Must Catholics Favor Socialized Medicine?

Nun aids Civil War soldier

Among the many debates triggered throughout America by Obamacare, one concerns whether access to healthcare may be described as a “right.” Assuming such a right exists, a related issue is what this means for public policy.

For Catholics, the answer to the first question seems clear. In a 2012 message to a conference for healthcare workers, Benedict XVI referred explicitly to “the right to healthcare.” This right is grounded, the pope specified, in the truth that “health is a precious good for the person and the community” that must be “promoted, preserved and protected.” Here the pope followed the classic Catholic and natural law understanding of the derivation of rights: they are grounded in those goods which are central to human flourishing.

So far, so good. But the real debate for Catholics starts when we consider how to realize this right. Rights are a matter of justice, and justice is a primary concern of the state. Indeed Benedict XVI noted in his 2012 message that healthcare is subject to the demands of justice—specifically distributive justice—and the common good.

Some Catholics may believe this implies we’re obliged to support a more-or-less socialized healthcare system such as Britain’s National Health Service. Yet nothing in Benedict’s message or Catholic social teaching more generally implies this is the only possible path forward.

In the first place, it’s hard to deny the mixed track-record of nationalized healthcare regarding what Benedict called “render[ing] effective” the right to healthcare “by furthering access to basic healthcare.” Surveying the NHS’s performance, for instance, the British social commentator, medical doctor and psychiatrist Theodore Dalrymple commented in 2011:

The cumulative increase in spending on the NHS from 1997 to 2007 was equal to about a third of the national debt. After all this spending, Britain remains what it has long been: by far the most unpleasant country in Western Europe in which to be ill, especially if one is poor. Not coincidentally, Britain’s healthcare system is still the most centralized, the most Soviet-like, in the Western world. Our rates of postoperative infection are the highest in Europe, our cancer survival-rates the lowest; the neglect of elderly hospital patients is so common as to be practically routine. One has the impression that even if we devoted our entire GDP to the NHS, old people would still be left to dehydrate in hospitals.

Obviously efficiency-issues aren’t the only questions Catholics should address when judging how to widen access to healthcare. Justice and efficiency are different. Yet Dalrymple’s analysis underscores how the ineffectiveness of socialized healthcare has helped facilitate significant injustice.

Looking then at justice, the idea that everyone has a right to healthcare means that all of us have some positive duties concerning others’ healthcare. Sometimes these duties are clear. Parents, for instance, have the primary responsibility to meet their children’s healthcare needs, consistent with the use of family resources to promote all of its members’ overall flourishing.

At the same time, justice requires us to consider precisely what everyone in a given society owes to everyone else with respect to people’s often different healthcare needs. Must, for instance, a man sacrifice his entire family’s resources (and thereby severely compromise his family’s ability to support all of its other members’ capacity to participate in goods that include but also go beyond health) in order to provide his alcoholic father suffering from terminal liver-cancer with a treatment that has a 15 percent success-rate at keeping patients alive for another six weeks?

Certainly distributive justice is about need. But distributive justice also embraces questions of merit. As Donald Condit notes in his monograph A Prescription for Healthcare Reform, “we can expect to be held accountable for choices we make, including those regarding our personal health…. A Christian discussion of health care reform cannot neglect the role of personal responsibility when considering the prevalence of obesity, alcohol abuse, smoking, and lack of exercise.”

Clearly there are many issues that even a well-founded recognition of a right to access healthcare cannot resolve by itself. Nor is it obvious that government top-down control of healthcare is the only (let alone the most optimal) way of actualizing such rights.

Here an analogy might be made with the state’s responsibilities concerning the right to work. In his encyclical Centesimus Annus, Blessed John Paul II affirmed that the state has responsibility for “overseeing and directing the exercise of human rights in the economic sector.” Immediately, however, the pope qualified this statement by noting that “primary responsibility in this area belongs not to the State but to individuals and to the various groups and associations which make up society.” Part of the pope’s reasoning was that “The State could not directly ensure the right to work for all its citizens unless it controlled every aspect of economic life and restricted the free initiative of individuals.”

John Paul’s careful delineation of the responsibilities of different social groups (of which the state is obviously a unique entity) vis-à-vis facilitating people’s participation in the good of work is applicable to realizing the rights flowing from the good of health. His distinctions arise from attention to what is objectively owed to others (justice), how we would want others to treat us (love), and the requirements of human freedom. These questions of love, justice, and liberty direct us in turn to two key foundational—and inseparable—principles of Catholic social teaching: solidarity and subsidiarity.

Though it is invoked regularly across the political spectrum, Catholicism understands solidarity to be the virtue of living the commandment to love our neighbor. Speaking of solidarity in Gaudium et Spes, the Second Vatican Council stated that Christ “clearly outlined an obligation on part of the sons of God to treat each other as brothers” (GS 32). Solidarity thus involves not only fulfilling the duty to be just to each other, but also to love one another—and love is something that takes us beyond the demands of justice.

What might this mean with regard to healthcare? Insofar as governments have responsibilities to promote solidarity, they have a part to play in expanding access to healthcare. But living the principle of solidarity doesn’t absolve individuals and other communities from their responsibilities to help others access healthcare. Nor does it imply that these particular responsibilities may be delegated to the state, let alone that they are somehow fulfilled by voting for those who promise to provide more healthcare through the state.

