Goal Posts of Acceptable Health Care Reform
by Fr. Roger Landry - September 25, 2009
The debate about health care reform continues to occupy much of the nation's attention, as well it should, considering the gravity of the need for reform and the magnitude of the proposed changes presently being proposed by members of Congress.
It is obviously important for Catholics to look at the proposed reforms through the light of the Catholic faith. We continue today a series of editorials in which we will try to provide that light.
We give the floor today to the thoughts of Bishop R. Walker Nickless of the Diocese of Sioux City, Iowa. On August 17, he wrote an article — quoted and referenced by many other bishops in their own comments on the matter — in which he described four "goal-posts" to mark out what is acceptable and unacceptable reform. Bishop Nickless admits at the outset that not only is there much confusion about what is in the various interminable bills put forth in the House and Senate, but that there's been a befuddling imprecision on the perspective of the Catholic Church with regard to various parts of health care reform. He wrote to clarify what the Church teaches and doesn't teach with respect to health care reform.
The first goal-post he described is the one that has gotten most attention because Bishop Nickless says it is the "most important": "The Church will not accept any legislation that mandates coverage, public or private, for abortion, euthanasia, or embryonic stem-cell research. We refuse to be made complicit in these evils, which frankly contradict what 'health care' should mean. We refuse to allow our own parish, school, and diocesan health insurance plans to be forced to include these evils. As a corollary of this, we insist equally on adequate protection of individual rights of conscience for patients and health care providers not to be made complicit in these evils. A so-called reform that imposes these evils on us would be far worse than keeping the health care system we now have."
This first goal-post is what Cardinal Rigali of Philadelphia has stressed on several occasions in his statements on behalf of the U.S. Bishops' Conference. It's also what our August 7 and 28 editorials emphasized. President Obama's September 9 declaration in his address to Congress that "under our plan no federal dollars will be used to fund abortions and federal conscience laws will remain in place" seemed to be a sign that he has clearly heard what Cardinal Rigali has written and Cardinal Sean O'Malley said to him in private at Senator Edward Kennedy's August 29 funeral: that if the President wishes to have the support of the Catholic Church for his health care reforms, abortions must not be funded and the rights of consciences must be protected.
There are still serious concerns about whether the President will make good on these promises. Bishop Nickless says, in words that are still valid after the President's address: "The current House reform bill, HR 3200, does not meet the first standard. As Cardinal Justin Rigali has written for the USCCB Secretariat of Pro-life Activities, this bill circumvents the Hyde amendment (which prohibits federal funds from being used to pay for abortions) by drawing funding from new sources not covered by the Hyde amendment, and by creatively manipulating how federal funds covered by the Hyde amendment are accounted." We will leave more in-depth analysis of this point to a later editorial.
It bears stating, though, that for months various political strategists have been alleging that the administration's health care game-plan has been to get pro-lifers, Catholics, and other conservatives so focused on abortion, conscience protections, public options and the like that, when the administration pulls these unpopular political cyanide pills from the eventual bill, their main opponents will be mollified enough to claim victory and accept various other radical reforms that change the whole culture of health care. Whether or not that accusation is true, Bishop Nickless's analysis of the health care reform proposals does not stop with only the first goal-post.
His second point of clarification focuses on the "right" to health care. In various places, both secular and Catholic, the stipulation has been made, without any reference to magisterial documents, that the Church believes everyone has an absolute right to health care. Bishop Nickless makes clear that this is a misunderstanding and misstatement of Church teaching. "The Catholic Church does not teach," he stresses, "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 owns 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.'"
That leads directly to the third goal-post or clarification. When some hear certain Church members speaking about a putative "right" to health care, they conclude that the Church teaches that the government has the duty to provide it. But the Church does not prejudice the "prudential judgment" in that way. "The Catholic Church does not teach," Bishop Nickless underlines, "that government should directly provide health care." Then he provides a prudential analysis of his own:
"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. Private, religious hospitals and nursing homes, in particular, should be protected, because these are the ones most vigorously offering actual health care to the poorest of the poor."
The fourth and final goal-post concerns the personal duty each one has to stay healthy. Members in society are not obligation to cover for others' own preventable unhealthy choices, the Sioux city prelate implies, and before one looks to government for entitlements one must fulfill his own responsibilities to God and others. "Preventative care," Bishop Nickless says, "is a moral obligation of the individual to God and to his or her family and loved ones, not a right to be demanded from society. The gift of life comes only from God; to spurn that gift by seriously mistreating our own health is morally wrong. The most effective preventative care for most people is essentially free — good diet, moderate exercise, and sufficient sleep." We need to be stewards of our own health and many Americans are not as responsible as they ought to be.
Bishop Nickless concludes his letter by encouraging all Catholic citizens "to make your voice heard to our representatives in Congress. Tell them what they need to hear from us: no health care reform is better than the wrong sort of health care reform. Insist that they not permit themselves to be railroaded into the current too-costly and pro-abortion health care proposals. Insist on their support for proposals that respect the life and dignity of every human person, especially the unborn. And above all, pray for them, and for our country."
We will continue next week with other thoughts from leading bishops.
Father Roger J. Landry is pastor of St. Anthony of Padua in New Bedford, MA and Executive Editor of The Anchor, the weekly newspaper of the Diocese of Fall River.
