The Editors

They say the best place to keep an appointment with the devil is at a crossroads. We are again drawing near another political crossroads on health care. If we cannot move past our own diabolical short-sightedness and partisan tendencies this time, we will miss a historic opportunity to put our health care system on a path toward sustainability, fairness and common decency. It could be decades before the chance comes around again.

We cannot afford to wait to reform our system. It is costing us too much as individuals and as a society. The current system regularly turns medical misfortune into personal tragedy and economic ruin; it also weighs down U.S. industry, hindering American manufacturing in an increasingly competitive global marketplace. It also drains fiscal resources at the local, state and federal levels that could be better invested in preventive care, better education for our children or shoring up our crumbling infrastructure.

As people of faith we can be guided by a long tradition of Catholic social teaching that unambiguously supports public initiatives to ensure access to health care when markets alone fail to achieve universal coverage. Those who express exaggerated fears of a government takeover and bureaucratic centralization tend to portray government as somehow a threat to the people and their freedom, but Catholic social teaching consistently reminds us that public authority is the ordinary mechanism by which people undertake collective action. The principle of subsidiarity provides a check against needless centralization, but it must not be misinterpreted as an excuse to forgo truly necessary national initiatives.

Catholic social teaching offers a distinctively organic view of society that calls all parties to be open to sacrifice for the good of the whole. That common good springs from true cooperation, not merely the competitive interaction of self-interests. Reforming health care should not be reduced to a partisan issue, with the eyes of negotiators distracted by the goal of scoring political advantage. We will achieve the aims of reform—extending coverage to the uninsured, rationalizing procedures and policies and lowering costs—only if all parties check their egos and partisan interests at the door and work together.

The greatest temptation now is to despair of true reform any time soon. After all, powerful special interests have a stake in the status quo, and the major political parties clearly desire different outcomes. But the light shed by Catholic social teaching reveals the possibility for progress, a progress that can be assured only if we recognize that health care is not just another commodity to be distributed according to people’s ability to pay. Many resources within Catholic social thought—including its requirement of a preferential option for the poor—challenge us to re-imagine health care as a basic human need, no less a religious obligation than providing food for the hungry, shelter for the homeless and clothing for the naked.

The church has for more than a century stood for the civic components of our God-given human dignity, a dignity that our current system too often diminishes. We cannot now allow a handful of discordant voices to confuse what has been the church’s longstanding position: that in a just society, access to effective health care is a human right, not a negotiable social privilege.

That does not mean that the church should compromise at all on its clear resistance to any deployment of federal resources for abortion services. It does not mean that any watering down of conscience clauses for Catholic health care workers should be tolerated. These are breaking points for Catholic support on health care reform, and the Obama administration appears well aware of this. Thanks no doubt to the vigorous interventions of the advisers from the U.S. Conference of Catholic Bishops, it was no accident that assurances on these two principles appeared in the president’s speech before Congress on Sept. 9. The president is keenly aware that he must win over Catholics if he is to win over Congress in November.

The time has come to put aside our childish ways on health care. Other industrialized nations resolved the challenge of universal and equitable care decades ago. It is unacceptable that in a society as wealthy as the United States, which may ultimately spend as much as $3 trillion on a war of choice in Iraq, millions are without access to reliable health services; that as many as 18,000 die each year because of poor access; and that an unknowable number die because they were denied care by the for-profit entities to which they had entrusted their lives.

In his speech the president threw down the gauntlet to the fear-mongers and the Congressional hired hands of the status quo. It is time to stop dithering and get behind the president’s proposal.


