Change for the Better, Part II

by Fr. Roger Landry - October 9, 2009

Last week, in our continuing survey of Catholic analysis of the present health care reform proposals, we began an examination of the "Principles of Catholic Social Teaching and Health Care Reform," a pastoral letter published jointly by Archbishop Joseph Naumann of Kansas City, Kansas and Bishop Robert Finn of Kansas City-St. Joseph, Missouri. They present four principles, the first two of which we covered last Friday: subidiarity, "the principle by which we respect the inherent dignity and freedom of the individual by never doing for others what they can do for themselves and thus enabling individuals to have the most possible discretion in the affairs of their lives;" and the life and dignity of the human person as the "driving force for care and the constitutive ground of human justice." We then mentioned how the Kansas City prelates applied both of those principles to the present proposals that have been introduced up until now in Washington.

Today we turn to the other two principles they describe. The third is the obligation to the common good, which, according to the definition found in the Catechism of the Catholic Church, is "the sum total of social conditions that allow people, either as groups or individuals, to reach their fulfillment more fully and easily." Part of those social conditions facilitating a person's achieving life, liberty, and pursuit of happiness is obviously that people who are ill or injured are able to be cared for and assisted to toward recovery. Hence they declare that, respectful of the common good, "it is very clear that we must find some way to provide a safety net for people in need." They stress, however, that, consistent with the principle of subsidiarity, such a safety net must avoid two things: it must not "diminish personal responsibility" or create an "inordinately bureaucratic structure that will be vulnerable to financial abuse, be crippling to our national economy and remove the sense of human from the work of healing and helping the sick."

In examination of those conditions, we could say that part of the common good is to increase personal responsibility, particularly with regard to one's health; it would not be an advance of the common good if either personal decision-making were seriously reduced or if the responsibility that each of us has to keep ourselves as fit and health as possible were minimized by making everyone else, rather than ourselves, responsible for paying for the consequences. They add that "these safety nets are not intended to create a permanent dependency for individuals or their families upon the state, but rather to provide them with the opportunity to regain control of their own lives and their own destiny." The safety nets, in other words, are not supposed to become permanent webs that entangle people in them and limit their legitimate freedom.

Moreover, the conditions for human excellence in our country would not be promoted, they assert, if health care reforms led to the formation of another large, inefficient, costly and corruption-prone federal bureaucracy. It is already bad enough that many need to deal with the red tape of some large health insurance companies; adding multiple levels to the administrative chain through a federal bureaucratization wouldn't be a step in the right direction. The bishops imply that they believe that present proposals to centralize control of our health care system at the Department of Health and Human Services in Washington would do greater damage than good to the common good. Some people may not have as pessimistic evaluations of the efficiency and vulnerabilities of mammoth federal agencies as they and their fellow Midwesterners do, but these bishops are clearly consistent with Catholic teaching when they say that, if health care reforms were to violate the principle of subsidiarity, they would likewise be violating the principle of the common good.

The fourth and final principle they describe is solidarity, which they call "a particular application — on the level of society — of Christ's command to love your neighbor as yourself" and of the Golden Rule to "do unto others as you would have them do to you." When we see people suffering, we cannot as individuals and a society walk by on the other side of the road, as the two of the characters did in Jesus' parable of the Good Samaritan. As with the character of the Good Samaritan, who cared for a wounded Jew even though the Jews and Samaritans at the time meticulously avoided each other, we also cannot get so caught up in peripheral issues like race, ethnicity or immigration status, that we forget about the essential humanity of the people who might be suffering in our midst. For this reason, Archbishop Naumann and Bishop Finn state that "legislation that excludes legal immigrants from receiving health care benefits violates the principle of solidarity" and is "unjust" and "not prudent."

Even though they do not explicitly mention it, the principle of solidarity would likewise say that failing to provide a safety set for illegal immigrants would be "unjust" and "imprudent." It's interesting that throughout the country, public health officials are trying to make sure that even illegal immigrants be inoculated against the H1N1 flu virus, because they recognize, at a level of public health, that there is already a connectedness among us. Failure to care for illegal immigrants with regard to the swine flu would place many others at risk. Likewise, failure to care for illegal immigrants in general would place our humanity at risk. The prelates give a simple application of the principle of solidarity when they say, "in evaluating health care reform proposals, perhaps we ought to ask ourselves whether the poor would have access to the kind and quality of health care that you and I would deem necessary for our families." If the roles were reversed, and our family members were those who would get no medical care when they had been involved in a catastrophic accident, or were in great pain, each of us would want them to have access to health care. Each of us would hope that someone would prove to be a Good Samaritan to us, and that our society would model itself after the Good Samaritan rather than the other two figures in the parable.

None of this discussion necessarily means that the bishops believe that solidarity requires a federalization of health care. It minimally requires that society determine structures so that there is a safety net for those who have no other protection. They ask, without giving an answer (probably because they do not yet have a model to propose), "Is there a way by which the poor, too, can assume more responsibility for their own health care decisions in such manner as reflects their innate human dignity and is protective of their physical and spiritual well being?"

The bishops say that the principles of solidarity and the promotion of the common good mean that "we cannot be passive concerning health care policy in our country." Each of us has an obligation to the common good and to others not to delegate totally our personal responsibility to elected officials in Washington. They say that "there is important work to be done," especially in order to ensure that the result of these reforms are not merely "change for change's sake;" or worse, "change that expands the reach of government beyond its competence," "change that loses sight of man's transcendent dignity or the irreplaceable value of human life," or "change that could diminish the role of those in need as agents of their own care." Such change would "do more harm than good," they say, and not be "truly human progress at all."

They call on the Catholic faithful and all people of good will to "hold our elected official accountable" to these principles of Catholic Social Teaching with regard to health care reform. This is the only way to ensure that all such reform be built on the solid foundation that "all people in every stage of human life count for something." Otherwise, if health care reform leads us to have to "violate our core beliefs," they warn that we would not be "aiding people in need, but instead devaluing their human integrity and that of us all."


Father Roger J. Landry is pastor of St. Anthony of Padua in New Bedford, MA and Executive Editor of The Anchor, the weekly newspaper of the Diocese of Fall River.