Herein lies the significance of the principle of subsidarity in operationalizing solidarity. At its core, subsidarity is concerned with providing a way of thinking coherently about how we help others in a manner consistent with everyone’s need to make free choices if they are to participate in goods like health. Subsidiarity also reminds us that there are numerous communities that precede government institutions and which help establish many of the conditions that assist people to promote, protect, and freely choose the good of health.

Taking this background into account, it would seem that policies which attempt to realize all the rights and responsibilities of all individuals and communities associated with health more-or-less exclusively through the state are hard to reconcile with Catholic teaching. Certainly, where no other community is capable of fulfilling a particular healthcare requirement, subsidiarity indicates such needs may be met directly by the state. Thus the government’s provision of a healthcare safety-net is legitimate—provided such a safety-net is focused upon addressing emergency situations and helping those people with no other community to care for them. Nevertheless the government’s assumption of total control (direct or indirect) of a society’s healthcare arrangements would normally be excluded.

Within these parameters, there remains considerable room for reasonable differences among Catholics concerning how to promote the right to access healthcare. Indeed, although Catholics can often identify many options that meet the requirements of the principles stated above, there is no system of providing healthcare that’s uniquely correct in promoting these principles.

Thus, when addressing a question such as “how can I promote better access to health care,” living the Church’s teaching does not always mean that Catholics can only support one particular healthcare policy. I would even venture that the same framework of analysis suggests that no Catholic would be obliged, as a matter of informed conscience, to support an Obamacare stripped of elements such as the HHS mandate that directly violate Catholic teaching. When it comes to healthcare—and, in fact, most public policy issues—there are often many legitimate ways for Catholics to do good: ways that may be incompatible with each other but are nevertheless fully consistent with Catholic teaching. As Aquinas and the entire Church tradition from apostolic times onwards has emphasized, while one may never intentionally choose evil, the doing of good doesn’t always mean there’s just one right path to follow.

No doubt, some believe such arguments risk weakening the Church’s effectiveness in promoting the right to healthcare in the public square. The point, however, of Catholic moral reasoning is not to maximize political effectiveness, let alone ensuring that the Church remains a “player” in Washington, D.C. Rather it is about helping Catholics to live Christ’s way through all our free choices, thereby contributing to the substance—starting with ourselves—that He will raise up at the end of time, as Gaudium et Spes states, “freed of stain, burnished and transfigured, when Christ hands over to the Father: ‘a kingdom eternal and universal, a kingdom of truth and life, of holiness and grace, of justice, love and peace’” (GS 39).

Granted, this may mean little in worldly-terms. It is nonetheless the ultimate horizon to which Christ calls us—including in healthcare policy.

Author’s note: This essay is based on a 2012 paper published in the Notre Dame Journal of Law, Ethics and Public Policy.

Samuel Gregg

By

Samuel Gregg is Research Director at the Acton Institute. He has authored many books including, most recently, Becoming Europe: Economic Decline, Culture, and How America can Avoid a European Future (2013) and Tea Party Catholic (2013).

  • Fred

    I am a Catholic but not all Catholics believe you.

  • Salvelinus

    There was just a dual march, sponsored by my diocese, with my bishop in attendance. The two issues? We must pass “comprehensive immigration reform” and we must make health care more available to all, from the tax payers.
    This is the democratic party platform.
    No wonder why Obama was voted in twice, thanks to us Catholics

    • John O’Neill

      Most American bishops came from Irish Catholic families; most Irish Catholic families were raised to worship the democrat party and John F Kennedy as their patron saint. There used to be the observation when you went into an Irish Catholic family in America you would find three pictures; one of the Sacred Heart, one of Pope John XXIII, and one of the John F. Kennedy and this was before JFK became a martyr. So the Catholics who support this religious party naturally can never oppose it even in matters of abortion and gay marriage. It also explains why so many American bishops opposed Pope Benedict XVI; he was a staunch defender of the pro life and pro family position which the democrat party opposed. I have sibling who along with her husband considers Barack Obama to be a god and spouts his propaganda at every family gathering.

      • Salvelinus

        For sure. Even after JFK renounced his faith in that famous speech. The unfortunate thing with my situation though, is that I’m in a south Texas diocese. Not many Irish bishops here… and yet still influenced by the northeast progressive state I tried to escape.

      • bethannbee

        Yours is a perfect description of the Catholic Democrat. The corruption of the party, that was to insure the election of JFK, and the Kennedy “family business” shared the same moral principles. “The ends justifies the means”.

  • Catherine

    A few things always bother me about this issue:
    1. Can we define, adequately, just what Pope Benedict XVI’s “basic health care” consists of, and is it different from comprehensive health care.
    2. In every population, there are those who will take care of their health (or their children’s health), and those who will refuse to, no matter how much coverage they have or their ability to co-pay.
    3. With regard to the scenario in the article about the alcoholic father…as a Catholic I am not comfortable with denying health care on grounds of “personal responsibility”. It seems to fly against Christian forgiveness, and not abandoning your own.

    Dr. Gregg, I very much enjoyed “Tea Party Catholic”. My daughter and I started a small business in order to pay Catholic school tuition, and were very concerned about adhering to principles of subsidiarity. Your book was a great source of information and comfort in ‘anti-business’ Rhode Island. Thank you.

  • BillinJax

    Here is the Abortion we had hoped for last fall that the secular progressives did not allow!

    OBAMAFFAIR …….an affair to abort!!

