Articles 5 (Politics/Health Care)

I won't normally post two articles at the same time, but because of the expected House health care vote today, this is an excellent time to delve into the question of social justice in the context of a concrete social challenge. -NB


The Economist (Mar 18th 2010) "Pass the bill"

American health-care reform

Hugely expensive and full of flaws though it is, Barack Obama’s health-care plan is still worth having—just...

**GRAPH** Health Spending as % of GDP (2007): U.S. 16%, France 11%, Germany 10%, Canada 9.5%, UK 8.2%, Japan 8%

IT WILL cost close to a trillion dollars over the next ten years, a vast sum of money at any time and a heart-stopping prospect when America’s budget deficit is gobbling up nearly 11% of GDP and unemployment seems stuck at close to 10%. It takes only tentative steps towards controlling the relentless above-inflation rise in health-care costs that has gone on for decades, squeezing corporate and personal budgets alike and threatening, if unchecked, to overwhelm the federal budget entirely. It squanders a golden opportunity to shift away from a payment model that encourages doctors to prescribe too many overpriced tests. Its sponsors in Congress are likely to suffer in the mid-term elections, and it will probably always be cited as an example of Barack Obama’s leftish mismanagement during much of his first year as president.
So the latest version of health reform which Democratic leaders hope to vote on in a matter of days is, to put it mildly, a terrible disappointment. Despite that, the Democrats must summon up their courage and vote for reform. This poor bill is still better than no bill at all for two reasons.

One part basic decency, one part cost control
The first has to do with coverage. This newspaper loathes needless government intervention. But it also thinks that it is wrong for a country as rich as America to have tens of millions of people without health insurance. Beyond them is the much larger number of people who fear falling into that position through losing their jobs; and the larger number again who cannot get affordable insurance because they have an existing medical condition, or because they are too old, or because they have exhausted the “lifetime caps” imposed by insurance companies. The health-reform plan represents the last chance, perhaps for decades, of erasing one of the least creditable differences between America and the rest of the industrialised world. If this president, who came into office with solid congressional majorities and stratospheric ratings fails, neither he nor his successors will dare touch health care for many years to come; and that would be a tragedy.

The second somewhat paradoxical reason is that this bill will have to be improved on after it is passed—especially when it comes to costs. America’s health-care system is a nightmare of perverse incentives. Because employer-provided health insurance is not considered to be a taxable benefit, people feel insulated from the real cost of their coverage and consequently over-consume. Because hospitals and medical practices in many areas face too little competition, they charge absurdly too much even for simple procedures. Because of the rapacity of America’s lawyers, the fear of lawsuits encourages doctors to practise “defensive” medicine, again driving up costs.

The current bill chips away at all of these problems. Gold-plated insurance policies will in effect lose their tax-exempt status, though not for a while, and not in full. An independent presidential commission will have some power to force down the rates paid to medical-service providers—though, insanely, hospitals are exempted. Tiny steps in the direction of tort reform are also provided for. All these things could be expanded in due course. For instance Republicans elected in November may well return to the issue of malpractice costs.
Some health-reform purists will scoff at such incrementalism. They argue that it would be better to do nothing now, wait for an old-fashioned fiscal crisis to force the issue, and then start again. That is an alternative we think most Americans would rather not experience. Mr Obama’s bill does a morally desirable thing in expanding health coverage, and it does a bit on costs. That is, on balance, enough for it to deserve to pass.


St. Louis Post-Dispatch (March 18, 2010) "Whose Vision of Social Justice?" (article taken from www.eppc.org)
By Colleen Carroll Campbell (Fellow, Ethics & Public Policy Center)

Talk-show host Glenn Beck recently struck a nerve -- and ratings gold -- when he urged his audience to abandon any church that espouses social justice. The term is "code" for extremist political ideas akin to those of Nazis and Communists, Beck said, and churches that use it are promoting "a perversion of the Gospel" that privileges big government over individual charity.

Beck's controversial advice sparked a passionate backlash, particularly from the political left. Leading the boycott-Beck brigade is liberal social activist the Rev. Jim Wallis, who says Christians now should consider Beck's show as obscene and unworthy of their patronage as shock jock Howard Stern's. "Social justice is an integral part of God's plan for humanity," Wallis wrote on his blog, after admitting that "Christians may disagree about what social justice means in our current political context."

That caveat is crucial, and it's one that politicized pastors like Wallis often forget. A spiritual adviser to President Barack Obama and author of the rather presumptuously titled manifesto "God's Politics," Wallis is an intensely partisan critic of those who reject his statist vision of social reform. He's not the Rev. Jeremiah Wright -- a preacher of ranting, anti-American sermons whose Chicago church Obama attended for decades and whom Beck cited as an example of a pastor promoting extremism. But Wallis has his moments of fire-breathing invective, directed almost always at Republican politicians and conservative Christians.

Beck makes his living by making provocative statements, so he probably was not displeased by the attention that Wallis' fury generated for his show. For Wallis, the controversy has given him a bigger platform to plead his case for the inextricable link between a Christian social conscience and leftist public policy. Lost in the fray is an interesting question worth pondering: What's the meaning of social justice? Anyone who has cracked open a Bible knows that justice is indeed a recurring theme. Calls for a just social order hardly qualify as a "perversion" of a Gospel that emphasizes, again and again, God's concern for the poor and marginalized. A religion premised on the idea of original sin does not promise its adherents a pain-free existence this side of eternity, but neither does it exempt them from the duty to build a better society here and now.

Still, there's a reason that the term "social justice" provokes sighs and rolled eyes among many Christians today. The promotion of leftist politics as infallible religious dogma by pastors such as Wright and, to a lesser extent, Wallis, goes a long way toward explaining public fatigue with the term. That fatigue stretches beyond Protestant circles into Catholic ones, where the phrase has its origins. The Catholic Catechism defines social justice as a situation in which people are able to "obtain what is their due" and says such justice "can be obtained only in respecting the transcendent dignity of man." The church lays out a few non-negotiable principles when it comes to respecting this personal dignity -- defense of the right to life is preeminent among them -- while leaving many public policy decisions subject to the prudential judgment of individual Catholics.

Catholicism is not libertarianism by any stretch; government is expected to have a role in protecting the poor and weak. Yet the church also defends the principle of subsidiarity in political life -- the idea that the people closest to a problem should be the ones to solve it. Despite these careful doctrinal distinctions, many Catholics -- like many mainline Protestants -- assume that social justice demands their reflexive support for unlimited expansion of the social welfare state, even when a new government program may not be the most effective way to help the poor. Meanwhile, many of these same Catholics ignore the Church's clear admonition to defend social justice by defending the right to life of the unborn from abortion and the elderly from euthanasia.

The call for social justice is an outgrowth, not a perversion, of the Gospel. But the devil is in the definition. Christians concerned about mission creep in their churches should not abandon social justice. They should fight to reclaim a fuller understanding of it, one independent of any narrowly partisan political agenda.

Colleen Carroll Campbell is an author, television and radio host and St. Louis-based fellow at the Ethics and Public Policy Center. Her website is www.colleen-campbell.com.