Friday, August 28, 2009

Roman Missal @ USCCB

The United States Conference of Catholic Bishops(USCCB) has launched a new web site devoted to the new translation of the Roman Missal used in the English version of the Mass.
Still nothing from the Congregation for Divine Worship on when the new translation will start being used.

Sunday, August 23, 2009

So what should the Christian perspective on health care reform be? To start with it must be rational. That means it must look at the facts as they are, not as we wish them to be. It must be informed by faith, that is the center of any reform must be the inherent dignity of the individual and their right to life.
In my last entry I ran through some numbers on health care and pointed out that the "health care crisis" is in reality a money crisis. A rational look at our health care situation demands that we start by looking at what our present situation is. We have already done that. Then we must lay out the principles that we can, as Christians, accept as the goals of health care reform. Then we must face the requirements that exist which takes us from where we are to where we need to be to meet our goals.
I would propose the following principles must be applied.
Medical care must be available to all Americans. Than means from conception to natural death. Abortion is not health care, neither is euthanasia.
The quality of the medical care must be equitable.
Equitable means that care, of a quality now enjoyed by those who have good health insurance must be expanded to all, not that everyone receive less car through the practice of rationing.
Business must continue to carry their fair share of health care coverage. That means they must either continue to pay their portion or they must give that money to their employees so that they can use it to purchase health care. No windfalls by dumping employees on some government health care program. Health insurance is part of a benefit package for most employees, that is part of their compensation for doing their job. To withdraw that compensation without replacing it with cash is equivalent to a pay cut.
If those are our goals then we must face one fact. We will be spending more on health care. Not just "We the People", that is the government, but we the individual. We pay more for a car in 2009 than we did in 1965. We can not realistically expect to pay the same for health care in 2009 that we did in 1965. No one expects that in 2015 cars will cost less. Is it rational to expect that health care will be less?
We also know that as we get older we will need more health care. We should expect that our health costs later in life will be more than when we are young. Just as we plan for retirement, those of us who are fortunate enough to be able to invest and save for retirement must expect that some of this money will go to increased health care costs.
We must also face that there are those who either don't or are not financial fortunate enough to be able to save for this period. We must accept the fact that we will have to pay for them. Either through private Christian charity or government mandate. If we refuse to do it through the former method we should not be surprised if we are force to do it through the latter.
We must also face some other facts. We do not have enough doctors to give equitable care to everyone. This is one of the reasons care is rationed in Canada and Great Britain. The other is investment of too much of their health care dollar(pound) in bureaucracy instead of health. That is the natural result of a single payer system.
So how to get there from here?
Continuance of health savings plans is one way. This is set for the ax under the House's Health care bill. Health savings plans encourage individuals to save for their health care needs. They should be allowed to carry over from year to year amounts that are not spent. At the present time any amount not spent goes to the administrator of the plan.
13% of Medicare is lost to fraud. The way to stop that is not more rules and tighter constraints but more investigators, prosecutors and jail sentences.
Not all of the uninsured are equal. There is a difference between a family which truly cannot buy food, shelter and clothing and afford health insurance and one which chooses to live in a better house or buy nicer things rather than pay for health insurance. Each group must be addressed individually and it must be admitted that it will cost the rest of us money, either through taxes or fees. We cannot cover these people for free, and pretending that we can merely means we are not paying for someone else's care.
Efficiency can make it cheaper to cover these people. When deciding how this part of health care should work looking at whether government or industry is more efficient should tell us how we will get the most for the money we have to spend to cover the uninsured. I doubt anyone would claim government is more efficient.
If we want to lower the cost of insurance we must broaden the insurance base. Insurance is a risk easement game. A group of people pool their money through an agreement that if someone gets sick the money for care will come out of the pool. Since the company that manages the pool is a business they skim a portion off the top and then use the remaining assets to pay for the care. The more healthy people that are in the pool the less each member must pay.
There are two ways to lower the cost to individuals. One is to limit the amount the managing company skims off. This is a finite amount. At some point the venture becomes unprofitable and the managing company goes out of business. So only a finite amount of savings comes form this method.
The other is to increase the number of healthy people in the pool. One way to do that is to allow insurance companies to sell anywhere in the United States. That way not only can they increase the number of people in the pool, but they are incentivized to keep their operating costs low, so as to be competitive.
At the bottom we should expect that some people will just not play. They will not get health insurance. Even under single payer they will remain outside the system, by accident or deliberate choice. When they get sick the more bureaucratic the system the less well it will deal with them. There will always be a need for Christian charity in the care of these people.

