The Affordable Care Act and Economics 101

   Last week our business manager and I attended a diocesan workshop on parish compliance with the provisions of the Affordable Care Act (a.k.a. Obamacare).  The presentation was excellent, and honestly it's not that hard to understand what we will have to do to be in compliance with the ACA and avoid penalties.  There is a regulatory burden we'll have to deal with, and there are portions of the law that are utterly unworkable.  The thing that most disturbs me, though, is what the ACA is going to mean for the future of health care in the U.S., because there is simply no way this legislation will accomplish its primary aims: greater access and lower cost.

   The reason is basic economics - the law of supply and demand.  Obviously there is a demand for quality health care at a price people can afford.  Common sense tells you that the way to improve access and lower cost is to increase supply.  What we need are more doctors, more nurses, more medical professionals, more facilities and equipment.  Concentrate on increasing supply to meet demand, and more people will receive decent care at lower cost.  

   But the ACA does none of these things.  Its whole premise is to insure everyone, but insurance is not actual care.  How is the creation of more bureaucracy going to encourage people to pursue careers in the medical field?  How is a tax on medical devices going to increase the amount of equipment and techonological advancement?  The whole law is designed to increase demand on an already strained system of available health care, while doing nothing to address the supply-side problems.

   There were legitimate problems in health care and insurance that the ACA aimed to fix.  But the law is fundamentally flawed in its grasp of basic economics, and it is doomed to fail.  The Obama administration is attempting to make the insurance companies the scapegoat for people losing their coverage or seeing premiums skyrocket, but the individual mandate was itself an unholy alliance between government and insurers.  If we want to improve health care in our country, we need to grow supply faster than demand, but the ACA does exactly the opposite.  It's the law now, so God help us.

The Perils of Politics

   Some people follow politics closely, some not at all.  I confess to being the former.  I've developed a keen interest in what happens in the political and economic sphere, largely because I'm fascinated by the way in which ideas and philosophies are manifested in the flesh of policy and action.  I'm intrigued by the why and wherefore of laws and the reasoning of the people behind them.  I do firmly believe in American exceptionalism - not of the U-S-A!  U-S-A! variety, because we are far from perfect, but in the sense that we are unusual and special.  There's something about the American experiment that is marvelous, even with its misfires.

   The government shutdown makes most of us roll our eyes in disgust.  We expect our elected officials to put the good of the country before ideological purity; namely, to compromise when necessary to avoid a greater evil, and a government shutdown is not, by any measure, a good thing.  I'm not going to weigh the merits of each party's arguments, but I do have a few observations about what has happened and why.  As so often happens, the truth is hidden not in what politicians do say, but what they don't.

   Republicans complain about the intransigence of Democrats, including the President, who refuse to compromise on any aspect of the Affordable Care Act in order to pass a budget bill.  Republicans point out the inequity of letting corporations, trade unions, special interests and even Congressional and White House staff off the hook when every other individual in the country must comply with the insurance mandate.  But let's face it, part of the reason for the House offering up one compromise bill after another is that they want Senate Democrats to cast a vote on these controversial and unpopular provisions so that they can use their record against them in future elections.  Senate Democrats and President Obama are standing firm and refusing to compromise because deep down they know the ACA is a giant bureaucratic mess and they own it.  The only hope they have is that the ACA will, in time, prove to be successful and more popular than it is at present.  However, that hope fades if they can't squeeze every cent possible from the provisions of the law in order to fund it.  That's why the Senate and President have said no to every compromise offered by the House, because practically everything the House has suggested would, in some fashion, affect the revenue meant to be generated by the law.

   In the end, there has to be some sort of compromise, because that's the way politics work.  The Republicans have leverage in the upcoming debt ceiling battle.  It should be possible to give President Obama something he wants - perhaps a strife-less hike of the debt ceiling - in exchange for something like a one-year delay of the individual mandate or repeal of the medical device tax.  Not negotiating is a recipe for failure, and it's everyday Americans who will pay the price.  One-party rule tends to be a bad thing in our national politics.  Nobody gets to call all the shots.  Politics is the art of the deal, and no one gets everything they would want according to their ideal.  Our political representatives should know the difference between hard and fast principles that must not be broken, and the many practical things where it is possible to bend.  Let's hope the folks in D.C. grasp this difference sometime soon.