David Ha | 10/14/2009 - 7:06pm
Very convincing and logical artical. I read earlier comments that state the fact that abortion was covered by this particular bill. If that is so, I understand why Catholics should not rally under Obama's decision. But this is not true, it makes perfect sense for us, Catholics, to give full support because it is physically and spiritually moral.
Dan Hannula | 9/30/2009 - 3:11pm
#13 (Chris Mulcahy) above-are you kidding me?
Under your logic, (i.e., "It's morally wrong to advocate Government schemes without addressing ... behaviors...etc") the Fire department would only respond to house fires where the owners had paid their real estate taxes and had otherwise made what you judge to be reasonable repairs and upkeep to the house.  "Morally wrong?"  So, a poor overweigh person suffering from diabetes is not helped because it is "morally wrong" to help him?  I thought Herbert Spencer was roundly discredited in the modern world.
And, now we have "tort reform" as the latest road block to universal health care. Are you kidding again?  And, assuming that no one could recover damages for medical negligence what do you suppose that would save the system?-forget that it might be unjust to force a person to live with a serious permanent injury without compensation.  Forget that-what would it save?  Recently the Washington Post cited a Harvard/AMA study that said 3% savings.  But, check it out:   The article also pointed out that the current system treats malpractice "too lightly."  That is, many victims of malpractice are treated unjustly now.
The moral imperatives to universal health care are, to an honest observer, clear. Your love-song to Capitalism strikes a tinny chord.
Chris McNiff | 9/29/2009 - 12:57am
For those who question the intent of President Obama to make abortion a
cornerstone of public health policy, please see White House link that
reinstituted abortion as an instrument of proper foreign affairs funding.
It should not go without saying that this health bill is a huge transfer of
wealth from young to old.  This is on top of the mountain of debt that
already exists for the next generation.  It is not appropriate to laden
the young with more unpaid bills.  Disgraceful.
Pam Sokolowski | 9/27/2009 - 6:08pm
I was absolutely floored to read this article. How dare you (The Editors) use Catholacism as a platform for your political views. Catholic social teachings teach us to be giving of our own free will, not through (political) governmental force. I have not heard one single person deny that health care reform is needed so that all can get the medical care they need. But the current plan is not what the people want and therefore we will not "get behind the president's proposal" just to get it over with.  Your attempt to instill your political ideologies by providing erroneous statistics in the name of Catholic social teachings is discusting. Furthermore, my "exaggerated fears of a government takeover" stem from the recent actions of an errogant government led by a tyranical president. End of story. 
dr joseph kiernan | 9/26/2009 - 8:51am
Abortion and Nationalized health care.
Saying that health care proposals won't cover abortion because abortion is not mentioned in a bill is just plain dishonest.  I haven't been 'mislead' by anyone.
Two things:  1. If supporters of health care proposals say that abortion will not be covered let them prove it by putting into the bill a specific disclaimer that it won't be covered.  They won't, so it will be covered. 
                  2.  Look where the abortion lobby stands on the proposed bills.
Sorry, I don't care if someone has a pulitzer prize, a nobel prize or a Stalin prize; this is just plain common sense!  Abortion will be covered under these bills.
Catholics should not support a bill that covers abortion.
Ron Plante | 9/25/2009 - 8:27pm
There is no question that we need health insurance reform; however, we currently have a healthcare system that is the envy of the entire world.  Rabble rousers will claim that our healthcare system is far from the best based on a single metric, lifespan.  First, there are many factors which influence lifespan including a prevailing sedantary lifestyle among many in this country, combined with improper eating, smoking, and a very mobile population (auto accidents.) 
Secondly, since when is lifespan the best or only measure of the quality of our healthcare system.  I, personally, have employed the services of Opthalmologists, Orthopaedic Surgeons, Allergists, General Practicioners, Dermatologists, Dentists, an Orthodontist, Neruologists, General Surgeons, and ER Doctors, while my wife has also been seen by OB/GYN doctors (in addition to the above), and my kids have also been seen by Pediatricians (in addition to the above.)  None of these have been life threatening; however, they have all had positive influences on our quality of life.
The forty-seven million Americans without health insurance has been debunked by multiple sources.  Between 10 and 30 million of those are illegal aliens (who still receive healthcare.)  Another 10 million plus have incomes which allow them to purchase medical insurance; but, they have made a choice to buy a better car or live in a bigger house instead of purchasing insurance (their right.)  There is also a large number in that group who are between jobs and are temporarily without medical insurance.  Most sources believe that there are 10-15 million people who are truly in need of medical insurance who cannot get it, due to pre-existing conditions, etc.  This is an issue which must be addressed; however, not in the manner proposed by the Democrats.  By the Non-partisan Congressional Budget Office's numbers, the Public Option proposed by the Democrats will result in an additional 80 million people losing their health insurance and being forced into the Government Option.  Additionally, to cover the 10-15 million in need of coverage, a Trillion Dollars will be added to the national debt. 
That doesn't even address the lies in the President's address.  On at least two occasions, ammendments were proposed to exclude abortion funding and funding for illegal aliens.  Both were dismissed out of hand.  There many ways that can reduce the cost of healthcare, and all have been ignored.  Tort reform is the biggest; however, the Democrats are beholden to the slip and fall lawyers, so that will never happen.  Allowing people to buy insurance across state lines whould help, but that might cut into liberal states which require insurers to cover things like sex change operations.  All that is left that can save enough money is what they have embraced, rationing.  They will deny our grandmothers hip replacements so that they cannot run away from the Death Panels.  No, they are not called that, in fact, in Great Britain these panels are actually called "NICE,"  (Typical socialist euphemism.)
Make no mistake, there is no such thing as Government compitetion.  The Government will make the rules, and has unlimited funding.  They will crush any competion until we are all on the Government Option.  We have already seen examples of what that will mean: The Post Office, Fannie Mae, Freddie Mac, Medicare, Medicaid, Social Security, etc.  Some have pointed to the VA as an example of a success.  I volunteered as a Paramedic for 10 years and will never forget the time I brought someone to the local VA hospital and saw EEG electrodes attached to the OUTSIDE of a sleeveless t-shirt!  I have also heard a Veteran say that there is an old joke, that the place old Veterans go to die is the waiting room of a VA hospital.
The American People have spoken.  They want medical insurance reform, but not the proposed plan.  Fix what is broken, but do not mess with what works.
Ron Plante
Elena Vitug | 9/25/2009 - 9:23am
The author of this article seems to piously accept anything and everything that is in the health reform legislation in the name of social justice.  Does he/she even know what is included in the 1000-plus pages? What planet is he on?
Larry DiPaul | 9/24/2009 - 5:12pm
Folks with health care simply do not understand the Lazarus-like anguish of the un-insured.  The pursuit of the Common Good is the basis of a just society and world.  Not now, however.  The pursuit of the Common Good is seen as socialism.  Those who oppose Health Care Reform use the same misguided information and fear that was used to oppose all those other Common Good, socialist, government initiatives - Social Security, The G. I. Bil of Rights, Medicare, and Public Education.  We pray that our Church speak as prophet, without fear or favor, in solidarity with our vulnerable sisters and brothers - and reisist greed in all its forms.  Justice will be served when the unharmed feel the pain of the harmed!
Marie Rehbein | 9/24/2009 - 12:00pm
Dear Chris Mulcahy,
     You have a responsibility to contribute something toward your medical care.  However, that amount should be sensitive to your income.  If it's not sensitive to your income, then why not thow up your hands in despair and behave the way you describe?  After all, every time you think you are finally a bit ahead financially, you find yourself forking over $$$$$ for office visits and meds that you could have had a lot more fun spending on grease and high fructose corn syrup.
     How about if 1% of your pay goes into a medical account and every time you get sick, you go to the doctor and he gets paid out of that account without your having to fill out any papers, pay any co-pay, and worry that your claim will be denied and you'll have to pay the $$$$$?  Wouldn't that make you feel better just by itself, not to mention that now when you put a few bucks aside by eating cheaper, healthier homemade meals, you get to keep the money you saved?
Chris Mulcahy | 9/22/2009 - 8:04pm

