Obamacare, “and then what”? – UPDATED

We had a busy weekend, and I barely was able to keep up with the headlines, but I did read a little about the Obamacare arguments before the SCOTUS. I also heard about former Vice-President Dick Cheney’s heart transplant, and some of the less-than charitable, often outright hateful remarks emanating from the left. The most interesting of those, I think, are the ones instantly re-embracing the “constitution-shredding” and “war criminal” narratives of 2001-2008 without the merest acknowledgment that the current president has assaulted the first amendment, circumvented the congress, and has either kept most of the Bush-Cheney policies in place or expanded upon them.

Funny how that works.

Anyway, my column at First Things this week considers the timing-synchronicity of the Obamacare debate and the grousing that a heart transplant was wasted on a 71 year old man — particularly one already counted as “less-than-human” by some — and then takes a page from the great saint, Philip Neri:

Here, within the neat columns of taxes, fines and policies received versus benefits paid out, hide the little demons of our spiritual destruction; they encourage the appointing of some flawed and imperfect humans to gauge the worthiness of other flawed and imperfect humans and then relentlessly advise for or against a life based on ever more relativistic (but called “practical”) lines. Giving public voice to their relentless prompting, pundits who recently declared that “60 is the new 40” will suddenly be opining that 71 is too old for a heart. 75 will be considered too old for a new knee—news that will stun active, fully engaged and vital people like my 80 year-old father-in-law.

Saint Philip Neri used to listen to the dreams of those around him, and ask, “and then what?” If someone mentioned a lofty ambition, Philip would tease them about what comes next: “you become rich and successful, and then what?”

“And then I marry a beautiful woman and we travel and enjoy life!”

“And then, what?” Philip would gently ask, over and over, until the dreamer was forced to acknowledge that beyond their dreams lay only death, and an eternity reflecting the values and choices of their relatively short blip of a life.

Once a society commits itself to the notion that only certain people meeting certain specs will be considered for certain procedures, it will soon determine that fatties who are 50 will either submit to increased governmental control over their appetites and exertions or be denied a stent. And then what? Perhaps expectant parents, unwilling to do the socially-and-fiscally-responsible-thing and abort their less-than-perfect children, will face the wrath of their fellow-citizens; having been identified as cruel, heartless people too-willing to birth a child whose quality of life has been determined to be sub-optimal, they may not be allowed to parent at all.

And then what? Perhaps a 45 year-old woman who has never married and has no children (and therefore with no one in urgent need of her existence) will be thought too dispensable and unnecessary for chemo therapy. What does she have to live for, anyway?

And then what? Perhaps people with lower IQ’s—whose lower earning potentials can never generate substantial tax revenues—will be deemed unworthy of costly extended therapies.


Missing from all of that, of course, is consideration of the dignity of the human person, and the intangible valuations of love. Those balancing ideas might have been supplied by the church, as they have always been, in a kind of partnership with the government efforts to provide health care for all.

Now, they will have to be supplied by the church, indeed, but contra voce, in resistance.

You can read the whole thing, here.

UPDATE: Speaking of Obamacare, Glenn Reynolds has an interesting post

Jen Fulwiler: pleading for hearts and a home over institutionalization.

About Elizabeth Scalia
  • kevin

    That is a great insight from Neri. Hits you like a cold shower.

    I’ve always thought that someone like Obama, with his deep messianic delusions, is dying to play God. It’s as old as the Garden of Eden. “She may want to take that painkiller.”

  • http://www.savkobabe.blogspot.com Gayle Miller

    Ignoring the hate-filled spewings of the left, Dick Cheney is a national treasure and I hope that all goes well with his recovery.

    As to the left ignoring all of Mr. Obama’s shredding of the Constitution – which will not stand with any luck (or divine intervention), I still remain committed to insuring his defeat at the polls this November and continue to earnestly pray that he will accept his defeat as the extreme rejection of the American people to the extent that he realizes fully that we will not stand for any post-election shenanigans from him – like imposing martial law in order to maintain his stint in an office he has served so poorly! The man is despicable and always has been. He has a lot of personal charm – but so do most sociopaths!

  • fiestamom

    From the Instapundit link: ” The mandate does not merely regulate commerce—it requires it. In 2008, President Obama understood this distinction. In 2012, his administration is pretending the distinction does not exist. And counting on the press not to note the contradiction.”

