by John L. Allen Jr.
Opening a new front in official Catholic reaction to health care reform, the two bishops of Kansas City have issued a joint pastoral statement warning not only against an expansion of abortion or mandatory end-of-life counseling, but also the dangers of “excessive centralization” and “government socialization” of medicine.
Experts say that the critique goes beyond pronouncements offered by the United States Conference of Catholic Bishops, or by other American prelates, which typically have called for preserving “pluralism” in health care but otherwise seem neutral, or even favorably inclined, to new government initiatives.
In terms of the politics of reform, the statement thus appears likely to lend Catholic weight to opposition from secular conservatives to proposals for a so-called “public option.”
The pastoral statement, titled “Principles of Catholic Social Teaching and Health Care Reform,” was issued by Archbishop Joseph F. Naumann of the Kansas City, Kansas, archdiocese, and Bishop Robert W. Finn of Kansas City-St. Joseph. Dated August 22, the statement was posted on-line Sept. 1.
The bishops write that President Barack Obama, “to his credit,” has made addressing the flaws in America’s health care system a major priority. Among the flaws cited by Naumann and Finn are that some 47 million people lack health insurance; that health care costs continue to rise; and that individuals with pre-existing conditions often can’t get care.
Those defects, the bishops write, underscore the need for “authentic reform” to provide a greater “safety net for people in need.”
“In evaluating health care reform proposals, perhaps we ought to ask ourselves whether the poor would have access to the kind and quality of health care that you and I would deem necessary for our families,” they write. The bishops include legal immigrants among groups which merit improved care.
Nonetheless, Naumann and Finn also warn that “change for change’s sake, change which expands the reach of government beyond its competence, would do more harm than good.”
The bishops assert that “our country, in some ways, is the envy of people from countries with socialized systems of medical care.” Grounding their critique in the principle of subsidiarity, which holds that higher levels of authority should not usurp what can be done better or more efficiently at lower levels, the bishops write that a “centralized government bureaucracy” poses three risks:
- t“A loss of personal responsibility”
- t“Reduction in personalized care for the sick”
- t“Higher costs”
Although Catholic teaching asserts a right to health care, Naumann and Finn say that this right “does not necessarily suppose an obligation on the part of the government to fund it.”
“In our American culture, Catholic teaching about the ‘right’ to healthcare is sometimes confused with structures of entitlement,” the bishops write. “The teaching of the universal church has never been to suggest a government socialization of medical services.”
A hasty expansion of government programs, the bishops warn, could create “a future tax burden which is both unjust and unsustainable” as well as fostering “permanent dependency for individuals or families upon the state.”
In that light, Naumann and Finn propose that “some system of vouchers – at least on a theoretical level—is worthy of consideration.” Vouchers, they write, could give individuals an incentive to make prudent financial decisions and to take common-sense preventative measures, such as better diet and exercise, while still giving them a direct say in their own care.
Noting that 85 percent of Americans have insurance, they say that in some cases people lacking health insurance are not taking advantage of programs open to them, such as Medicaid or the State Children’s Health Insurance Program.
On the pro-life front, Naumann and Finn strongly reject any expansion of abortion, as well as mandated end-of-life counseling for the elderly or disabled.
“Any health care reform package must keep intact our current public polices protecting taxpayers from being coerced to fund abortions,” they write. “Given the penchant of our courts over the past thirty-five years to claim unarticulated rights in our Constitution, the explicit exclusion of so-called ‘abortion services’ from coverage is essential.”
Similarly, Naumann and Finn say that “health care reform legislation must clearly articulate the rights of conscience for individuals and institutions,” warning that otherwise Catholic health care in America could be jeopardized.
“The loss of Catholic hospitals and health care providers, which currently do more to provide pro bono services to the poor and the marginalized than their for-profit counterparts, would be a tremendous blow to the already strained health care system,” they write.
On mandatory end-of-life counseling, Naumann and Finn echo a recent warning from the National Association of Pro-Life Nurses that such a requirement “would place undue pressure on the individual or guardian to opt for measures to end life, and would send the message that they are no longer of value to society.”
Naumann and Finn acknowledge that while no Catholic can disregard the basic moral principles outlined in their statement, “there can and likely will be vigorous debate about their proper application.”
