Health Care: No Solution without Christianity
Arguments over socialized medicine, national health care, whatever term one might use, generally fail to factor in something of great historical importance — the fact that our whole modern health care system, indeed the very concept of a health care system, is largely the invention of the Catholic Church. Hospitals were nonexistent in pagan antiquity. The very idea that anyone was in any way entitled to be cared for simply by virtue of being sick was unimaginable, because there was no concept of charity. That concept was absent because there was no concept of universal humanity. Certainly, love and compassion existed even in pagan societies, but they were something people felt for family members and friends, not for others simply in virtue of their humanity.
Christianity changed all that. Suddenly, there was the revolutionary idea that simply because a sick or injured person was a fellow human being you owed him whatever help and treatment you were able to provide. More than anything else in Scripture, the parable of the Good Samaritan epitomizes it. Because we are all so familiar with it we fail to notice how absolutely revolutionary that parable is. Pagans would have found it incomprehensible. In the ancient world, if you were sick and had money, you could get medical treatment. Otherwise, you were out of luck.
As the Roman Empire fell apart, monastic orders, both male and female, came into being. These were not generally created specifically to care for the sick, but it came naturally to them to be centers of hospitality. That included providing lodging to travelers as well as taking in and caring for the sick, both corporal works of mercy (note that the words "hospital" and "hotel" have their origin in the Latin "hospitalis"). This must have gradually become institutionalized, to the point where a part of the monastery, maybe even a separate building, was set aside for these purposes. Some monks must have been trained specifically to minister to the needs of the sick.
Since this cost money, it was only natural that the monasteries would seek to finance it by free-will donations. While care would be provided gratis, as an act of charity, there would be an expectation that those who could afford to would donate to the best of their ability. I would imagine that a certain amount of psychological pressure, even manipulation, went into seeing to it that affluent patients contributed generously (I like to think, with some amusement, how very adept the nuns would have been at this). So eventually, we had a kind of socialized medicine, following the principle, "from each according to his ability, to each according to his need," but without government coercion or government bureaucracy. The whole program was a function of the communion of saints operating within and informing the human community.
The system was, in other words, grounded in love, grounded in Christianity. Can it survive the demise of Christianity as a major influence on society? No, of course not. As Christian influence in the West has declined during the past few centuries, the health care system has in fact more and more lost its character as an institution grounded in love, and has instead become an industry, a business that operates for profit. Those who cannot pay are likely to be excluded, though there is still enough residual Christianity around to keep this from being total — even people with no money can still get treatment in emergency rooms, for instance. We have been heading in the direction of a return to pagan antiquity, where the rich get treatment and everyone else dies, but we are not quite there yet.
We have a kind of hybrid system, part market based and part charity based. One of the effects of this situation is to make medical care very expensive by inflating prices. A system that operated simply as a business, providing services only to those who could pay, would be very efficient, and in such a system market forces would keep prices low. But many would be unable to pay even those low prices, and this is unacceptable to people with some residual Christianity still in their blood. So we try to avoid this consequence through things like private insurance and Medicare and Medicaid, which keep people from dying because they cannot afford care, but which have the effect of inflating costs. More and more, the answer proposed to this is to put the whole system under government control.
Here is the problem — while many people, including a number of Christians, would like to think that this solution represents a return to a system grounded in Christian love, it would in fact be nothing of the kind. It would, on the contrary, have the effect of further extending the dehumanization of health care, bringing us closer to the situation that prevailed in pagan times. Under the medieval system, care was given to people simply because they were fellow human beings, children of God and brothers in Christ, because the human person was seen as having, as such, intrinsic worth and value. Governments are not able to do things that way. Under government-controlled medicine, the criteria will be utilitarian. People seen as having utility, as being useful to society, to the government, maybe even to their families, will be cared for. Others, those, for instance, with severe disabilities, terminal illnesses, or simply old age, will not. They will be offered a lethal injection. It is just too expensive to keep all these old and sick people alive. The cost of caring for them cannot be justified by any utility to society that such care brings, and it will not be offered.
As with all our major societal problems, the only factor that will make a difference is a restoration of Christian civilization. Period. The institutions that are falling apart and that we want to resuscitate have their roots in Christianity, in Catholicism, to be more precise, and simply will not work when they are transplanted to the soil of a secularized society. If we finally reject Christianity, we will lose the uniquely Christian institutions and will be condemned to a cruel, inhuman society where the human person doesn't matter except for his utility to the state.
Propagandists for socialized medicine have for some time now been telling us that the costs of such a program can be kept down through preventive medicine. Just prevent enough people from getting sick, and the system will be cheap. This nonsense highlights the atmosphere of unreality that permeates the thinking behind proposals for national health care, as well as its potential for cruelty and inhumanity toward human persons. In the first place, the assertion that we can cut the cost of medical care through preventive medicine has about as much credibility, to my mind, as the oft- repeated claim that we can cut the cost of government programs in general by eliminating waste, fraud, and abuse. That just isn't going to happen, at least not as long as that pesky little detail known as original sin continues to be a factor.
What preventive medicine mostly means is lifestyle modification. If our government is to seriously try to make people modify their lifestyles, by losing weight, exercising, eating a healthy diet ( whatever that is — there is substantial disagreement about this even within the medical community), not smoking, and so on, that is going to require massive invasion of people's privacy, as well as coercion. The coercion will involve the threat to drop people from all coverage if they fail to cooperate with what the bureaucrats tell them to do. The system will thus actually cut health care costs by denying health care to many, many people.
Preventive medicine has always been mostly a will-o'-the-wisp anyway. Most people are just not morally and mentally equipped to do all the things doctors pester them to do. So the notion of keeping health care costs down through preventive medicine epitomizes the utilitarian direction that socialized medicine inevitably takes.
A pagan recognizes no obligation to help a stranger in need. He might do so, if some utilitarian consideration makes it advantageous. And the same is true of post-Christian man. There might be all kinds of good, pragmatic reasons to take care of sick people — the costs of their illness to the economy ( how often we hear that one), getting them back to work so they can contribute to the economy ( it always seems to be about the economy!), and so on. But the idea that someone in need has a claim on our help simply by virtue of his humanity, the image of God that he shares with us, even though he is neither relative nor friend, indeed, even though he is our worst enemy, is something unique to Christianity, something that will disappear when Christianity disappears.
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© George A. Kendall
This item 9035 digitally provided courtesy of CatholicCulture.org
