The Catholic case against health-care reform

By Phil Lawler ( bio - articles - email ) | Dec 15, 2009

President Obama’s crusade to enact health-care reform legislation is nearing its climactic battle in the US Senate. How should Catholic Americans look upon this legislative struggle?

The US bishops have consistently voiced their support for health-care reform, while insisting that the legislation must include some language ensuring against public support for abortion. In the House of Representatives their lobbying had its desired effect, and the “Stupak Amendment” gave the bishops a bill they could support. In the Senate a pro-life amendment was rejected. Still the US bishops’ conference has clung to the bare hope that some acceptable language might be inserted, somewhere during the remaining steps of the legislative process.

As a matter of practical politics, I think the bishops’ hopes are unrealistic. The Senate vote against the pro-life language was decisive. If the Senate passes a bill without a pro-life amendment, a joint committee will iron out the differences between that legislation and the version passed by the House. That reconciliation process will be dominated by the Democratic majority leadership, which is wholeheartedly committed to abortion coverage. Thus if a health-care reform bill is passed in this Congressional session, it will almost certainly include subsidies for abortion.

But just for the sake of the argument, let’s assume that the final legislation includes a solid pro-life amendment. Should Catholics then give their legislation their wholehearted support?

Absolutely not, for four reasons.

First, even if it doesn’t subsidize abortion this year, the federal health-care program will subsidize abortion in the future. All it takes is one act of Congress to amend the bill, one federal judge to rule that a ban on abortion funding is discriminatory, or one bureaucrat to rule that abortion is a “preventive” medical procedure, and the subsidies will snap quickly into place. Pro-life forces have battled valiantly to stave off the public funding of abortion this year, but as long as the federal government controls the health-care market, the battle will be fought repeatedly—month after month, year after year, legal case after case—until the left reaches its goal, and locks in the funding.

Second, abortion isn’t the only moral issue. The main focus of public attention has been the potential subsidies for abortion. But the legislation would also ensure federal subsidies for contraception and sterilization. American citizens could soon find themselves paying for in vitro fertilization treatments and sex-reassignment surgeries, if doctors and their federal overseers certified that these procedures were necessary.

He who pays the piper calls the tune, and if the federal government pays for health-care treatment, the White House ultimately will set the standards to determine which procedures warrant support. We already know where President Obama stands on embryonic stem-cell research, and we can easily predict how he will respond to the use of medicines obtained from human embryos in the treatment of diseases. Such medicines (if any ever appear) will receive federal subsidies. On the other hand, efforts to provide rudimentary medical care (as opposed to extraordinary treatment) for comatose patients will be stifled. So at both beginning and end of human life, the financial pressures will be adverse to the cause of human dignity.

Third, the financial cost will be prohibitive. Neutral observers agree that the legislation now under discussion will dramatically increase the costs of health-care coverage. The costs borne by the federal government will add to a load of debt that is already sapping the economy and adding to the burden that future generations will be forced to bear when they, inevitably, are required to pay the bills for our current spending. Just today, in his message for the World Day of Peace, Pope Benedict called for a “greater sense of inter-generational solidarity.” That sense of solidarity would militate against rolling up new debts for our children to pay off.

Fourth, and most important, a massive new federal program would violate a cardinal precept of Catholic social teaching. In an ideal world, medical decisions are made by individuals, families, and their doctors. Hospital administrators and insurance adjusters complicate that relationship, but it is difficult to devise a modern health-care system that could avoid such complications. However, allowing the ultimate authority over health-care decisions to flow to Washington-- to be settled by functionaries who are unacquainted with the circumstances of individual cases—violates the principles of common sense, American federalism, and subsidiarity.

The principle of subsidiarity teaches (as the Catechism of the Catholic Church (1894) puts it) that “neither the state nor any larger society should substitute itself for the initiative and responsibility of individuals and intermediary bodies.” Since health-care coverage can surely be handled by private organizations, resort to the government is questionable at best. Since state governments can surely regulate health insurance, federal involvement is clearly unnecessary.

And not only unnecessary but unjust, according to the best traditions of Catholic social thought. In Quadregesimo Anno (79), Pope Pius XI explained:

As history abundantly proves, it is true that on account of changed conditions many things which were done by small associations in former times cannot be done now save by large associations. Still, that most weighty principle, which cannot be set aside or changed, remains fixed and unshaken in social philosophy: Just as it is gravely wrong to take from individuals what they can accomplish by their own initiative and industry and give it to the community, so also it is an injustice and at the same time a grave evil and disturbance of right order to assign to a greater and higher association what lesser and subordinate organizations can do.

By those standards, set forth in one of the main magisterial texts of Catholic social teaching, the health-care reform legislation now pending before Congress could be judged an “injustice” and a “disturbance of right order.” But Pope Pius XI used still stronger language. Such a program, he said, would be “a grave evil.”

A grave evil, notice. The testimony of Catholic tradition, common sense, political prudence, financial responsibility, and pro-life morality all weigh heavily against this legislation.