Health Care Reform
Robert G Kennedy
Department of Catholic Studies
27 January 2012
Health Care Reform
 Some Observations
 The Catholic social tradition does not fit neatly into the secular
categories of liberal and conservative, socialist or libertarian.
Instead, it recognizes that human persons are creatures with a
social nature, who flourish in community without extinguishing
their individuality.
 As the U.S. bishops observed in their 1981 pastoral letter,
health care is the responsibility of individuals, of families, of
immediate communities, and of medical professionals. Health
care is a broad category. But when we speak to day about
“health care” reform, what we really mean is managing and
reforming the delivery of professional medical care.
Health Care Reform
 Some Observations
 Many categories of things are necessary for a decent
human life, such as food, shelter, energy, education, and
so on. The ordinary way in which we acquire what we
need for ourselves and our families is by purchasing them
with what we earn through our work (which is why the
Catholic tradition considers work to be so important).
 Professional medical care is one of the things that is
ordinarily purchased.
Health Care Reform
 Some Observations
 But medical care is different in important respects:
 • the demand for medical care has no natural limit
 • the capabilities of medicine are constantly changing but
often at great cost
 • we are unwilling to acknowledge and accept different levels
of quality and cost
 • medical resources—personnel, equipment, supplies, etc—
are always finite
 • people do not always behave responsibly in support of their
own health and well-being
Health Care Reform
 Some Observations
 We aspire to a situation in which every member of the
society has access to top-quality medical care without
regard to personal situation or ability to pay—but this is
impossible to achieve—so what can we really do?
Some Catholic Concepts
 The Good Society and the Common Good
 The Catholic social tradition conceives of a good society
as an ordered and organic whole, a collection of
individuals with particular talents and vocations, not a
faceless and homogeneous crowd of people nor an
aggregate of isolated individuals seeking their own utility.
 The common good of such a society, in a famous
definition, is:
“The sum total of those conditions of social living whereby persons
are enabled more fully and more readily to achieve their own
perfection.” (MM 65)
Some Catholic Concepts
 The Good Society and the Common Good
 A critical part of well-being of each person concerns the
achievement by that person, as far as it may be possible,
of his or her own fulfillment. (The Catholic understanding
of the integral development/fulfillment of the person is
critical here.)
 We respect the dignity of other persons when we assist
them to develop; development is not something we can
do to or for others.
 The fundamental task of government is to establish,
sustain and protect the common good of the civil society
and thereby to promote the flourishing of each and every
member of the community.
Some Catholic Concepts
 Medical Care in the Ordinary Sense
 In the ordinary case, mature and responsible adults
attend to their own health and the health of their family
members, making arrangements to purchase medical
care services as required.
 Purchasing medical care is either out-of-pocket
(budgeted) or through some form of insurance as a hedge
against unforeseeable expenses.
 There is a right to medical care in the ordinary case but it
is a negative (liberty) right.
Some Catholic Concepts
 Medical Care in Extraordinary Cases
 Extraordinary cases arise either because of general
incapacity, emergencies or overwhelming challenges. In
such cases, we do not and should not expect individuals
to purchase medical care on their own.
 Charity supplements justice in extraordinary cases.
 The “right” to medical care in extraordinary cases is a
positive (demand) right but it is not unlimited. Limitations,
though, will inevitably be arbitrary.
What Role for Government?
 A society can organize itself in a variety of ways, which
could include an expansive or a limited role for government
in providing medical care.
 In the ordinary case, government should at least:
 remove unnecessary impediments to acquiring medical care
(unnecessary regulations, disincentives, litigation, etc)
 ensure public safety (public health, licensing, disclosure, etc)
 support functioning markets (artificial limits to supply, etc)
 encourage individual responsibility for health care
What Role for Government?
 In the extraordinary cases, government might at least:
 encourage private charity (incentives)
 establish provisions for emergency response
 act as supplier of last resort
What Role for Government?
 In any case, government should:
 respect the principle of subsidiarity (proper functions) and
tolerate the “messiness” that may result
 respect conscience and autonomy