No Waiting Room

They say the best place to keep an appointment with the devil is at a crossroads. We are again drawing near another political crossroads on health care. If we cannot move past our own diabolical short-sightedness and partisan tendencies this time, we will miss a historic opportunity to put our health care system on a path toward sustainability, fairness and common decency. It could be decades before the chance comes around again.

We cannot afford to wait to reform our system. It is costing us too much as individuals and as a society. The current system regularly turns medical misfortune into personal tragedy and economic ruin; it also weighs down U.S. industry, hindering American manufacturing in an increasingly competitive global marketplace. It also drains fiscal resources at the local, state and federal levels that could be better invested in preventive care, better education for our children or shoring up our crumbling infrastructure.

As people of faith we can be guided by a long tradition of Catholic social teaching that unambiguously supports public initiatives to ensure access to health care when markets alone fail to achieve universal coverage. Those who express exaggerated fears of a government takeover and bureaucratic centralization tend to portray government as somehow a threat to the people and their freedom, but Catholic social teaching consistently reminds us that public authority is the ordinary mechanism by which people undertake collective action. The principle of subsidiarity provides a check against needless centralization, but it must not be misinterpreted as an excuse to forgo truly necessary national initiatives.

Catholic social teaching offers a distinctively organic view of society that calls all parties to be open to sacrifice for the good of the whole. That common good springs from true cooperation, not merely the competitive interaction of self-interests. Reforming health care should not be reduced to a partisan issue, with the eyes of negotiators distracted by the goal of scoring political advantage. We will achieve the aims of reform—extending coverage to the uninsured, rationalizing procedures and policies and lowering costs—only if all parties check their egos and partisan interests at the door and work together.

The greatest temptation now is to despair of true reform any time soon. After all, powerful special interests have a stake in the status quo, and the major political parties clearly desire different outcomes. But the light shed by Catholic social teaching reveals the possibility for progress, a progress that can be assured only if we recognize that health care is not just another commodity to be distributed according to people’s ability to pay. Many resources within Catholic social thought—including its requirement of a preferential option for the poor—challenge us to re-imagine health care as a basic human need, no less a religious obligation than providing food for the hungry, shelter for the homeless and clothing for the naked.

The church has for more than a century stood for the civic components of our God-given human dignity, a dignity that our current system too often diminishes. We cannot now allow a handful of discordant voices to confuse what has been the church’s longstanding position: that in a just society, access to effective health care is a human right, not a negotiable social privilege.

That does not mean that the church should compromise at all on its clear resistance to any deployment of federal resources for abortion services. It does not mean that any watering down of conscience clauses for Catholic health care workers should be tolerated. These are breaking points for Catholic support on health care reform, and the Obama administration appears well aware of this. Thanks no doubt to the vigorous interventions of the advisers from the U.S. Conference of Catholic Bishops, it was no accident that assurances on these two principles appeared in the president’s speech before Congress on Sept. 9. The president is keenly aware that he must win over Catholics if he is to win over Congress in November.

The time has come to put aside our childish ways on health care. Other industrialized nations resolved the challenge of universal and equitable care decades ago. It is unacceptable that in a society as wealthy as the United States, which may ultimately spend as much as $3 trillion on a war of choice in Iraq, millions are without access to reliable health services; that as many as 18,000 die each year because of poor access; and that an unknowable number die because they were denied care by the for-profit entities to which they had entrusted their lives.

In his speech the president threw down the gauntlet to the fear-mongers and the Congressional hired hands of the status quo. It is time to stop dithering and get behind the president’s proposal.

This article appears in September 28 2009.