Thinking about universal health care

My dad, who gets most of his information from radio and TV, is adamantly opposed to President Obama's proposal of a government-run health insurance program. I, on the other hand, get most of my information from the far-more-reliable internets, and so-- wait a sec.

Maybe we both ought to think for ourselves for a moment.

Let's start with a few principles. First, it's hard to deny that a basic level of health care is a fundamental human right. No one seriously believes that, if you get the flu, you should or could be denied the bed rest and clear liquids and chicken noodle soup required to get over it.

But I have some friends, one of whose kids is hydrocephalic. I have another friend who is undergoing treatment for breast cancer. In order to survive, to say nothing of living "normal" lives, they require costly and time-consuming treatments -- more costly than they are able to afford on their own.

Is such treatment a human right? Were all the generations of humanity with the misfortune to live before the mid-twentieth century deprived of their rights? What about citizens of poor or "undeveloped" nations today, who don't have access to the cutting-edge research-driven medicine of the United States of America?

This is where the notion of "rights", so foundational to our political discourse these days, might get in the way of thinking clearly. Society as a whole has the responsibility of distributive justice, meaning that we have to allocate (or distribute) the goods and resources we hold in common to our members in a just fashion. So asking, "to what level of health care do we have a right?" or "what constitutes the basic health care (to which I am entitled)?" leads the conversation in the wrong direction. I think the question should rather be, "are we using our medical resources in a just manner? do all the members of our society have access to the goods available to us as a whole?"

From a Catholic point of view, the question is asked out of charity as well as out of justice: in other words, while "strict justice" might ask what the minimum level of health care is that we must provide, charity asks how much health care are we able to provide to those who need it?

So, that said, universal health care is certainly a human right, but it will look different from one society to another depending on the resources available.

Which leads to the second principle: that society as a whole has the responsibility for providing this health care.

Now, theoretically, there are lots of ways that this can happen. We could support doctors and other medical professionals directly through patronage or sponsorships. The Church could provide health care and hospitals, as she has in decades past. We could have various private medical providers compete to offer the best care. Or, we could offer insurance policies, in which a company pools resources from individuals to pay for health care. The government may wield a strong hand, or almost no hand, in any of these systems, so long as they proceed to work justly.

I can fully understand those people, like the ones my dad has been listening to, who see dangers in too much government involvement in health care. Especially the U.S. government. Can we really trust them to be efficient? to be fair? to provide consistent treatment? Will the government legislate what "health" is? force doctors to perform abortions or euthanasia? force pharmacists to distribute contraceptive drugs? force citizens to undergo sterilization or other unnecessary medical procedures? take away a patient's choice and control of his/her own treatment?

However, morality is always the art of the practical: what do we do here and now? So, with these principles in hand, let's take a look around and see what the practical possibilities are.

It seems to me that there are only two institutions that have the scope and breadth to offer (much less guarantee) health care to the whole of society: the government and the Catholic Church. (As for a third option, starting a new private endeavor, I say: Good luck with that.)

In the late 19th and early 20th centuries, the Church took advantage of its vast, inexpensive, and well-trained workforce of religious sisters to establish hospitals and clinics all around the nation to serve the poor and those who could not otherwise afford health care. However, those sisters are no longer so numerous, nor do Catholics contribute financially to the Church as they did, nor is the training needed to provide quality health care so readily available as it once was.

Which leaves the government to pick up the slack.

After all, left to themselves, our largely for-profit medical providers will simply do whatever they can to turn the greatest profit and reduce their own expenses and obligations. This will not lead to a just distribution of health care resources.

So, I see two practical options: either to accept government-run health care, as imperfect as it is; or to devote our time and energy and money to building and supporting a Church-run health care system on a scale we haven't seen since the 1950's. If you don't like Obama's proposal, then are you giving to the Church? Are you writing the bishops and heads of sisters' congregations? Are you volunteering your time and talents? Are you supporting young men and women to give their lives to the work of caring for the sick and injured?

To do neither is to allow our society to remain unjust with regard to health care.

[crossposted at The Good, The True, The Just]