It has been a week since the historic vote to pass health care reform. Having waited till the dust settled, here are a few clear convictions I have developed on what has transpired, offered from the perspective of a Christian ethicist:
I believe that extending health care access to every American was always the right goal and reflects the moral commitments of the Christian faith. Any way one might come at this issue morally, the answer was always the same: health care as a human right; as an aspect of compassion for our neighbors; as doing to others as we would have them do to us; as a dimension of basic justice; or as an aspect of the kingdom of God, one of whose characteristics is healing of the sick. Everything points in the same direction. I therefore find incomprehensible those Christians who are cavalier about a society with fifty million people lacking adequate access to health care.
I believe that the law passed over the last week fills a hole in the American social safety net that has needed attention for decades. I identify with the progressive social reform tradition of American public life, which can be traced back well into the 19th century and has always been heavily stocked with religious voices and motivations. I think that the kinds of impulses that drove the recent health care movement are the same that drove the movements on behalf of worker's rights in the late 19th and early 20th centuries, civil rights for African Americans in the 1950s and 1960s, and women's rights in the 1960s and 1970s. Every human being is sacred in God's sight and must be treated as such. A just society seeks to address systemic problems that diminish human flourishing or end human life prematurely. Inadequate health care access was just such a systemic problem.
I believe that the health care law also reflects, in a quite striking way, the commitments of the anti-abortion movement. Under the pressure of pro-life Democrats especially, the law bends over backwards to cordon off abortion as a morally dubious act that no American should have to pay for who does not purposely elect to do so. While Roe v. Wade established a trimester-based moral-legal evaluation of abortion, this law (and the president's executive order) reinforces a cause-based moral-legal evaluation of abortion. Rape, incest, and a threat to the mother's life are now even more deeply entrenched as the only causes for procuring an abortion that the state should support, and thus as the only clearly morally legitimate reasons for abortion. The pro-choice activist community knows that this is true, which is why they are so unhappy with this part of the law. It marks a major defeat for them.
I believe that the health care law is in many ways an experimental and pragmatic piece of legislation that takes just about every one of the best available ideas for extending health care access and controlling costs (except a single-payer system or the public option) and gives each a try. It is not a government takeover of health care, a socialist plot, an aspect of totalitarian rule, a United Nations scheme, a Freemason conspiracy, or the end of the world as we know it.
I believe that it is amazing how many news outlets were prepared to offer extensive, balanced, careful analysis of the health care law soon after it was passed when we really could have used that kind of analysis beforehand. It's as if before the bill became law, the media felt obligated to report whatever charges and countercharges were circulating in the political fight, however ridiculous they were, whereas afterwards they felt free to actually offer a grown-up analysis of how the health care bill might actually work.
I believe that Republicans' 100-percent opposition to this bill will come back to haunt the GOP -- not to mention the total hysteria that mounted in the days before and just after the bill was passed. If the bill works even remotely well, it will build a massive constituency, especially if the president continues to remind people of the most humane provisions of the law, such as the end of the pre-existing condition fiasco and lifetime caps in health policies. Republicans will get zero credit for any of this.
I do believe that the Republicans and critics are right about two things. One is that in the end, our nation must grow its economy, because the social safety net cannot forever absorb the needs created by a 10-percent unemployment rate. Nor can our social fabric sustain the anger and fear and grief and family dislocation. Secondly, I believe the Republicans are right that we cannot continue to borrow our way into national oblivion. Of course, they would have had more credibility on this matter if they had been concerned about it during the last presidency.
Therefore I believe that Barack Obama must now pivot toward job creation and fiscal responsibility. On the latter front, he needs to use his political capital to push forward serious entitlement reform and, as soon as possible, reduce dramatically our sacred cow of a military budget. That will involve reconsideration of our role in the world. I hope he, and we, are ready for that.