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So I’ve been reading Fintan O’Toole’s Enough is Enough: How to Build a New Republic on my Kindle recently. I know what you’re thinking: why would someone read a book about how to make Irish politics more left-wing when he is neither 1) Irish nor 2) left-wing? And it’s true, I have a problem; I need help.

But leave that aside for now. I’m currently on a section in which O’Toole rails against the large place the Catholic Church has in providing health care in Ireland. It seems that the Irish bishops have actually had the temerity to oppose increased government involvement in health care, as this would interfere with the Church’s role. For example, in 1948 the Bishops opposed a government plan to provide free health care to children and new mothers. O’Toole quotes Bishop Cornelius Lucey of Cork laying out the Church’s view on the part the state should play in health care:

What should we expect from the State? Help to enable us to help ourselves. Thus, instead of providing directly through its own agencies free housing for all, free health services for all, free school meals for all, etc., it should rather see to it that these are available and that people can afford to pay for them. Thus the real answer to the problem of the man who cannot afford medical care for his wife and children is not a free mother and child service for all, but a rise in wages – or cut in taxes – sufficient to enable him to pay.

Milton Friedman couldn’t have said it better himself.

I note this because you sometimes hear it said that American political culture is fundamentally protestant, and that Catholics who believe in limited government are somehow buying into protestant individualist notions. Correct me if I’m wrong, though, but my impression is that Ireland circa 1948 was pretty Catholic.

More to explorer

God Bless Bishop Strickland

The Joy of Pillaging

Great lunch hour game.

Saint of the Day Quote: Saint Bertilla Boscardin

Here I am Lord, to do your will, whatever comes.


  1. On a slightly more serious note, I should say that when he isn’t attacking the Catholic Church O’Toole’s book is pretty good. The Irish really are getting shafted by bankers, the EU, and their own government, and many of O’Toole’s proposals (more localism, decentralization, etc.) are music to my ears.

  2. Blackadder,

    Do you know how much an increase in wages would be required for the majority of families to be able to afford their own health insurance? It would seem to me to be quite a large increase, but you might have a sense of the number.

  3. WJ,

    A majority of families already pay for their own health insurance, so the answer would be $0.

    Of course I would not want to settle for a majority of families being able to afford their own health insurance. All families should be able to afford it. My guess though is that if you changed the way the health care payment system is structured you could bring down costs such that it wouldn’t take a big increase in wages for everyone to be able to afford it.

  4. Art is of course right WJ. We owe our present deranged pairing of health insurance with employment to the confiscatory income tax rates of World War II. Unions bargained for good health insurance plans for their members instead of wage increases, due to the taxes their members would have had to pay on increased wages.

  5. Awaiting Morning Minion’s explanation on how Ireland came under the influence of Calvinism…

    Easy enough. Via Jansenism. 😉

    Also, IMO it is an error to conflate health care and health insurance. One could easily argue that a large part of why the cost health care visits and procedures are high is the proliferation of health insurance for a few generations. If things like regular doctors visits were never included in plans, and the plans were geared more towards the catastrophic health issues, I doubt the YoY cost of health care would be nearly as high.

  6. It would very much help the reader’s level of cognitive dissonance if you refrained from using the phrase “free healthcare”. Nothing is ever free, least of all when government attempts to provide it.

  7. RL, whatever you take out of health insurance, I think regular doctor’s visits probably shouldn’t be one of them. It’s the one form of health care that we actually want consumed more. Plus, as it isn’t an emergency service, insurers can limit access to in-network clinics which keeps costs down.

    I’ve become cynical about significantly reducing the cost of health care. End-of-life care is the biggest cost and you can’t control those unless you let people die. The public won’t stand for that, especially not from a private insurer, unless you convince them that the care simply isn’t available. I suspect that’s how countries like Canada controls their costs: “Sorry, we’ve done everything we can. But there are hospitals in the US that can do more if you’re willing to spend out-of-pocket.”

  8. I guess I was operating under the assumption that most people who have health insurance do get it from their employer. (I could be mistaken about this as well–I have no strong views on health insurance other than a desire that it be less expensive!) If we were to divorce health insurance from employment, how much higher would wages have to be so as to allow individuals to buy their own insurance? Would this number still be $0? I am assuming–but maybe incorrectly–that companies, etc. might get discounted rates based on scale, but that if the purchase were to devolve onto individuals, it would be at a higher cost to them.

    I mean, do you really think that, given the cost-structure currently in place, it would be better if individuals were left on their own to purchase insurance? (I’m not being argumentative here; I just want to see whether you–Blackadder and Art Deco–think that this proposal above is in principle workable today, or whether other things would have to change before it became possible.)

  9. WJ,

    I think the point that’s being made is that employers already factor in health-care costs. For example, my employer will provide us with a worksheet that basically lays out our total compensation, including benefits, and that amount is obviously a lot more than what our actual salary is. So employers would presumably simply just makeup in salary what they are no longer covering in health benefits. So essentially the net change to them would be zero.

