Medicine, Health Care, & Ethics: Catholic Voices

Part V. Health Care Reform

Part V Health Care Reform W hy are Catholics concerned with health care? The Catholic concern flows out of the Gospel call to serve as Jesus served others, and in so doing to serve Jesus as well. This concern also flows out of the social mission of the Church to work for the common good. As explained in the Catechism of the Catholic Church: LifeandphysicalhealtharepreciousgiftsentrustedtousbyGod.Wemusttakereasonable care of them, taking into account the needs of others and the common good. Concern for the health of its citizens requires that society help in the attainment of living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance.1 In this final part of the book, then, we will explore whether or not the current health care system in this country—including the Catholic facilities that help make it up—promotes the true common good and serves humanity as Jesus would. Another way to put this is: does our health care system meet the needs of people and is it just? Regarding current conditions, some Catholic scholars raise doubts on both counts. Americans continue to spend more and more of the gross national product on health care—some would say, disproportionately so—yet indications are that millions of people in this country are still not receiving even basic care. We also continue to hear about the growing number of people who are uninsured or underinsured, or who simply do not have access to even the most basic forms of health care. It would seem that many needs are not being met. Further, when we hear that the majority of those whose 301 basic health care needs are not being met are children and women, the lack of justice in our current system of care begins to come into focus. We often hear it argued today that health care is a “business”—this seems an obvious assumption because of the vast amounts of money it generates. But there is danger lurking in the fact that American society has accepted the “market mentality” behind the development and delivery of health care today. In traditional economics, we are told that the market is a “morally free zone.” The presumption is that business takes care of itself due to the mutual desires of all parties involved. Thus, according to this view, bringing “morality talk” into discussions about our health care system would be unnecessary . And on the surface of things, in a pluralistic society like ours, the market approach seems to be an efficient way to deal with each other and tolerate our differences. However, does the current “market mentality” behind health care delivery provide an adequate foundation for understanding what really goes on in actual “health care”? Consider the following points. It is difficult to shop around for health care services. Many of us are limited to specific health care providers by insurance packages. We are given the names of providers we can see—but how do we determine who is a good doctor for our medical needs? The reality is that buying a new car is far easier than picking a doctor or therapist. Further, when it comes to specialists, many people need direct referrals from their primary physicians—thus, personal choice is constrained even more. Of course, for those in rural areas the limitations run even deeper due to the limited number of providers and practitioners willing to serve in rural communities. The problem here is not merely a quibble over the difference between limited choice and complete freedom of choice. Rather, we must remember economists argue that for the market to function, there must be no force, no fraud, and no monopolies. But the way health care delivery works in practice exerts some “force” on consumers, and a single hospital serving a large rural area certainly seems like a “monopoly.” In short, people and health care institutions are not really “free” in the manner that the theory of capitalism requires. We are also told that a key rule of the market is “Buyer beware!” What is implied in this cliché is that consumers must examine and research the products they purchase. The responsibility of the “seller of goods” appears limited. Yet such an attitude is simply untenable in health care. Given the fact that the various health care professions require extensive education and 302 health c are reform training...