The Problems with Government-Run Healthcare

by Deal Hudson - September 3, 2009

Reprinted with permission.

As the White House backs away from the so-called public option in health-care reform, Catholic experts are hopeful that the proposed government control of the nation's medical care will be put aside. They argue that rejecting the public option will better serve a culture of life, maintain the present high quality of health care, serve economic sustainability, and respect the Catholic teaching on subsidiarity.

Though the bishops have spoken out collectively against abortion coverage, only a handful have issued specific warnings against government-run medical services. Two of those are Bishop Robert W. Finn and Archbishop Joseph F. Naumann of Kansas City, who wrote recently, "The right of every individual to access health care does not necessarily suppose an obligation on the part of the government to provide it." Bishop R. Walter Nickless of Sioux City, Iowa, stated, "The Church does not teach that government should directly provide health care."

The Catholic Medical Association (CMA) is on record arguing that, while health-care reform is needed, it should be "achieved by legislation that empowers people to own their health insurance policies (as contrasted with government, or employer controlled healthcare insurance) and using targeted measures to help people who cannot afford the entire cost of their insurance premium."

Dr. Steven White, a former president of the CMA, currently has a private practice in pulmonary medicine and is medical director of respiratory care and pulmonary rehabilitation services at Halifax Medical Center in Daytona Beach, Florida. He applauds the bishops for their outspoken defense of human dignity in health care, but said, "Informed members of the laity need to help devise a system based upon Catholic moral principles and apply them in the marketplace."

"The last thing we want in health care," White told me, "is for the government to impose a single ethic on us because they hold the purse strings – we have to separate Catholic moral guidelines for health care from the question of financing it."

Dr. Donald P. Condit is an orthopedic surgeon specializing in hand surgery in Grand Rapids, Michigan, who has written extensively on health-care reform for the Acton Institute. Condit agrees that health-care reform is needed to achieve a better allocation of service, but added, "Reform needs to occur at the level of the doctor-patient relationship rather than introducing a third party, especially the federal government."

"Medical care is a scarce commodity that has to be allocated," Condit went on, "but why would you take that allocation away from the doctor-patient and hand it over to government committees, when the government does not respect human life?"

When I asked him how the cost of the present system could be reduced, Condit explained that the cost of private insurance coverage would come down if there were more competition. "There is very little competition between insurance companies," Condit explained, "which would be changed if companies could sell coverage across state lines."

Both Dr. White and Dr. Condit were certain that the quality of U.S. health care would suffer under government control. White said, "Socialist systems do not put their resources into treating serious illness – for example, our cancer survival rates are significantly higher." Condit explained that the World Health Organization ratings are biased against the United States because of our lack of universal care. "If you look at the disease-specific statistics, the U.S. is at or near the top, which is why wealthy people come here from all over the world when they face serious illness." (Their concerns are corroborated by today's news that, under the UK's National Health Service, terminally ill patients are being allowed to die prematurely.)

Jim Cabretta, a fellow at the Ethics and Public Policy Center, served for three years as the Bush administration's top budget official for health care. Cabretta claims that the present health legislation is not economically sustainable. "The plan as it stands," Cabretta concludes, "is not really a trillion-dollar bill; it really adds up to 1.5 trillion."

He explained the reason why the health-care bills are under-budgeted. "The legislation requires anyone who has job-based insurance 'has to stay there and not take the government subsidized program.' In addition, anyone who has not bought into their workplace insurance will be required to purchase it, 'even if they cannot afford it."'

Anyone not presently covered will be able to get into the subsidized program, creating what Cabretta calls "horizontal inequity." In other words, everyone covered by employers will be paying significantly more for health care than those on the government plan.

"What will happen next is inevitable," says Cabretta. "People will complain about the inequality, and Congress will eventually allow everyone to purchase the lower-cost, government-subsidized programs. The overall cost of the nationalized plan will rise by 50 percent."

The United States is just too big for a centralized health-care system, according to Cabretta. Other industrialized countries are not as big: "We are 300 million; that's too many people to manage by central planning, a fact which underlies the public angst." He prefers a subsidiarity approach, a market system mixing health savings accounts with a primary wellness system, costing about $60 to $70 per month, all with government oversight.

Cabretta also agreed with White and Condit that the quality of care would suffer. "In countries with nationalized systems, they tend to invest in things that 90 percent of the people use, but if you have cancer or need brain surgery they are underinvested in hospitals and complex treatment programs."

The Obama White House is saying that the public option does not have to be part of health-care reform; powerful leaders in Congress disagree, along with the liberal wing of the Democratic Party. While the prospect of government-run health care is still a live option, these Catholic experts are hopeful that Congress will consider their suggestions in keeping medical care private – in the hands of doctors, patients, and private insurance companies.

Deal W. Hudson is the director of the Morley Institute, and is the former publisher of CRISIS Magazine, a Catholic monthly published in Washington, DC. His articles and comments have been published in The Wall Street Journal, New York Times, Washington Post, Washington Times, Los Angeles Times, National Review, Richmond Times-Dispatch, The Village Voice, Roll Call, National Journal, The Economist, and by the Associated Press. He appears regularly on television shows such as NBC Nightly News, One-on One with John McLaughlin, C-Span's Washington Journal, News Talk, NET's Capitol Watch, The Beltway Boys, The Religion and Ethics Newsweekly on PBS, and radio programs such as "All Things Considered" on National Public Radio. He was associate professor of Philosophy at Fordham University from 1989 to 1995 and was a visiting professor at New York University for five years. He taught for nine years at Mercer University in Atlanta, where he was chair of the philosophy department. He has published many reviews and articles as well as four books: Understanding Maritain: Philosopher and Friend (Mercer, 1988); The Future of Thomism (Notre Dame, 1992); Sigrid Undset On Saints and Sinners (Ignatius, 1994); and Happiness and the Limits of Satisfaction (Rowman & Littlefield, 1996). His autobiography, An American Conversion (Crossroad, 2003), is available from Amazon.com.