American Thinker | Mark Wauk | Sep. 6, 2009
The 9/2/09 issue of the Wall Street Journal, in its Notable and Quotable feature, calls attention to an important article that Roman Catholic Bishop R. Walker Nickless of Sioux City, Iowa, published in his diocesan newspaper on the subject of health care and health care reform. The article is important for two reasons: first, because there has been and continues to be a certain amount of confusion regarding Catholic social teaching as it affects health care; second, because Bishop Nickless goes to great lengths to base his discussion on principles, and not merely on tactical considerations.
Bishop Nickless begins by noting the importance of the ongoing debate over proposed reforms of our health care system:
“There is much at stake in this political struggle, and also much confusion and inaccurate information being thrown around. My brother bishops have described some clear “goal-posts” to mark out what is acceptable reform, and what must be rejected. First and most important, the Church will not accept any legislation that mandates coverage, public or private, for abortion, euthanasia, or embryonic stem-cell research.”
After further noting particular concerncs for Catholic hospitals and health care professionals — the possibility that the Government would attempt to force them to act in violation of Catholic teaching as well as in violation of their consciences–Bishop Nickless concludes:
“A so-called reform that imposes these evils on us would be far worse than keeping the health care system we now have.”
However, Bishop Nickless doesn’t stop here. He goes on to enunciate several additional considerations of great importance. The bishop’s second point gets to the heart of the role that government should play in health care:
“Second, the Catholic Church does not teach that “health care” as such, without distinction, is a natural right. The “natural right” of health care is the divine bounty of food, water, and air without which all of us quickly die. This bounty comes from God directly. None of us own it, and none of us can morally withhold it from others. The remainder of health care is a political, not a natural, right, because it comes from our human efforts, creativity, and compassion. As a political right, health care should be apportioned according to need, not ability to pay or to benefit from the care. We reject the rationing of care. Those who are sickest should get the most care, regardless of age, status, or wealth. But how to do this is not self-evident. The decisions that we must collectively make about how to administer health care therefore fall under “prudential judgment.”
In other words, provision of health care must ultimately rest on prudential considerations that affect an entire society. Broad assertions of generalized “rights” without reference to underlying prudential considerations are not helpful. The relevant considerations include need, but also cost. Another important prudential consideration, however, is this: who should be the main provider of health care, government or the private sector? Bishop Nickless insists that health care provision is not only not a central concern of government as such, it is also likely to introduce harmful economic and policy distortions:
“Third, in that category of prudential judgment, the Catholic Church does not teach that government should directly provide health care. Unlike a prudential concern like national defense, for which government monopolization is objectively good – it both limits violence overall and prevents the obvious abuses to which private armies are susceptible – health care should not be subject to federal monopolization. Preserving patient choice (through a flourishing private sector) is the only way to prevent a health care monopoly from denying care arbitrarily, as we learned from HMOs in the recent past. While a government monopoly would not be motivated by profit, it would be motivated by such bureaucratic standards as quotas and defined “best procedures,” which are equally beyond the influence of most citizens. The proper role of the government is to regulate the private sector, in order to foster healthy competition and to curtail abuses. Therefore any legislation that undermines the viability of the private sector is suspect.”
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