    Obama has nothing to fear from the press. I was at the Y yesterday, forced to watch CNN and HLN as I was doing the stairmaster. Both channels had “reports” on certain families and how much they have been helped by Obamacare. How horribly they would suffer if they lost their insurance if the Supreme Court rules against Obamacare. I can honestly say it’s been months maybe almost a year since I’ve watched any “news” channel.

  • Rhinestone Suderman

    As the parent of a special needs child, all these questions of life, and death, are extremely important to me.

  • Rhinestone Suderman

    Of course, some of us have feared for a long time that this reduction of life to who is “necessary”, and who is not—counting people merely as economic units—would eventually lead to something like this.

    The Nazis didn’t start out with Auchswitz; they started out by getting rid of the “Useless eaters”—the chronically ill, mentally retarded and handicapped.

  • Rhinestone Suderman

    I can see the day coming when, in order to supply all those allegedly hapless 30 year old “Schoolgirls” with free birth control, we will need to make some “Hard choices” (Can’t you just see politicians saying this on T.V. ads, with their assumed long faces, and deep, “serious” voices?) After all, Granny’s lived her life, hasn’t she? All those defective children should have been aborted before they were born, and all those people needing cancer treatements, or insulin, or any kind of long term medical treatment, are just a drain on the economy. Isn’t free birth control/abortion/sterilization a woman’s right?

    You just know they’re going to argue this.

    It’s all part of the culture of death.

  • Pingback: “When shall we begin to do good?” « The Anchoress

  • Will

    How about the House (Ryan) plan to replace Medicare with a health insurance voucher for those who are currently under 55 years old when they reach 65? What happens when the voucher covers less and less of their health insurance premiums?

    [We needn't concern ourselves with Ryan's plan because it will never be passed. Obamacare is something that has actually passed and is looming toward us. -admin]

  • http://jscafenette.com Manny

    I don’t usually pray over political issues. I figure the Lord has more important life and death issues to worry about, and it’s not always clear whether my political opinion is truely the best for all, and under that ambiguity I’d rather not involve or evoke God into it. But on this Obamacare issue I have. It’s that big and that moral an issue. I pray that our Lord provides the best insight to our Supremes and has this striken down.

    If this law is deemed constitutional and all individuals are now at the beck and call of the Federal government obligated to buy something they do not want, then I doubt whether I can be a patriot any longer to this country. They will have stripped away my freedom. I might as well live in Cuba.

  • Rhinestone Suderman

    Manny, during this Lent, I’ve been offering up prayer and fasting for God’s continued protection of American. I think it’s a good thing to do in these troubled times.

  • Will

    [We needn't concern ourselves with Ryan's plan because it will never be passed. Obamacare is something that has actually passed and is looming toward us. -admin]

    Might it not pass if Republicans retain control of the House and take control of the Senate and the White House?

    [Well, I don't think that's going to happen, but if it does, THEN it will certainly be something to discuss, won't it? I can't see having a bit debate about something that is hanging there like a big question mark. Why don't we stick to today, and what is real today? -admin]

  • kevin

    The questions from the “conservative” Justices – - including Kennedy – - have been pretty incredulous and withering so far, so that is a decent sign.

  • Brian English

    “What happens when the voucher covers less and less of their health insurance premiums?”

    How do you know that is going to happen? And personally, as a 48-year old, I am willing to take my chances with just about anything other than the monstrosity currently in place. It turns out Obamacare is going to cost at least twice as much as originally represented. How is it moral for my children and future granchildren to be stuck with that bill?

  • Will

    “It turns out Obamacare is going to cost at least twice as much as originally represented. How is it moral for my children and future granchildren to be stuck with that bill?”

    There is much misinformation about costs. There are many decisions about coverage and costs that are not being made by either side. It is easy to criticize what is in place, but more difficult to come up with a replacement that will provide affordable health care and not break the bank. Many people do not care about others as long as they have health insurance coverage for themselves.

  • Rhinestone Suderman

    Will, Obamacare has already passed. Therefore, that’s the thing we need to be concerned with, at the moment. Might-have-beens and could-be’s just don’t figure into this (and speculating about them is a waste of time.)