    America’s love affair with hope and change orchestrated by the glamorous liberal
    democrats and directed by their Prince Charming Barrack H. Obama was all the
    rage for the enchanted elites in Hollywood and the media with their agenda to establish a free range for socialist Utopia in the land for the past five years. It has been a grand and gay affair with constant wooing and cooing over its many nights together toasting victories
    over all opposition and the ability to cover up any chance of failure through
    the use of the protective shield of an adoring media. However, this affair
    reached critical mass and, in the heat of passion in the middle of the night America
    in 2010 without proper protection by a mesmerized but distracted media, was liberally
    and legislatively impregnated by what became known as Obamacare.

    This caused much consternation among the people with some pleading to the pro-choice elements of our society who had approved of and sanctioned the affair in the beginning that America needed to take a political or constitutional morning after pill to avoid the
    development of what surly would be another deformed and unmanageable monster
    government program. Their cry for a judicial abortifacient was too late too
    little and as trimester after trimester passed the country faced the impending
    disastrous arrival a potential federal fetal catastrophe which would, depending
    on your concept of conception¸ either create chaos within our economy or
    further entrench the socialism infancy the love affair intended to spawn in the
    first place. The pro-choice democrats unanimously and single handedly chose to
    let the liberal’s law come to term with this bureaucratic baby and suffer any
    and all economic consequences.

    This past November an online experimental website sonogram
    revealed our worst fears. It was clear nothing of the hoped for and all the
    corruption of a drastic change became visible on the screen of public awareness
    and ripe to explode in our faces if we fail to take immediate measures to stop
    the process.

    All those who may still dare under penalty of political correctness recognize the Almighty need to pray that the Pro-Choice late term abortionist activists who were largely responsible for the wedding and liaison begun in 2008 will be willing to come to their senses in time to follow their beliefs a political step forward and abort this abomination created by their Obamaffair before it arrives on our doorsteps in January.

    TODAY WE NOW HAVE ANOTHER SPECIAL NEEDS GOVERNMENT PROGRAM TO ADD TO OUR FAMILY OF MEDICAID, MEDICARE, FOOD STAMPS, UNEMPLOYMENT CHECKS, AND OUR ECONOMY IS IN NO CONDITION TO SUPPORT IT. BUT THAT IS EXACTLY HOW THEY PLANNED TO DEMAND AND INVOKE THE SINGLE PAYER SYSTEM THEY WANTED IN THE FIRST PLACE.

  • Watosh

    This is a subject that deserves our attention. The trouble is there are many who insist that the government has no business to get involved in health care because the “free market” is the answer to all our problems. Subsidarity and private assistance are real concerns too. Often one hears that “competition” is the answer. But health care is not like selling automobiles. When one is sick one does not have time to compare doctors and prices, for one thing. Shopping around is not like shopping around for an automobile. Then too, it has happened that when there is more competition, i.e. more Drs. and hospitals and treatment centers in an area has resulted in higher prices as all these establishments have to pay for their expensive equipment. Now England’s socialized medicine has its problems, but that is not the only government solution. In Germany health care is provided by private insurers, France’s approach to health care is generally rated one of the best. In Canada Doctors and Hospitals are all private affairs that are reimbursed by the government. Most major developed countries have instituted some form of government sponsored or administered health care, and they generally have improved people’s health care measured by conventional criteria at half the amount spent per person than in the U.S. There are many people who have lost their homes in this country because of medical expenses who had health insurance. No one in these other countries have had that happen. The problems with unregulated private insurance is that in order to keep rates low they will not insure people with a lot of health problems, and they must make a profit. Profits come when they take in more money than they pay out. Young healthy people can get by without health insurance, but any insurance scheme is an attempt to spread the risk. By spreading the risk the costs to individuals is reduced. So insuring the young and healthy will reduce the costs to the unhealthy and the old. some sy thesis unfair to the young,but in the long run, the young and healthy will get old and often unhealthy so then they will benefit.

    Now am I saying that we need a government administered health care? Well possibly. What I am saying is that this needs to be given some thought, and that the subject of health care should be dismissed as unnecessary. It is good to read articles like Mr. Gregg’s that address this situation. How do we best incorporate subsidarity? How best do we incorporate private charity? These things should certainly be given consideration. My own feeling with respect to subsidarity, is that applies to size of countries too. We may be too big to have a workable, affordable health care.

    One more thing, no question providing health care to all is an expensive proposition, and can be very, very costly. Realistically there is some need for “rationing” health care. Those who oppose a government scheme of health care often protest that it will involve governmental rationing of health care, which they regard with horror, yet they seem unaware that that is precisely what privately owned insurance companies now do. Rationing health care by means of costs is also very much present today in this fair country. This subject too needs to be addressed thoughtfully and morally. Providing health care is a subject that has been contaminated with ideology and emotion, so I expect some heated personal attacks for saying what I have said. I don’t have a solution, but I do think we need to come up with one. I do think this subject deserves thought like Mr. Gregg has displayed in the above article. And if Catholics don’t propose any system of providing health care, the liberal, secular forces will.

    • TheAbaum

      “no question providing health care to all is an expensive proposition,
      and can be very, very costly. Realistically there is some need for
      “rationing” health care.”

      Stunningly incoherent.

      • Nazu

        Health care is already “rationed”. Every insurance company employs professionals who decide what care will be covered, what tests can be administrated and what medicines can be purchased. Anyone who has ever heard their doctor say, “I’d like you to have X, but I don’t know if it will be covered by your insurance” is a potential victim of “rationing”.

