 A Catholic Voice on Health Care
Fr. J. Steele, C.S.C.
Originally posted on 1/10/2010
One voice largely missing from the most heated and passionate national conversation in recent memory has been that of the Catholic tradition on health care. Catholic thought on matters of health has been reduced in the press to a mere squawk over federal funding for abortion. The sheer force of the Catholic bishops’ voice on this issue was largely credited (or blamed) for stopping federal funding provisions in the House version last fall, but Catholic teaching and Catholic experience have so much more to say about healthcare reform than an urgent “no” on abortion. Principles such as Subsidiarity and Distributism stand above party politics and have the potential of breaking the current political impasse. The Catholic voice is one the US can ill afford to ignore if we want to get these major reforms right.
Having her own high moral principles as well as practical ones, it is impossible to peg the Catholic Church’s teachings as conventionally liberal or conservative in the American political lexicon. This is no less true in the struggle for healthcare reform.
The Bishops, Abortion and Immigration
The Unites States Conference of Catholic Bishops has mobilized its political forces in an unprecedented fashion this year. Fears that Obama would make good on his campaign trail promise to Planned Parenthood to pass the Freedom of Choice Act motivated a church wide post card campaign in the first weeks of Obama’s administration firing a shot across the bow and setting up an adversarial relationship that has been playing out ever since.
As the House Bill was nearing completion with a provision for federal funding for abortion in early November, the US bishops pressed against it with a heavy lobbying effort as well as a national Sunday mass bulletin insert urging Catholics to contact their representatives. It worked. At the eleventh hour, those provisions were dropped and the Stupak amendment was included prohibiting such federal funding. A remarkable victory for the pro-life movement, Catholics at every level from clergy to parishioner made possible another major defeat of the abortion rights movement.
Immigration
The Catholic Bishops have spoken out on another aspect of healthcare reform which has gotten less attention but is no less vital – Immigration. Basing herself in scripture, the Catholic Church sees remarkable parallels between the American story and the story if the ancient people of Israel:
- “You shall treat the alien who resides with you no differently than the natives born among you; have the same love for him as for yourself; for you too were once aliens in the land of Egypt” (Lv 19:33-34).
The American Catholic bishops require therefore any plan for universal health care to grant access to all immigrants regardless of their legal status. Whether health care is an absolute right remains open, but access to healthcare is a fundamental requirement for human flourishing.
- “…immigration policy that allows people to live here and contribute to society for years but refuses to offer them the opportunity to achieve legal status does not serve the common good. The presence of millions of people living without easy access to basic human rights and necessities is a great injustice.”
Catholic Social Teaching
Catholic Social Teaching is a body of teaching on the proper relationships between peoples, nations, economics and governments and human rights. This body of teaching offers two important principles for looking at national health care reform, namely, Subsidiarity and Distributism.
Subsidiarity
Subsidiarity is an odd term for a rather simple principle which ideally should guide all governance. It is the concept “that matters ought to be handled by the smallest, lowest or least centralized competent authority.” The local, state and federal levels of government in the United States as originally constituted express well this concept. For instance, we do not have a national governmental body for fire protection. Primary and secondary school systems are not run by the states, but by local governments and sometimes are even semi-autonomous entities. A single federal healthcare system would be roughly six times larger than a comparable education system, as a portion of GDP.
Favoring the local or regional levels of administration over the national has several benefits. First, local problems demand local solutions. For instance, it is hard to imagine a federal system capable of responding with general policies to the particular needs of coal mining regions, retirement communities, suburban families and migrant workers with sufficient effectiveness, flexibility and care. Subsidiarity implies another general principle, “the greater the scale of a system the greater the risk of waste and corruption.” Subsidiarity avoids these pitfalls.
The principle of subsidiarity, then, asks the question, on which level is healthcare most reasonably and effectively provided? If it is possible for the local or state levels to provided health care, they ought to. We have many of examples of public health care provided by cities and counties across the country. City and county hospital systems suggest that Americans have historically viewed health care as a municipal responsibility. State run institutions for the mentally ill and other categories of patients suggest that states also have a role to play.
Distributism
Distributism is another principle which has its origin in Catholic Social Teaching. It holds that “the ownership of the means of production should be spread as widely as possible among the general populace, rather than being centralized under the control of the state (indirect socialism) or a few large businesses or wealthy private individuals.” The principle of Distributism suggests a third way of economic and political organization which stands between government and private ownership, between socialism and capitalism in their purest expressions. A more modern way of stating the principle would be that all stake holders of a public good ought in some sense be share holders. Economic cooperatives and credit unions are examples of Distributism. Employee owned corporations such as United Airlines are an ideal as well as Cooperative businesses such as Credit Unions or retailers like REI, where consumers own shares in the company. These organizations are essential not for profit businesses and function as services to those who collectively own them.
Health Care Cooperatives
The idea of health care cooperatives was briefly considered in the Senate this past fall. If operated on scales large enough to disperse liabilities and small enough to remain efficient, health care coops could be an ideal way to re-organize American health care. Coops are similar to other not for profit organizations with ownership vested in the consumer rather than a charitable organization. Like other not for profit organizations, coops have the advantage of encouraging the highest level of care for the least cost. In recent decades , the non-profit sector has provided about 70% of US hospital capacity (17% in Catholic hospitals), so this middle way is already quite present in the field. It is now a question of whether the non-profit sector can provide an alternative to for-profit and government insurance.
Some of the benefits of health care cooperatives include that they are:
- Consumer Owned. The consumer’s best interest is the interest of the cooperative.
- Not for Profit.They are not looking to minimize care.
- Nongovernmental. They tend to minimize waste and the risk of corruption.
- Collective. They provide small companies with bargaining leverage to maintain low costs from health care providers such as hospitals, doctors and pharmaceuticals.
The Catholic Church with her focus on the dignity of every human person particularly in time of need has an abundance of experience providing health care and other human services in a non-profit manner. Her hospitals, schools, and social service agencies all are able to provide high quality care at a significantly reduced cost compared to for-profit and governmental organizations. It is in America’s interest to learn from this wealth of experience and apply these principles to its modern health care crisis.
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