  10. I suspect Blackadder is in error. Most people receive medical insurance from their employer. It is the accounting convention that the cost is partially expressed as a charge against the employee’s nominal salary.

    There are certain advantages to having medical insurance conjoined to one’s employment. A collection of working adults generally does not include people who are old and/or disabled and the federal government has for some time been willing to assume the cost of the most ruinously expensive treatment for the able bodied (kidney dialysis). A body of employees can form a viable actuarial pool.

    The trouble you get with general reliance on insurance purchased by individual households (and Mr. McClarey has spoken of replacing Medicaid and Medicare with vouchers to purchase household insurance) is the problem you get with the market for long-term care insurance as we speak – a considerable mass of households will be deemed uninsurable risks making necessary some sort of financing arrangement apart from and outside of the market for household insurance. (Make necessary in our world, not in the world of Ayn Rand-bots).

    Memo to RR: nursing home care currently accounts for only about 11% of the some of expenditures on medical care and allied services.

  11. http://reason.tv/video/show/get-some

    I know; I hate a lot of Reason Magazine too. Its name is condescending and pretentious, but here’s the rub: as much as we don’t like him, he has a point- not the whole answer, but a valid point.

    A while back there was a discussion on the right to adequate health care, while I agree with that right (and don’t think that ADEQUATE health care is really up for grabs or disagreed with much in the Church), I don’t agree that people who could afford health insurance, who choose to spend the money on other things, should get to reap the fruits of other’s labor, without any reciprocity for them. This seems to be beyond orthodoxy vs. individualist heresy.

  12. Art Deco, I wasn’t even thinking about nursing homes. I mean those expensive treatments that aren’t expected to extend life much. More than half the Medicare budget is spent on patients who will die within 2 months.

  13. “Easy enough. Via Jansenism. ”

    Not true. Jansenism never gained significant traction in Ireland.

    “Jansenism”. The Oxford Companion to Irish History. 2007.

    “Jansenism was viewed with great suspicion by Rome, and 17th-century Irish synods toed the Roman line. Indeed, while its moral rigorism made it attractive to elements of the Counter-Reformation church, Jansenism’s theological and political radicalism alienated both local hierarchies and Catholic monarchs. This was especially the case in France and most Irish clerical students there associated with milieux hostile to the movement. Indeed their anti-Jansenist opinions were singled out for criticism by the pro-Jansenist journal Nouvelles ecclésiastiques, Irish clerics, in general, being more attracted to Jesuit-style humanism. The success of the anti-Jansenist bull Unigenitus (1713) marginalized the movement but it survived as a popular millenarian-cum-miracle cult. Neither as a theology nor as a political attitude did Jansenism recommend itself to the Irish Catholic community, either at home or abroad. The frequent claim that Irish Catholicism was Jansenist-influenced springs from the tendency to confuse Jansenism with mere moral rigorism.”

    Dr Thomas O’Connor. Ph.D.
    Senior Lecturer – Department of History, National University of Ireland

    author of:

    _Irish Jansenists 1600-1670: politics and religion in Flanders, France, Ireland and Rome (Dublin, 2008)
    _Strangers to Citizens: the Irish in Europe 1600-1800 (Dublin, 2008)
    _An Irish Jansenist in seventeenth-century France: John Callaghan 1605-54 (Dublin, 2005)
    _An Irish Theologian in Enlightenment Europe: Luke Joseph Hooke 1714-96 (Dublin, 1995)

    Healy, John. Maynooth College : its centenary history (1895). Dublin : Browne & Nolan, 1895.

    “During the eighteenth century many of the most eminent Churchmen in France were, to some extent, tinctured with these Jansenistic views, even when repudiating the Jansenistic errors regarding the operation of grace and free will. But although so many of our Irish ecclesiastics were educated in France during the eighteenth century, none of those who came to Ireland ever showed the slightest trace of this Jansenistic influence, either in their writings or their sermons. Nor has any respectable authority asserted, so far as we know, that the French Professors of Maynooth were in any way tinged with the spirit of Jansenism.”

    Most Rev. John Healy, D.D., LL.D., M.R.I.A

  14. Umm, thanks for this, Shane. I’m sorry to have wasted your time though. I was just being sarcastic. A terribly thing about blogs where you have a relatively steady readership and commentariat is that we assume everyone else knows where we tend to stand on issues and where those who differ generally stand. My comment was just a continuation of the previous quip. 🙂

  15. heh.

    Morning’s Minion says:
    December 17, 2010 at 3:15 pm

    From the article Colbert quoted, it would appear so. That’s nothing unusual with American Catholics brainwashed by the dominant Protestant culture, and tinged anyway with Irish Jansenism.

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