Acton Director of Research, Samuel Gregg, recently discussed Catholicism and healthcare over at Crisis Magazine. In his article, he asks “Must Catholics favor socialized medicine?” Gregg begins by addressing whether or not “access to healthcare may be described as a ‘right.'” He asserts that Catholics should agree it is a right based on a 2012 address Pope Benedict XVI made to healthcare workers, in which he unambiguously spoke of the “right to healthcare.” Gregg continues:
But the real debate for Catholics starts when we consider how to realize this right. Rights are a matter of justice, and justice is a primary concern of the state. Indeed Benedict XVI noted in his 2012 message that healthcare is subject to the demands of justice—specifically distributive justice—and the common good.
Some Catholics may believe this implies we’re obliged to support a more-or-less socialized healthcare system such as Britain’s National Health Service. Yet nothing in Benedict’s message or Catholic social teaching more generally implies this is the only possible path forward.
He quotes Theodore Dalrymple, a medical doctor and British social commentator who spoke about Britain’s National Health Service’s performance in 2011:
The cumulative increase in spending on the NHS from 1997 to 2007 was equal to about a third of the national debt. After all this spending, Britain remains what it has long been: by far the most unpleasant country in Western Europe in which to be ill, especially if one is poor. Not coincidentally, Britain’s healthcare system is still the most centralized, the most Soviet-like, in the Western world. Our rates of postoperative infection are the highest in Europe, our cancer survival-rates the lowest; the neglect of elderly hospital patients is so common as to be practically routine. One has the impression that even if we devoted our entire GDP to the NHS, old people would still be left to dehydrate in hospitals.
Gregg argues that while state run healthcare programs may not be efficient, another issue to look at is whether or not they are just:
Looking then at justice, the idea that everyone has a right to healthcare means that all of us have some positive duties concerning others’ healthcare. Sometimes these duties are clear. Parents, for instance, have the primary responsibility to meet their children’s healthcare needs, consistent with the use of family resources to promote all of its members’ overall flourishing.
At the same time, justice requires us to consider precisely what everyone in a given society owes to everyone else with respect to people’s often different healthcare needs. Must, for instance, a man sacrifice his entire family’s resources (and thereby severely compromise his family’s ability to support all of its other members’ capacity to participate in goods that include but also go beyond health) in order to provide his alcoholic father suffering from terminal liver-cancer with a treatment that has a 15 percent success-rate at keeping patients alive for another six weeks?
Certainly distributive justice is about need. But distributive justice also embraces questions of merit. As Donald Condit notes in his monograph A Prescription for Healthcare Reform, “we can expect to be held accountable for choices we make, including those regarding our personal health…. A Christian discussion of health care reform cannot neglect the role of personal responsibility when considering the prevalence of obesity, alcohol abuse, smoking, and lack of exercise.”
Clearly there are many issues that even a well-founded recognition of a right to access healthcare cannot resolve by itself. Nor is it obvious that government top-down control of healthcare is the only (let alone the most optimal) way of actualizing such rights.
He concludes by arguing that Catholics should not feel compelled to favor socialized medicine and that there are several potential solutions to this issue of healthcare access:
Thus, when addressing a question such as “how can I promote better access to health care,” living the Church’s teaching does not always mean that Catholics can only support one particular healthcare policy. I would even venture that the same framework of analysis suggests that no Catholic would be obliged, as a matter of informed conscience, to support an Obamacare stripped of elements such as the HHS mandate that directly violate Catholic teaching. When it comes to healthcare—and, in fact, most public policy issues—there are often many legitimate ways for Catholics to do good: ways that may be incompatible with each other but are nevertheless fully consistent with Catholic teaching. As Aquinas and the entire Church tradition from apostolic times onwards has emphasized, while one may never intentionally choose evil, the doing of good doesn’t always mean there’s just one right path to follow.
No doubt, some believe such arguments risk weakening the Church’s effectiveness in promoting the right to healthcare in the public square. The point, however, of Catholic moral reasoning is not to maximize political effectiveness, let alone ensuring that the Church remains a “player” in Washington, D.C. Rather it is about helping Catholics to live Christ’s way through all our free choices, thereby contributing to the substance—starting with ourselves—that He will raise up at the end of time, as Gaudium et Spes states, “freed of stain, burnished and transfigured, when Christ hands over to the Father: ‘a kingdom eternal and universal, a kingdom of truth and life, of holiness and grace, of justice, love and peace’” (GS 39).
Granted, this may mean little in worldly-terms. It is nonetheless the ultimate horizon to which Christ calls us—including in healthcare policy.