I insist on my God-given right to eat grease.  And wash it down with Coke.  Don’t lecture me about exercise—it’s boring, and if I go out I might miss Dancing With the Stars.  And all that baloney about vitamins and Omega 3’s is a lot of hype.  When my child cries, or I see a drug on TV, I expect to get into the doctor’s office at the latest by 10:00 AM the next morning—unless the emergency room is closer.  I have a God-given right to medical care, whether I can pay for it or not, and don’t get in my way or I will call my uncle.  He’s a lawyer, and he can make you pay big time if you deny me my rights.  When the new legislation passes, you’ll see me often in the waiting room—like I said, I know my rights, even though I don’t have my green card yet.  I will soon enough, and so will my extended family when they arrive from Eastern Europe.  Actually, I love America, and they will, too!  By the way, would you like a donut?

Monica Socinski.OP | 9/22/2009 - 7:51pm
Thank you for that editorial! I totally agree! The politicians have been procrastinating about health care since the Truman administration! HOW MUCH MORE TIME DO WE NEED??
When is Congress getting down to work!?Actually, did not our president state that public funds would not be used for abortions from the plan he proposed? SO WHY ARE CONSERVATIVES SO RILED UP?
Let's not forget to pray for our president!
I Heart EWTN | 9/22/2009 - 12:09pm
Health care reform would lead to more abortions, killing of the elderly, permitting cloning of humans, paying for illegal aliens and raising taxes.  America has the best healthcare in the world, it does not need to be reformed. The poor can go to an emergency room. Faithful Catholics should be working toward removing Obama and his Democrat cronies from office and returning America to Real Americans.
David Nickol | 9/21/2009 - 8:06pm
It is understandable that people who oppose abortion don't want their taxes to pay for other people's abortions. But it says in Time Magazine that "nearly 90% of insurers cover abortion procedures, according to a 2002 survey by the Guttmacher Institute . . . ." How many of the people who are so concerned about their tax dollars going for abortions are equally concerned that the premiums they pay for their current insurance, or that their employers pay, don't help pay for abortions?  Shouldn't all who consider themselves pro-life make sure that  they are not covered by a policy from an insurance company that pays for abortions?
William Shields | 9/21/2009 - 11:21am
This article is a refreshing note of reasonableness in a cacophony of mis-information and partisan hype.
Thank you very much.
Jane Seifer | 9/21/2009 - 10:18am
Are we forgetting that these reforms are being offered and supported by the same President who said these things at a speech to Planned Parenthood in Chicago (July 2007).
"We know that a woman's right to make a decision about how many children she wants and when - without government interference - is one of the most fundamental freedoms we have in this country."
"we should never be willing to consign a teenage girl to a lifetime of struggle because of a lack of access to birth control or a lifetime of illness because she doesn't understand how to protect herself."
"We need more leadership at the federal level. That's why I'm an original co-sponsor of the Prevention First Act. To guarantee equity in contraceptive coverage, Provide comprehensive sex education in our schools and offer rape victims factually accurate information about emergency contraception."
"Well, the first thing I'd do as president is sign the Freedom of Choice Act."
"in my mind reproductive care is essential care, basic care so it is at the center, the heart of the plan I propose."
These are the princples he was elected upon, and we're to think that he won't include them on medical reform?
Fran Rossi Szpylczyn | 9/20/2009 - 7:11pm
Thank you for this great editorial. We can no longer afford to wait. I am opposed to federal funding for abortion. I am also opposed to people dying because they can't afford to go to the doctor. I am opposed to rationing that already exists due to economics and circumstances. I am opposed to a system in which medical care is a commodity available to the one with the most money and beyond the reach of many. I am opposed to a system that has very little to do with the dignity of the human person - that is the system that we have now.
Marie Elks | 9/20/2009 - 4:39pm
For evidence of my previous post, please review:
Medicare bills high at Los Angeles hospitals
Known as hospital "frequent fliers," heart failure patients typically cost Medicare $24,000 in inpatient expenses annually. To patients like Adenis, it's money well spent.
But a 2006 Dartmouth study contended that almost a third of the money spent on the chronically ill was wasted on "rescue medicine" for people with advanced diseases who could not be cured.
Shah questions that logic.
"Letting people die early is actually more cost effective," said Shah, who heads the cardiology unit at Cedars-Sinai Heart Institute. "But that's a perverted way of looking at things."
Marie Elks | 9/20/2009 - 4:30pm
Catholic teaching is also very clear about the proper role of the government in the individual's life. Before I converted, I thought that Catholicism was communism without guns. Imagine my surprise when I started reading encyclical after encyclical that condemned the process of suborning the individual to the interests of the collective.
Make no mistake-this health care Trojan horse is the fastest route to a state that completes the obliteration of subsidarity, freedom of conscience and the right to direct one's own future. Everything the Faith has taught for centuries regarding personal rights and responsibilities, subsidarity and civil authority will be ground to dust beneath the collective's need for "financial savings" and so-called "common sense solutions to the problems of aging, disability and other high-cost health situations."
Were we a 100% faithful Catholic society a case could be made. Given the onslaught of the culture of death at all levels of society-especially government-the current health care plans are the culture of death's express route to control.
Remember, the road to hell is paved with good intentions ill thought out.
LEONARD VILLA | 9/20/2009 - 3:34pm
You desire haste with respect to health legislation. Need you be reminded of the Latin saying "Festina lente"(make haste slowly)? Or the even more proverbial haste makes waste? There are many mistakes in your editorial both factually and with respect to Catholic teaching. First there is no health care crisis per se. The U.S. has the best health care in the world! There is need of health insurance reform! Secondly there is the notion that centralized government is the only answer to respond to the needs of the common good. In that regard you gloss over a cardinal principle of Catholic social teaching: subsidiarity, which to paraphrase states a social issue should be treated at the lowest level possible. Given the track record of socialized medicine and the gross mismangement of medicare you would think  you would pause before urging quick passage of what would be yet another Federal program headed for mismanagement and WHICH WE CANNOT AFFORD!
