Current Comment

Rx: Real Reform

In his epic distillation of the wrongheadedness of the U.S. health care system (Time, 3/4/2013), Steven Brill asks a simple question: Why is health care so expensive? What Mr. Brill discovers is old news to those who have closely followed the decades-long debate over health care reform, but the numbers he uncovers retain the power to shock. In his forensic accounting, Mr. Brill discovers jaw-dropping mark-ups at every stage of health care delivery. The gouging is rampant at both for-profit and allegedly not-for-profit facilities, where in a white-collar gold rush, some executives reward themselves with million dollar—and beyond—salaries.

U.S. health care now consumes as much as 20 percent of the nation’s economy. Yet despite its high cost—as much as triple the per capita expense of other industrialized nations—it still achieves only poor to mediocre outcomes.


It is clear who benefits from the status quo, but who pays? U.S. taxpayers and health plan members, many of whom surrender each year a percentage of compensation that represents the difference between working for want and a reasonably secure middle-class lifestyle. About the only dependable players in this carnival of overbilling have been much-derided government bureaucrats striving to keep hospital invoices honest in the nation’s vast Medicare system. So why has a greatly expanded Medicare, the so-called public option, been tabled in discussions of health care reform?

Mr. Brill explains that however sensible it may be, the public option creates too many “losers” among people in health care with clout in Washington. The cloutless outside the Beltway, however, deserve better treatment. Allowing industry lobbyists to continue to dictate the parameters of “reform” is a prescription for disaster.

Mainstream Celibacy

The confluence of the papal conclave and the resignation of Cardinal Keith O’Brien of Scotland focused the media’s attention on celibacy. Cardinal O’Brien was accused by several priests of making inappropriate sexual advances; soon afterward he resigned, turned down a chance to attend the conclave and then issued an apology. For a few in the media (not all, of course) this was an opportunity to opine on something that some opinion-makers seem to know little about: the celibate life. Priests are lonely, said several op-eds; and celibacy was said (against all the evidence) to be a direct cause of sexual abuse.

Some op-ed articles seem to have been written by people who have never met a priest who has promised celibacy or a member of a religious order who vows chastity. (That the two—celibacy and chastity—are different also eludes many commentators.) There are, of course, fewer celibate men and women around these days in the clergy and religious orders. But it rarely seems to dawn on some essayists that they already know many celibate people—unmarried men and women, widows and widowers, for example—who are not child molesters. Second, it seems impossible to them that someone could forego sexual intimacy and not be either sick or crazy and certainly lonely. Yet a survey by the Center for Applied Research in the Apostolate in 2009 showed that a staggering 97 percent of priests (that would be celibate priests) are “very happy” or “pretty happy”—two thirds of them being “very happy.” Celibacy and loneliness rank relatively low as “problems” for them. High among “sources of satisfaction” was the “opportunity to work with many people and be part of their lives.”

Unforced Error

The nation was treated to the mother of all Beltway paralyses on March 1 with the beginning of sequestration. A doomsday tactic that had been cobbled together as a prod toward rational compromise grew into the monster that consumed the 2013 budget, as $85 billion in defense and social spending cuts began. Worse, as sequestration ticked closer in February, some politicians began to promote it to the public as a more or less harmless way to get Washing-ton spending under control.

But as it takes effect over the coming months, sequestration will begin inflicting real pain on people least able to endure it. While the nation’s scandalous defense spending has long required sensible reduction, many Americans still suffering in the aftermath of the Great Recession need government support now. Some vital programs that serve the most vulnerable, like nutrition aid and health services, will be protected. But other programs—housing vouchers for the poor and disabled, for example—will suffer more from the cutbacks.

If common sense prevails, there remains negotiating room this year to put the country on a path to sensible spending control, measuring the special demands of the economic moment against the long-term requirement of deficit reduction. Are this White House and this Congress up to that challenge? The current rhetoric suggests otherwise. The public may have to wait until the next round of congressional elections, which may deliver a Congress more amenable to reality and less captive to ideology.

