Basic healthcare is a human right, but the ends don't justify the means: how we get there is just as important so as to ensure other rights are also protected.
As of this writing, the United States government is shut down. We have arrived at this impasse chiefly because of the efforts of a small band of House Republicans protesting the Affordable Care Act, popularly known as Obamacare. For Catholics, this political battle raises important questions. According to Catholic social teaching, the common good demands that “basic health care” be provided for all members of the political community (Compendium of the Social Doctrine of the Church, 166). The fact that many millions of Americans do not enjoy even basic health care is indeed an injustice that cries out to heaven. Obamacare at least purports to address this injustice.
Nevertheless, I believe there are three chief reasons why Catholics should reject Obamacare. While we could get into constitutional arguments or arguments at the level of Obamacare’s effectiveness as public policy, the reasons I raise are moral in character. I want to focus on these because I think they are the most important ones for Catholics to consider, and these are the moral reasons that speak to the very heart of politics, and the provision of health care, as a human enterprise with a supernatural dimension.
First and foremost, a right to health care only makes sense in light of the keystone principle of Catholic social teaching: the right to life. If the patient doesn’t exist, there’s no need for health care. Yet Obamacare requires employers offering health insurance to include contraceptive and abortion “services” among their health care offerings. This is a direct attack against the lives of some of the most vulnerable in our society, an attack that the United States bishops have vigorously and courageously opposed. This gravely immoral provision of Obamacare is sufficient to scuttle any claims to its justice. For there is no such thing as “care for the common good” that includes threats to the very lives of members of the community.
Second, Obamacare violates our right to make our own choices in regard to health care, which is to say, our right to act as responsible moral agents. While Obamacare does provide for some measure of choice in regard to how one will purchase health insurance – e.g., through one’s employer or through one of the state exchanges – it still leaves to the federal government the decision as to what items will be on the menu. It even penalizes individuals who choose, for whatever reason, not to buy health insurance. It is one thing for the federal government to seek to provide health care services for the indigent. But on what moral principle can the federal government legitimately arrogate to itself choices regarding health care? Work, according to Catholic social teaching, is also a basic human right. Does that mean that, in order to alleviate unemployment, the federal government has the right to choose how and where we should work, even among a range of choices? Of course not. And neither should the federal government interfere with our health care choices.
Yet another key principle of Catholic social teaching is the principle of solidarity: that we take care of one another, that we don’t let the weakest and poorest among us slip through the cracks of our concern. But what is the best means of helping these poor? Obamacare mistakes the requirements of solidarity. Commitment to solidarity doesn’t necessarily require commitment to the interventions of the federal government. Indeed, solidarity is not even an exclusively legal category; it is a moral one. True, the federal government has a role to play in providing health care for our citizens, but so do, even more appropriately, state and local governments (according to the principle of subsidiarity, Compendium of the Social Doctrine of the Church, 187), and most appropriately, private organizations, such as Catholic hospitals. Health care, we should remember, is not essentially “public policy,” or a mere “service” like that of the gas company. It is an act of love and, for Christians, a witness to Christ’s healing presence. Accordingly, the human and supernatural dimensions of health care are not well provided for by a bloated federal bureaucracy whose concern for the common good is predominantly materialistic and managerial in its outlook.
Notice, moreover, how the Compendium of the Social Doctrine of the Church defines solidarity:
We see here that the essence of solidarity is caring for the good of one’s neighbor so that the neighbor can exercise his or her own freedom in action. The aim of solidarity in the arena of health care, therefore, is not just that of providing services to the poor, but that of helping others to the point where they can make their own health care choices.
Many Catholic misconceptions of the role of government in providing for the basic right of health care assign to the federal government a role that actually abridges fundamental rights of citizens. Even apart from the fact that the federal government is too big, too inefficient, and too materialistic to play the assigned role, the role itself undermines aspects of the human person even more fundamental than the need for health care: the right to life, the right to exercise one’s liberty, to right to a truly human solidarity.
Daniel McInerny is an author, philosopher and journalist. Contact him at danielmcinerny@gmail, and follow him on Twitter: @danielmcinerny.