    Why not let the free market take over, in the insurance business? Or, why not try to create jobs that ensure that everybody has enough money to buy their own insurance plans? Why are we being forced into buying Obamacare—a program nobody really seems to know what’s in it, full of all kinds off hidden costs, and dangers—including the one the Anchoress mentions in her post; government starting to ration health care (to save costs, of course, of course), and deciding who lives and who dies?

    You sound as if you want all those “bad” people who, supposedly don’t care if anybody else has health insurance coverage or not, punished. If this is your real motive for supporting Obamacare, I must say I don’t think it’s a very good one. And, again—why should I be forced to pay for Kim Kardashian’s birth control? Or for some rich kid from the OC going into re-hab? And how is it moral for us to stick our children and grandchildren for the horrific bill for this? And what about the disabled, and elderly? How is it moral to endanger their lives, and health, by placing them at the mercy of bureaucrats who may, at some point, decide they must be denied medical care, because their lives ae worthless?

  • Rhinestone Suderman

    Given our trillion-something debt, and the fact that it’s not getting any smaller—and the fact that our economy is in such bad shape at the moment—I don’t think we’re going to be able to pay for Obamacare. (One reason for getting rid of it—there are others.)

  • http://@dau1776 dau1776

    My dad, God rest his soul, had some chronic problems which required some periodic hospital stays during his adult yrs. He used to live in another city before my parents were married and had a great doctor he wanted to keep. Since he didn’t need care between these episodes, it was not a problem to go ahead and drive the 2 1/2 hrs to see him and be admitted for the treatment he needed for a few days. All this is to say that although we are not Roman Catholic, he insisted on going from LA to San Diego for this one doctor AND the nursing sisters at Mercy Hospital (there were more actual nuns doing patient care in those days). He said just walking in the place made him feel better. Said he NEVER got better care anywhere else.

    My son in law (also not RC :) is THRILLED that the residency he got is at an OUTSPOKENLY pro-life Catholic hospital; my dau. works there too, as an RN.

    My favorite EVER family doctor is a devout traditional RC lady. Her practice stated up front no artificial birth control or abortions OR referrals for them!, and mentioned pro-life care from conception to NATURAL death. America – who do YOU trust to care for YOU when you’re really expensively sick? PS: I used & taught NFP :) People have NO idea what they’re in for if we can’t repeal (not modify) this monster.

  • Brian English

    “There is much misinformation about costs. ”

    There were figures issued by the CBO about a week ago stating that the cost has actually doubled. Tell me how they are wrong.

    And you still have not explained to me how it is moral to heap debt on future generations, regardless of how wonderfully you think the money will be spent. Voting ourselves goodies at the expense of those who can’t stop us because they can’t vote is immoral.

  • kevin

    Jeffrey Toobin on CNN, who last week predicted an 8-1 vote in favor of Obamacare, just declared that today was a “TRAIN WRECK” for the Obama administration, and said it looked very likely that the law would be declared unconstitutional.

    Too early to break out the champagne but sounds like our system of checks and balances may still be working.

  • http://jscafenette.com Manny

    The people arguing over which approach cuts costs, and therefore benefits, the most are missing the point. The government expenditures of the medical system is over extended. Everyone’s plan will cut costs in some way, and it’s not clear which cuts more.

    The real issue is whether Obama’s plan is constitutional, whether our freedom to choose our way of life, our insurance company, our plan with that insurance company, and therefore satisfy our conscience are violated.

  • Mike M.

    I am of the generation that was taught to believe that Humani Vitae was square, old-fashioned, retrograde, unrealistic, behind the times, etc., etc.

    Now I am more and more sadly aware that it was true, and that I willingly believed a lie out of a lack of courage and faith.

    I see Obamacare as one of the fruits of the abortion and contraception culture. All the babies who should have been here, some in their 40′s by now with kids of their own, are not here. All that energy. All that vitality. All those taxes and social security payers! are not here. The fathers that never were have left us fatherless. Since Dad and Our Father have been banished, the State then compels.

    We dispensed with all those babies. Now our government – which is in no sense “ours” any longer – will dispense with us when it deems fit.

    I am not even sure prayer can save us now. It may be too late.

  • http://jscafenette.com Manny

    Good heavens my syntax got garbled there at the end of my last comment. Sorry.

