LOPEZ: What are the social-justice concerns in the current health-care debate?
NELSON: In a July 17, 2009, letter to Congress on behalf of the United States Conference of Catholic Bishops, Bishop William Murphy stated: “The Bishops’ Conference believes health-care reform should be truly universal and it should be genuinely affordable.” Bishop Murphy then proceeded to list some specific reforms supported by the bishops, including expansion of Medicaid and CHIP and limitations on premiums and out-of-pocket expenses for low-income families.
LOPEZ: Why does it make economic sense for Catholics to oppose universal government-run health care?
NELSON: It is appropriate for Catholics to oppose universal government-run health care under the principle of subsidiarity. The principle of subsidiarity has been frequently mentioned in papal encyclicals as a basic principle of Catholic social teaching. It requires that matters such as health-care reform be handled in a decentralized fashion by local authorities or intermediate groups where feasible. Recently, in Caritas in Veritate, Pope Benedict XVI noted:
A particular manifestation of charity and a guiding criterion for fraternal cooperation between believers and non-believers is undoubtedly the principle of subsidiarity, an expression of inalienable human freedom. Subsidiarity is first and foremost a form of assistance to the human person via the autonomy of intermediate bodies. Such assistance is offered when individuals or groups are unable to accomplish something on their own, and it is always designed to achieve their emancipation, because it fosters freedom and participation through assumption of responsibility. Subsidiarity respects personal dignity by recognizing in the person a subject who is always capable of giving something to others. By considering reciprocity as the heart of what it is to be a human being, subsidiarity is the most effective antidote against any form of all-encompassing welfare state. [footnotes omitted]
LOPEZ: What is wrong with the heath-care system in America today, and how would you make it different?
NELSON: The health-care system is definitely broken. Cost inflation for health-care premiums continues at a rate that is well in excess of the [Consumer Price Index]. And there are a large number of people without health insurance. The basic problems are the lack of competition among health-care plans and providers due to the role of third-party payers, the link between employment and insurance, and the current tax treatment.
Health insurance essentially consists of two coverage components: (1) pre-payment of annualized routine health expenses, and (2) catastrophic coverage for protection against major medical expenses. The current tax exclusion should be changed so that consumers would receive a tax credit to assist them in purchasing their own health-care coverage. This tax credit could be used to fund a health-savings account for routine expenses and to purchase high-deductible catastrophic coverage. This would provide incentives for consumers to shop around for the best deals. These tax credits would be refundable and advanceable so that low-income persons could participate in the system. Catastrophic coverage could be purchased from any insurer, including a faith-based group that would base its coverage on Catholic principles. I believe this approach is consistent with Catholic social teaching and the principle of subsidiarity. It is essentially the health-care reform proposal endorsed by the Catholic Medical Association.
LOPEZ: Was it a strategic misfire for pro-lifers to focus on FOCA when regulations short of it can be more stealthily invidious?
NELSON: This remains to be seen. At this time, FOCA has not been introduced in Congress, and the Obama administration has indicated it is not a priority. The efforts of the bishops last spring in mustering opposition to FOCA may have had a beneficial impact in heading off attempts to pass FOCA or similar legislation. It is, however, particularly important that the bishops continue their vigilance, because the current health-care reform proposals have the potential to achieve everything FOCA would have achieved and more. Following up on Bishop Murphy’s July 17 letter, Cardinal Rigali’s letters of July 29 and August 11, 2009, clearly articulated the objection of the USCCB to health-care reform measures that aren’t abortion-neutral and do not provide conscience protection.