One Catholic's View of Health Care
I have been wanting to say something about the health care debate for sometime, but I have refrained from doing so for one simple reason; not only do I not know enough about the issue, but I am not certain where to even look for relevant knowledge about it. There are two, sometimes more, narratives about what the government is proposing that are so completely at odds, but put forward with such ferocity and vehemence, that it is difficult to know how much of the truth each side is portraying.
Thus I am left to wander about with my own hazy speculation. All I can speak to are my own principles and what little I do know about the state of health care and the dimensions of the problem, neither of which are adequate for the task at hand, but I will proceed anyway and let the discussion develop as it may.
One thing I believe that the vast majority of Catholics can agree to is that, somehow, some way, everyone is entitled by way of their human dignity to health care. Among the things that Christ will judge us for at the end of time is whether or not we helped Him, through the least of our brethren, while he was sick; did we care for Him, or turn our backs on Him?
To put it another way, if we act on the assumption that Christ is present in all men and women, that logically demands we find some way to take care of them when they are ill. And as much as it may raise the ire of some of my fellow commentators, I believe this applies in full to so-called “illegal aliens”, regardless of what we decide; while I don’t demand that they be given the full array of services that citizens are entitled to, it is obscene and manifestly anti-Christian to propose that they be denied basic and emergency health services.
Secondly, there is the issue of subsidiarity; those services which can be provided locally, ought to be. A number of bishops have spoken out on this topic as it relates to the health care debate. One bishop made a statement that reflects my own thinking on the matter, quoted at LifeSiteNews.com:
Bishop James Vann Johnston quoted the Catholic Catechism to emphasize that subsidiarity is “opposed to all forms of collectivism” and “sets limits for state intervention.” He explained, however, that “the higher order” of central government does have a role in health-care reform; but it must only play a very limited and supporting role, not a dominant one, so as not to run the risk of crushing all the other necessary functions and expressions of society and trampling on the individual.
This follows quite well John Paul II’s commentary on the welfare state in Centesiums Annus. There is a role for the state to play in providing health care, but it is a decided small one. In my view, the ideal system would be one in which federal money could reach the local level without the federal government exercising total control over how the funds are used. It would be the place of the government to establish broad guidelines and goals, but the responsibility of local health care providers to determine in what specific ways the funds are allocated and put to use.
Thirdly, and this is all too often overlooked in debates over health care, I would prefer to see a plan that heavily focuses on prevention. There are an embarrassing number of health problems that are related to lifestyle choices alone. While I do not propose denying, or making prohibitively expensive, health services to people whose illnesses are related to personal choices, I do propose taxes on the consumption of goods and services that are known to contribute to poor health. We are past the point where one has an absolute right to be unhealthy and have society pay the tab. Rights without responsibilities are not rights at all, but indulgences granted to children. It’s time to grow up.
Finally, and most importantly, there is the matter of federal funding for abortion, euthanasia, and other anti-life policies. No plan that contains these elements is acceptable, and it would be better for the broken private system to remain in place than for an efficient system that makes it easier to murder and dispose of people “unwanted” by our consumerist society to be established.
For my part, I have been impressed with the changes several European countries have made to their once heavily socialized systems in favor of approaches that more efficiently combine state and market approaches. I think America would benefit from moving in the same direction from the other side, and meeting Europe somewhere in the middle.
In an article proposing that the Dutch system could be adapted for the US, the authors highlight consumer choice as one of its features – in my view, it is the fear of “government doctors” that prevents many Americans from getting on board with any sort of government involvement in healthcare. The article states:
As discussed, insurance companies are required to accept each applicant for basic insurance coverage. Individuals can choose from among 14 private insurance companies and several related subsidiaries. The Dutch government has set up a Web site where consumers can compare all insurers with respect to price, services, consumer satisfaction, and supplemental insurance, and compare hospitals on different sets of performance indicators.
The Dutch system provides healthcare through private companies which are subsidized by the government. This sort of private-public response to the problem of healthcare appears to be, no pun intended, what the doctor ordered for the United States. Of course I am not arguing that the Dutch system is perfect, and many have noted its flaws and potential problems for the future. But it seems to me that they at least have the right idea.
Unfortunately there will be some on both sides that are unsatisfied; some want no private involvement, some want no government involvement. Neither of these positions is reasonable in the year 2009. Big problems require big solutions and a role for the state; but no problem is so big that we can disregard the dignity of individuals and the integrity of local communities. Anyone insisting that either the public or private sector alone offers the entire solution is marching out of step with Catholic social teaching and with Pope Benedict’s latest encyclical, Caritas in Veritate, which states,
“When both the logic of the market and the logic of the State come to an agreement that each will continue to exercise a monopoly over its respective area of influence, in the long term much is lost… The exclusively binary model of market-plus-State is corrosive of society, while economic forms based on solidarity, which find their natural home in civil society without being restricted to it, build up society.” (39)