The counsel of Bishop Samuel Aquila, the Bishop of Fargo, ND should be heeded: "As a society seeks to bring about any good such as health care, there are many organic and intermediate groups which cooperate together to reach the desired goal. There is a danger in being persuaded to think that the national government is the sole instrument of the common good.(emphasis added) Rather, according to the classic principle of subsidiarity in Catholic social thought, many different communities within society share this responsibility. These various strands of community life within society build up a strong and cohesive social fabric that is the hallmark of a true communion of persons. States, towns, fraternal organizations, businesses, cooperatives, parishes and especially the family have not only legitimate freedom to provide the goods they are rightly capable of supplying, but often times do so with far greater efficiency, less bureaucracy and, most importantly, with personalized care and love. "
Ted McGoron | 9/20/2009 - 3:18pm
   I doubt that anyone disagrees that our health care is too expensive. But changing the insurance will not make the care any cheaper. The president and most legislators have said there is a good deal of waste and mismanagement that should be eliminated. Assuming that this is true, (we all know politicians never say anything that is not true) why don't they first fix those things? They should not need legislation so it should be simple. Then if the changes result in money saved we can go on to find better ways to help those who need help getting care. It sounds so simple.
Charles Beck | 9/20/2009 - 11:11am
I am a believer in health care reform and the ability of our country to extend a least basic coverage to all Americans.  Nevertheless, I find myself unable to support the politicized Democratic proposals as they either move us toward a socialistic system, with too much government intervention or simply pass over responding to essential concerns and details in the name of the 'greater good'.  This latter point is essentially the theme of this article...."let's do it for the greater good".  Having lived in Belgium for 5 years and participated in the universal health care system there, it is clear that the reality of the costs of such a system and the benefits from the extent and level of care are misunderstood.  On two occasions family treatment waited until our return to the US on 'home leave' due to the wait time to treat the issue or the lack of coverage.  We are asked in the last sentence to 'get behind the President's proposal".  What is that proposal? This is a true act of faith as there is no proposal, just concepts that congress keeps juggling in the name of their special interests.  Does anyone believe that the politicians are listening to the real concerns that have been stated time and again?  The only adjustments I have seen are the ones that gather a few more votes from within the party in power. Ample time has existed (and still exists) to have a clear and concise communication to the public regarding issues that have been raised and their solutions, i.e. specifics!  Because each of these issues requires taking a position that will be untenable for some part of the political constituency I fear that we will end up with consequences that that will only be realized after the fact.
Marie Rehbein | 9/20/2009 - 10:03am
Actually, joseph kiernan, none of the current proposals cover elective abortions.  Perhaps, as a person who puts MD after his name, you would be aware that sometimes when a miscarriage is in progress, a procedure is used to complete the process, and that procedure is called abortion.  If you believe that the current proposals cover something different than that, then you probably would think that they cover cosmetic surgery in addition to reconstructive surgery.  It seems that you are more Catholic than the pope in your opposition.
JOHN WALTON MR | 9/20/2009 - 8:50am
I would remind our Jesuit writers that "subsidiarity" is also a tenet of CST, meaning that the smallest and most local solution is often best.  Instead we have plans by the house and senate which inevitably removes decisions and control from the doctor-patient into community control boards (for those of you New Yorkers old enough to remember what that meant.) Under the house plan, if you change jobs or if your company drops insurance you have no alternative but go into the government program. 
Of the 46mm "uninsured"  approximately a quarter could afford to purchase insurance, but elect not to do so (most likely as they are young and in good health), another quarter are eligible for some form of government assistance but lack the knowledge or tenacity to seek out the programs, a bit under a quarter are illegal aliens who receive health care in emergency rooms or "doc-in-a-box" (on Route 46, or Route 17 in NJ), and perhaps just over a quarter are truely uninsured.  I would also remind our writers that of this last cohort, some 10's of thousands are retired nuns whose archbishops, in their infinite wisdom, declined to allow the women to enroll in Social Security, and are thus ineligible for Medicare.
With all due respect to Dr. Donohue, he is inartfully playing with statistics.  The "death rate" for US citizens, 0.83% in 2007, is lower than those countries with socialized medicine (Uk 1.01%, France 0.92%, Germany 1.07%) and these percentages are consistent over time.  What is remarkable is that the numbers are so low, yet we have far from a homogenuous society. 
Running the "death without doc" argument at 1 per 12 minutes means that 98.6% of the dying have seen a doctor.  Adjust Dr. Donohue's statistic for accidents and suicides and the number change again to the better.
To fix the system - allow purchase of insurance across state lines, enhance medical savings accounts, allow for deductibility or tax credit for the first $1,200 of medical expense, enhance the portability of health insurance and fix the tort bar.  All these suggestions will ameliorate the problems discussed in the editorial, none will break the system or deprive the economic framework from continuing to foster innovation.  Under the plans currently contemplated by congress, the system of innovation will be irreparably broken.
Wendy L Warner | 9/20/2009 - 6:29am
I agree with Dr Kiernan....Govt should not pay for abortion!
Why is the war always mentioned.... Money spent trying to help others have basic rights...
What about the money spent on space....bring that to earth......
T. O'Brien | 9/19/2009 - 7:37pm
