When the United States Conference of Catholic Bishops (USCCB) raised a reasonable objection to the HHS mandate connected to the Affordable Care Act”a rule which will require all employers (including organizations like the Little Sisters of the Poor and the Sisters of Life) to betray their consciences and include free sterilization coverage and free contraception and abortion drugs in their health insurance plans”White House Press Secretary Jay Carney was dismissive. “The bishops,” he asserted, “never supported health care reform to begin with.”

“That is not the case,” shot back Bishop Stephen Blaire, of the Committee on Domestic Justice and Human Development, “Since 1919, the United States Catholic bishops have supported decent health care for all and government and private action to advance this essential goal.”

This week the U.S. Supreme Court is hearing arguments regarding the constitutionality of what has become known colloquially as Obamacare. On the eve of these hearings, former Vice-President Dick Cheney’s heart transplant came under fire from some questioning whether such surgery is “wasted” on a 71 year-old in retirement, or if the procedure should have been reserved for a younger patient, someone whose life still held the promise of productivity and use.

Such remarks, of course, illustrate how easily publicly funded issues of morality and humanity ironically become publicly funded hotbeds of immoral choices and inhumane calculations. In this case the attempt to provide health care for the greatest number of people quickly becomes a matter of chilly accounting. Human beings become mere units; the consideration of who receives what care becomes a utilitarian process focused on arbitrary valuations of life, and whether one human being is “worth” more than another.

Here, within the neat columns of taxes, fines and penalties received versus benefits paid out, hide the little demons of our spiritual destruction; they encourage the appointing of some flawed and imperfect humans to gauge the worthiness of other flawed and imperfect humans and then relentlessly advise for or against a life based on ever more relativistic (but called “practical”) lines. Giving public voice to their relentless prompting, pundits who recently declared that “60 is the new 40” will suddenly be opining that 71 is too old for a heart. 75 will be considered too old for a new knee”news that will stun active, fully engaged and vital people like my 80 year-old father-in-law.

Saint Philip Neri used to listen to the dreams of those around him, and ask, “and then what?” If someone mentioned a lofty ambition, Philip would tease them about what comes next: “you become rich and successful, and then what?”

“And then I marry a beautiful woman and we travel and enjoy life!”

“And then, what?” Philip would gently ask, over and over, until the dreamer was forced to acknowledge that beyond their dreams lay only death, and an eternity reflecting the values and choices of their relatively short blip of a life.

Once a society commits itself to the notion that only certain people meeting certain specs will be considered for certain procedures, it will soon determine that fatties who are 50 will either submit to increased governmental control over their appetites and exertions or be denied a stent. And then what? Perhaps expectant parents, unwilling to do the socially-and-fiscally-responsible-thing and abort their less-than-perfect children, will face the wrath of their fellow-citizens; having been identified as cruel, heartless people too-willing to birth a child whose quality of life has been determined to be sub-optimal, they may not be allowed to parent at all.

And then what? Perhaps a 45 year-old woman who has never married and has no children (and therefore with no one in urgent need of her existence) will be thought too dispensable and unnecessary for chemo therapy. What does she have to live for, anyway?

And then what? Perhaps people with lower IQ’s”whose lower earning potentials can never generate substantial tax revenues”will be deemed unworthy of costly extended therapies.

And then what? Repeat substance abusers will be deemed too costly for yet another stint in rehab. It might be cheaper”and more “humane””to let them go out with one big-government-facilitated bang.

And then what? Maybe women who insist on having more than two children in their lifetimes will be forced to accept sterilization or lose their coverage.

And then what? Maybe genetic-engineers will manage to determine which fetuses, in utero, will be predisposed to cancer, diabetes, obesity, or dementia and their lives will be disallowed to proceed. In an election year, this will be called “A plan for future savings.”

And then what?

The urge toward utilitarianism is an urge toward an eventual eclipse of humanity; it is an urge toward material and ideological conformity in creatures so individualized that their fingerprints are as resolutely unique as snowflakes, and thus it is most unnatural.

The Catholic bishops, committed to the equitable treatment of human beings, and ever-mindful of the sanctity of human life, have for nearly 100 years advocated for “decent health care” via “government and private action.” It may be supposed they intended to be one of the private entities assisting toward that goal. In 1919, however, the bishops could not have imagined that the U.S. government would prefer to do without the Catholic social assistance that helped to build the nation, unless it came with an approving nod toward life-denying drugs and procedures.

If Philip Neri’s game of reductive realization is useful”and it is”and if the Supreme Court determines Obamacare to be constitutional, the bishops may yet find themselves with an important role to play; their constant advocacy for human life and the dignity of the human person will serve as the invaluable balancing pole; it will remind the public that their lives are valuable beyond bureaucratic measure, and perhaps it will keep the bean-counting high-wire act from slipping into the void of dehumanizing utilitarianism.

Elizabeth Scalia is the Managing Editor of the Catholic Portal at Patheos and blogs as The Anchoress . Her previous articles for “On the Square” can be found here .

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