Servant of the Poor

   Today is the feast day of St. Vincent de Paul.  Before I entered seminary at St. Vincent Seminary in Latrobe, PA, I never delved into the life of this famous saint.  There was an active chapter of the St. Vincent de Paul Society in my hometown of Green Bay; we occasionally dropped off bags of clothing when my mother went on a closet-cleaning binge, but the significance of the holy man who inspired Bl. Frederic Ozanam to found the societies was lost on me.  I did, at least, associate St. Vincent de Paul with the virtue of charity.

   When I first went to St. Vincent Seminary in the foothills of the Alleghenies, I wondered why the first Benedictine monastery in North America - including a basilica, parish, liberal arts college and seminary - would be named for a saint who had no discernible connections to the Benedictine order.  Of course, the reason was that the parish pre-dated the founding of the monastery by fifty-plus years, and had been served, among others, by a priest from Belgium.  (Side note: it's amazing how many Belgian priests were missionaries in the U.S. One runs across them everywhere.  That country must have been a veritable priest factory.)  The Benedictines made St. Vincent de Paul the patron for everything they built on the hilltop near Latrobe.  Since part of the original vision was to establish a seminary to train priests for what was then the American frontier, St. Vincent was an excellent patron for priestly formation.  I loved my time there, and as a diocesan priest felt like I received the full benefits of the Benedictine sense of stewardship along with the pastoral zeal and charity of St. Vincent de Paul.

   It's worth taking the time to learn more about St. Vincent de Paul and his example of holiness.  There are a number of great films of his life, excellent books and novels, and best of all, the countless men and women who have been inspired to serve the poor by his example and teaching.  We all need to be challenged to interact more with the poor.  There are people who are poor because of their own bad choices in life, there are people who are poor because they are oppressed, there are people who are poor because they are simply unlucky in life.  This doesn't even touch on the spiritual and moral poverty so rampant even in wealthy countries.  But does it matter why a person is poor?  We do what we can for them, and in so doing we fan that flame of charity in our heart.  Once you start serving your neighbor, especially in the poor among us, you simply can't stop, and you don't want to.  St. Vincent de Paul discovered this path of holiness in his own life, and invites us to walk it with him in the service of Jesus, who was the poorest of all.

A Few Thoughts on Popes

   As with most other people in the world, I didn't know what to make of Jose Mario Bergoglio when he stepped out on the balcony of St. Peter's as Pope Francis.  (Oddly enough, I had a premonition that morning when I woke up that whoever was elected pope was going to take the name Francis.  I'm not sure why I thought that; perhaps it seemed overdue considering the tremendous spiritual influence the great saint of Assisi has had over the last eight hundred years.)  Pope Francis has made waves in the first several months of his papacy, but they are good waves, in my opinion.  He believes in simple, direct gestures that manifest the gospel of Jesus Christ.  I would agree with George Weigel that these waves represent the rising tide of evangelical Catholicism.  However, it's not a tidal wave that has come out of nowhere.  It has been building for some time.

   Over the last one hundred and fifty years or so, we've been blessed with exemplary popes, in my opinion.  They've all been holy men, but still men with faults and shortcomings.  The College of Cardinals chooses the successor of St. Peter under the guidance of the Holy Spirit, and I trust that the man who is selected and answers the call provides something that is necessary to the challenges the Church faces in that moment of history.

   I spent my childhood, my youth, and my young adulthood under the pontificate of the soon-to-be Pope St. John Paul II.  I wept for an hour when I received the news that he died.  With the force and charisma of his personality, he brought order out of the chaos of the 1960s and 70s and articulated a bold, fearless vision for the Catholic Church as we entered a new millennium.

