Pelosi's Machiavellian Conscience: Why the End Does Not Justify the Means

Posted: Nov 02, 2009 12:01 AM

Gestation has ended. The bill has arrived. On Thursday, Speaker Pelosi proudly announced the arrival of her 1990 page, $894 billion health care bill in the House of Representatives. Labor and delivery occurred in smoke-filled back rooms, unviewed by the layman's eye, and it is not known if an epidural was required.

Much has been made of Washington's wrangling over health care in the past few months. Pundits from all sides, and a few from the faith community, have weighed in on the right and the left of health care reform.

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However, very little has been written about the morality of health care reform, and of this bill in particular. The few commentatorswho have written on the morality of health care have focused on the basic moral teaching that human beings deserve health care and that Jesus has commanded his followers to serve the poor and the disfranchised. That is a noble, moral end to be sure; however, moral thinking does not end there. Rigorous examination also requires that we consider the means by which we provide for one another and offer health and help to those who have none. Very simply, the end does not necessarily justify the means. It is important that we not only do the right thing, but also that we do it in the right way(s).

With that in mind, an analysis of the morality of the means of this healthcare bill's proposed actions is in order. In the end, it is found morally lacking for at least three reasons.

1) Stewardship

Humans are called to manage our resources well. Just as pollution of the creation is an example of poor stewardship of our resources, so too is the squandering of our material wealth. We live in a world of finite resources. Leadership requires careful decisions on the highest and best use of those finite resources. In the end, we answer for how we use what has been entrusted to us.

If the goal (as has often been stated) is to provide health insurance coverage for all those who currently cannot afford to purchase their own, this health care bill spends twice as much as is needed to achieve this noble end. Given Washington's predilection for spending, that should not surprise us. For bureaucracies, waste is a way of life, and overspending an ever-present reality. How such bureaucracies degrade human dignity is a moral discussion for another day. For now, bureaucratic squandering is more than enough moral material.

Given that a large portion of this bill will be funded by more incurred debt and by our children and grandchildren, it is morally right to achieve a good end by means as efficient as possible. The numbers show that about 14 million non-elderly, legally resident adults in America desire health insurance coverage but cannot afford to pay for it. Medicare will already cover any elderly who need coverage, and other programs exist to do the same for children. If we assume that we will pay for the entire cost of coverage for those 14 million adults, insuring each of those persons should be achievable for a cost of about $3000 per person based on what our small non-profit pays to insure our employees and their families. At that rate, we can provide insurance for all persons in America simply by spending $42 billion per year to insure those who desire to be insured.

At that cost, the price for ten years of coverage will be about $420 billion. The Speaker's proud bill projects a cost of more than twice that. Bad stewardship. Resources squandered. Morally wrong.

2) Social Justice

Most persons of faith agree that all human beings deserve access to quality health care. That is a basic issue of human dignity and compassion. Unfortunately, this health care bill not provide access for all Americans in spite of the initial grandiose political statements of the Washingtonians. Everyone in Washington, on the left and the right, acknowledges that this bill does not provide coverage for every person who needs it. Therefore, were we to pass this bill, we would not only be wasting resources, we would also be failing to achieve the moral end we were seeking to reach. The rhetorical flourish of President Obama and Congressional leaders throughout the debate has indicated that the motivation for health care reform was to ensure that all Americans had coverage. This bill fails to do just that.

Those, like Jim Wallis, who call themselves the “Religious Left” should be disturbed. They have been used as a tool in a political effort that has failed to do what they set out to do. The basic issue of social justice that has motivated Wallis and his followers has not been achieved, and their voices have been exploited. Morally wrong.

Remarkably, the above figure of $42 billion to cover everyone who needs and desires it, also coincides almost exactly with the amount Speaker Pelosi projects that we can save each year on Medicare “fraud and waste.” First, leave aside the moral matter of why we have not already acted to save the money squandered on “fraud and waste” in a government program of publicly administered money for healthcare. Instead, marvel at the simple fact that by managing one public fund (Medicare) well, we can pay for everyone in America who desires health care to have it. Social justice with stewardship. Good moral concepts to inject into Washington.

3) Sanctity of Life

Finally, this health care bill denies the very moral nature of health care itself. Destroying the lives of the unborn in the name of health care is not only paradoxical, it is immoral. Rep. Bart Stupak, a Democrat from Michigan, has rightly noted this bill's immorality and its codification in the attached Capps Amendment. Despite the squeals of President Obama, Press Secretary Gibbs, and Speaker Pelosi, this bill, as it stands now, will allow the use of federal monies to pay for the termination of human life in the form of abortion. Public subsidies will be used to support the purchase of insurance for persons unable to afford insurance themselves. The insurance purchased will be required to cover abortions. Fortunately, Rep. Stupak has proposed an amendment to rectify this situation, and he has declared himself unwilling to vote on the entire health care bill until his amendment has first been considered by the House. Moreover, he claims to have the votes to ensure that such consideration occurs. I pray that he is right, and that he holds to his word.

It is more than ironic that one Catholic politician (Stupak) would have to hold accountable another Catholic politican (Pelosi) on the issue of the sanctity of human life. In fact, it is tragic and sad. But good for Mr. Stupak. He has the moral courage to stand for what is right and has suggested that he is even willing to lose his seat, should his position on life do so, in order to do the right thing.

Would that Washington possessed other such figures whose votes were shaped by their morals, rather than vice-versa.