Friday, August 7, 2009

Health Care

The need for health care reform is a subject upon which in principle all men of good will in the United States can seem to agree. It is almost universally agreed upon that our health care system is in trouble and that action must be taken to fix the problem. As always the actual problems are masked in flurry of political posturing.
The problems with health care in the United States can be divided into several key areas. First, the number of uninsured continue to grow. Second, the majority of U.S. Citizens above the age of 65 have health care either partially or entirely provided by the government funded Medicare program. Third, a majority of Americans receive their health insurance through their employers, most commonly through a cost splitting arrangement. The increasing cost of this arrangement is causing increased overhead for employers and financial hardship for workers.
Approximately 45 million people in the U.S. are uninsured. Of this number approximately 11 to 12 million of these people are foreign born, the majority of them in the United States illegally. The population of the United States is estimated to be approximately 305 million people. So approximately 15% of the population is uninsured.
About 9 million of those who are uninsured could afford insurance if they so chose. Another eleven and a quarter million is eligible for coverage under existing government health programs, should they apply. The rest are simply unable to afford health coverage. As many as a tenth of those could afford regular group coverage but due to pre-existing conditions cannot afford, or will not be accepted for individual health insurance.
The fact that so many people can not or will not get health insurance coverage is a problem because, quite apart from the Christian principles that call for access to medical care for every individual based upon their inherent dignity as a being created in God's image, most of these people are not unable to get health care in an emergency. The law requires that any hospital receiving public funds care for anyone who shows up at their emergency care facilities, whether they have insurance or not. Of course emergency care is some of the most expensive health care available. Members of this group are also likely to be sicker and live a lower quality of life because they wait to receive medical attention until their problems are acute. This also requires that more expensive treatments be used, because chronic conditions, which can sometimes easily be treated with drugs, not themselves always cheap, must instead be treated with expensive invasive procedures.
The number of people covered by Medicare is approximately 45 million people, the majority of whom are over 65. As of last year Medicare is 14% of the national budget. In the next few decades the number people on Medicare is expected to almost double, while the number of people paying in to support the program is not expected to rise consistent with this increased funding need. Medicare is a unfunded liability which will require a larger and larger percentage of the GDP. It is a program which is basically unsustainable. In 2007 Medicare cost $440 billion of which approximately $60 is thought to have been the result of fraud. In other words over 13% of the cost of Medicare is wasted.
In the last eight years the cost of employer provided health care has increased 78%. There are several reasons for this increase in cost. Advances in medical technology add to the cost of health care. New diagnostic equipment, pharmaceuticals and methods add to the cost of care. Liturgical considerations, that is the cost of malpractice insurance and litigation which results in reimbursements and penitential awards have some effect. The increased care required by a culture which tends to promote both overeating of unhealthy food and lack of physical exercise is arguably the greatest contributor to cost.
Note that in the above discussion problems with the actual quality of care, the ability of medical organizations to carry on research or for researchers to deploy new treatment options are not negatively impacting American health care, which is seen internationally as the best in the world.
The huge health care crisis is a money crisis. It is also no wonder that solutions being proposed by congress and the Obama administration are solutions based on improving the bottom line, not on improving care. Like old style efficiency experts and corporate managers their goal is a hard nosed cost analysis based change, not a change based on Christian social values. The end game is not the highest quality care for all, but something called “equitable” care, a euphemism for health care rationing. Everyone will have health insurance, but that health insurance will be as meaningless as the “universal” care possessed by citizens in Canada, Britain or France. Though I have no doubt members of Congress and the President will continue to enjoy the best health care America can provide.
Such a financially centered modification of our health care system would enjoy dubious support of Christian organizations on its best face. The fact that the present effort in health care reform is actually using the financial justification as a distraction to hide the real agenda of the Administration which is to use reform to push federally financed and mandated abortion support which will be used as a club against Catholic hospitals and medical professionals who oppose abortion. Also being hidden in the plus 1000 pages of the reform bill are attempts to destroy the private insurance industry, the one part of the American health care system which provided freedom from the tyranny of a government run health care system. Efforts to control and collect medical information about patients, who as U.S. Citizens should be protected from government intrusion in their private lives.
The cost of continuing to support the existing Medicare system, while effectively doubling the number of people covered is only the down payment. If Medicare is unsustainable how can doubling the size of the program be sustainable? Of course the 85% of those now covered by private insurance will not remain so. I have seen nothing in the bills rolling through Congress that will in any meaningful way prevent employers, large and small from dumping their employees onto the public health care system. This is the almost sure result and barring other factors the cost of health insurance continues to rise. In the present environment of high job turnover even if employers were prevented from dumping present employees, if they were allowed to simply not cover new employees, in a very short time, measured probably in years not decades a majority of the workforce would almost certainly land in the government program.

