Mandate
Posted by Step2 | March 29, 2010 6:56 PM
1. Laws are necessarily coercive, but their legitimacy depends upon the majority consent of the people either directly or through representation.
No, they're not either. This country is not a majority-ruled Democracy. We're a Constitutional Republic. The legitimacy of a law is how well that law addresses the common good of the public--and we've been informed by our Representatives, and by our own research, that the law is not good legislation.
One positive aspect of this abomination of an administration is a renewed interest in Constitutional Law. Indeed, Obama has brought the country together; just not in the manner he he had hoped.
Posted by Guest | March 29, 2010 7:30 PM
Wow. If those propositions are derivable from Christianity, let no one wonder why I am not a Christian.
Posted by tehag | March 30, 2010 5:18 AM
Step2, if I may, libertarians do not deny a common good. What they deny is the efficacy of a common good, or the presumption of a basket of common goods, founded in centralized power. Power does exist, doesn't it? And so does commonality among persons, the question is, how best to serve or develop this set of conditions.
And whatever did happen to choice and privacy?
But enough. Step2, I have a deal for you. I have a great new car that you might be interested in. I'll sell it to you. You pay me every month for the next four years and at the end of that time you get the car.
How can you go wrong?
Posted by johnt | March 30, 2010 9:36 AM
Oddly no one appears yet to have made what to me was a very obvious modification:
Posted by anonymous | March 30, 2010 4:32 PM
Well everyone can't have a responsibility to pay for health care. Small children, for instance, have no way to buy their own healthcare and must be provided with it. Who must provide it is the question...in this case the answer is obvious--the parents. Similarly, past a certain age the elderly are likely unable to pay for their own health care as well, and their children are responsible for it. If you are capable of working and paying for health care, then it is your responsibility to provide it. If you have a stay at home spouse, then you must provide healthcare for them. In some cases, a parish or other community should provide healthcare for a member should they be unable to.
So on and so forth. There are difficulties, but the left's error is not that people have no right to health care, it's in insisting that this right is binding upon everyone such that there is no particular party that is solely responsible. In trying to make everyone responsible, no one is ultimately responsible, and responsibility itself suffers.
Posted by Matt Weber | March 30, 2010 5:53 PM
That, and the fact that the left doesn't expect people to not be burdens on others if they can arrange their lives that way. Whatever it may say on the matter to that effect is contradicted by its actions.
The fact is that everyone has a responsibility to save for their twilight years, to save money to support their family in bad situations and things like that. One of our serious problems is that people don't do much of that anymore because they know they can rely on others to foot the bill.
Posted by Mike T | March 31, 2010 9:03 AM
Wow. If those propositions are derivable from Christianity, let no one wonder why I am not a Christian.
Wow it's easy to smell rotten eggs. Now try laying a better one.
Posted by Scott W. | March 31, 2010 9:20 AM
I don't know about the rest of you, but I was wondering why tehag was not a a Christian. Matter of fact we had a big discussion around the dinner table last night about that.
I'm still wondering, so do the millions, arms outstretched, crying, "tehag, speak to us".
But our cries go unanswered, and we wander in the dark.
Posted by johnt | March 31, 2010 11:08 AM
"Wow it's easy to smell rotten eggs. Now try laying a better one."
Okay. Maybe later. How 'bout not forcing me to eat the rotten ones (UHC) in the meantime.
"Matter of fact we had a big discussion around the dinner table last night about that"
I'm sorry to discover your world is so circumscribed that my life is interesting to you. I'm worked hard not to become so.
Posted by tehag | April 1, 2010 7:55 AM