"The time has come to put aside our childish ways on health care" is a regrettable way of bastardizing Scripture to make a cheap political point.  What's the difference between that and calling someone who disagrees with the President a "racist?"  Either way, you are trying to silence opposition through insult rather than valid argument. 
I do not understand why if we do not take this opportunity to change now, we will not have another chance for decades.  This health care crisis has been manufactured by the media and this administration precisely at the time when it was at the zenith of its political popularity.  They did not want to waste such an opportunity to influence, and that is why this issue became front and center.  Unfortunately for the White House, their eagerness to fix a plethora of things simultaneously reduced their chances for success.  As more Americans see the inability of the federal government to manage the things it currently is supposed to manage ("Render unto Caesar what is Caesar's"), and then attempt to take on additional responsibilities (auto companies, Wall Street, etc.) which it is not equipped to handle, all the while pushing us deeper into debt, naturally the public should be hesitant to accept this new "entitlement."  The president referenced the billions of fraud and waste already in the system-why doesn't he eliminate that first and prove the government's ability to successfully tackle a problem?
john vercellone | 9/19/2009 - 3:34pm
john vercellone | 9/19/2009 - 3:28pm
Edward Cardoza | 9/19/2009 - 2:11pm
Many of your reader's view contain valid points with which I agree.  However, I'm concerned that it seems to be too expensive to afford.  Perhaps it would be preferable to reform health care for the +/- 15% who are without adequate health care, rather than to change the health care system which is already in place for the 85% of Americans who already have health care with which they are satisfied?
Chris Seeber | 9/19/2009 - 2:00pm
Could someone calmly, logically and rationally explain why health care is a "right?"  Not why it is an obligation, which it is, but why it is a right.  In other words, as I type and exercise my "right" to free speech, I don't take anything from anyone.  On the other hand, in exercising my right to health care I take something from the health care provider in the form of knowledge and services.  Is this just?  We don't talk about food in these terms, why health care?  In addition, if health care is a right why should we even compensate health care providers?
By the way editors, interesting metaphor about the crossroads.  I guess the racism charges didn't stick so trying the diabolical tactic will?  How about relying on an old Ignation tradition to present why health care should pass - the veracity of your ideas!
John Zeigler | 9/18/2009 - 9:45pm
This is naivete at his highest and best. Getting behind the President's plan is concomitant with endorsing abortion, stripping the elderly of care that they've paid for during their working lives, and endorsing a windfall for trial lawyers (yet again). Ask - Why is it that these other countries can provide universal healthcare of one form or another, yet America struggles so mightily with it? Because other countries leave medical practice to medical practitioners, not parasitical trial lawyers who line their own pockets by the very laws that they pass. Our uniquely American problem is that we've got one of the richest groups (the lawyers) dictating healthcare and its payment modalities for the masses, and healthily stripping out their handsome payments. And furthermore, the ones that have been stripped of healthcare are the less privileged - not because it wouldn't be provided by an empathetic and caring medical and church population - It was for centuries in America before the advent of Social Security - but it is that very (lawyer designed SS) that began excluding the "poor" because they didn't fit in with the "potential sueing" populace from whom the lawyers scarf their payments. Get the "non-provider" hands out of the healthcare pot in America, and we'll see greater and greater expansion of care by those who commit their lives altruistically to this noble calling.
DeaconScholar | 9/18/2009 - 8:12pm
Yes, without a doubt, the country needs substantial reform of our healthcare system.  There should be basic, affordable healthcare available to every citizen (not illegal immigrants who should be treated with a different, but humane system).  Young people, the healthiest portion of our population, should be required to have health insurance.  There should be fair and productive accountability for every part of the system - hospitals, doctors, insurance companies.  The government should get out, not in, of micromanaging doctors and hospitals.  The USCCB statement should be the guiding principle.
There are three significant problems that President Obama and liberal Democrats are not addressing.
First, reform should be just that - reform.  So far the proposals are anything but reform.  Secondly, reform should not bankrupt this country.  A country without the ability to pay its bills means that no one can be covered.
Finally, and most important for your consideration, is that healthcare decisions should not be decided upon a person's ability to produce - his or her value to society.  And this is exactly the foundational principle of President Obama's "reform."  Rahm Emanuel's brother Ezekiel, a physician, a well-published scientist, and a top-level advisor has clearly stated that decisions should be founded upon two considerations: the individual's ability to produce and that concerns of society should have equal consideration along with the benefit to the individual.
My dear friends, this is not "reform".  It is completely the opposite of the teachings of the Catholic Church.  What happened to the dignity of the human being?  How a publication such as yours can entertain the idea of promoting such "reform" is simply beyond my comprehension.  I am dismayed.  I am utterly speechless that you sincerely believe that this "reform" is "now-or-never".
robert bjorkman | 9/18/2009 - 7:34pm
Bravo!  I am in complete agreement.  Now, how do we do it?  There is no bipartisan way to accomplish meaningful healthcare reform.  One side is totally uninterested in changing anything.  How do you get their head out of the sand??
orville | 9/18/2009 - 6:26pm
Deacon Evans should go to the USCCB website  to see that the bishops have repeatedly said that health care is a basic human right. See especially [url=][/url]
I also point out that this week our Archbishop in Washington repeated this position and I suspect that other bishops have as well.
Pete | 9/18/2009 - 6:14pm
Beware of a wolf in sheep's clothing.  All explicit efforts to deny funding for abortion have been voted down.  As worthy as all these social goals are, our government is going bankrupt.  Without draconian cuts in other areas, we cannot afford this.  The government has promised more than it can deliver.  It is also immoral to bankrupt the nation.
M. Daniels | 9/18/2009 - 5:10pm