So what's the Christian answer to these problems?

Thursday, August 6, 2009

Worldview

There was a scholar of the law who stood up to test him and said, "Teacher, what must I do to inherit eternal life?"
Jesus said to him, "What is written in the law? How do you read it?"
He said in reply, "You shall love the Lord, your God, with all your heart, with all your being, with all your strength, and with all your mind, and your neighbor as yourself."
He replied to him, "You have answered correctly; do this and you will live."
A scholar of the law was called a scribe, and in Matthew's version of this Gospel the questioner is identified as a Pharisee. The first law is from Deuteronomy 6:5:
You shall love the Lord your God with all your heart, with all your soul, and with all your strength.

Monday, August 3, 2009

"You are a priest forever..."

I have been blessed these past years with a pastor very scrupulous in his adherence to the books of the liturgy, and orthodox in his beliefs. Soon he will be retiring. With the state of the American Church being what it is, whether the bishop will be able to find us a new pastor or whether we will be clustered or have to undergo a period under a pastoral coordinator is unknown.
Meanwhile we are fortunate to have a visiting priest to aid father in his last few months. This priest, not strictly a visiting priest, but rather one who is on sabbatical from his own parish for a year also seems to be a very prayerful priest, who seems very careful in his celebration of the Mass.
His homily touch very much on his own experience as a priest as he talked about the meaning of the holy Father's declaration of the Year of the Priest. His example reminded me very much of the experiences I had heard related by those priests who were in New York in 2001. How strangers, seeing the Roman Collar, knew that there was Christ in their midst, and ran to him for comfort during a period which exceed the capacity of any earthly comfort. I was reminded of the letter of His Holiness, which was published in June to announce the Year of the Priest.
The Curé of Ars was quite humble, yet as a priest he was conscious of being an immense gift to his people: "A good shepherd, a pastor after God's heart, is the greatest treasure which the good Lord can grant to a parish, and one of the most precious gifts of divine mercy".[3] He spoke of the priesthood as if incapable of fathoming the grandeur of the gift and task entrusted to a human creature: "O, how great is the priest! ... If he realized what he is, he would die... God obeys him: he utters a few words and the Lord descends from heaven at his voice, to be contained within a small host...".[4] Explaining to his parishioners the importance of the sacraments, he would say: "Without the Sacrament of Holy Orders, we would not have the Lord. Who put him there in that tabernacle? The priest. Who welcomed your soul at the beginning of your life? The priest. Who feeds your soul and gives it strength for its journey? The priest. Who will prepare it to appear before God, bathing it one last time in the blood of Jesus Christ? The priest, always the priest. And if this soul should happen to die [as a result of sin], who will raise it up, who will restore its calm and peace? Again, the priest... After God, the priest is everything! ... Only in heaven will he fully realize what he is".
Yet how many of us give little thought to the man in the collar, until disaster strikes! So in this Year of the Priest don't forget to offer prayers for your priest. But also don't for get to thank him and help see to his worldly needs too. Dinner, suitable thank you gifts and appropriate donations are always welcome Remember here is a man who puts on Christ daily, not for his own glory but for the salvation of souls. Be grateful.