        • TheAbaum

          Right off the Talking Points Memo email.

          And you have options in the coverage you can elect, selecting different limits, coverages and drug formularies. If your insurer denies coverage, through error or misconduct, you can file a complaint with the state regulator.

          Obamacare explicitly includes a rationing agent without recourse, the IPAB.

          • Art Deco

            As long as our desires exceed resources, there will be rationing. You can ration with prices, you can ration with scrip, you can ration with queues, you can ration with administrative controls, but you will always have rationing.

            • TheAbaum

              “As long as our desires exceed resources.”

              Welcome to Earth.

              No. You do not understand the concept of rationing and you are very confused.

              There’s a difference between making choices and having some central authority saying we’re removing your choice, arbitrarily.

              It remains that to complain about a “lack” of healthcare but respond to the objection of rationing with assertion that rationing already exists and will always exists is logically incoherent.

              • Art Deco

                You do not understand the concept of rationing and you are very confused.

                Oh yes I do, and I just gave you a summary.

                • TheAbaum

                  Once again, stop being pachycephalic.

                  Your summary is incorrect in concept and application. You have rationing confused with allocation.

                  The curious task of economics….

                  http://www.oxfordreference.com/view/10.1093/acref/9780199237043.001.0001/acref-9780199237043-e-2586?rskey=PUUGC5&result=2458

                  Note the exclusion of pricing as a ration mechanism.

                  • Art Deco

                    My summary in concept and application is what is otherwise referred to as ‘principles of microeconomics’ Adam.

                    • TheAbaum

                      No, and I documented it. Perhaps you should just admit you are wrong.

                    • Art Deco

                      I am not wrong Adam. Considering how to allocate scarce resources is what microeconomics is all about.

                    • TheAbaum

                      It’s also about production and consumption. You are wrong.

                    • Art Deco

                      You’ve also misunderstood my thesis.

                    • TheAbaum

                      Funny, I managed to understand economic theses enough get A’s in every economics course I ever took.

                      All twelve.

                    • TheAbaum

                      You need a refresher course.

                    • Art Deco

                      Adam, you’re just wrong. Remarks such as mine would be incorporated into any elementary microeconomics text.

                    • TheAbaum

                      I have a bookshelf full of econ books, and the rather successful completion of a multitude of courses at the undergraduate and graduate level.

                      I’m well aware of their content. None would ever accept your premise that price allocation is the same as administrative rationing. I’m done with this competitive urination now.

  • Florian

    With all the problems, moral and otherwise, we have with Obamacare, have the U.S. Bishops ever considered setting up a Catholic health care plan/insurance? Word is that many doctors are refusing to comply with Obamacare – a Catholic/Christian plan would, I believe, be endorsed by many….

    • TheAbaum

      Religious hospitals and healthcare (not just Catholic) are shutting down everywhere. I was once involved in the audit of a Lutheran enterprise that was selling off its nursing homes, because they no longer thought that they had a “distinctive competence” in providing that care anymore. One of their facilities was in my Dad’s home town in walking distance from the Catholic Hospital that is now a shuttered white elephant.

  • http://outsidetheautisticasylum.blogspot.com/ Theodore Seeber

    There is a better way to deliver this NEED- and it is a need, not a right. Given that we have a pluralistic society, we can’t rely on the Holy Orders anymore. But that doesn’t mean, as secular people, we can’t use the same methods.

    The other two models I’m extremely interested in are the local government owned co-op model, in which the people of a city band together to do fundraising to fund a local clinic and hospital where care is free for all who have need of it. And the subscription model, where a local business charges $X/month/patient, to fund a hospital and clinic, and only members get to go there.

    *BOTH* of these models take something into account that larger governments simply cannot do- community.

  • poetcomic1

    What is the ‘Catholic Answer’ to the needs for healthcare? An army of religious called to to serve the sick and hurting. That, my friends IS the Catholic answer and if it is gone.

    • Martin 5

      And even that, in its heyday, was far from perfect – there was plenty of abuse and neglect then too, and this is a result of that universal fall.

  • Art Deco

    The editor should have returned this to the author with a request that he resubmit it when he had worked out a clear argument.

    • TheAbaum

      Perhaps you could provide a clear objection.

      • Martin 5

        Perhaps Samuel can provide solutions instead of merely picking holes at the British NHS. It’s very easy to pick holes, but where are his solutions???

        • TheAbaum

          Define “solution”.

          Or are you on board with this bit?

          “Something must be done, even if it doesn’t work.” -Sir Bob Geldof, Live8 concert, July 3, 2005.

          By the way, how did your name change from “Tim” to “Martin 5″.

          Does your last name begin with an “O”?

          • Martin 5

            There’s no Tim here so I have no idea what you are talking about. Nor do I get your reference to the number ’0′.

            • TheAbaum

              Nor do I get your reference to the number ’0′.

              Guess not, since I asked about the LETTER O.

        • Crisiseditor

          There are plenty of solutions, none of which were considered by Obama other than a single payer system that Obamacare was meant to help bring about. Dr. Gregg did not intend to provide solutions here, only to propose that socialized medicine is not the only option for Catholics. The point of objecting to the NHS was to show that socialist options do not necessarily fulfill the principles of Catholic Social Thought. This should then open up a conversation about alternatives to Obamacare.

