Obamacare, whatever the delays in its full implementation, has arrived. Though a small cadre of members of Congress are still fighting to withdraw funding for the program, the success of that effort, as Miracle Max from The Princess Bride would say, “will take a miracle.”
For the past year and a half or so, U.S. Catholics have been agitating in particular against a mandate laid down by the Obama administration’s Department of Health and Human Services that requires employers offering health insurance to include coverage of artificial contraception and abortion. The legal battles on that front continue, and there remains a fair hope that the right not to have one’s conscience compromised by the State, whether that conscience belong to a Catholic or to any other kind of believer, will be fully protected by the courts.
Meanwhile, some forward-thinking Catholics are not simply sitting on the sidelines; they are pro-actively looking for ways to circumvent Obamacare entirely. For these Catholics, turning the U.S. health-care system into a government program neglects the wisdom in the principle of subsidiarity:
This statement of the principle of subsidiarity can be found in the great social encyclical of Pope Pius XI, Quadragesimo Anno (1931), which, with Pope Leo XIII’s Rerum Novarum (1891), helps form the backbone of the Church’s modern social teaching. The whole point of the principle of subsidiarity is to protect the activities and enterprises of individuals and small organizations from being subsumed by larger powers, be they larger private enterprises or the State. This principle has been a source of inspiration for Catholic economic thinkers such as G.K. Chesterton, Hilaire Belloc, and E.F. Schumacher, and continues today to inspire those seeking to win back their health care choices from an aggressive federal government.
For in the minds of many Catholics, health care choices are best left up to individuals and the organizations with which they freely cooperate. The thought is, that while the common good may require that the State provide some kind of financial safety net for the indigent who simply cannot afford decent health care, the majority of citizens should be left alone to exercise responsibility in this area. The State has no right to take upon itself decisions that essentially depend upon the prudence of individuals, families, and business enterprises. Besides, the state has no special competence in this area. And the behemoth and wasteful nature of our federal bureaucracy makes it wildly unsuited to the task of managing one-sixth of the U.S. economy.
So how are some Catholics seeking to avoid the strictures of Obamacare? Simply by foregoing traditional health insurance altogether and participating in health-care cooperatives. As in other areas of the culture wars here in the U.S., the Protestant churches have shown the way. Samaritan Ministries, for example, offers a non-insurance approach to health care in which its participants contribute to a general pool–a contribution that does not exceed $370 per month–from which they can draw whenever they have a health-care need. This faith-based cooperative ensures that medical expenses will not be approved that violate the shared Christian commitment of the participants. Also, as stated on the Samaritan Ministries website, this approach satisfies the Obamacare requirement that individuals have insurance or pay a penalty-tax.
Unfortunately, there is at present no specifically Catholic health-care cooperative. In the last year or so a Catholic concern named Solidarity Health Care seemed poised to help fill this void, but has since disappeared from view. The American Catholic landscape is desperately in need of its own health-care cooperatives. If the National Catholic Bioethics Center is correct in judging that it is immoral for Catholic business owners to purchase health insurance for their employees under the strictures of Obamacare, the need for such cooperatives is especially acute.
But in lieu of specifically Catholic cooperatives, Catholics will have to make use of enterprises started by their fellow Christians.
There are, of course, lots of questions about such health-care cooperatives. Do they insure every kind of medical need? Do they cover participants with pre-existing conditions? Is the participant guaranteed coverage of his or her medical expenses, or is it possible that the pool will run out of funds?
Such questions need to be asked. But Catholics shouldn’t let the challenge of answering them deter them from the prospect of a cooperative alternative to Obamacare that relies on the principles of Catholic social teaching. That is too heartening a prospect to be shunted aside without serious deliberation.
Daniel McInerny is an author, philosopher and journalist. He can be contacted at firstname.lastname@example.org.