WASHINGTON ? Would health-care reform be prayer answered for Catholics? Or is it a disaster waiting to happen? It depends which Catholic expert you ask.

Sister Carol Keehan, president of the Catholic Health Association, and Kathy Saile, director of Domestic Social Development for the U.S. Conference of Catholic Bishops, both see it as a great opportunity to create a health-care system that provides better care to Americans ? and conforms to Church teachings.

But Dr. Steven White, past president of the Catholic Medical Association, sees the situation as a potential crisis.

White, who chaired the task force that produced the CMA?s 2004 document, ?Health Care in America: A Catholic Proposal for Renewal,? warns that a comprehensive reform in the current political context is likely to force Catholic health-care institutions and medical personnel to engage in anti-life activities and transgress against their rights of conscience.

One thing that virtually everyone agrees on is that Catholics should have a major say in the health-care reform process, given that one in every six ill Americans receives care at a Catholic medical institution.

Sister Carol told the Register the CHA believes there is a moral responsibility ?to get health-care reform that is worthy of the American people.? The CHA?s approach to reform is articulated in detail on its website, chausa.org.

Sister Carol said reform must achieve two fundamental objectives: to provide health care equally to everyone, regardless of financial resources or personal circumstances, and to be affordable and efficient in meeting Americans? health-care needs from conception until natural death.

Only a comprehensive reform of the current system can deliver the CHA?s vision, Sister Carol said.

?If we don?t get comprehensive reform, we don?t get the bang for our buck,? she said. ?We have gotten past the point where stop-gap measures are adding much.?

That opinion is shared by Saile, whose office collaborates closely with the CHA in setting health-care policy priorities.

An article Saile wrote to help guide Catholic voters with respect to health-care issues has been posted on the U.S. bishops? Faithful Citizenship website, faithfulcitizenship.org.

Saile said reform is likelier to succeed now than in the early 1990s because ?there seems to be a much broader consensus in the nation that we need health-care reform.?

At the top of the bishops? conference and CHA?s list of reform priorities is addressing the health-care insurance needs of the 47 million Americans, mostly low-income, who currently lack medical coverage.

Saile said assigning priority to providing better health care for poor and vulnerable Americans is rooted in the Gospel imperative to continue Jesus? mission of healing and caring for the ?least of these,? as articulated in Matthew 25:40.

At the same time, the CHA and the bishops are also stressing that any acceptable health-care reform package must respect the sanctity of life, especially with respect to unborn children.

Another basic priority identified by the U.S. bishops and the CHA is that the health-care system continue to reflect ?pluralism.? That means both public and private health-care providers, including voluntary, religious and not-for-profit organizations, should continue to participate in the system.

Pluralism also means that differing religious and ethical beliefs of patients and providers should be respected, protecting the freedom of conscience of Catholics to refuse to participate in immoral actions like abortion and sterilization.

Also identified as key by both the CHA and the bishops? conference is implementing ?sound stewardship? principles, in order to make better use of the finite resources available for financing the health-care system.

Currently, health-care costs are increasing much faster than wage gains, and those increased costs are not distributed fairly and effectively among those who fund the system, according to Sister Carol.  

Said Sister Carol, ?We feel reform is imperative not only for people with no insurance now, and with no access, but for everybody because, particularly in these economic times, it is eroding any kinds of wage gains people get because their health care goes up so much faster.?

^{Another Perspective}

In contrast, the Catholic Medical Association does not support comprehensive health-care reform.

White, a Florida specialist in pulmonary medicine who served as CMA president in 2004-05, said the CMA?s health-care reform task force identified three areas of vital concern: defending the sanctity of life, protecting the freedom of conscience of Catholic health-care providers, and protecting the private property rights of individuals to own their own health-care policies.

Today?s calls for comprehensive health-care reform are coming primarily from Democrats, whose party platform calls for government-funded abortion and embryonic research, White noted.

The Democratic Party is also more sympathetic than the Republicans to a ?single-payer? approach that would see the federal government assuming direct control over most of the health-care system.

Consequently, White said, all three areas of concern that were highlighted by the CMA task force are likely to come under attack if presumptive Democratic nominee Sen. Barack Obama of Illinois becomes president and introduces a comprehensive health-care reform initiative.

Instead of comprehensive reform, the CMA favors an incremental approach that would address the most glaring problems of the current system individually, such as the problem of the uninsured.

And, White said, even in those areas, Catholics should insist that proposed solutions should not be based on a monolithic, government-driven model.

The CMA acknowledges that widespread frustration exists among Americans over the current system?s economic problems, White said. And that frustration has led many people, including many Catholics, to conclude the only reasonable approach is to support a comprehensive reform initiative that would grant complete control over the health-care system to the federal government.

But White warned that in practice, that would inevitably result in the imposition of principles that conflict with basic Church teachings regarding the sanctity of life and freedom of conscience.

Said White, ?If you promote today a comprehensive solution, and that comprehensive solution is a large, monolithic single-payer system, I would go so far as to say that we would impose the ethic of the culture of death on the entire health-care system.?

^{Responsible Voting}

The U.S. bishops? website gives the following criteria for judging health care plans:

?Respect for Life ? Whether it preserves and enhances human life from conception to natural death.

?Priority Concern for the Poor ? Whether it gives special priority to health care needs of the poor, ensuring that their health care is quality health care.

?Universal Access to Comprehensive Benefits ? Whether it provides universal access to comprehensive benefits sufficient to maintain and promote good health.

?Pursuing the Common Good and Preserving Pluralism ? Whether it allows and encourages the involvement of all sectors, including the religious and voluntary sectors, in all aspects of health care, ensuring respect for the ethical and religious values of consumers and providers.?

The bishops refer readers to the 1981 encyclical Laborem Exercens (On Human Work). In it, Pope John Paul II urged that health care be made available and affordable to workers:

?The expenses involved in health care, especially in the case of accidents at work, demand that medical assistance should be easily available for workers,? he wrote, ?and that as far as possible it should be cheap or even free of charge? (No. 19).

In the 1995 encyclical Evangelium Vitae (The Value and Inviolability of Human Life), Pope John Paul II wrote that ?Causing death can never be considered a form of medical treatment, even when the intention is solely to comply with the patient?s request.?

He added that ?Although laws are not the only means of protecting human life, nevertheless they do play a very important and sometimes decisive role in influencing patterns of thought and behavior. I repeat once more that a law which violates an innocent person?s natural right to life is unjust and, as such, is not valid as a law? (Nos. 89, 90)

Saile said Catholic voters have a responsibility to study the health-care issue and to assign it a high priority when deciding how to cast their ballots in November.

?People need to be very familiar with the candidates? position on health care,? Saile added. ?And they need to be familiar with Catholic teaching on this.?

Tom McFeely writes from

Victoria, British Columbia.