Saturday, August 1, 2009

The Principle of Solidarity

The term “solidarity”, widely used by the Magisterium, expresses in summary fashion the need to recognize in the composite ties that unite men and social groups among themselves, the space given to human freedom for common growth in which all share and in which they participate.
-Compendium of the Social Doctrine of the Church.
By virtue of their participation in the society that surrounds them individuals are debtors. They owe a debt to the others in society who through their efforts
make human existence liveable, and because of the indivisible and indispensable legacy constituted by culture, scientific and technical knowledge, material and immaterial goods and by all that the human condition has produced.
Promotion of division of the classes, division into employer and employee, haves and have-nots, along racial or ethnic or other lines is a violation of the Principle of Solidarity. Likewise it falls not just to the rich to promote justice, engender charity or bankroll government programs.
Class warfare, the principle upon which the idea of redistribution of wealth is based, as well as most modern interpretations of employer/union relations is based upon an adversarial relationship which violates the idea that we all have a responsibility to contribute to society.
The employer and the employee together work to make the business enterprise successful. Both benefit as does society. When demands of the employee become an unreasonable burden on the business, such that it becomes unprofitable, the employee is not a contributor to society, but a burden. Likewise for the employer maximization of profits, to the exclusion of the common good is un-Christian.
This does not mean that profit in and of itself is an evil.

Profit is useful if it serves as a means towards an end that provides a sense both of how to produce it and how to make good use of it. Once profit becomes the exclusive goal, if it is produced by improper means and without the common good as its ultimate end, it risks destroying wealth and creating poverty.
-Caritas in Veritate, BXVII
Solidarity makes it the responsibility of those who are well fed to feed the hungry, of those who have a riches of blessings to help those who do not. In this context it should be remembered that wealth is relative. Generally speaking the $22,500 which is the designated poverty level for a family of four in the United States is more income than the balance of the human population on Earth sees in their entire lifetimes. Most of our poor enjoy luxuries which are unthinkable to people in most of the world.
In this context the inequalities which exist between most Americans pale in comparison to the inequalities which exist between even our poorest and most of the world.
This leads the conclusion that every member of American society should be willing to contribute to the well fare of those less fortunate than ourselves and to the common good.
So what is the common good?
The Church speaks about that throughout the Compendium and indeed through many other documents throughout the ages. It is also very specific about what does not contribute to the common good.

No legislation, no system of rules or negotiation will ever succeed in persuading men and peoples to live in unity, brotherhood and peace; no line of reasoning will ever be able to surpass the appeal of love. Only love, in its quality as “form of the virtues”[456], can animate and shape social interaction, moving it towards peace in the context of a world that is ever more complex.
-Compendium of the Social Doctrine of the Church.
Charity is not something which can be imposed by government. Attempts to do so are disruptive to Solidarity.

Support for fringe activities, such as homosexuality, homosexual "marriage", pornography, contraception, abortion, in short activities which undermine the family are not just detrimental to the individuals involved, but also to society as a whole. To the common good.
Governments, and the individuals in those government which support such activities fracture the Solidarity of the society and work against the Common Good as understood by the Church. Such a government or administration is not acting in conformance to Catholic Social Teaching.