A new commentary from Dr. Donald Condit. Also see the Acton Health Care resource page.

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Health Care Rights, and Wrongs

By Dr. Donald P. Condit

As Speaker Nancy Pelosi promoted passage of Sunday’s health care reform bill, she invoked Catholic support. However, those who assert the right to health care and seek greater responsibility for government as the means to that end, are simply wrong. This legislation fails to comport with Catholic social principles.

Claiming an entity as a right requires clear thinking about who possesses a claim to something while defining who must fulfill this obligation. We can clearly agree on responsibility to care for our neighbor and yet not promote federal dominion over doctors and nurses.

Some mistakenly quote Pope John XXIII‘s 1963 Encyclical Letter Pacem In Terris (Peace on Earth) discussing “the right to live… the right to bodily integrity and to the means necessary for the proper development of life, particularly food, clothing, shelter, medical care, rest, and, finally, the necessary social services (11).” In this context, the Holy Father speaks of health care as a natural right, with corresponding responsibilities, not as a direct obligation of the state. Nowhere in Pacem In Terris is government assigned accountability for food, clothing, shelter or health care.

Archbishop Charles J. Chaput recently reiterated the Church’s understanding of health care as a right. “At a minimum, it certainly is the duty of a just society. If we see ourselves as a civilized people, then we have an obligation to serve the basic medical needs of all people, including the poor, the elderly and the disabled to the best of our ability.” Yet, there are options for society to meet this duty apart from the federal government.

In a May 2008 address to the Pontifical Academy of Social Sciences, Pope Benedict XVI guided us in correct understanding and action:

“The four fundamental principles of Catholic social teaching: dignity of the human person, the common good, subsidiarity and solidarity…offer a framework for viewing and addressing the imperatives facing mankind at the dawn of the 21st century…The heart of the matter is how solidarity and subsidiarity can work together in the pursuit of the common good in a way that not only respects human dignity, but allows it to flourish.”

Respecting these four principles can help this country achieve consensus without increasing reliance upon Washington.

The first principle, Respect for Dignity of the Human Person, is prerequisite. Health care reform is meaningless without it. Life must be safeguarded from conception to natural death. Tax dollars must not subsidize abortion or euthanasia. This principle must apply on both ends of the stethoscope, respecting both patient and provider. Health-care professionals must be able to follow their conscience in prescribing and providing treatment.

We share a duty in the United States to nearly 50 million uninsured, and millions more who are precariously insured, to reform health care. Human dignity also predicates responsibility to care for oneself and one’s family. Many medical problems arise from personal decisions affecting health, and medical resources are over-consumed when perceived as free. Therefore, reform must not abrogate personal responsibility for decisions which affect health, nor financial participation in consumption of medical goods and services.

Pope John XXIII was clear on this as well. “Every basic human right draws its authoritative force from the natural law, which confers it and attaches to it its respective duty. Hence, to claim one’s rights and ignore one’s duties, or only half fulfill them, is like building a house with one hand and tearing it down with the other. (30)”

The second principle, the Common Good, requires us to promote “those conditions of social life” that allow people “access to their own fulfillment.” Impending Medicare insolvency and the inability of strained state budgets to cover more Medicaid patients requires re-evaluation, and not expansion, of government responsibility. Moving forward with incremental improvements that are achievable with consensus is more prudential than comprehensive, and unaffordable, legislation without bipartisan agreement and popular approval.

Policy changes could approach more universal coverage without tremendous additional cost. Tax and insurance market reforms could increase premium affordability and policy portability. National coverage mandates, instead, will hinder insurance affordability. Defensive medical practices, particularly in emergency rooms and critical care circumstances, result in unnecessary expense and compromise compassionate care.

The third principle, Subsidiarity, emphasizes providing care by those closest to persons in need. A community of a higher order in society should not assume tasks belonging to a community of lower order and deprive it of its authority. As Pope Benedict XVI wrote in his 2005 encyclical Deus Caritas Est, “We do not need a State which regulates and controls everything, but a State which, in accordance with the principles of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need.”

This principle argues for strengthening and protecting the doctor-patient relationship. Individuals and families with health savings accounts would be better able to prioritize health care resource allocation through the marketplace, rather than distant bureaucrats assigning mandated benefits. Educating patients about costs, outcomes, and quality of medical goods and services will improve resource allocation, rather than rationing by appointed advisory panels. The fourth principle, Solidarity, obliges us to maintain a preferential option for poor and vulnerable. Our results will be judged by how we have fulfilled our duty, in the spirit of loving our neighbor, feeding the poor, and caring for the sick. (Mt 25:40).

Neighbors who become sick or injured within our borders cannot be left out of the health care reform equation. Doctors and hospitals are required by law and conscience to care for those who come to emergency rooms. The debate over immigration reform has no place at a patient’s bedside. Those with chronic disease are particularly vulnerable and vigilance must be maintained to ensure their safety net. Yet again, this does not mean state expansion. Government can play a role by facilitating the activity of charitable organizations in health care, but the primary obligation falls on all of us to be generous with our time, talents, and treasure. There will always be a place for charity in care for the sick and dying.

We ought to agree on the right to health care as a moral duty, but not as a federal responsibility. Supporters of this deeply flawed bill should contemplate these universal principles.