Your premise assumes that this new system of socialized medicine in America will be more compassionate than the current system.  That premise may simply be inaccurate.  If the government solution of guaranteed universal medical care is installed, then the government will have to control its costs. A shift to a public plan will reduce the number of people in the medical field, while adding millions of new clients.  This will lead to healthcare rationing. Someone in the government will have to determine how “ration” the health care dollars spent.  Most likely a new Federal Coordinating Council will be established to determine which treatments are deemed most effective and thus eligible to be paid for by government. These decisions would be based on statistical averages that cannot take into account specific facts of individual patients. That is not compassionate healthcare.

Under the present system, if you are suffering from abdominal pain due to gallstones, for example, who should decide whether medication or surgery would be more effective for you? The doctor who has felt your abdomen, listened to your heartbeat, and knows your drug allergies? Or the bureaucrat who got his job by telling the right joke to the right person at the right Washington cocktail party?

If the government controls the medical purse strings, it will inevitably dictate who receives what health care and when. He who pays the piper calls the tune.  A Canadian woman who feels a lump in her breast might wait months until the government approves her surgery and chemotherapy. In contrast, an American woman can receive the necessary treatment in days. In socialized medical systems, health care is never truly a right, but just another privilege dispensed at the discretion of bureaucrats.

Instead of universal health care, we need free-market reforms that repeal prior government controls, lower costs and allow patients to exercise that right.

Patients should be allowed to purchase insurance across state lines and use Health Savings Accounts for routine expenses. Insurers should be allowed to sell inexpensive, catastrophic-only policies to cover rare but expensive events. States should repeal laws that force insurers to offer (and patients to purchase) unwanted mandatory benefits such as in vitro fertilization coverage. Such reforms could reduce insurance costs over 50% - making insurance available to millions who cannot currently afford it, while respecting individual rights.

Good Catholics can agree that we have an obligation to provide quality healthcare at affordable prices to all.  We just don’t have to agree with you that the government option is the best way to accomplish this goal.  I personally believe the best government program to reduce healthcare costs would be to provide a free education to anyone wishing to become a doctor.  Built on the model of the Army, these college and graduate students would receive a free education and then be required to give back 6 years of duty in health clinics established to help the poor.  This is a win/win scenario, American gets more doctors reducing the cost of healthcare naturally, and the poor get medical care.  Socialize medicine merely means less medicine … less quality … less compassion for everyone.

MICHAEL WARNER | 9/18/2009 - 5:08pm
NONE of the current proposals allow for directly governement funded abortions.
As the editors rightly suggest, Catholics might not agree with all of President Obama's politics, but we can recognize that he isn't politically stupid - he needs Catholics, abortion is (and should be) a deal breaker, that's why it's off the table.
The only question arises with the "public option" and whether those covered by it would also have abortions covered. If I understand it correctly the somewhat shady answer to that seems to be that these costs would be covered by consumer premiums instead of government subsidies. Either way, it seems like the public option has lost a lot of political steam and is not going forward.
But lets be clear... other than that very far off possibility, all bills are as the current phrase goes: "abortion neutral"
Christopher Mulcahy | 9/18/2009 - 4:17pm

