It is hard not to despair of democracy. To observe from afar the work of our elected representatives in House and Senate on health care reform is to watch an expensive exercise in futility. Real reform would involve separating the provision of care for the body, which everybody needs and everybody should get, from the fictions of insurance and the vagaries of employment. This has long been off the table. It would also involve accepting as axiomatic that everyone who is here merits care, and that none who are here should be deliberately killed by providers of care. But it is now broadly agreed that these things, too, are beyond debate. The result is that we will (quite certainly) tinker with our insurance- and employment-based system rather than replace it with something better; that we will (almost certainly) continue to exclude the undocumented from access to proper care; and that we will (very likely) make it easier to use public money to kill the unborn than is presently the case.
As the good and defensible options vanish from the table, often so quickly that it seems they were never there, the intensity of discussion about the form and shape and texture of what is in principle indefensibly bad increases. That is democracy as it ordinarily functions.
Perhaps some things will be mildly better after the reform. Perhaps more Americans will find the help they need in healing their sick bodies than do now. And if that turns out to be so, it should be celebrated. But any such celebration should be laced with tears: we will have made things worse as well as better (if better at all), and we will have done so because we cannot, collectively, see clearly, a lack of clarity to which democracy as practiced here in this bloodsoaked land has made and is making direct contributions. Sackcloth & ashes & fasting & lament are all that is left to the Church. Contributing to public debate has done, for the Church, as much as it usually does, which is nothing at all.
