Here is a remarkable piece by Donald Wuerl, the archbishop of Washington, in Politics Daily (which sounds almost like a homily) reminding readers that health care is an issue that has long been part of Catholic social teaching (h/t to Grant Gallicho at Dotcommonweal):
We teach that health care is a basic human right, an essential safeguard of human life and dignity. Here in the Archdiocese of Washington, the Catholic community serves nearly 600,000 people in our hospitals and other health care facilities and over 120,000 persons through Catholic Charities, including its Family Centers, and even more through parishes. It is this direct, frontline experience that has guided the Church's efforts for decades to expand and improve health care coverage in our nation and our work for genuine health care reform today.
Hard on the heels of Wuerl's article come these comments from Cardinal Renato Martino, head of the Pontifical Council for Justice and Peace, and who, as the CNS blog points out, lived in the US for 16 years:
The health of their own citizens belongs to the authorities, to the central government. And so I have been 16 years in the States and I was wondering why a big portion of the American people is deprived, have no health assistance at all. I could never explain this…
And you know that everywhere in the world it is a concern of the government first of all, and after there are possibilities also on the private sector, but those who are without anything… the central government must provide to that. So I cannot but applaud this initiative.
And in our editorial today we make the same case:
As people of faith we can be guided by a long tradition of Catholic social teaching that unambiguously supports public initiatives to ensure access to health care when markets alone fail to achieve universal coverage. Those who express exaggerated fears of a government takeover and bureaucratic centralization tend to portray government as somehow a threat to the people and their freedom, but Catholic social teaching consistently reminds us that public authority is the ordinary mechanism by which people undertake collective action. The principle of subsidiarity provides a check against needless centralization, but it must not be misinterpreted as an excuse to forgo truly necessary national initiatives.
Catholic social teaching offers a distinctively organic view of society that calls all parties to be open to sacrifice for the good of the whole. That common good springs from true cooperation, not merely the competitive interaction of self-interests. Reforming health care should not be reduced to a partisan issue, with the eyes of negotiators distracted by the goal of scoring political advantage. We will achieve the aims of reform—extending coverage to the uninsured, rationalizing procedures and policies and lowering costs—only if all parties check their egos and partisan interests at the door and work together.
Medicare patients go to nursing homes to receive intravenous antibiotics. Private patients go home with home care.
Doctors will not lose their job with a government takeover. Doctors get better job security with a government takeover. They likely will have better work hours as the AMA (who is in bed with the POTUS) will be the doctors union at the government healthcare table. Nothing like a union to protect the doctors at the expense of the patient.
This "health care is a right" statement is a smoke screen that tries to imply a certain type of system (single payor) is the only way to go.
I believe that people should have the "right" to ration their own health care based on their perception of cost/benefit. I do not think that we should give this right to the government.
I don't think you understand my point. I am not laying claim to any money. I am asking "how much health care is a right"?
Is it a right to have $100,000 of care for a 4 week improvement in metastatic colon cancer survival (such as with Avastin)? If you do not think this to be a right then please justify where the right begins and where it ends.
Is it a right for an end stage cancer patient to have hemodialysis?
Is it a right for a patient to get a $90,000 internal defibrillator?
Is it a right for a patient to get the most convenient once monthly drug rather than the cheaper generic once weekly drug?
Who should make this rationing decision?
I would argue that the best system for health care will empower the patient to make this decision.
No one is immune to illness and injury. You are laying claim to money that you do not have a moral right to claim as exclusively yours even though it has been paid to you in exchange for your time and effort. This is because it is not only a right of every person to receive necessary medical care, but an obligation of every person to contribute something toward meeting their inevitable needs.
I think the confusion is the result of your having become accustomed to having insurance companies dictate appropriate treatment. In part this comes from people not having any money left after paying for their insurance that they could use to pursue treatments that the insurer does not cover. Doctors prescribe and people receive the treatments that insurers will pay, and not necessarily those that could lead to the best outcome.
The specific questions that you pose cannot be answered once for everyone. As you say, the patient has to make the decision in consultation with a doctor. If that happens, cost will not be the primary consideration if the payment comes from the government administered health care pot.
In the scenario of a single government health care pot, if one person gets $100,000 of medication and ends up only living five more weeks, that money is simply removed from the pot without judgment. Each year, an assessment is made as to whether the income sensitive contributions into the pot were enough to cover expenditures for that year. If they were not, the percentage rate that each person contributes goes up. On the other hand, if contributions did cover expenditures and there is a surplus, then the rate would go down. There is no concern for getting or keeping enough money in the pot to show a profit.
You have to remember that there is no incentive for patients simply to choose the most expensive treatment (though there may be something in it for corrupt doctors or medical facilities). Also, people do not necessarily wish to prolong their lives when there is no hope of improvement simply because they can do so. However, sometimes they may have a reason to do it, and it would not be right for anyone to suggest that the reason is not valid.
Another result of this approach would be that it would be much easier to see where the government should put its medical research money. It is unlikely that the system would result in medical care rationing, but it likely would result in more effort at illness prevention. If cancer is bankrupting us, then more effort would go to understanding cancer, etc.
Marie: Medicare is a great example of how the government has trouble controlling cost of health care unless they make arbitrary rationing decisions when the ''pot'' runs dry.
Jim: Of course rationing exists now. The question is not whether we ration or not. The question is what is the best way to ration? Those with private insurance have many advantages compared with those who have medicare, especially when it comes to home infusion therapy. Medicare patients get sent to the nursing home for their antibiotics while those with private insurance go home and have home infusion and home nursing.
Medicare costs are being held hostage to the current system also. It is only when everyone, the good risks and the bad, are part of the system that the system can stay solvent. Insurance companies know this, that is why they do what they can to only insure those who are unlikely to put demands on the money they collect.
I cannot really say whether one approach or another is best for treating an elderly person who needs antibiotics. This, too, should probably be something that the patient's circumstances determine, instead of being a one size fits all approach.
Notice when we allow the free market to work most unhampered, such with clothing, we get the best results? And when the government involves itself more-most recently in the disastrous housing bubble caused by speculation, greed, and the Community Investment Act/gov't mortgage insurance-we have turmoil and scarcity?
Though health care is a basic human right sounds good, it is merely a bromide passing for deep thought.
Were it not for the government, there is no reason to think that housing would be affordable and that families would not be living in boxes in some places. Health care, currently, is such that some families experience the equivalent of living in boxes, but unlike with housing, it is not the poorest who have this experience, but those who are doing just a bit too well to qualify for government aid.
Food is not entirely a free market enterprise either. The poor get Food Stamps, food is monitored for safety, and food producers get subsidies.
Clothing is abundant in our society, such that no one is likely ever to die from lack of clothing. Still, the government does oversee the working conditions of clothing producers.
Finally, there is a kind of right to clothing, food, and shelter that is the result of all of us having a human right to a decent life. Why you think this should not include being able to receive needed medical attention at a price that will not prevent us from also having clothing, food, and shelter is not clear to me.
Would you really rather be at home with an IV in you? Also, there's nothing like pretending you are defeated so that you do not have to engage positively in the debate. I know many doctors who experience all the same aggravation in getting their medical care that the rest of us do. I find it rather hard to believe that they are looking out for themselves at the expense of the patients.