Failing Grade in Social Doctrine
When vice-presidential nominee Paul Ryan, R-Wis., gave an address at Georgetown University this past spring, more than 80 faculty members signed a letter challenging his claim that his budget proposal had been informed by Catholic social teaching.
The faculty members could not fathom how a proposal that checked the growth of the federal government could be consistent with their myopic view of the Church’s social teaching.
A similarly narrow reading of Catholic social teaching, one that erroneously equates it with social-welfare state policies, has also been evident in the ongoing debate about Obamacare.
For example, both the Catholic Health Association and leaders of the recent “Nuns on the Bus” tour have intimated that a federally controlled universal health-care system is part and parcel of Catholic social teaching.
To bolster this argument, they and others have pointed out that the U.S. Conference of Catholic Bishops has been an advocate of universal health care for decades and that the Compendium on Social Doctrine of the Church mentions our Christian obligation to care for those without health care.
While these assertions are both true, it is quite a stretch to equate the Church’s concern that the poor have access to adequate health care with support for Obamacare.
It is even more of a stretch to argue that Obamacare is consistent with a fully integrated understanding of Catholic social thought.
Just like the Georgetown professors who took Ryan to task, those who claim Obamacare is a natural outgrowth of Catholic social thought tend to reach their conclusion by focusing on an extremely simplistic reading of just one aspect of Catholic social teaching, namely the preferential option we should exhibit toward the poor.
The Church describes this preferential option in its Compendium, indicating that “the poor, the marginalized and in all cases those whose living conditions interfere with their proper growth should be the focus of particular concern.”
While it is clear that care for the poor must be of particular concern for Catholics, the Compendium does not maintain that this must be done through the federal government via ever-expanding social-welfare programs.
In addition, there are other aspects of the Church’s social teaching that must be considered when evaluating programs such as Obamacare.
If we evaluate Obamacare in light of the full scope of Catholic social teaching, it fails to hold up to scrutiny.
The cornerstone of Catholic social teaching is the recognition of the equal dignity of all people.
The Compendium teaches that it is “necessary that public authorities keep careful watch, so that restrictions placed on freedom or any onus placed on personal activity will never become harmful to personal dignity.” Yet Obamacare violates this core principle with the “contraception mandate” that requires everyone to subsidize the universal provision of “free” abortifacients, birth control and sterilizations.
In the Declaration of Independence, Thomas Jefferson coined the immortal phrase “life, liberty and the pursuit of happiness” to represent the unalienable rights bestowed upon us by our Creator, rights that should be protected by our government.
Unfortunately, the life part — the most fundamental of the three — will be eroded by Obamacare, not only through the mandate, but also by federal tax dollars indirectly subsidizing abortion-covering plans in the soon-to-be-created Obamacare health exchanges.
Far from being consistent with Church teaching, Obamacare, in which we are compelled to participate in life-destroying activities, represents a clear affront to Catholic social teaching.
But even if Obamacare were to be stripped of the mandate and the abortion coverage, it would still not be in the clear with Catholic social teaching.
Catholic social teaching upholds the principle of subsidiarity, something that Obamacare does not. This principle requires that one should try to accomplish a task at the most immediate level of society.
For example, if effective child rearing can be done best in the context of a family, one should not delegate the role of child rearing to the state.
The Compendium warns against the danger of not following this principle: “Experience shows that the denial of subsidiarity, or its limitation in the name of an alleged democratization or equality of all members of society, limits and sometimes even destroys the spirit of freedom and initiative.”
Obamacare, in which the federal government decides what health insurance is appropriate for all citizens, as well as how it will be delivered, is a clear violation of this principle.
Under Obamacare, federal bureaucrats are deciding and will continue to decide what coverage limits will be acceptable, what treatments must be included at no cost — contraception, abortifacients, etc. — and what treatments will eventually be denied.
Rather than encouraging states or local groups or communities to develop insurance plans that best fit their particular needs and are consistent with their values, the federal government has usurped this freedom. This obviously leads to problems when it comes to the inclusion of morally problematic procedures, but there is another equally pervasive effect of such a top-down system.
