An e-mail: “I’m in the same boat as you are: I’m a free-market guy, but I’m also Catholic. . . . The catechism says that health care is a right. I’m pretty sure that doesn’t mean I have to support Obamacare. But what do you think it means? I’m not looking for you to explain it away, just for some thoughts.”
The reader is referring to this passage (at 2211): “The political community has a duty to honor the family, to assist it, and to ensure especially: . . . in keeping with the country’s institutions, the right to medical care, assistance for the aged, and family benefits.” He is right to think that the passage does not compel (or preclude) support for any particular set of health-care policies. It may be that the political community adequately discharges its duty to see to it that people get medical care by seeing to it that a market with clear and transparent rules is established. It may also be (I don’t believe this, obviously, but the thought is consistent with this passage) that truly discharging this duty requires the central government itself to provide health care, or at least to have a monopoly on its financing. Which of these alternatives best serves the goal of health care for all, is most consistent with the principle of subsidiarity, and otherwise furthers the goals the Church rightly deems important is a matter of prudential judgment on which people who agree with the Church’s teaching will disagree. That doesn’t let Catholics off the hook so much as it increases their burden to think these questions through.
One thing to keep in mind on encountering passages such as this is that the Church is not following the modern usage of the term “rights.” It is not, for example, suggesting that a society needs to make health care a right vindicable in its central government’s courts to adhere to its teaching. When the Church talks about rights, even negative rights such as the right not to be murdered or enslaved, it is not talking solely or even primarily about the duties of governments. The primary obligation, even with respect to negative rights, is for those in a position to enslave or to murder not to do so, although of course governments also have an obligation to stop those who try. When positive rights are identified, the precise obligations of government and of other actors are harder to specify.