U.S.C.C. Watch: Health and the Other Hillary

Last month I suggested that if the American bishops wanted a radically Catholic solution to inadequate health care services in this country, they might propose changes in the tax system that would encourage large contributions to the Church for health, education, and other matters of human welfare. Without constitutional debate, without careful reflection on and prudential application of Catholic social teaching, we suddenly find a near-universal presumption, even within the Church bureaucracy, that the federal government now has an obligation to oversee provision of all such services.

Our Constitution was created precisely to spell out and limit governmental powers. Did anyone but the drug companies ask whether, absent immediate and overriding national interest, the government has the authority to control, say, drug prices, even in a “good cause”? Did anyone but the AMA speculate that perhaps the government would be monopolizing medical service and one-seventh of the economy? (The whole health-care reform has the appearance of the lawyers thinking the doctors are making too much.)

In any case, my radical suggestion could probably not be seriously even considered at this late date without massive protest and serious social disruption. So, for prudential reasons, if nothing more, such proposals must remain thought experiments for the present.

There are, however, worrisome precedents. In 1911, G.K. Chesterton and Hilaire (“the other Hillary”) Belloc broke with the Liberal Party in England over its support for the Insurance Act. Briefly, the Insurance Act was the beginning of unemployment insurance, social security, and nationalized health care — all measures that today many regard as liberal and almost logical legislation for capitalist democracies. But Chesterton and Belloc, who denounced “capitalism” as they understood it and cannot be accused of callousness toward the poor, thought the Insurance Act wrong because it seemed the first, coercive step toward the Servile State.

Both of them, Belloc particularly, feared that the various well-intentioned attempts to supply state remedies for the failures of capitalism would permanently block people from ownership and voluntary participation in economic activity. Belloc predicted that unemployment insurance would lead to disincentives to work, then to black-mail of the working man to accept a job, any job, at determined wages. He foresaw that difficulties in setting a significant difference between the dole and the minimum wage would become a steel trap for the worker, even though the intention would be to make work more attractive and relief less so. Ultimately, he thought, Labor Colonies would have to be introduced by the very logic of this kind of state intervention.

Belloc was not a perfect prophet. Welfare has contributed to the breakup of the family and the dependency of unmarried women with children, rather than to the enslavement of the working man.

But 80 years later, workfare and mandatory federal low-wage jobs seem to both liberals and conservatives, among the few plausible solutions to the conundrum of welfare dependency. Even President Clinton has proposed something like workfare in his “two years and out” plan, with its subsidized and compulsory training and job at the end.

A similar logic may be about to unfold in health care, but with a far different effect. This time, the Church herself may be caught within state pressures, and over more than just abortion.

Professor Stephen L. Carter of the Yale Law School has just published a widely acclaimed book, The Culture of Disbelief. In it, he laments both the exclusion of religion from public questions (the naked public square) and the pressure on religion to conform to fashionable social mores backed by progressive legislation. Carter is neither Catholic nor conservative, but black, liberal, and Episcopalian. As a constitutional scholar, however, he believes that one of the primary contributions the churches make in a democracy is to remain autonomous centers of value and powerful critics of the state.

In addition, he finds the churches as perhaps the most important forms of the intermediate institutions Tocqueville thought needed as a counterbalance to the state in our kind of society. But Carter warns that we have entered a period in which threats to the wall of separation — and to the freedom for religion to adopt unpopular stands — come strongly from the state side.

Carter believes that the removal of tax exemptions for racist religious institutions was a correct legal decision. He is not as sure, however, that questions of women’s and homosexual rights belong in the same category, though he is personally pro-feminist and pro-gay rights. He points to the conflict that arose not long ago in New York when a Catholic hospital was the target of protests by certain homosexual groups because it intended, more or less, to follow Catholic teaching on condoms and homosexuality in counseling and caring for AIDS patients.

Carter fears that we have entered an age in which, despite traditional religious exemptions, federal regulation of “irrational” and “illiberal” religious belief and practice will become ever harder to resist:

many religions provide social service functions in their communities and, in that capacity, they receive direct governmental assistance. Thus the welfare state has already trapped the religions, and the day will doubtless come when they, too, face pressures to behave correctly with respect to race, sex, and many other issues, or lose valuable government patronage. (Indeed, the day may be here already, as the Roman Catholic Church, a major operator of a variety of welfare services and thus a major consumer of government largess, is learning).

Carter suggests that given the threat, the churches may actually need to think about giving up their tax exemptions to put themselves wholly be-yond government interference. Clearly, that is an extreme solution, and one that would severely hamper institutions that are rarely well-funded even under current law. But Carter concludes: “it might be time for the religiously devout once more to render unto Caesar that which is Caesar’s, instead of rendering Caesar’s due to the church and then writing it off.”

A curious warning. But note that all welfare functions are assumed here to be Caesar’s. A construal of our Constitution and Catholic social teaching that demands limits on the federal reach might have led to a different result. Nevertheless, Carter’s argument is chilling. Unless the churches in this country develop the energy to defend themselves from intrusions — and not only on still-contested moral issues like abortion, condoms, and euthanasia — the choice in very short order may be to submit or to become a sect. For the Catholic Church, the “church” par excellence in Tonies’ church/sect distinction, this would be a bitter pill to swallow as a consequence of health reform.

Perhaps it would be wise to pay greater attention to the other, earlier Hillary again.


Robert Royal is editor-in-chief of TheCatholicThing.org, and president of the Faith & Reason Institute in Washington, D.C. His most recent book is The God That Did Not Fail: How Religion Built and Sustains the West, now available in paperback from Encounter Books.

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