Personal choice and responsibility, essential aspects of healthy living and, incidentally, key components of controlling health-care costs, are gradually replaced with an expectation that someone else is going to take care of your health-care problems.
This leads to a loss of human initiative and a degradation of the human spirit. The Compendium recognizes the risk this poses, stating, “By intervening directly and depriving society of its responsibility, the social-assistance state leads to a loss of human energies and an inordinate increase of public agencies.”
Unfortunately, many Catholics who support Obamacare downplay or ignore such issues. Really, what could go wrong with a multitrillion-dollar federally controlled health-care system?
Instead, in their single-minded desire to support Obamacare, they continue to focus solely on the preferential-option-for-the-poor aspect of Church social teaching. Yet, even if one were to lay all other facets of Catholic social thought aside, it is far from clear that Obamacare is the best approach to increase access to quality medical care for the poor.
In fact, there are many reasons to suspect that the majority of Americans, the poor included, will fare worse under Obamacare.
For starters, Obamacare will move millions of people into Medicaid, a program that is already failing to meet the needs of the poor. The present state of Medicaid is such that doctors are being reimbursed at such low rates that many are either refusing to take Medicaid patients or they are making up for it in volume by herding patients through like cattle.
Medicaid patients are left without the ability to easily gain access to the system, which subsequently increases health problems and decreases health outcomes amongst this population.
In fact, a recent University of Virginia study found surgical patients on Medicaid fared worse than patients with no insurance at all. Moving more and more people into such a dysfunctional system can hardly be called a preferential option for the poor.
The other major issue with Obamacare is that its poor design and high cost could drive up the number of uninsured. The new mandates that require plans to cover certain “essential” benefits, the community rating aspect that will require younger people to pay higher rates to subsidize older individuals, and the fact that insurers must issue policies to people even after they get sick all mean that the average cost of insurance will go up. In fact, premiums have been going up since the signing of Obamacare, a fact that shouldn’t surprise anyone with a basic familiarity of “Economics 101.”
As the cost goes up, more and more people are going to elect not to purchase insurance. Sure, there is the fine — I mean tax — that is associated with not having health insurance, but the fine ($695) is much lower than the cost of health insurance.
For many individuals, particularly those who are healthy, it makes no sense to buy insurance. Just pay the fine — I mean tax — each year, and if you or your family happens to get seriously ill, buy insurance then. The Congressional Budget Office predicts that millions of lower- to middle-income families will move toward this option because of the increasing cost of insurance.
Such a situation encourages irresponsible behavior and fails to make individuals full partners in their own health. Setting up a health-care system in which people have the right to get affordable health insurance after they get a serious illness but have no responsibility or incentive for taking care of themselves or contributing to a functioning health-care system is inconsistent with Catholic social teaching. The Compendium seems to warn about the dangers of this type of arrangement, stating, “Those … who claim their own rights yet altogether forget or neglect to carry out their respective duties are people who build with one hand and destroy with the other.”
Clearly, the health-care system in the United States needs to be reformed. As Catholics, we need to ensure that this reform is consistent with Catholic social teaching in its entirety. A one-size-fits-all federally controlled system that violates religious freedom, takes health-care decisions out of the hands of individuals and incentivizes both individuals and businesses to drop health-insurance coverage is clearly not the answer.
We need a system that incentivizes the purchasing of individually tailored insurance plans through the private market via tax credits and subsidies for low-income individuals.
We need a diversity of plans that allow people to acquire health insurance that does not violate their religious and moral convictions.
We need plans that incentivize healthy behavior through rebates or lower costs that are passed on to individual consumers.
Such a system would be much more consistent with the many interrelated aspects of Catholic social teaching, not to mention the founding principles of our country.
Daniel Kuebler, Ph.D.,
is a professor of biology at
of Steubenville, Ohio.
- August 26-September 8, 2012