The budget proposals put forward by Rep. Paul Ryan,  chairman of the House Budget Committee, present, as his “Path to Prosperity” text states, a choice between two futures for the nation. And, let us stipulate at the outset, that Ryan is both sincere and correct when he bemoans the current inability of Washington to courageously address the nation’s fiscal issues. But, in this case, the remedy is worse than the disease because the future for America that Ryan’s budget paints is a vicious future in which the rich get richer, the poor and the marginalized are left to fend for themselves, vulnerable seniors are given vouchers, not health care, and – most disturbingly for Catholics – the common good is entirely set aside in the name of freedom.
The freedom Ryan touts is the freedom of the jungle. One of the hallmarks of a civilized society is its capacity to care for the least fortunate of its members. Ryan, and other Republicans, regularly decry such care as “a culture of dependency.” Of course, as believers, we understand that we are all well advised to bask in a culture of dependency – we depend on the grace of God and the munificence of His creation for all that is most dear to us: Our lives, our health, our relationships, our daily bread. It is very, very strange to me that in this most religiously observant of the Western, industrialized nations, dependency should become a swear word.
Be that as it may, the basic rule that Ryan follows is this: In the name of freedom, we will trust the invisible hand of the market to reach the best solutions. The maximization of individual freedom is understood to be the sole vehicle for reaching a just future, a kind of Wild, Wild, West economics, rooted in the anti-Christian writings of the Austrian economists. There is something a bit idolatrous, and also a bit foolish, about such trust in market solutions. Certainly, as Pope Benedict XVI has clearly and unambiguously taught, the market, like every other human invention, stands in need of moral critique, and not just of specific unethical behaviors by corporate fat cats, but of how the market, or a political system, or any other human invention does, or does not, advance the cause of human dignity and the common good, how its inner dynamic succeeds in engendering solidarity as well as competition, gift as well as profit. There is precious little in the way of solidarity in this budget proposal and no understanding of the idea that human beings, qua human beings, should receive basic human necessities likes housing and health care, no matter the circumstances of their lives.
The most dangerous part of the Ryan budget proposal remains its commitment to turning Medicare into a voucher program. Of course, wealthy seniors will be able to pay for any increases in premiums above the amount of the vouchers they receive. But, less affluent seniors will not be able to purchase health care plans that meet their needs. Medicare stands for a simple moral proposition: After a lifetime of hard work, no human person should have to worry about paying for their health care in a society as wealthy as ours. No budgetary fact, such as the explosion in health care costs, and no demographic fact, like the increasing number of elderly living longer, can obscure the truth of that moral proposition. America is alone among the modern industrialized nations in being unable to get the profit motive largely out of the health care industry, and consequently, we are the only modern industrialized nation that pays so much in health care costs for so little result. Americans pay double what most nations pay for health care and we do not live longer, our rates of infant mortality are not lower, and apart from a few horror stories from Canada and the UK, there really is little evidence that the peoples of other nations are unhappy with their health care systems. Competition is not the remedy. Single payer is.
But, the real danger of the Medicare proposal is different. Like the proposal in Massachusetts to legalize physician-assisted suicide, the idea of introducing personal, financial decision-making into the delivery of health care to seniors opens up the possibility of social and familial pressure on seniors, when they are most vulnerable, to act against their own interests and to acquiesce in threats to their own dignity. In Oregon, which legalized euthanasia some years back, if you are, say, 85, and you go to the doctor and she discovers that you have a condition that will be very expensive to treat, along with the options for treatment and care, you will receive a nice, well-crafted brochure about how to kill yourself. Imagine for a moment, if in addition to that kind of social pressure, there would be added an additional layer of concern: What if the health care you purchased with your voucher doesn’t cover the treatment you need? What if a different, more expensive health care plan would cover it, but under the Ryan plan you would pay the difference of course, and you would need to mortgage your home to do so. Your children have looked at that home as their inheritance. Some families would do the right thing, but is there any doubt that some family members would bring pressure to bear upon their older family member to forego the treatment they need?
There is the usual level of deceit in the Ryan budget. He talks about lowering tax rates and cutting loopholes, which is something I favor but, surprise, surprise, when you turn to page 50 of the “Path to Prosperity,” you will search in vain for the delineation of any actual loopholes the plan intends to close, just the candy of lower rates. Ryan says his plans for Medicare will save the system, which is a lie. &c.
Earlier this month, the USCCB sent a letter to all members of Congress which read, in part: “Our nation has an obligation to address the impact of future deficits on the health of the economy, to ensure stability and security for future generations, and to use limited resources efficiently and effectively. A just framework for future budgets cannot rely on disproportionate cuts in essential services to poor persons; it requires shared sacrifice by all, including raising adequate revenues, eliminating unnecessary military and other spending, and addressing the long-term costs of health insurance and retirement programs fairly.” I hope that all the bishops will ask themselves if the Ryan budget meets the just framework the bishops outlined. I hope the bishops will ask themselves if the Ryan budget coheres – hell, if it in anyway even resembles – the vision set forth in the past 120 years of Catholic social teaching. I hope the bishops will be as fierce in their determination to defend the poor and the vulnerable whom this budget would harm as they have been to defend the religious liberty of our Catholic institutions.
Libertarianism is a cancer in the American body politic, and the Ryan budget usefully demonstrates just how dreadful their social Darwinism is. The “circle of protection” the bishops asked for regarding anti-poverty programs is removed, and replaced by a circle of protection for the Pentagon budget. The cuts in programs for the poor are matched not by shared sacrifice but by tax cuts for the super-rich. The sense of social solidarity enfleshed in Medicare and Medicaid is abandoned and seniors and the poor turned over to the whim of state legislatures and the market. The society Ryan envisions may be a rosy prospect for the “best and brightest” who work at the Heritage Foundation, on Capitol Hill, and the Club for Growth. But, the Church is called to advocate for the less fortunate, the less able, the infirm, and aged, the undocumented, the unborn. Let’s hope our bishops find their voice before the groundswell of anti-Christian libertarianism becomes too strong. They should oppose the Ryan budget with the same vigor as they have opposed the HHS mandates. I will offer to write a prayer to be read at all Masses.