Catholic social teaching stresses individual responsibility.  It is morally wrong to advocate government schemes without addressing the oft-disfunctional behaviors of our unhealthy citizens and making associated recommendations.  For example, drug use (particularly in the light of Mexican violence) must be roundly condemned by the bishops, even in San Francisco.  Another example: gluttony is one of the seven deadly sins, despite the fact that it is seldom mentioned on church grounds any more.
Catholic social teaching opposes theft.  The legal profession must be prevented from preying on any system proposed by Catholics.  We all know this means tort reform first.
Catholic social teaching recognizes the murderous central tendencies of true socialism, as we have experienced time and time again in recent history.  For this reason, any federal insurance schemes must respect the individual and be voluntary.
Catholic social teaching defines charity as the individual's personal sacrifice for the good of another.  It rejects the philosophy of taking from an impersonal "other"  to give to another in the name of charity. "Let's not tax you, let's not tax me, let's tax that guy behind the tree." 
Finally, we must recognize that Catholic social teaching failed historically to timely recognize democratic capitalism as the single most significant development in the world's effort to combat poverty.  Christians fail today in many ways to recognize the dramatic progress that democratic capitalism has made possible.   Christians and non-Christians alike commonly fail to distinguish between actual poverty, which consists of inadequate food, clothing, shelter, and medical care, and wished-for benefits, which can consist of anything imaginable that the individual envies among the possessions of another.  Sadly, these failures jeopardize capitalism itself, failure of which would return us all to the condition of our ancestors.

Peter Hanrahan | 9/18/2009 - 3:54pm
Will you PLEASE make some recomendations! You continue to preach to the choir rather than offer real reform suggestions that everyone knows are needed. Come out with it, be honest about it. You know as well as any half educated person that real tort reform must be accomplished, properly manned and funded fraud, waste, and abuse oversight must be established, as well as access for all citizens. If the basic problems are not truly reformed why bother? All this nonsense about dissenters being bad people needs to be further examined by you and the politicians. These are concerned people who are fed up with a congress that is so partisan and unresponsive to true reform that protesting seems to be their only way out.
LAWRENCE DONOHUE MD | 9/18/2009 - 3:35pm
Dear Dr Kiernan
Can you tell me where the evidence is that "All the current proposals cover abortion."?
The 2009 Pulitzer Prise Winner, labels that claim "False"
It would be a shame if you have been mislead into opposing the needed health care for the poor.
Charles Erlinger | 9/18/2009 - 3:28pm
I wouldn't expect a lot of debate among readers of America as to whether health care in the U.S. is a moral as well as civic right, but I would expect more discussion than I have been reading about such questions as whether the current proposals are more about insurance than they are about health care. If health care is a right, then if follows that provision of it must be universal, if that right is to be respected.  But the insurance model that current efforts have assumed to be the correct model for implementation, is entirely inappropriate for the provision of universal health care.  The insurance model depends for its viability, not merely as a commercial and hopefully profitable enterprise, but even as a non-profit enterprise that still depends upon break-even results for survival, upon the application of underwriting selectivity and pricing principles to the results of actuarial science risk analysis.  If the application of these methods is politically constrained, the insurance model only insures non-survivability.  Therefore, the current efforts should be built upon a different model, but who is discussing that?
joseph kiernan | 9/18/2009 - 3:10pm
Leaving the decision about medical care in the hands of the government rather than the individual is the opposite of freedom, and, if anything, runs against catholic teaching.
Asking oneself, or others to help those in need is charitable.  Forcing another person to pay for a third party is not charity
neither the administration nor democratic supporters of the various bills will  sign onto restrictions of abortion coverage.  this is well known; for readers of America (who are very intelligent) to write that the bills will not cover abortion is disingeuous.
the government has a very poor record of running programs, either the recent 'cash for clunkers' or the older social security, or for that matter, medicare-both essentially ponzi schemes.  so it can run health care?
why is anyone trying to change the medical system that 85% of us are happy; why not just help those in need?
yes, as catholics we have an obligation to help those in need; this is not the way to do it!
Joseph p Kiernan, MD
Richard Cross | 9/18/2009 - 3:00pm
I agree with every word in this editorial. 
I'm astonished at Mary Rehbein's comment (#4).  President Obama has gone out of his way to be conciliatory and to obtain a health care bill that reflects a broad consensus.  That that consensus has not emerged is certainly not his fault.  Nor have any accusations of racism on the part of his opponents come from the White House. 
The absence of consensus or any move toward it reflects Republican stonewalling.  Where is their health care reform proposal?  For that matter, where was it when they had control of both the White House and the Congress?
Should the Democrats resort to reconciliation to get a bill through the Senate?  The need is so urgent that I think the answer has to be, if necessary, yes.  Republicans are not in a good position to object to this.  They passed a massive tax cut nearly all of whose benefits went to the very well off and that has resulted in crippling deficits via reconciliation.
I'm sorry if this sounds unduly partisan.  I grew up in a family that had been Republican from the 1860s onward.   Nearly all of us have peeled off in recent decades, including my 92-year-old mother.  What we see now is not our parents' Republican party.  Too bad.  One needs two parties capable of governing.  We don't have that at this point.
joseph kiernan | 9/18/2009 - 2:57pm
All the current proposals cover abortion; so as a Catholic I oppose them.
joseph kiernan, MD
John McShane | 9/18/2009 - 2:51pm
If the Catholic Church is consistent in thought and action, why is it that it doesn't require registered Catholics to mandatorily fund Catholic medical suppliers with its own version of a health tax so that every Catholic can avail themselves of health services?  I'm certain that it would be less expensive that sending money through state and local governments who have a tendency to drain away resources before it reaches the front lines.  So, to maximize the impact of Catholic wealth for the benefit of everyone ... the Bishops should impose a Catholic health tax.  That would be putting faith and theory and philosophy into action.  The governemnt is a lazy way out ... and expensive.  Who every would think of having a government secular breaucrat to manage the Catholic Church?  Turning over the Catholic social commitment to government is essentially doing that.  Its time for Catholic tyhought to focus on Catholic action ... not government mandates pretending to be social justice ... or medical justice ... to implement a grand and unmanageable scheme that the shifting sands of govenment personalities and conflicting agendas dooming success to ultimate failure.
Larry Donohue M.D. | 9/18/2009 - 1:06pm

