We need real reform
On the day before his installation as Archbishop of New Orleans, at which the native New Orleanian was greeted with thunderous applause, Gregory Aymond, re-iterated the USCCB’s position on health care reform:
The Catholic bishops in the United States recognize a pressing need for health care reform. Too many American citizens lack basic health care coverage and the cost of health care is becoming prohibitive for many more.
The Lord Jesus, who came to save us from our sins, manifested a great concern for the sick in his public ministry. He also urged us to reach out to the poor and sick in our midst. The Church rightly considers that government has a responsibility to ensure access to basic health care for all.
The bishops do not propose a specific plan or policy. But we set out the following principles to shape public policy:
Strident or shrill rhetoric does not help us to engage in civil and respectful deliberation about a serious social issue with significant moral implications. God grant us the wisdom to discern what is right and the courage to do it.
* We need to develop a plan which ensures access to basic health care for all.
* We need to make sure that the poor and the vulnerable, including legal immigrants, are part of this plan.
* We need to control health care costs so that it is affordable to all.
* We need to make sure that abortion, euthanasia or other immoral activities are not mandated or financed with tax payer dollars. This includes conscience protection for all providers, whether institutions or individual persons, and for all recipients.
The bishops, without proposing either a public or private sector option, urge that any plan which is developed embrace these principles. Catholics are urged to contact their United States Senators and Representative to ask them to use these principles to evaluate all proposals that are developed.
I find nothing with which to disgree in Archbishop Aymond’s statement. The health care reform on which we, as Catholics, must insist should look, in part, like what he has described. If we, as Catholics want not merely to stake out the moral high ground, but to actually work toward real health care reform, much more needs to said and done.
First, if we are serious about having a health care system which does not fund abortions, we must not merely cry foul whenever abortion is mentioned, but offer real ideas for compromise. The bishops have offered the abstract goals and ideals. Catholic politicians must be willing and able to help put those ideas into concrete form to establish a real reform. If being anti-abortion is a part of the Republican platform, then Republican senators and congressmen, especially those that are Catholic, must be willing to sacrifice one or more of the other Republican demands as a trade-off in order to help assure that abortions are not funded by our tax dollars.
Second, one of the prime reasons we are in dire need of health care reform is that health care has become primarily about making money. An entrepreneurial culture has invaded the health care industries. Therefore, patients have become a means to an end, rather than being treated as ends in themselves. Atul Gawande of the New Yorker made this point excellently in a well researched article entitled, the “Cost Conundrum.” He found that the areas with the most expensive health care statistics, those that get the most care, do not reflect better health. That is, even though a person in these areas receives more health care, even though he pays more for health care, his health care is not better but is found to be deficient when compared with others who have paid less. Gawande found that in some cases, less is more. When? When the climate of the health care institution is one of patient-centered care, the Mayo Clinic for example. However, this is rare, because every incentive in the system pushes toward health care as a business. (We see this reflected throughout society. As a former high school teacher, I can attest that a majority of students who claim to want to become doctors site money as the primary reason.) Gawande writes:
[A] choice must be made. Whom do we want in charge of managing the full complexity of medical care? We can turn to insurers (whether public or private), which have proved repeatedly that they can’t do it. Or we can turn to the local medical communities, which have proved that they can. But we have to choose someone—because, in much of the country, no one is in charge. And the result is the most wasteful and the least sustainable health-care system in the world.
Thus, we need real reform. We need reform which will give doctors and institutions the incentives to work toward patient-centered care rather than profit-driven (I hesitate to call it) care. We need reform which sees the person as possessing inestimable dignity and as being worthy of quality affordable health care.
If these two things are not addressed – political comprimise to ensure that we will not be funding abortions and real reform which is centered on the dignity of the patient – then whatever “reform” we end up with will not be real reform and will only serve to further undermine the dignity of the human person.