Mirror of Justice

A blog dedicated to the development of Catholic legal theory.
Affiliated with the Program on Church, State & Society at Notre Dame Law School.

Tuesday, November 5, 2013

How Not to Do Social Justice: The Obamacare Example

You knew that at some point that someone here on the Mirror of Justice just had to say something about what HHS Secretary Sebelius has now acknowledged to be the Obamacare “debacle.”

There will be ample time in the coming months to explore in more detail the underlying issues about affordable health care, health insurance options, access to physicians, controlling costs of health care (or not), whether Obamacare expands the availability of affordable health insurance as much as it contracts that availability, etc.

And it’s always possible that, after an initially disastrous unveiling, the new health care regime will evolve into a model of government-managed efficiency that strengthens the social safety net and enhances the health care system to the popular applause of the American people.

But as the shoes continue to drop, and the focus shifts from bad website tech to bad policy collateral effects, such a happy outcome seems increasingly unlikely.

Consider how quickly political fortunes are shifting.  Just a couple of weeks ago, House Republicans were pilloried by the media and chastised by the public for shutting down the government and risking a default on the national debt service for the solitary and dominating purpose of undoing or at least revamping Obamacare.

But now and in the light of recent events, people are recalling that President Obama and the Senate Democrats were equally willing to shut down the government and risk a default rather than allow even the most modest adjustment to Obamacare.  When House Republicans sought to save face by asking only for a delay in the individual mandate—which would have been parallel to the delay granted by President Obama to big business in providing more comprehensive health insurance benefits to employees—President Obama and the Democrats would have none of it.  (Ironically, now President Obama is thinking of doing exactly that because of the web site failure, which I guess makes his hard-line against House Republicans and the consequential government shutdown all for naught.) When moderate Republican senators proposed at least abolishing the new tax on medical devices, which had been criticized by senators of both parties as undermining American innovation and increasing the cost of health care, President Obama and Senate Democratic Leader Harry Reid were immovable.

In sum, the public is coming around to the realization that President Obama and the Democrats are just as ideologically committed to Obamacare as the Republicans are ideologically opposed to it.  To be sure, the Obamacare crack-up has not meant that Republicans are ticking up in popular approval.  But President Obama and the Democrats are definitely ticking down.

Three-and-a-half years ago—right after it had been enacted on a straight Democratic-party-line vote—I predicted that Obamacare was unlikely to succeed and that the just cause of greater access to health care might be set-back rather than advanced by this irresponsible legislation.  I argued that we should keep our attention on the matter of health care and diligently continue the search for genuine reform, because Obamacare was not prudent, was not economically viable, and was not politically sustainable.  (That March, 2010 five-part series can be found here, here, here, here, and here).  The points I made then remain salient today (mostly).  But, again, there will be ample time in the coming months to return to these issues.

For today, one lesson emerges most clearly for anyone advocating social justice initiatives:  Be scrupulously honest.  If there will be winners and losers under a proposal, admit as much.  If enactment of a government program or regulation will restrict freedom of choice by citizens to a certain menu of options approved by the government, be willing to say so.  If intervention by the government will have economic effects, such as increasing the costs of products, don't pretend otherwise.  If advancing the common good will require sacrifices by the many in order to provide better for the few, be forthright in defending that result.

If instead, you mislead the people about what will come, even for what you believe to be a higher cause, then the public cynicism and popular backlash may do more than damage your cause in a political sense.  It may set back the cause of social justice altogether and dissolve the common good into a battle of special interests seeking advantage in the aftermath of failure.  By overreaching—and by being disingenuous as you overreach—the most vulnerable in our society may suffer the most when the house of cards collapses and public faith in civil society is weakened.

Peggy Noonan’s column today on the prevarications that accompanied the adoption of Obamacare makes this general point more specific in this context:

They said if you liked your insurance you could keep your insurance—but that’s not true. It was never true! They said if you liked your doctor you could keep your doctor—but that’s not true. It was never true! They said they would cover everyone who needed it, and instead people who had coverage are losing it—millions of them! They said they would make insurance less expensive—but it’s more expensive! Premium shock, deductible shock. They said don’t worry, your health information will be secure, but instead the whole setup looks like a hacker’s holiday. Bad guys are apparently already going for your private information.


Sisk, Greg | Permalink