          • Art Deco

            No, there are adjustments you can make to current practice which have benefits and costs. There are no ‘solutions’.

            • Crisiseditor

              You are being pedantic here. If it makes you feel better, replace “solutions” with “alternatives” or “adjustments.” It doesn’t change my point. Healthcare costs are unnecessarily high and there are ways to change that short of wholesale state control of the healthcare system. I would hope you would agree.

              • Art Deco

                I am not being pedantic. I am promoting clear thinking. The peculiar problems associated with the finance and provision of medical care do not admit of a ‘solution’ or ‘solutions’. There will be problems with any system you adopt. Unlike producing and destributing pencils, there will one wagers be no arrangement that does not leave constituencies dis-satisfied.

                • Crisiseditor

                  Obviously, there are vested interests who benefit from the status quo. Tort reform, for instance, will dissatisfy the trial lawyers. But I’m not going to lose sleep over their inevitable complaints given how much their greed has harmed millions of people. It should not be necessary to state such obvious facts to make a simple point.

                  • Art Deco

                    I am not actually referring to sectoral rent seeker constituencies, but to broad sectors of the public who might be injured by one alteration or another in financing methods, or suffer anxiety over potential losses. By way of example, restoring true prices in medical care will require more extensive use of out-of-pocket finance, which tends to irritate the public generally given current expectations, to irritate the elderly, and to and irritate women in particular who have a higher propensity to visit doctors.

          • Arriero

            Which kind of healthcare systems have old Catholic nations like Spain, Portugal, Italy, Ireland, Poland or Slovakia?

            Which were the thoughts of convinced Catholics like Adenauer, Franco, Salazar, Alcide de Gasperi, Andrej Hlinka et al about healthcare, many of whom builders of the modern Welfare States in their respectives countries?

            Which is the Church’s attitude regarding healthcare?

            The other day, in a self-described «true conservative» american tv program appeared someone (another pseudo-calvinist, from those who I, and this Pope, dislike so much) who said: «Poor people has just to learn how not to be poor. Period».

            It’s also, at least, quite annoying the confusion – sometimes misunderstanding – between concepts like «government», «state», «power», «socialism», «authoritarianism», «freedom», etc.

            The Church, for instance, is a very powerful (despite the anti-government-per-se attacks) dogmatic authoritarian Institution (take each adjective as a compliment, of course). But she is not, obviously, socialist, or absolutist, or anti-freedom; in fact, it’s the only religion which believes in real free men, and in natural law).

            PD- It’s fair saying that the public and universal healthcare system in some european countries is currently broken. Mainly for «cyclical» reasons, but also for some important structural ones. I think the debate is open, because the «european-style» healhcare should and could be improved too. Catholics, who have a long tradition of health care (beginning with the Order of Malta, for instance), must have a voice in the debate.

  • Chase Padusniak

    While I mostly agree with the spirit of the article and see why it was written, I just find it interesting because most practising Catholics I know are anti-Obamacare. The non-practising people who may identify culturally as “Catholic,” that is a different question.

  • John Uebersax

    The problem I see is that our society has not evolved a means of governance capable of managing socialized medicine. The US federal government, which is (1) dysfunctional and (2) beholden to corporate and other special interests, can no more manage healthcare in a sensible and just way than it can manage foreign policy.

    Moreover, our whole healthcare system is wildly out of whack: it favors expensive and invasive treatments, and doesn’t take prevention seriously; in the long run, industrialized medicine — which socialized medicine will only develop further — probably kills or harms more people than it saves or heals.

    Further, we have the problem that many health issues are a direct result of moral error (e.g., smoking, alcohol abuse, obesity); handing out free healthcare reduces the natural incentive to correct these moral errors to avoid paying the doctor.

    • TheAbaum

      “The problem I see is that our society has not evolved a means of governance capable of managing socialized medicine.”

      Nor will it. In the late 1950′s, economist Leonard Read visited the pencil factory where my Mother worked in order to familiarize himself with the manufacture of pencils. He pointed out that while it was a simple device, the components, the wood, the graphite, the rubber and the metal of the ferrule were so different and far-flung that no one person knew how to make a pencil (and certainly not efficiently).

      He aptly demonstrated the illusion of centralized knowledge or expertise. To believe that the state can acquire the omniscience, inerrancy and incorruptibility that would allow it to improve the manufacturing of pencils, let alone a a system that provides medicine like water is to impute divinity to it and a form of idolatry.

      In a few weeks, if convention holds, “The Ten Commandments” will be broadcast. Dathan is now a politician is a thousand dollar suit, compelling many Aarons to use the temple arts to erect a golden calf, telling you “there is your god”. People never change.

      • LarryCicero

        Why not government grocery stores? People have a right to eat.

        • TheAbaum

          It’s a SNAP.

      • John Uebersax

        “To believe that the state, can acquire the omniscience, inerrancy and incorruptibility that would…” Yes, I forgot about Read’s essay ‘I, Pencil’, which illustrates the point very well.

        Further, besides lacking sufficient practical and technical knowledge, centralized government has no way of incorporating wisdom, intuition and other intangibles (piety, humility, trust in God, etc.) into policy and decision-making. Nor can decisions be nuanced and dependent on the contingencies of a given case; all policy must be ‘one size fits all’.

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  • Harm

    The problem what if you’re a Catholic who is quite conservative regarding social issues but are liberal regarding fiscal issues? You have to vote GOP in order to clean your soul clean and that is not right.

