Health Care Myths

An interesting article from the WaPo of a couple weeks back: 5 Myths about Health Care around the World. Here's a quote that caught my eye:

The key difference is that foreign health insurance plans exist only to pay people's medical bills, not to make a profit. The United States is the only developed country that lets insurance companies profit from basic health coverage.

The main problem with the article's proposals is that it would require a complete overhaul of our current medical insurance system. That's something the current administration is dead-set against doing. Strange: you'd think an administration that ran on the slogan of "CHANGE" would be interested in, well, change.

Criteria for Health Care Reform from U.S. Bishops

The Catholic Bishops in the U.S. have, both individually and collectively, sought reform of our health care system for many years. It was part of their support of labor unions, part of their preferential option for the poor, part of the greater ideals to which they have called the sheep of their flocks, and particularly our political leaders.

However, they have always held that health care reform should be true reform: that is, it is currently deformed, and needs to return to its true form. Health care must truly care for the health of all people.

In a letter to Congress [.pdf], the United States Conference of Catholic Bishops set out four main criteria for authentic health care reform.

1. A truly universal health policy with respect for human life and dignity
2. Access for all with a special concern for the poor and inclusion of legal immigrants
3. Pursuing the common good and preserving pluralism including freedom of conscience and variety of options
4. Restraining costs and applying them equitably across the spectrum of payers

This is very similar to a list which they articulated back in 1993, when another president was attempting to push through major health care reform. In fact, they also have re-issued this message, because its argument remains valid.

Note that the Bishops are not supporting or opposing any legislation. Rather, they are giving principles based on human nature, and which can be understood and accepted without any other relation to Christ or Christianity. They simply are voicing the concerns that arise from a Christian worldview.

G.K. Chesterton on the Common Good

The "common good" is one of those concepts that is so plain and obvious that it outwits our attempts to define it -- or at least, outwits my attempts. But I have stumbled upon a particularly clear definition from G.K. Chesterton, in his 1909 book Orthodoxy (Ch. IV):

The first [principle of democracy] is this: that the things common to all men are more important than the things peculiar to any men. Ordinary things are more valuable than extraordinary things; nay, they are more extraordinary. Man is something more awful than men; something more strange. The sense of the miracle of humanity itself should be always more vivid to us than any marvels of power, intellect, art, or civilization. The mere man on two legs, as such, should be felt as something more heartbreaking than any music and more startling than any caricature. Death is more tragic even than death by starvation. Having a nose is more comic even than having a Norman nose.

This is the first principle of democracy: that the essential things in men are the things they hold in common, not the things they hold separately. And the second principle is merely this: that the political instinct or desire is one of these things which they hold in common. Falling in love is more poetical than dropping into poetry. The democratic contention is that government (helping to rule the tribe) is a thing like falling in love, and not a thing like dropping into poetry. It is not something analogous to playing the church organ, painting on vellum, discovering the North Pole (that insidious habit), looping the loop, being Astronomer Royal, and so on. For these things we do not wish a man to do at all unless he does them well. It is, on the contrary, a thing analogous to writing one's own love-letters or blowing one's own nose. These things we want a man to do for himself, even if he does them badly. I am not here arguing the truth of any of these conceptions; I know that some moderns are asking to have their wives chosen by scientists, and they may soon be asking, for all I know, to have their noses blown by nurses. I merely say that mankind does recognize these universal human functions, and that democracy classes government among them. In short, the democratic faith is this: that the most terribly important things must be left to ordinary men themselves--the mating of the sexes, the rearing of the young, the laws of the state. This is democracy; and in this I have always believed.

Text of Obama Health Care Plan

I'm pretty sure that this is the text of the much-talked-about "Obama health care plan." The official title is H.R. 3200. In case you wanted to know what it actually, you know, said.

It's also available in .pdf format.

An interesting proposal: Read the Bills Act

According to the non-profit group Downsize DC, both houses of Congress have eliminated requirements that Representatives and Senators hear and/or read -- or even have full copies of -- legislation that they vote on. They have therefore submitted a bill entitled The Read the Bills Act and are trying to get a Congressman/-woman to introduce the bill.

They are having little success.

Now, much of the Downsize DC agenda seems to be taken from the Libertarian handbook, and I don't want to imply support for their agenda; but this piece of legislation seems pretty common-sensical to me. Is there any real objection to such requirements as a full verbatim reading of legislation before a quorum of each House? or a seven day waiting period between the final text of legislation and a vote thereon?

I'm asking real questions. If there are real problems with this bill, I'd like to know.

Thinking about universal health care

My dad, who gets most of his information from radio and TV, is adamantly opposed to President Obama's proposal of a government-run health insurance program. I, on the other hand, get most of my information from the far-more-reliable internets, and so-- wait a sec.

Maybe we both ought to think for ourselves for a moment.

Let's start with a few principles. First, it's hard to deny that a basic level of health care is a fundamental human right. No one seriously believes that, if you get the flu, you should or could be denied the bed rest and clear liquids and chicken noodle soup required to get over it.

But I have some friends, one of whose kids is hydrocephalic. I have another friend who is undergoing treatment for breast cancer. In order to survive, to say nothing of living "normal" lives, they require costly and time-consuming treatments -- more costly than they are able to afford on their own.