  • TAF

    If the Government wants to assist the public with their health care needs, then it may be that a policy of catastrophic or those with previous conditions, will be covered by the government as long as they have an insurance policy. The insurance company’s could offer a basic policy where the government will pick up the cost for catastrophic or previous conditions and the insurance company’s could pool money to cover the government cost.

    The problem is that; insurance company’s drop people that are at high risk after a contract expires, people without insurance use county hospitals for medical care, and hospitals need to over charge to cover cost. There is even more, but enough said on that point.

    I believe, if I can’t afford health care then I better learn how to take care of myself or save the money to pay for my medical cost per condition, or die. I am without insurance for I don’t have the income to pay for it and if I got cancer today, I will die and I am OK with that.

    When people are put in a spot to survive they learn how to do more.
    When people are given an easier way to survive they learn less.
    When it comes to those who can not afford insurance, as myself, try harder to survive.
    I am pushed everyday to improve my life and just maybe, I can someday afford insurance or at least have enough money saved to pay the cost of a Doctor.
    Until then I hope I don’t die first

  • kenneth

    Mike, how exactly would more babies bail us out? I’m 42, so I’m supposedly squarely in that demographic that was contracepted or aborted down to some “too small” cohort. Among people within 10 years of my age either way, the real unemployment rate is at least 20%. I have one brother. How would having three or four or five more largely unemployed siblings help us right now? More to the point, why should I feel the least bit guilty about not having children of my own right now? For what? So I could have an impoverished family as opposed to a couple? So they could someday graduate college with debts a decimal place higher than ours were and never have a real job with real benefits (we at least had 15 years or so of that)?

  • Gerry
  • Rhinestone Suderman

    Kenneth, many of those kids who were never born might have grown up to start new businesses, for which they would have hired people—creating jobs. They might have created new inventions, which would have opened up previously unthought of vistas, again, creating new jobs. They would have built things. They would have discovered cures for various illnesses, creating medicines; they would have started their own businesses, invested, taken risks, created new industries.

    Most importantly, they would have paid taxes—those taxes that pay for all those social programs the liberals demand. Fewer taxpayers = fewer tax dollars + a large nanny state = societal collapse, as in Greece.

    You talk as if unemployment, and college debt, are unchangeable, immutable conditions, like the law of gravity. They aren’t. A younger, hard working society might be more inclined to tackle such problems, instead of simply standing around moaning. Have we really reached the point where all we can do, in the face of debt and unemployment, is demand more aid from our over extended government? To get tax dollars, you need tax payers. We don’t have a lot of young taxpayers. We don’t have enough people investing, and creating jobs, so we have lots of unemployment. And we make the problem worse by demanding more and more government bailouts—bailouts we can’t pay for.

    (And Mike isn’t blaming you, personally, for not having children—where do you get that? He’s talking about society in general.)

  • Rhinestone Suderman

    Gerry, the real question is—why should anybody take precedence over anybody? Why not let the free market, partnered with a healthy economy, sort out the question of health care: who gets it, when do they get it, what sort of insurance can they get, how much can they afford, and so one.

    One problem with government-rationed healthcare is that it pits us against each other; the aged against the fat, smokers against non-smokers, drinkers against non-drinkers, bureaucrats against patients and the handicapped against everybody. This is not the way society should be run.

  • o.h.

    If St. Philip Neri had such conversations, then he must have been immersed in his classics, as that anecdote appears fifteen centuries earlier in Plutarch, where the “and then?” questions are attributed to Pyrrhus’ chief ambassador, Cineas.

    [Philip was extremely well-read and had made his living, for a time, as a tutor. -admin]

  • doc

    I’m surprised Kenneth didn’t trot out the (discredited) Freakonomics argument crediting abortion with the drop in the crime rate.

  • Mike M.


    You attitude is the problem. Sorry. You are exactly the reason civilization is collapsing around us.

    I know it is impossible for you to admit that you are wrong – dead wrong in the literal sense – but perhaps simple mathematics can help.

    Argue against numbers. Perhaps if you try hard enough they will go away.

    In 1950, there were 16 workers for each social security recipient. Today there are 3.3 workers. By 2040 there will be 2.1 workers.

    Only willful ignorance allows you to suggest that all of the babies never born would be currently unemployed today if they had been born…..

    Unreal. That is one of the most ridiculous statements I’ve ever heard.