  • Rhoda Penmark

    Isn’t Medicare “socialized medicine”? Do you advocate taking it away from all those elderly people whose lives depend on it?

    • Aldo Elmnight

      It should be phased out. It is unconsitutional. It is forced charity (i.e. theft).

      • Art Deco

        Maybe you can find an Objectivist forum more to your liking.

  • Martin 5

    It’s funny reading this as a resident of the UK. My experience with the NHS over many years has been pretty good. Samuel’s theory is great, but it neglects one thing: other people’s willingness and ability to help others. Because of the fall, we aren’t so inclined to help those in need, particularly strangers. Without the NHS and the work of charitable bodies, the people of Britain would be worse off. Things aren’t so bad in the UK as regards healthcare as is often made out, and it varies by region. I don’t think we can look to America as providing some some of ideal. Their existing healthcare system has its own flaws, not to mention Obama-care.

    • Chase Padusniak

      As an American living in the U.K., I’ve had difficulty verbalizing how I feel about the NHS. It’s as if all the stereotypes were met. On the good side, it’s generally completely free. I mean nada and that does wonders for the poor. In fact, I once stayed in a hospital here and everyone I shared a room with seemed as if they wouldn’t have been able to afford meaningful healthcare in the U.S. Of course, I’m assuming that, but they were mostly everyday folk with serious medical problems (one had been in and out of the hospital for 10 years!). In that sense, I can’t fault what helps people live good lives.

      On the other hand, it’s always felt a tad slower and less personal than American service. The secretaries, nurses, and doctors feel over-worked and rushed. It’s as if everyone is a number. It just doesn’t feel personable. And that aspect I have found very troubling.

      As I’ve said elsewhere on this post, I understand the spirit of this article and I agree in part. But at the same time, I find this issue very hard to decide on. I’m not of the camp that believes that government healthcare means theft. I, personally, think Catholic notions of freedom and liberty are much richer than that.

      At the same time, it’s true that the state can become a stand in for God. I’ve seen that in Europe time and time again.

      It’s a tough call to make and we can only pray to do the best we can with these difficult issues.

  • tim

    Has anyone ever heard of “Samaritan Ministries”. The main concept seems to be that through
    prayer and helping bare some of the medical burden of others (through your
    monthly contribution), you live up to this right to healthcare more biblically.

  • Greg Cook

    Well of course if you are promoting a right wing agenda then you will trot out health care in the UK…but there are other examples. Why does right-wing criticism of health care costs ONLY vilify government? It seems to me that the biggest villain in all this is the insurance industry which has been the biggest driver of cost escalation and other problems for the past 40 years.

    • LarryCicero

      Why does left-wing criticism only vilify the private sector, in your case the insurance industry? What about the lawyers, and the people they represent, and the people who hand out payoffs/settlements, that drive up the cost of the doctors’ insurance, that drive up the costs of healthcare, that drive up the costs of health insurance? Then maybe you can explain why med school is so expensive.

      • Greg Cook

        Who says I’m from the left wing? I am merely pointing out Acton’s agenda and the false dichotomy of government bad/free market divine, or vice versa. I am no fan of the left either. It’s easy to see the flaws in the “social justice” wing of Catholicism, but that doesn’t mean the only alternative is a neo-Reaganism pushed by Acton’s shills and hucksters. A plague on both their houses. (Not literally, of course.) The whole shmear of “health care” in our society is based on flawed anthropology and perversely incentivized economics. I think good reading on the subject would include Victoria Sweet’s “God’s Hospital.”

        • LarryCicero

          “Acton’s shills and hucksters”–have you read Fr. Sirico’s book on free markets?

          • Greg Cook

            That’s exactly what I’m talking about: the idea of “the morality of the market” is an absurdity with a light coating of supposed Catholicism. I’ll take my Hayek and von Mises without any pretense to sanctity, thank you very much.

            • TheAbaum

              But the state is populated with incorrupt, public minded geniuses, right?

              • Greg Cook

                It certainly doesn’t appear to be at this particular benighted point in our history.

                • TheAbaum

                  This moment in history is no different than any other in the type of individual that seeks power over others.

            • LarryCicero

              What about Adam Smith’s “The Theory of Moral Sentiment”?

        • Art Deco

          Who says I’m from the left wing?

          It’s manifest in your complaints and your terminology.

    • TheAbaum

      “It seems to me that the biggest villain in all this is the insurance
      industry which has been the biggest driver of cost escalation”

      If there is a potential criticism of insurance, it is that on several counts, healthcare perils do not meet the definition of “insurable event”, there are several other factors that drive cost escalation. Specifically, that the magnitude of the loss is outside the control of the insured, and the magnitude of the loss if fixed in amount and timing. Of course if that’s your answer, then NO insurance will ever work, including government sponsored plans.

      Occupational licensure, tax-preferenced employer provided healthcare (Sec 106 of the Internal Revenue Code), federal and state mandates of benefits, and us, since we have a costly tendency to favor plans that pay “benefits” for common routine items (such as office visits), rather than extraordinary items (catastrophic illness).

      • LarryCicero

        Any time a third party payer is involved, (encouraged by the tax code)then prices get distorted- but insurance is a necessary evil that is there for the patient, just in case there is a major medical issue. It should not be about cold medication or contraceptives. Then there is technology. How much should it cost to make a machine that can produce an MRI or a CAT scan, or non-invasive heart surgery, or any other surgery unheard of only a generation ago? Somehow the increase is blamed on evil greedy corporations and the untamed free market. Baloney.