The importance and the urgency of health care reform is given strength in a Harvard study, Health Insurance and Mortality in U. S. Adults in the American Journal of Public Health Vol 99, No. 12.  Their findings are shocking and embarrassing in this nation of plenty.

Lead researcher, Andrew P. Wilper MD, MPH said, "The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease - but only if patients can get into our offices and afford their medications."

Dr. Steffie Woolhandler, study co-author, professor of medicine at Harvard and a primary care physician in Cambridge, Mass., noted: "Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives."

Dr. David Himmelstein, study co-author said that "The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate - now one dies every 12 minutes."

Former Oregon governor and physician John Kitzhaber M.D. was pretty direct in calling basic health care a right when he said, "Who of us would tell an employed but uninsured fellow citizen that they must… die on the ambulance ramp for lack of insurance coverage.”

Acknowledging that basic health care is a right, then operationalizing and ensuring that right becomes a problem of finance.

We can and must control and eliminate the inefficiencies, waste and fraud that stand in the way of universal health care.

The time to weigh in with your Member of Congress is now. 

Jim McPhillips | 9/18/2009 - 12:53pm
The "other industrialised Nations" you mention resolved their heaalth care problems
by fixing the various "pieces' of health care which were the major obstacles to reform.  Several of our Senators, from both sides of the isle, have suggested
a similar approach here in U.S..  However ,our "My way or the Highway" President
has refused to listen to them.  And now, anyone who criticizes him for his arrogance
in refusing to listen, are accused of racism and,as you say "dithering' over the
Marie Rehbein | 9/18/2009 - 12:33pm
Not only is it unlikely that elective medical procedures such as abortion would ever be covered by a government payer plan, but it is very likely that there will be dramatically fewer abortions if the fear of medical problems and costs associated with pregnancy and children is addressed by providing affordable medical care to everyone.  This is the most effective way to address the high incidence of abortion.
Colin Donovan | 9/18/2009 - 12:33pm
I agree with everything you said. It IS diabolical that the Congress can't write a bill that tells the truth about the goals of health care, rejects every effort to get bi-partisan support and every effort to make clear that abortion and euthanasia will not be covered, that exorbitant lawsuits that drive up the cost of care by forcing doctors to practice it defensively, that outlandish claims regarding the future efficiency of a government-run program bear no relation to the track-record of federal social programs, and that the truly poor and health-care needy are being held hostage to the political ideology of the left, which brooks no opposition in its establishment of a culture of death in America, while spouting pious platitudes about the poor and justice.  Yes, let the partisans in Congress end their childish ways, and give us the bi-partisanship and transparency that was promised, so that a truly workable health care bill that is in keeping with Catholic social and moral teaching, and doesn't bankrupt the country, can be passed.
Deacon Mike Evans | 9/18/2009 - 12:20pm
It would help immensely if our United States Bishop's Conference would endorse without equivocation a strongly worded teaching regarding health care as a basic human right. The church needs to be in a leadership role on this issue. Leave the bickering about choosing funding options to the politicos. This is not the time to fight imaginary battles, look for conspiracy theories, or retreat into the woodwork of separation of church and state. As Catholics and people of faith we have the obligation to assure all our fellow citizens can have access to quality, affordable health care, NOW.
LEONARD VILLA | 9/18/2009 - 12:11pm
Health care itself does not need to be reformed.  We have the best health care in the world.  This is why people flock here for it.  What needs to be reformed is the current system of health insurance.  It's important to define reform.  Given the track-record of socialized medicine in other countries and given the gross waste and mismanagement of medicare by the government, we should be leary of another massive bureaucratic scheme to "reform" health insurance.  We should heed the excellent pastoral teaching of Bishop Sam Aquila of Fargo:
"As a society seeks to bring about any good such as health care, there are many organic and intermediate groups which cooperate together to reach the desired goal. There is a danger in being persuaded to think that the national government is the sole instrument of the common good,” (emphasis added) “Many different communities within society share this responsibility,” Bishop Aquila explained, naming communities such as the state, towns, fraternal organizations, businesses, cooperatives, parishes and the family as contributors to the social fabric. Bishop Aquila invokes a bedrock principle of Catholic social teaching: subsidiarity.  Too many Catholics think social justice, concern for the poor, and the social teachings of the Church equal centralized government or that because a certain piece of legislation is trumpeted as being for the poor and marginalized it will accomplish that result.  There are books already written about how programs like the Great Society actually hurt the poor, families, and the common good without solving the alleged problem.
One alternative solution re needed health insurance reform is to allow people to buy health insurance that go beyond state boundaries thus increasing competition and lowering the cost.

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