Politics & Policy

Health-Care U

Catholics don't oppose universality -- but what does that mean?

If you were to ask the proverbial person on the street what the Catholic Church thinks about health-care reform, the answer would sound pretty much like this: Catholics have serious problems with the surreptitious inclusion of abortion in the current health-care proposal, as well as with the absence of genuine protection for conscientious objection among health-care workers. Apart from those deep reservations, Catholics are 100 percent behind the proposed health-care reform.

Thus, Bill Claydon could write: “The U.S. Conference of Catholic Bishops supports the proposed current health-care reform provided it includes conscience protection clauses and specifically prohibits abortion funding” (American Thinker, Aug. 16, 2009). Yet something is wrong with that picture. As straightforward as this summary seems, it doesn’t do justice to the Catholic Church’s far more nuanced position.

It’s true that vocal objection to proposed health-care reform has focused almost exclusively on these two closely related issues. Last week, the USCCB sent inserts to nearly 20,000 Catholic parishes across the country to be included in the Sunday bulletins distributed to the faithful. The inserts urged readers to contact Senate leaders and encourage them to support efforts to “incorporate longstanding policies against abortion funding and in favor of conscience rights” in health-reform legislation. The text adds, “If these serious concerns are not addressed, the final bill should be opposed.”

The fact that the bishops openly oppose the reform bills in their current form, however, does not mean that they would fully support the bills even if they were to be freed of their more egregious flaws. Surely many bishops do feel this way. In their efforts to eschew partisan politics, many take pains to show that they are neither Left nor Right, neither conservative nor liberal, neither Democrat nor Republican. This is commendable, as far as it goes, since it allows bishops to elude unfair pigeonholing and to remind the faithful that the Church espouses principles that transcend partisanship. But some bishops, in an effort to counterbalance their steadfast stand against abortion, have shown a willingness to embrace virtually any initiative purporting to advance “social justice,” as long as the program doesn’t directly attack innocent life.        

This uncritical approach certainly doesn’t describe all the bishops, and probably not even the majority. If the bills are eventually tweaked to eliminate the possibility of abortion funding and to guarantee the rights of conscience, we shouldn’t expect the USCCB to send another bulletin insert to parishes urging Catholics to support the legislation. Though the bishops support “health-care reform” in the broadest sense, many problems remain with proposed legislation. Above and beyond specific concerns, the key question revolves around the fundamental issue of the government’s role in health care.

What many fail to realize is that the Catholic Church has a long history of support for a core principle of social ethics called subsidiarity, which seeks to limit government control while protecting the rights of individuals, families, and associations against harmful intervention.

The Catechism of the Catholic Church elaborates on this principle in theological, and almost poetic terms:

God has not willed to reserve to himself all exercise of power. He entrusts to every creature the functions it is capable of performing, according to the capacities of its own nature. This mode of governance ought to be followed in social life. The way God acts in governing the world, which bears witness to such great regard for human freedom, should inspire the wisdom of those who govern human communities. 

In his widely acclaimed 1991 encyclical Centesimus Annus, Pope John Paul II issued an unusually stern warning regarding the tendency of governments to expand, creeping toward what had come to be known as a “social assistance state.” He noted several problems with this tendency, including increased costs, a loss of personal initiative and responsibility, and ultimately ineffective service.

By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending. In fact, it would appear that needs are best understood and satisfied by people who are closest to them and who act as neighbours to those in need.

Yet the Catholic Church’s resistance to government expansion doesn’t seek to place blame for bureaucracy solely on the shoulders of overly aggressive state officials. It also recognizes and opposes the natural human tendency to abdicate personal responsibility and to assign overarching duties to the state — duties that could perfectly well be carried out by the private sector. In its important text on the Church in the modern world, after noting the duty of rulers to respect the legitimate autonomy of families and private organizations, the Second Vatican Council sought to temper the demands of the general population on state services:

Citizens, for their part, either individually or collectively, must be careful not to attribute excessive power to public authority, not to make exaggerated and untimely demands upon it in their own interests, lessening in this way the responsible role of persons, families and social groups. (Gaudium et spes, No. 75)

This last note seems particularly important at the present juncture, while private citizens still have the opportunity to let their voices be heard. In the end, few would disagree that universal healthcare is a good thing, and that health care reform is imperative. The question remains as to how comprehensive a role the federal government should have in administering and controlling health care in the United States. On this question the Catholic Church may offer some unexpected resistance to current proposals.

– The Rev. Thomas D. Williams teaches Catholic social doctrine at the Regina Apostolorum Pontifical Athenaeum in Rome and is Vatican analyst for CBS News. He is also author of Who Is My Neighbor? Personalism and the Foundations of Human Rights (CUA Press).


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