The Long Reach of Obamacare
The entire country, including and especially the blogosphere, is ablaze with commentary, debate, and verbal warfare over the merits and potential consequences of Obamacare’s passage into law on Tuesday. Among us Catholics debate has been particularly intense, since the American Church played a key role in opposing Obamacare due to its anti-life provisions, though I can’t say that I agree at all with the bishops when they suggest that the bill was otherwise acceptable.
I opposed, and continue to oppose Obamacare for many reasons, abortion funding being only one of them. Indeed, while the absence of the Hyde language from the bill is certainly troubling, the truth is that Catholic taxpayers have been funding “medically necessary” or “exceptional” abortions at the state level through Medicaid for decades – abortions which are still offenses against life according to the teaching of the Church. Some Catholics have also been doing so through their participation in private health care plans that cover abortion. In modern America, we may as well forget about any kind of meaningful “conscience protection.”
It occurs to me that there are – among several others – two major problems that I have not seen adequate coverage of in the news that will result from Obamacare, though I admit, I can’t read everything, so if someone can direct me to analysis of these issues, I would be grateful.
The first is what I believe will be the transfer of a problem already faced by private health insurance, particularly when it is provided directly by employers, to the federal program. Recent years have seen more companies, in an effort to control health care costs, take measures against smoking in the workplace, from educational campaigns to outright bans – the legality of which has been challenged in some states. It doesn’t stop with smokers either; people who engage in any sort of unhealthy or risky behavior could become a financial burden on the system, from over-eaters to people who need to play extreme sports every weekend.
This situation is hazardous enough already at the level of private health insurance, which a person is free to purchase or not purchase, or to make the choice between cheaper coverage and the risky behavior that necessitates higher premiums. How will this play out in a system that everyone is forced to participate in? Is there any reason we shouldn’t expect, at some point in the future, the federal government to attempt to regulate personal behavior using the same logic? Though the Obama government doesn’t seem to care one bit about costs and spending, future governments will be faced with this problem as well, if this bill remains law. Who is to say what a future administration will deem necessary in order to control health care costs?
This brings me to the second problem, a ticking time-bomb of health care: the severe health crisis of this nation’s youth, from childhood obesity and related illnesses to mental health problems, all of which have skyrocketed over the past few decades. One report states:
In the past 30 years, the occurrence of overweight in children has doubled and it is now estimated that one in five children in the US is overweight. Increases in the prevalence of overweight are also being seen in younger children, including preschoolers.
On the mental health front, this list breaks down the various disorders commonly found in children these days. Among the most serious problem is Attention Deficit Hyperactivity Disorder:
It is estimated that between 3 and 5 percent of children have ADHD, or approximately 2 million children in the United States. This means that in a classroom of 25 to 30 children, it is likely that at least one will have ADHD.
The abysmally poor health of increasing numbers of American children could make this entire program more unsustainable than it already appears to be. It’s one thing to have universal coverage when the vast majority of citizens are generally healthy. Take Japan for instance – culturally homogeneous, politically stable, economically restrained – its life expectancy is the highest in the world, due in part to the excellent diet and nutrition provided by Japanese cuisine. In that context, universal coverage makes sense.
It is another thing to have universal coverage in a culture that is saturated with countless threats and risks to both the body and the mind, many of which are freely indulged in without regard to the personal or social consequences. Between the nearly limitless availability of cheap food high in fat and cholesterol, which does as much harm to the natural environment in its production as it does to our bodies, and the culture of escapism and mindless entertainment that replaces social and familial activities for millions of children, the American public has never been less prepared for the costs of universal health coverage.
This is all the more so considering that this plan that allows children to remain on their parents plan until they’re 26. This means – and I hope I’m wrong but I don’t see how – that we will be facing future waves of increasingly unhealthy children and young adults who will have a right to unlimited medical care while not having to pay a dime into the system. What were they thinking?
There were a thousand-and-one alternatives that could have been considered, and were actually proposed by Republicans, libertarians, and others in the run-up to Obamacare, that were completely ignored by ideologues who are single-mindedly and irrationally devoted to one and only one type of solution to problems. Among those alternatives would have been to focus heavily on preventative care. Here’s one idea, from my preferred distributist angle: to promote through incentives new and innovative agricultural projects such as vertical farming, or any number of similar ideas that could have been owned and administered at the local level to provide city-dwellers with more fresh fruits and vegetables. This isn’t pie-in-the-sky stuff; access to healthy food is severely limited for poor people in the inner cities. This in turn has devastating health consequences.
Approaches such as these are favored by Catholic social teaching. For example, we read in the Compendium:
Meaningful testimonies and examples of self-organization can be found in the numerous initiatives, business and social, characterized by forms of participation, cooperation and self-management that manifest the joining of energies in solidarity. These are offered to the market as a multifaceted sector of work activity whose mark of distinction is the special attention given to the relational components of the goods produced and of the services rendered in many areas: instruction, health care, basic social services and culture. The initiatives of this so-called “third sector” represent an ever more important opportunity for the development of labour and the economy. (293)
This “third sector” is, countless times across countless documents dating back over 100 years in Church history, promoted as the alternative to both dog-eat-dog individualism AND the uncontrolled expansion of government and the imposition of a bloated and inefficient “social assistance state.” Anyone who harangues fellow Catholics because they OPPOSE this unprecedented power-grab by the federal government would do well to remember the words of JP II in Centesimus Annus:
Malfunctions and defects in the Social Assistance State are the result of an inadequate understanding of the tasks proper to the State. Here again the principle of subsidiarity must be respected: a community of a higher order should not interfere in the internal life of a community of a lower order, depriving the latter of its functions, but rather should support it in case of need and help to coordinate its activity with the activities of the rest of society, always with a view to the common good (48)
But instead of thinking creatively, everyone is obsessed with the idea that federal involvement is absolutely necessary to solve the problem, no matter how intrusive or expensive that involvement becomes. I have said it before, and will say it again: Catholic social teaching is not a bankruptcy pact. It is not a mandate to spend obscene quantities of money that we don’t even have – especially when we are the world’s greatest debtor! It opposes excessive and unfair taxation. And it insists that we at least try to address our problems locally, through the principle of subsidiarity.
It is a complete and utter fallacy to argue that the health care crisis we face today is somehow “proof” that the problem can’t be solved locally. Aside form the fact that some locales are actually managing to address their problems with minimal or no assistance from the federal government, it is also true that in the most stricken areas, the ability of the community to address problems has been crippled.
It’s that problem that should be addressed – not the symptoms or consequences of that problem, such as lack of health coverage. That falls within the proper scope of government, according to both CST and the US Constitution. Obamacare is an abomination, and I hope the states are successful in their nullification efforts.