  • Roger McKinney

    “…the right to bodily integrity and to the means necessary for the proper development of life, particularly food, clothing, shelter, medical care, rest, and, finally, the necessary social services…”

    That seems like a major expansion of rights beyond the rights to life, liberty and property. That doesn’t mean that a person has the right to anyone’s property, only that he has the right to his own which he has earned. If someone deprives him of that right, that violator of his rights must go to jail or provide restitution.

    If a person has a right to the things mentioned by the Pope, then his has the right to other people’s property if he can’t supply them himself. And if we refuse to give him what is rightfully his, then we are guilty of a major injustice and should go to jail.

  • Neal Lang

    “That seems like a major expansion of rights beyond the rights to life, liberty and property. That doesn’t mean that a person has the right to anyone’s property, only that he has the right to his own which he has earned. If someone deprives him of that right, that violator of his rights must go to jail or provide restitution.”

    No, “the right to bodily integrity and to the means necessary for the proper development of life, particularly food, clothing, shelter, medical care, rest, and, finally, the necessary social services” does not imply that such must be provided by either government or “thy neighbor,” merely that you are entitled to such if for no reason of your own you cannot provide them your self. Not being able to “provide for yourself” creates a person need which can be corrected by working harder to attend them yourself, or only when that is not possible, to rely on the charity of others to meet those needs. This right does not create a mandate for government to provide these needs anymore than the individual right to property does not incur an obligation on government or society to provide this property. No, the government and society must only insure your right to peaceably own your property. It does not follow, then, that a “right to life” for any individual does incur a obligation on the part of government or society to provide anyone with everything necessary to sustain life, like health care, food, housing, etc. merely the obligation to secure one’s life from an unjust taking by someone else, including the the government. One’s Creator endowed, unalienable human rights do not incur any obligation on either any other human being or their government beyond requiring that they recognize these human rights and not unjustly deprive another of them.

  • Neal Lang

    “If a person has a right to the things mentioned by the Pope, then his has the right to other people’s property if he can’t supply them himself. And if we refuse to give him what is rightfully his, then we are guilty of a major injustice and should go to jail.”

    That is a false construction. One has the right to obtain the necessities of life (this is basically the right to obtain and hold property which is described as the “Pursuit of Happiness”), but it does incur an obligation on anyone else’s part to provide these necessities for them. Attached to this concept of rights is the understanding that along with these rights comes the individual duty to provide for oneself. In doing so, an individual or the government cannot violate another’s human rights. Of course, individuals may take it upon themselves to help another met their duty to provide for themselves, however, the should so in a way that will not restrict the helped individual from bettering or helping themselves. The big problem with governmental social programs is that they can’t or wont require the helped to meet their own obligation. Person charities, on the other hand, have a much better record in promote aid with self-help. Which is why welfare and other big government program of self-destructive for the individuals they are trying to help.

  • Neal Lang

    “We share a duty in the United States to nearly 50 million uninsured, and millions more who are precariously insured, to reform health care. Human dignity also predicates responsibility to care for oneself and one’s family.”

    Our duty, however, doesn’t require that we pay for a pediatrician for someone children, if that someone made the person decision that a giant flat screen HDTV was more important than paying for the children’s medical care. Many of the uninsured in our country are that way because of their person lifestyle decision. Beyond preaching to them about the consequences of their choices (something apparently the government is precluded from doing) their is little either society or the individual can do for them. Paying for their personal mistakes should not be a collective obligation.

    In Western Society charities such a the Church and other private organization have always provided health care for the less advantaged. This seemed to be a workable solution for nearly 2,000 years. Why, all of a sudden, should this private charity not work today is quite remarkable.

  • Gantt

    Our constitutional rights were written to protect us from an oppressive government. Religion, speech, assembly, arms, eminent domain, slavery, votes are all designed to protect the individual from a corruptible federal government.

    Health care is not a right, it is a responsibility. Our bishops seem to think that social justice requires them to legislate charity but legislated charity has no virtue.

    I’m just a simple man but it appears to me that our bishops cannot distinguish between social justice and socialism.

  • Roger McKinney

    Neal, I would love for your interpretation to be the correct one, but if you go over to Sojo’s web site, they are using the exact same text to justify state provision of those rights. And honestly I have to agree with them because the purpose of the state is to guarantee our rights. If someone doesn’t get what is rightfully his, then the state must make certain he gets what is rightfully his an the state is allowing a gross injustice. Rights are not options. Rights impose obligations on others.

  • Patrick

    Do we have necessities in life assuming the power of law as Rights which impose duties on our fellows rather than restrictions? Are we witnessing a restatement of “From each according to his ability to each according to his need”?

    I tend to believe that Gantt is on to something with his observation that our bishops cannot distinguish between social justice and socialism”. There is strong evidence that the American Church is in a crisis in fulfilling our duties in charity. Consider the following website’s analysis of the Catholic Campaign for Human Development.

    http://www.facebook.com/l/db430;www.realcatholictv.net/cia

  • Roger McKinney

    The Mises institute has a post from Acton on today’s blog called “American Federalism and the Civil War.” In it, Acton describes the real problem with the Constitution, the tendency toward democracy and the tyranny of the majority promoted by Jefferson and others. The Constitution was intended to limit the will of the majority, but the writers also knew that the worship of democracy and the absolute will of the majority would rip the document to shreds, as it has.

    The problem is not the state as much as it is the idolatrous worship of the majority opinion, both in legislation and in the courts.