A Right to Be Healthy?
The other day, Philadelphia Archbishop Charles Chaput was interviewed by the National Catholic Register regarding the U.S. bishops ongoing struggle with the Obama Administration over the definition of a religious employer. He was asked about the statements of the U.S. bishops in favor of a right to health care. This was his response:
The bishops really do believe it. Health is a basic human right; we have a right to be healthy. There’s no declaration on the part of the Church that that has to be accomplished through government intervention. There are many ways of approaching health care, and I think it’s very important for Catholics to understand the fact that the Church, seeing health care as a basic human right, does not mean [to say] there’s a particular method of obtaining that [right that’s] better than another.
With all due respect to the Archbishop and his teaching office, I would argue that this statement seriously distorts Catholic teaching on the subject. First of all, the right to health care is not merely reducible to the “right to be healthy.” When the major documents related to Catholic social teaching speak about this, they clearly indicate that the right to health care is meant to be understood as a right to medical care or treatment. Consider this excerpt from Pope John XIII’s Pacem in Terris.
But first We must speak of man’s rights. Man has the right to live. He has the right to bodily integrity and to the means necessary for the proper development of life, particularly food, clothing, shelter, medical care, rest, and, finally, the necessary social services. In consequence, he has the right to be looked after in the event of ill health; disability stemming from his work; widowhood; old age; enforced unemployment; or whenever through no fault of his own he is deprived of the means of livelihood (paragraph 11)
Or closer to home, one might read the USCCB’s 1993 statement A Comprehensive Framework for Health Care Reform:
Our approach to health care is shaped by a simple but fundamental principle: “Every person has a right to adequate health care. This right flows from the sanctity of human life and the dignity that belongs to all human persons, who are made in the image of God.” Health care is more than a commodity; it is a basic human right, an essential safeguard of human life and dignity. We believe our people’s health care should not depend on where they work, how much their parents earn, or where they live. Our constant teaching that each human life must be protected and human dignity promoted leads us to insist that all people have a right to health care. This right is explicitly affirmed in Pacem in Terris and is the foundation of our advocacy for health care reform. When millions of Americans are without health coverage, when rising costs threaten the coverage of millions more, when infant mortality remains shockingly high, the right to health care is seriously undermined and our health care system is in need of fundamental reform.
In this statement, the bishops go on to explicitly address the question of state action to achieve the right to health care:
Applying our experience and principles to the choices before the nation, our bishops’ conference strongly supports comprehensive reform that will ensure a decent level of health care for all without regard to their ability to pay. This will require concerted action by federal and other levels of government and by the diverse providers and consumers of health care. We believe government, an instrument of our common purpose called to pursue the common good, has an essential role to play in assuring that the rights of all people to adequate health care are respected.
There is simply no way to read these passages in a way that divorces the “right to health care” from the obligation of government to ensure that this right can be meaningfully exercised. At the level of language, it is contradictory to use the term “right” in a way that denies the need for an effective remedy to enforce that right. Section 8 of the United Nations Declaration on Human Rights–a document deeply influenced by Catholic Social Teaching–makes this point clear:
Everyone has the right to an effective remedy by the competent national tribunals for acts violating the fundamental rights granted him by the constitution or by law. (#8)
Archbishop Chaput is correct that there may be more than one way for the state to allow meaningful exercise of the right to health care. In the United Kingdom, the government acts as the direct provider of medical care. In Canada, the care delivery system remains largely in private hands, but the insurance function is socialized. The Obama Administration’s Affordable Care Act allows both care delivery and the insurance function to remain in private hands. However, it requires that all individuals purchase health insurance and provides subsidies to assist low-income families in doing this. It also creates a structure that–at least in theory–will promote both choice and vigorous competition between health care plans.
Any of these options–and a number of others–would be morally acceptable under Catholic Social Teaching. What is clearly not acceptable is a system that relies heavily on private insurance while making it impossible for tens of millions of people to afford it. A system that forces these families to seek care in overcrowded emergency rooms fails basic principles of distributive justice that have been part of Catholic Social teaching for more than a century.
The idea that the “right to health care” can be exercised apart from state action is–to put it mildly–a novelty in Catholic social thought that has no purchase outside the United States. Its popularity among certain American Catholics owes more to the baneful influence of libertarianism in this country than any serious engagement with magisterial texts. I suspect that the vast majority of the world’s bishops would find the concept nonsensical.
I realize that the U.S. bishops are tremendously frustrated at the Obama administration and some would clearly like to ease the consciences of Catholics concerned about voting for a candidate that has promised to repeal health care reform. It is not, however, acceptable to distort the social teaching of the Church in order to accomplish this end. To paraphrase Governor Romney, bishops may have a right to their own chanceries and croziers, but they do not have the right to their own personal version of Catholic Social Teaching.