Is such treatment a human right? Were all the generations of humanity with the misfortune to live before the mid-twentieth century deprived of their rights? What about citizens of poor or "undeveloped" nations today, who don't have access to the cutting-edge research-driven medicine of the United States of America?

This is where the notion of "rights", so foundational to our political discourse these days, might get in the way of thinking clearly. Society as a whole has the responsibility of distributive justice, meaning that we have to allocate (or distribute) the goods and resources we hold in common to our members in a just fashion. So asking, "to what level of health care do we have a right?" or "what constitutes the basic health care (to which I am entitled)?" leads the conversation in the wrong direction. I think the question should rather be, "are we using our medical resources in a just manner? do all the members of our society have access to the goods available to us as a whole?"

From a Catholic point of view, the question is asked out of charity as well as out of justice: in other words, while "strict justice" might ask what the minimum level of health care is that we must provide, charity asks how much health care are we able to provide to those who need it?

So, that said, universal health care is certainly a human right, but it will look different from one society to another depending on the resources available.

Which leads to the second principle: that society as a whole has the responsibility for providing this health care.

Now, theoretically, there are lots of ways that this can happen. We could support doctors and other medical professionals directly through patronage or sponsorships. The Church could provide health care and hospitals, as she has in decades past. We could have various private medical providers compete to offer the best care. Or, we could offer insurance policies, in which a company pools resources from individuals to pay for health care. The government may wield a strong hand, or almost no hand, in any of these systems, so long as they proceed to work justly.

I can fully understand those people, like the ones my dad has been listening to, who see dangers in too much government involvement in health care. Especially the U.S. government. Can we really trust them to be efficient? to be fair? to provide consistent treatment? Will the government legislate what "health" is? force doctors to perform abortions or euthanasia? force pharmacists to distribute contraceptive drugs? force citizens to undergo sterilization or other unnecessary medical procedures? take away a patient's choice and control of his/her own treatment?

However, morality is always the art of the practical: what do we do here and now? So, with these principles in hand, let's take a look around and see what the practical possibilities are.

It seems to me that there are only two institutions that have the scope and breadth to offer (much less guarantee) health care to the whole of society: the government and the Catholic Church. (As for a third option, starting a new private endeavor, I say: Good luck with that.)

In the late 19th and early 20th centuries, the Church took advantage of its vast, inexpensive, and well-trained workforce of religious sisters to establish hospitals and clinics all around the nation to serve the poor and those who could not otherwise afford health care. However, those sisters are no longer so numerous, nor do Catholics contribute financially to the Church as they did, nor is the training needed to provide quality health care so readily available as it once was.

Which leaves the government to pick up the slack.

After all, left to themselves, our largely for-profit medical providers will simply do whatever they can to turn the greatest profit and reduce their own expenses and obligations. This will not lead to a just distribution of health care resources.

So, I see two practical options: either to accept government-run health care, as imperfect as it is; or to devote our time and energy and money to building and supporting a Church-run health care system on a scale we haven't seen since the 1950's. If you don't like Obama's proposal, then are you giving to the Church? Are you writing the bishops and heads of sisters' congregations? Are you volunteering your time and talents? Are you supporting young men and women to give their lives to the work of caring for the sick and injured?

To do neither is to allow our society to remain unjust with regard to health care.

Classics of the Western Political Tradition

Most of the main texts that have informed political thought in the west are (thankfully) available for free online. Consider this reading list your homework. Life itself is the pop quiz.

• The Republic (Plato, ca. 360 B.C.)
• Laws (Plato, ca. 360 B.C.)
• Nichomachean Ethics (Aristotle, ca. 350 B.C.)
• Politics (Aristotle, ca. 350 B.C.)
• The Athenian Constitution (Aristotle, ca. 350 B.C.)
• De Res Publica (Cicero, 54 B.C.) [Younge translation] [Barnham translation]
• Treatise on Laws (Cicero, 51 B.C.)
• Institutes of Roman Law (Gaius, A.D. 160)
  
• City of God (Augustine of Hippo, A.D. 426)
• Rule of St. Benedict (Benedict of Nursia, ca. A.D. 547)
• Magna Carta (1215, amended through 1297)
  
• De Regno (Thomas Aquinas, A.D. 1267)
• Treatise on Law - qq.90-108 (Thomas Aquinas, ca. A.D. 1272)
• Utopia (Thomas More, A.D. 1516)
  
• The Prince (Niccolo Machiavelli, A.D. 1532)
  
• De Monarchia (Dante Aligheri, A.D. 1559)
• Politica (Johannes Althusius, 1614)
• Leviathan (Thomas Hobbes, 1651)
• Two Treatises on Government (John Locke, 1689)
• Discourse on the Origin of Inequality among Men (Jean-Jacques Rousseau, 1755)
  
• The Social Contract (Jean-Jacques Rousseau, 1762)
• The Communist Manifesto (Karl Marx and Friedrich Engels, 1848)
• On Liberty (John Stuart Mill, 1859)
  
• Utilitarianism (John Stuart Mill, 1863)