The Health Care “Debate,” Part Deux
As several commenters have pointed out, it would be nice to hear more Catholic voices (from all political perspectives) in the “debate” over healthcare. In light of the rich tradition of Catholic thought on issues of social justice, it would probably help to clarify some of the points of disagreement and elevate the discussion above its current Beck/Limbaugh levels of chaos, fear, and misinformation. Ryan Anderson passed on this thoughtful post at the Public Discourse blog. And this report of an emergent Religious Left coalition in support of health care reform includes a reference to Catholics United for the Common Good. Unfortunately, I think the current state of play is useful to a great many constituencies (including, likely, both political parties) for their own reasons, so I don’t hold out a lot of hope that things will improve anytime soon. In the meantime, please use the comments to share links to thoughtful discussions of the competing proposals from a distinctively Catholc perspective.
Having lived and worked in Toronto, and enjoyed the Ontario Health Insurance Program (OHIP), I fully endorse “single payer,” and urge all Commonweal readers to visit the site of the Physicians for a National Health Care Program at: http://www.pnhp.org
Paul Likoudis: Are you the Paul Likoudis who edits The Wanderer? If so, I’d be interested in your take on the many Catholic conservatives who seem to oppose a single-payer system. They just don’t know what they’re missing?!
And if you are not Mr. Likoudis of The Wanderer fame, well, thanks for the link anyway.
This 2004 statement of the Catholic Medical Association on what is wrong with health “care” in the United States and how to fix it is excellent
http://www.cathmed.org/assets/files/CMA%20Healthcare%20Task%20Force%20Statement%209.04%20Website.pdf
Eduardo – there are more and more Catholic responses to this “carnival”:
Link to an excellent article about Republicans and Terri Schiavo and the public reaction – http://www.religiondispatches.org/archive/politics/1747/the_resurrection_of_terri_schiavo/
Once August is over and Congress is back, there may be some form of public backlash for those who have tried to “score political points” from this key debate.
From Catholics in Alliance for the Common Good addressing internal Catholic debate e.g. EWTN and Ave Marie/Acton Institute: http://www.catholicsinalliance.org/node/20973
Of course, you have the neocon Catholics who are indifferent to the broader social justice tradition of the Catholic Church.
Another statement: http://www.catholicsinalliance.org/node/20959
David: Yes, I am.
Ten years ago, the Catholic Bishops of Connecticut endorsed “single payer,” and I don’t know off hand how many other state Catholic conferences have, but I am sure there are many, if not most.
Here is a quote for you from the late, great Dr.Herbert Ratner, who was for decades the “dean of Catholic physicians:
“The medical profession has the obligation to see to it that every patient has the medical care he needs and if this means what they call ‘socialized medicine,’ the medical prpofession has to be ready to accept it…..We must never permit a low common denominator of medical care to become entrenched; we must be satisfied with nothing less than excellence, and the conditions that make excellence possible.”
As to your other question, for 50 years American Catholics, especially so-called “conservative” Catholics have been taught to fear as “socialism” any element of Catholic social doctrine and social action — largely through the work of the late Mr. William F. Buckley and his followers.
Just as those followers never met a war or a military appropriation they didn’t like, so they have never supported a national health insurance program that would guarantee that people do not go bankrupt from an unexpected illness or accident.
And by the way, there is a lot doctors could do to undermine the insurance companies, as Dr. Ratner observed in his book, Nature, The Physician & The Family, (which you must read). He said that a doctor must never refuse to treat a patient that cannot pay.
How that mentality differs from doctors who hire lawyers to file lawsuits or liens against patients without insurance suffering through these hard economic times.
David: Just a note to say that from my experience and that of my wife, the Ontario health care program (OHIP), and its services by various providers, doctors and dentists, etc., were absolutely top-notch.
Our second son was conceived in Canada, and two months before he was due, I was told the Gov’t would not renew my work visa, so we had to leave, and settled in Buffalo, arriving on the day Bethlehem Steel shut down and two weeks before the Buffalo Courier-Express (Mark Twain’s newspaper) closed doors. Obviously work was hard to find. I was mostly unemployed and without health insurance when Son No. 2 arrived, but because he was conceived in Canada, OHIP paid for pre-natal care, hospital and doctor bills, follow-up care, plus we received Canada’s famous monthly “milk allowance” for a year.