        • Art Deco

          I am not sure why risk pooling is ‘evil’. It just incorporates certain problems, like any strategem in this world.

          • TheAbaum

            It also imposes deadweight costs, especially when one violates the tenets of insurable events, such as paying for rare and economically significant events as does property insurance and one begins “trading dollars” by paying for the insignificant and common losses as health insurance is commonly designed to cover.

            It’s not risk pooling to make contraceptives “free”, which apart from moral objections are economically insignificant and completely under the control of the insured.

            • Art Deco

              We’ve discussed that before. I understand that.

              • TheAbaum

                Good next time, don’t give Larry a hard time over the word “evil”, which in this context, can’t be separated from its adjective

          • LarryCicero

            “Evil” is not the best word- maybe expense would have been better. We’d be irresponsible if we didn’t have life insurance to protect our families. Insurance is good.

    • Art Deco

      vIt seems to me that the biggest villain in all this is the insurance
      industry which has been the biggest driver of cost escalation and other
      problems for the past 40 years.

      You need to show your work.

  • kmk

    This article failed to mention the increasing dependency upon medical care and the ridiculous costs of healthcare. The first Commandment states to put God first; love God and be totally dependent upon God. People are becoming more dependent upon their doctors. I am becoming weary of others describing their numerous doctor appointments, and medical procedures, and Rx lists. It is as if they have nothing else to talk about.
    I will share one example of outrageous cost. I used to work with psychiatrists. Because they were being reimbursed by the state, they would charge their typical hourly fee no matter how long the appointment took. No appointment ever took more than 15 minutes! Often, the appointments were 5 – 10 minutes long and the good doctor could get paid for at least ten hour-long ‘appointments’ in less than an hour (sorry to the good psychiatrists out there). The 4th – 10 th Commandments tell us to love others. Basically, you should be present to others (hold their hand, figuratively and literally).
    Are there any authentic catholic hospitals?

    • TheAbaum

      “”I used to work with psychiatrists. Because they were being reimbursed by the state, they would charge their typical hourly fee no matter how long the appointment took. ”

      No appointment ever took more than 15 minutes! ”

      In other words, they were engaging in medical malpractices (not providing the required time for services) professional misconduct and insurance fraud (by billing for services they did not priovide).

      • Art Deco

        I kmk worked for a psychiatric practice where all appointments took less than 15 minutes, she worked for a very strange practice.

        Physicians are not wage-earners, so I would not be too concerned about the condition of their time card. Old-style psychotherapy involved talking and listening and you actually were shorting the patient (if they can be said to have received services) by not giving them the full 50 minutes. I suspect nowadays psychiatrists do not do much talk therapy and that this is now handled by clinical psychologists and various and sundry junior grade counselers and such (yeah, I know, ‘counseling’ is not ‘therapy’). They are there to write prescriptions and make a cross-sectional evaluation of the client. The fellow I know best who does this work actually does see his patients for 50 minutes, just on a lower frequency than 1970s style psychotherapists (much less 1920s style pscyhoanalysts).

        I suppose the explanation of kmk’s employers might be that it’s like a mechanic’s flat rate book. If he can get it done in 35 minutes rather than 0.9 hours, you still pay him the hourly x 0.9 hours.

        • TheAbaum

          People aren’t cars.

  • bonaventure

    This comment may appear to be off topic, and in many ways it is. And I am not trying to denigrate the importance of the above article in health care.

    But, as of March 6th, 2014, 9:40 PM ET, I find it very strange that — after yesterday’s publication of the Pope’s interview by Corriere della Serra — the feature articles in many Catholic news services are silent on Francis’ support of “civil unions.”

    Did he, or did he not, “open a door” on homosexual civil unions in his remark? I would like to hear others’ opinions but, again, most Catholics seem to be silent on the issue, or scared, on do not know what to say and therefore keep quiet. Maybe they hope that this is not an evil omen of things to come at the October Synod?

    After all, when asked “Many nations have regulated civil unions. Is it a path that the Church can understand? But up to what point?” Francis answered:

    Marriage is between a man and a woman. Secular states want to justify civil unions to regulate different situations of cohabitation, pushed by the demand to regulate economic aspects between persons, such as ensuring health care. It is about pacts of cohabitating of various natures, of which I wouldn’t know how to list the different ways. One needs to see the different cases and evaluate them in their variety.

    I may be overreacting, but his response clearly suggests that he is leading in a direction that would have been not only unforseen under Benedict and John Paul (and Paul and John and Pius, etc), but also loudly laughed at if ever suggested that this particular door would be opened one day.

    So, my question stands: did he open the door to homosexual civil unions?

    To the editors of Crisis:
    Sorry for writing off topic, but I do believe that, on the day after such an interview with Francis, the main headline should have been about, precisely, the interview, rather than this article on health care…

    • Paul

      As a Catholic I do not oppose civil union as it is by its nature a civil matter and there must be a separation between Church & State, marriage is altogether a different kettle of fish as this forces unholy ceremonies to be carried out on holy ground. Moreover, should any religious denomitation refuses on the basis of their religious beliefs they could be sued or, worse still, be forced to close. One only has to look at the Catholic affiliated adoption agencies in the UK as an example when they refused gay-adoption and consequently were forced to close under the last Labor gov’t.

