Let us set aside, for the sake of this essay, various questions concerning the recent health-care bill passed by Congress. We will concede the highly dubious proposition that it will hold down costs; that it will not add hundreds of billions of dollars to the national debt; that it will not lead to the queues and the rationing that plague the English and the Canadian systems; and that there were no other ways, involving the private sector, to bring health insurance to people who did not have it and who did want it. We will even set aside the sin of abortion and the pressure that will be brought to bear upon Catholic hospitals to provide what they cannot remain Catholic and provide.
What I want to suggest here is that the bill represents but a late stage in the transformation of the relationship between the individual and the state. To do this, I must insist on a fuller definition of the “political” than we have become accustomed to. We now consider politics to be the realm, principally, of national legislation, executive order, and court decision. But what is lost is the life of the polis itself, a community of free people who live together, celebrate together, work together, and provide together for the common good. According to St. Thomas Aquinas, who held a generally sunny view of the polis, the community is a natural outgrowth of man’s capacity to reason: to participate in divine law by enacting measures in accord with the natural law, with an aim toward providing goods that embrace but also transcend the individual.
The Thomistic view of the polis underlies the Catholic doctrine of subsidiarity, which asserts that communities closest to the issue at hand should be allowed the freedom to tackle it. That is not simply because they do a better job of it, as some conservatives insist. It is because the fullness of community life is essential to our being human. It is doubtful that the state, much less the federal government, is better at educating children than were the fully engaged American townsmen of old, who hired and fired their own teachers at will, and had a fairly clear idea of what their children ought to learn. But even if it could do the job well, its assumption of that role would take from the community one of the most important responsibilities it possesses. It would overstep its own zone of authority to usurp another. Supposing some state agency could, with wonderful efficiency, feed children and make them do their homework and put them to bed; still, its exercise of this role would rob from the people one of the great challenges and joys of life, the raising of children according to one’s own best lights.
When Alexis de Tocqueville observed America, he saw a democracy, for the time being, both bolstered and buffered by free associations of people — by families, community schools, churches, fraternities and sororities, beneficent organizations, and so forth. These made for a vital public life — and were correctives against both the ambitions of the state and the radical individualism that democracy can encourage. There was still the strong sense that government at all levels was but the creation of free citizens, who possessed, in their families and in other associations, their own duties and even their own rightful giving of laws.
But what we have seen, in the last century and more, is the progressive centralization of power, allowing the functions and the authority of communities to wither and, paradoxically, freeing the individual from the constraints once imposed upon him by his neighbors, his church, his workmates, and his family. It is the strange collusion of a certain kind of libertarianism with a supine submission to the authority of the suddenly all-competent state. We see this clearly enough in the moves to approve same-sex pseudogamy. Two principles are at work. One is that the individual, unfettered from social constraint, can define for himself what a marriage shall be, in defiance of tradition and the obvious exigencies of nature. The other is that the state must sanction the definition; indeed, the state no longer recognizes marriages and families as societies that are prior to the state and that exercise claims for rightful self-governance. Instead, marriages and families will be the creations of the state — and the power to define is the power to control.
The welfare state offers the individual a pact. It effaces the mid-level institutions that are so effective at old-fashioned political action — that might build a school, for instance, and then see to it that the boys and girls in it were properly brought up to assume their roles as men and women of the community. It allows the individual the crucial freedom of the zipper. In exchange for that freedom, it assumes the role of benevolent patron, lavishing its largesse upon a community-free, unreliable, and undisciplined populace, who are now not the creators of the state but its clients, or wards.
The question, then, is not simply, “What system will most efficiently deliver health care to the most people?” I do not believe that it will help to nationalize medicine; but that is another issue. The real question is, “What traditions and laws best preserve the liberty of a people, not to do as they please, but to take responsibility for themselves and their communities, so that they will enjoy as fully as possible the human flourishing of the polis?” If we become beholden to the national government for our very health — let alone for the education of our children — what will be left for us to do but follow that government along tamely, conceding all matters to its purview?