   Pope Benedict XVI's election surprised me, only because he had been so clear about not wanting the job.  After years of service to his predecessor, he only wanted to retire to a monastery, pray and write.  And that was in 2005, at the age of seventy-eight.  Yet the "humble servant in the vineyard of the Lord" still answered the call and spent almost eight years filling the Fisherman's Shoes.  Pope Benedict was very different in personal character to Pope John Paul II, but he was a kind and gentle shepherd to the Church.  I think his greatest contributions have been his insistence on the hermeneutic of continuity in understanding the Church's past, present and future, and his wonderful emphasis on appreciating art, beauty, the sacred liturgy, and our interior life of prayer.  I believe he surprised many people (and disappointed media vultures) by his gentleness and pastoral concern.

   No one really knew what to expect from Pope Francis, since he was a bit of an unknown on the world stage, even in ecclesiastical circles.  Over the last several months, we've witnessed many people, especially in the media, attempt to draw their own picture on the blank slate.  Without doubt, however, Pope Francis will shape his own papacy.  He strikes me as a man of very firm character.  Journalism these days seems to be all about narrative and less about truth, but Pope Francis doesn't have any illusions about this.  I predict those who seek to use him for their own narrative are going to get quite frustrated.  He truly seeks to practice what Christ teaches.

   The things I value most so far about Pope Francis - and I speak from my perspective as a priest - are his pastoral zeal and simplicity.  In the now-famous Jesuit interview I was struck by a comment  that I haven't seen reported in any media other than the full text of the interview itself: the Holy Father decided not to live in the Apostolic Palace because it was too isolated, not because it was too large or luxurious.  After his election, he entered the papal apartments and felt like it was a bubble; access was too restricted.  So he refused to live in the bubble.

   What a great lesson there is for all of us in that.  How often do we choose the safety, the solitude, and the certainty of the bubble rather than the rough and tumble of the messy world?  As Christians, our lives rest on a solid foundation of faith in Jesus Christ.  Why be afraid to take that faith into the world, to bring light to others, and to bind up their wounds by showing them the path that leads toward holiness?  Whatever their lives have been up to that point, there is an opportunity to know the Lord and what life in him offers.  This is what Pope Francis tries to live personally and what he encourages us to do, and I believe great things will be born of it.  Once again, the Holy Spirit has given the Church exactly what she needs in the present moment.  Funny how that works.

Why a blog?

   I think a lot.  I have many hobbies and interests, but my favorite pastime is to sit and think.  Contemplate might be a better word, as much of my personal prayer time is spent mulling the mysteries of the universe.  I'm constantly being fed by the books I read, the people I meet, current events, and even the blogs I read (I don't actually follow many, but I'm constantly checking out the links to particular blog posts my friends recommend).

   I enjoy writing immensely, too.  I like to choose words carefully, to articulate a thought so that it means precisely what I want it to mean.  Everyday conversation isn't a great medium in which to practice, although we'd probably all benefit from considering and shaping more carefully the things we say with our tongues.  I don't know that the things I write on this blog will be particularly valuable or profound, or even well-said; there are far more erudite and brilliant writers in the blogosphere than I.  Like Albus Dumbledore's Pensieve, though, I find it helpful to get some thoughts out of my head from time to time, and it would be interesting to me to see what others make of them.

   The title of my blog is quite consciously a reference to Georges Bernanos' classic French novel, Diary of a Country Priest, published in 1937.  It is a story of a humble country priest enduring intense spiritual and physical challenges, weighed down by the darkness and pessimism of a world that has strayed from the path of salvation.  He dies of stomach cancer in the end, murmuring the words, "All is grace!"  A good lady of my acquaintance was surprised I liked this novel so much, as I'm of a sunnier disposition than the tormented, struggling priest of the story.  She thought it all horribly depressing.  Yet I find the nameless priest of the story to be a tremendous inspiration in my own priesthood.  He is gradually conformed to the Cross, descending into the darkness.  The wickedness of the world tears at him body and soul in ways subtle and not-so-subtle, the devil rages, but in the end there is the triumph of the Cross, and that marvelous cri de coeur, "All is grace!"

   A great deal of my ministry as a priest has been among college students at the University of Tulsa and Oklahoma State University.  I owe a lot of my sunny disposition to them, because they strengthen the virtue of hope in me.  I'm curious to see what fruit this blog will bear for me, for others... so let's see what comes out of my ol' noggin.  I don't promise gems and pearls, but if something makes you think more deeply, I'll consider it worth the time to have written it down.