If that be “socialism,” so what?
Paul, glad the The Wanderer makes its way by here now and then…and thanks also for your insights. It is hard to gauge how much “conservatives” are actually freaked out by single-payer health insurance, or why, and how much is just unreasoned anxiety by all kinds of folks as detailed in Eduardo’s posts below.
At my reptilian core I have a rather bourgeois, shopkeeper’s mentality–I like balanced budgets and such–so the conservative movement of late counfounds me. But one reason I find single-payer plans of some sort so appealing is that they would seem to be a no-brainer boon to small businesses, which are the heart and soul of American capitalism. Well, and to freelancers (like me).
This article in the Chicago Tribune does a good job of underscoring the moral dimension of the issue:
http://www.chicagotribune.com/news/local/chi-immigrant-health-transplantaug11,0,3342811.story
I am extremely happy with my HMO. I do not cede to the Government any authority to force me into a single-payer plan, nor do I want to be forced (again, by the government) to pay for other people’s health care. That is not charity. Charity is when I freely give of my wealth (such as it is) to others. Let that sorry bunch of gutless losers (the Bishops) bray all they want about my obligation to support Obama’s Health Care legislation. Let them also take a long painful hike. They all ought to be in prison anyway for obstruction of justice, and aiding and abetting child molestors.
Bob — I can’t tell whether you’re joking. You do know that you’re already paying for other people’s healthcare, right? That’s what an HMO is.
Hi, Eduardo, not that I speak for Bob, but the key part of his comment, I think, is “nor do I want to be forced” by the government. That’s different than freely contributing to an HMO.
There are a lot of people who feel that way. In fact, it seems that what this August town hall fiasco is illustrating is that there are an awful lot of people who just aren’t ready, psychologically, for reform that involves any government mandates or government restructuring of/interference with the market for health care.
Jim, do you know anything about health care or insurance markets? They are among the most “structured” and “interfered with” markets by government — state and federal — currently in existence. There is no free market for health care. If there were a free market for health care, I could put a sign on my front door and advertise my new home birthing service — I’ve had three children, after all, what else do I need to know? Let people figure out by word of mouth that I have no idea what I’m doing — by the time they do figure it out, maybe I will know what I’m doing. Furthermore, if payment is an issue, don’t worry, I’ll refer you to my husband’s newly organized prepayment plan.
The issue isn’t regulation or no regulation. The issue is, what kind. Since most of these people apparently have not a clue how insurance (or anything else) is currently regulated, you wouldn’t expect them to have much input beyond, “whatever you do, don’t make me worse off than I am now.” I can understand that. But dignifying that sentiment as a principled preference for a totally free market is to give it an underlying logic and knowledge base that don’t exist.
Believe me, I’ve worked in this arena for a long time — as soon as something goes wrong, these same people will be screaming for government to “do something!!!” and the only thing government can do is regulate. Every mandated benefit statute in existence is the result of such efforts.
Exactly, Jim. All medical insurance involves “paying for others’ health costs”., but I get to choose which HMO, and/or the HMO does not have the overwhelming power that the federal government has, in the case that it is employer-provided. Comically, Obama tried to make a point about competition by comparing Fedex, UPS, and the Post Office, and ending it by saying that the Post Office is perpetually in economic trouble! Well, yeah…
Congratulations on having that choice, Bob. Many of us don’t get to choose our medical coverage. But you’re mistaken in claiming HMOs don’t have “overwhelming power”–if by that you mean the power to decide whether you can receive potentially life-saving treatment. That is a power HMOs most certainly wield.
Hi, Barbara, yes, I am a customer of a health insurance company. I also worked in the insurance industry for a few years. I also read newspapers. By no means am I an expert but I have a general layperson’s understanding of how the industry works. It’s not news to me that there is government involvement and regulation at many levels and in many ways in the provision of health care.
I appreciate your expertise and your contributions to these health care discussions, but in this particular case, your response to me doesn’t really address what I take to be Bob’s concerns.
