Mirror of Justice

A blog dedicated to the development of Catholic legal theory.
Affiliated with the Program on Church, State & Society at Notre Dame Law School.

Wednesday, September 9, 2009

More on our disappointing health-care "debate"

Like Susan (though perhaps for some different reasons), I am "depressed about the prospects of passing meaningful health care reform."  This depression was greatly enhanced (exacerbated?) by reading the cover story in the September issue of The Atlantic.  (If I remember correctly, another MOJ-er called our attention to this piece earlier.)  It strikes me that (almost) the entire "debate" is taking place in an arena confined by mistaken premises and is, therefore, overlooking (almost) entirely a number of pressing -- indeed, crucial -- challenges.  A taste:

I’m a Democrat, and have long been concerned about America’s lack of a health safety net. But based on my own work experience, I also believe that unless we fix the problems at the foundation of our health system—largely problems of incentives—our reforms won’t do much good, and may do harm. To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government’s role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy.

These ideas stand well outside the emerging political consensus about reform. So before exploring alternative policies, let’s reexamine our basic assumptions about health care—what it actually is, how it’s financed, its accountability to patients, and finally its relationship to the eternal laws of supply and demand.

But, read the piece for yourself.  I came away, again, depressed.  The problem is huge and -- whether or not President Obama's, or Rep. Pelosi's, or someone else's "reform" bill passes -- it appears almost certain that we are going to continue spending a lot more than we should to get less than we should.

One thing that seems clear (to me) after reading the piece is that it is a mistake to think or contend that the Church's recognition that "health" is a basic human good and that political communities have an obligation to help secure this good translates neatly into a "Catholic" mandate for this or that health-insurance proposal.  Sure, we can find clear support for general principles -- we can say, for example, that the "keep all government out of health care" claim is silly -- and for a few clear markers -- for example, that the political community should not fund the provision of elective abortions.  But what, it seems to me, we cannot say is that the Church's teaching requires this or that tweaking of our (if the article is correct) deeply misguided insurance-based system. 

Sigh.

https://mirrorofjustice.blogs.com/mirrorofjustice/2009/09/more-on-our-disappointing-healthcare-debate.html

Garnett, Rick | Permalink

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