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John Doe
5 years 10 months ago
I think there is more to the sequestration than is apparently understood in the Unforced Error section. As is explained, the sequester affects both defense and social spending (and homeland security spending, if you consider that a separate section). Undoubtedly, the spending reductions will cause hardship on many Americans; however, there seems in this piece to be an incongruent lament about the social spending cuts, while the defense cuts are written off as overdue. Even ignoring whether defense spending has been "scandalous" and is overdue for cuts (I disagree with that opinion), I think it's important to point out that the defense sequester cuts may very well have a big impact on a family and/or personal level. Many people face the prospect of losing jobs or steep pay cuts due to possible furloughs. This could be very difficult for both lower-level employees who don't have grand salaries and for parents who will now struggle even more to support children and maintain households. It can be difficult to remember that there is a very human side to defense, but it is important to remember not only to remain nonpartisan but also because so many of our brothers and sisters are involved in the defense sector. It is a painful time for everyone.
rosanne santos
5 years 10 months ago
Yes, mainstream celibacy impacts widows, widowers, and some single persons, as you mention. The difference that makes all the difference is that celibacy is mandated in the priesthood. Just because a priest is married does not mean they cannot have the “opportunity to work with many people and be part of their lives" as you say. Celibacy is not a choice for priest that fall in love or decide after a dozen years or more that they wish to marry and have a family. Over 100,000 priests have left to marry and they would hardly agree with the survey that they were happy in the priesthood. Coercing sexuality in any form (and mandatory celibacy IS one form) is as wrong, unethical, and sinful in the priesthood as it is in cases of rape or abuse..
Tim O'Leary
5 years 10 months ago
Rosanne. To be able and willing to promise (vow) to stay faithful to a single spouse for life (even if intercourse becomes no longer possible), or to stay celibate for God for life (as religious or single), are examples of greater freedom, not less, compared to the inability to give lifelong vows. And you forget that God provides support in difficult times for those who have made such a promise. It may be heroic at times, but I see no evidence that being unfaithful or keeping one's fingers crossed when making a vow ever brings more health and happiness.
Lou Bordisso
5 years 10 months ago
While I have been, am now, and always will be a person who values and supports the giftedness of celibate chastity, it is clear to me that when it is imposed rather than offered as a response to a sacred invitation, the negative consequences are self-evident. The downside to imposed celibacy more often than not leads to sexual acting out, sexual violence and abuse, and additive sexual behaviors, and anonymous sexual encounters, often as a means to repress and/or avoid healthy sexual urges. The unfortunate reality is that far too many clergy and religious know from firs-had experience that imposed celibacy results in bouts of depression, abuse of power and control, aggressive behaviors, and an unhealthy pre-occupation with sex, substance abuse, or process addictions such as gambling, excessive work, or over-spending. Clearly there is more to the story than meets the eye and the rosy picture of priestly happiness “Mainstream Celibacy” suggests (March 2013, America). In my humble opinion, your report is short-sited and misleading. It only serves to placate those in the pews who suffer from “magical thinking” or are in denial of the fact that imposed celibacy actually is related to a happy priesthood. Mounting empirical data suggests the opposite. As a matter-of-fact, imposed celibacy is supported by and often rooted in a priestly culture of duplicity, deceit, and dishonesty not only by priests representing themselves in public in a way that does not reflect their private reality but also by not being honest with each other. Based on my casual observation, there is a “Don’t Ask/Don’t Tell” culture among many, if not most, religious and diocesan clergy. The unfortunate reality is that articles such as “Mainstream Celibacy” only help to perpetuate the myth, denies the rampant lack of fidelity public vows or promise, and undermines the credibility of the church. In other words, as with most “mainstream” Catholic publications, you seem to be mirror the tactic many bishops with so-called plausible deniability by intentionally mis-representing the truth about priestly sexual indiscretions often citing biased and apologetic data which may, in fact, create a veil of secrecy by “circling the wagons” but in the long run only serves to disgust informed Catholic who are thirsting for sincere authenticity not only from bishops but from publications such as America. A favorite saying, of my late Irish-Catholic mother was, “Tell the truth and shame the devil”. In the midst of public perception versus the private reality of how priests live “celibate chastity” and how Catholic apologists from the top down seek to perpetuate lies, it would behoove us all to take my late mother’s advice as we journey together seeking to be a transparent and virtuous People of God.


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