If I understand Bob correctly, he’s objecting to the fact that his tax dollars will very likely be used to subsize the insurance premiums for people who currently don’t have insurance – quite a few of whom voluntarily choose to do without it.
An aspect of a free market – and btw, a market can be regulated and still function as a free market – in fact, a modicum of regulation is usually essential to the smooth functioning of a free market – an aspect of free markets is that a prospective client can choose to leave the market.
Whether or not people should be forced to have insurance, or should be forced, via their tax dollars, to pay for other people’s insurance, would be a good thing to discuss. But let’s acknowledge what this provision would be. It’s not just an incremental ratcheting up of government regulation of the industry. It’s a pretty fundamental change in the health insurance landscape (and quite possibly a profitable one for your employer, if you work for a health insurer). The Federal government would be inserting itself into the market in a way that, until now, hasn’t been the case.
Again, I don’t speak for Bob, but I sense that he doesn’t particularly trust the government and doesn’t like to be told by the government what to do. All of us have to accept a certain amount of that in our lives, but that doesn’t mean that everything the government mandates is good, or that he should just roll over and accept it.
I’ve been pretty consistently in favor of health care reform, which doesn’t mean that I love every aspect of what is being proposed. But if Bob is opposed to the proposals, I would think the way to bring him around is to try to persuade him by making good arguments.
Grant, you’re right, of course. But a lot of people seem to see a difference between the HMO with whom they’ve contracted, and who hopefully told them upfront what is and isn’t covered, making those calls, and the government making those calls.
To take one obvious point of concern, I can sue my HMO if I believe they’ve unjustly denied a claim. Whether or not I can sue the Federal government for making exactly the same decision, I don’t honestly know. But let’s say, for the sake of discussion, that under current law, I can. But why should I believe that that right would remain in perpetuity (or, for the part of perpetuity that I am particularly interested in, the remainder of my life)? Governments exempt themselves from all sorts of things that the rest of society isn’t exempted from, frequently for capricious or corrupt reasons.
I think I misread the point of Bob’s complaint (hence my reason for not being able to tell whether he was joking). Thanks to Jim for the clarification. But I continue to think Bob’s missing the point. If you consume medical care, you are already being forced by the government to pay for the uninsured because (1) the uninsured go to emergency rooms to get their medical care in a pinch; (2) emergency rooms are required by law to treat them even if they cannot pay; and (3) since most of them can’t pay the emergency room, the hospital passes the costs along to everyone else (including your HMO) in the form of higher prices, which (4) your HMO passes on to you in the form of higher premiums.
I agree, though, that being forced to pay for the medical care of the poor is not “charity.” It’s “justice.”
Jim, let’s focus on the distinction between insurance and care: People who “voluntarily” go without health insurance do not “voluntarily” go without health care. If we are going for all intents and purposes to treat health insurance as the means by which health care is provided to individuals (assuming that we can all agree that it is unfair to designate fall guys for providing free care even though it isn’t really free because we all end up paying for it in a rob Peter to pay Paul scheme that is so convoluted only people like me really understand it) then, in effect, they are interchangeable concepts and we aren’t forcing people to purchase that which they are voluntarily foregoing for the moment because they aren’t really intending to voluntarily forego anything when they need it. They are just arbitraging.
Those are the “voluntary” ones. For the “involuntary” ones, the most equitable case to be made is that — they are already paying! If they work they pay Medicare taxes and other taxes that fund your care and mine as well as our parents.
None of this has to do with whether an insurance or health care market is “free.” If it were free you would be paying taxes on the income that would be attributable to the health care payments made on your behalf. That’s a huge benefit to you that the uninusred don’t get.
Although this doesn’t have anything to do with whether or not a health care reform is needed, it is definitely a sore point with me, and I suspect, to many others: Why do Congress and (other) government workers not have to be subject to the new plan? Why should our rulers be exempt? Do we really want our ruling class to be a cloistered and privileged group with their own medical care? Why?
Hi, Barbara, all interesting points. FWIW, I agree with Eduardo – I don’t think it’s asking too much of healthy young adults to contribute to the health care of fellow humans who need it and can’t afford it. Particularly when it will open up health care to the young adults themselves, and some of them are sure to need it.