      • TheAbaum

        “As a Catholic I do not oppose civil union as it is by its nature a civil matter and there must be a separation between Church & State,”

        That train left a couple years ago. The concept of a “civil union”, which was never anything more than a contrivance designed told confer the same rights and responsibilities as marriage without calling it marriage, in order to allow fork-tongued politicians to be for “traditional marriage” and “gay rights”,

        If you’ll notice, that is no longer discussed, because it was never anything more than a transitional contrivance, the same way “don’t ask, don’t tell” was a prelude open service. Now the militant homosexuals and their propagandists in Hollyweird and judicial handmaidens insist on SSM.
        Your position is the same as Cuomo’s on abortion-equivocation cloaked in civic virtue.

      • bonaventure

        As a Catholic you must oppose civil unions, as it is a violation of the very principles of Law, which the Catholic Church confirms. Two of these principles are: the common good and the Natural Moral Law.

        “Civil unions” violate both of these principles.

        As a Catholic you have to oppose “civil unions” just as, as a Catholic, you would/should have opposed the Nuremberg Laws, or Soviet Laws.

  • smartypants

    Let me make clear that I love Pope Benedict very much and I tried ( with mixed success) to read and understand all of his books.
    With that in mind , I am puzzled as to why the bishops talk so much about ” rights” to
    this or that thing. What does it matter if a citizen has a right to healthcare? Governments and their trappings come and go but the Church is forever. Isn’t it more to the point that it is our duty to care for our neighbor?
    It seems to me more in keeping with our duties as Christians that, if the Bishops see there are sick people who need care, then we as a church must help as an act of mercy, and establish catholic- run, catholic- financed medical clinics. No tax money involved. You don’t need the government to do this. The Church is a supernatural institution created by Jesus Christ. That should be sufficient.
    Forget about forcing taxpayers (most of whom are not Catholic or even Christian) to fund a ” charitable” act for which they will not receive any merit in this world or the next precisely because it is required by law.

    Quit using the state as a proxy for the church. When charity is direct and personal it blesses both the one who gives and the one who receives. I would imagine the clinics established by Mother Teresa have shed more grace in the world than the British NHS has in its entire history.
    The very first hospitals in the world were created by Christians. I don’t think the Christians back then were concerned about ” rights”. I think they were more concerned with their Christian ” duties”.

    Moreover, whenever the Church tries to use the State, the State just ends up eating the Church. Look what has happened already with the ACA. History proves time and time again, wherever there is the State, there is room for nothing else. Do it yourselves Bishops. Ask the parishioners ,and God, to help. You may be surprised by the response.

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  • http://eisbrener.info/blog Michael Eisbrener

    Interesting article as are the posts! The L/R paradigm argument keeps people apart and separate. The hoax healthcare program in the US was never about healthcare. The USA has some of the best minds on the planet and many are in healthcare. Mayo, Johns Hopkins, etc. There are places on this planet with working national healthcare programs that combine private and GOV. Nowhere is perfect, but had they looked for what is working outside the USA, who is doing an adequate to fine job of it and how could the system be designed to work perfectly… Build that. The issue isn’t healthcare. It is the food supply. The US food supply is in danger of putting everyone into the worst healthcare system ever never designed before passage.

  • Paul

    I am a UK resident and UK subject, and all I have to say is the UK NHS is a great disappointment to me. I was afflicted with Sarcoidosis for 13-14 years and during that time I was under NHS care and nearly died twice. At the time when I was given months to live in 2002, there was a drug available in the US and some other Western European countries that was not available in the UK due to a lack of funds. Although I managed to cheat death that time, I lost the sight in one eye as the result hence I am not enamored with our much beloved NHS. Again last year, I nearly died at Easter and the diagnosis still confounds the experts to this day ?!?!
    As for ACA, it is nothing more than another tax or another means of confiscating one’s earnings. First, we must remember that with any tax there is a penalty dished out by the ever more authoritarian gov’t if compliance is NOT met. Second, any $$$ collected from such a tax is supposed to be re-invested into society to help the marginalised and the disfranchised, however before that can happen our dear beloved gov’t takes a chunk out of it to lavish themselves and to feed their insatiable appetite for mispending & waste – just look at the growth of the Federal Gov’t under the current godforsaken administration.

    • Martin 5

      And yet there would be money for such drugs IF the NHS was not misused to provide free abortions and contraception to women and girls. Those things are not health-care but rather lifestyle choices, as wicked as they both are.

  • hombre111

    I am always cautious about people involved in the Acton Institute. But anyway, could the author, in a new paper, justify our current health care system controlled by huge for profit insurance companies? England might have an unjust system, but that is England. What about the United States? How does our system stack up within the principles outlined by Catholic social teaching?

    • Art Deco

      We usually get from you pinko twaddle, now here supplemented with the notion that it is vulgar for a business to make a profit. I’ve figured it out: “hombre111″ is the handle of Ramsey Clark.

  • CP

    The root of the problem is allopathic medicine, as it does not heal. Hence, we see more illnesses of a debilitating nature. “Classical” homeopathy on the other hand truly can heal mankind of those diseases which modern medicine has no answer for except more drugs and interventions at an increasing cost to mankind in both pain and money. Do you not think God would have given us a way to heal that truly can put all on equal footing, not just the wealthy or those with insurance?

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