The effective conversion of the Democratic Party to the belief that opposition to the sexual revolution is immoral and that this should be reflected in law, along with the addition of transgenderism to the homosexual agenda, including the most radical demands for the abolition of private spaces for the sexes and late-term abortion, has caused a grave situation for religious freedom. The current highest priority is the passage of the Equality Act, which specifically denies religious freedom protection against the LGBT agenda, and the Do No Harm Act, which denies conscience protection against abortion, as well as shaming the pro-life conscience by accusing it of causing “harm.” But another vehicle for enacting the LBGT and pro-abortion agendas, which was quite effective in the Obama Administration, was administrative action, and particularly action based on collectivized health care. It serves as a basis for the government making medical decisions, and more generally, for defining what “health” and even the good life is.
The crisis creates a grave (indeed a mortal) threat to Catholic health care. The values the American left is attempting to enact into law and policy are directly contrary, in fact in considerable measure are aimed at repeal, of Catholic and traditional Christian morality. The very attempt by the state to define morality is contrary to Christian faith, nor can any Christian practice such a morality without sinning. But in the wider world, it is important for people to know the benefits of the faithful practice of medicine by individuals and Christian institutions as opposed to health care provided by the state.
The Catholic Information Center assembled a panel to discuss the problem on September 11. Grace-Marie Turner, President of the Galen Institute, a public policy institute which promotes free market ideas for health care reform, reviewed the basics of why private enterprise is better than socialism in medicine. She began by observing that “health care should be affordable.” She believes that medical decisions should be made by doctors and patients (and thus not bureaucracy). Currently, the bureaucracy regulating medical practice does result in excessive medical expense, and thus there are demands for a single payer system, now proposed with Medicare and Medicaid rates. Private rural hospitals would go out of business with such a system, she said. With greater government control of health care, private decisions both on the part of providers and patients is diminished; instead the government makes decisions. In one extremity, of which there is more than one example, an infant with questionable survival prospects may be denied treatment, with parents or loved ones denied the right to obtain private care at their own expense, as recently happened in Great Britain. Similarly, a case in France earlier this summer involved a disabled man with a seeming will to live put to death by denial of food and water, despite the objection of his father, mother, and siblings.
She observed that few conscience claims were made by health care providers during the Obama Administration, as that administration was not supportive of religious freedom and liberty of conscience. But the Trump Administration’s Health and Human Services Department has received many complaints from health care providers concerning conscience violations. The Trump Administration is making changes to what existed during the Obama years “through its regulatory authority,” and in spite of Congress’ failure to “repeal and replace” Obamacare. She said that while Obamacare and most “socialized medicine” regimes spread health care thin, health care should aim to attend especially with the “most vulnerable at the beginning and end of life,” and there should be a “preferential option for the poor.”
It might be added to this that the contemporary shift from focusing on curing sickness to maintaining health is not conducive to attending to the most medically vulnerable persons. It is conducive to keeping the healthy strong, and the government addressing the whole life of the person, both mind and body. A state run or heavily regulated system will tend to see this in terms of values in life it wants to support. In our day, secularists who have an outsized influence on Democratic administrations will see Christian values, especially as related to traditional family and church authority, and sexual morality, as “harmful.” It is not that doctors should fail to consider the whole life of their patients. But Turner said that medical providers should provide services “consistent with their conscience and moral and religious beliefs.” Catholic medical services must be provided consistent with this, as they have been made “throughout history.” They cannot serve in a system which “is contrary to God’s creation of man and woman.”
Louis Brown, Executive Director of the Christ Medicus Foundation, which endeavors to support and defend the distinctively Catholic practice of health care, discussed further the values involved in it. His organization focuses on “sharing the love of God in health care.” It hopes to contribute to “building a new Christ-centered economy,” and also is concerned with “building the movement to defend religious freedom.” He said that all the freedoms we enjoy in America come through “the right to life and the right to religious freedom.” If these rights are not preserved, as they will not be in the collectivist versions of health care now being advanced, “the chronically ill, the handicapped, and the elderly” will be at especial risk if these rights are lost. In this regard, both pro-life positions and freedom in medical care “have to be thought of together.” The first stands or falls with the second.
Additionally, collectivizing medical care would amount to “a socialist takeover of nearly one eighth of the U.S. economy.” Government, not doctors and patients, will then make medical decisions. Because abortion would surely be mandated throughout the collectivized system, pro-life ob-gyn practices “would not survive,” nor would Catholic medical care survive collectivization. This is not something that will develop with time, Brown said, but the immediate prospect that the nation as a whole is faced with right now. He said that Christ Medicus Foundation is working with Catholic medical facilities to further develop a Christ-centered medical system, along with its medical cost sharing plan, and helping to educate the Catholic and general publics on the medical issues facing the nation.
Marguerite Duane, a primary care physician, is Adjunct Professor at Georgetown University, where she provides instruction concerning natural family planning. She discussed why a private medical system is far preferable from the viewpoint of Christian doctors. She observed that contemporary changes in the philosophy of medical practice are threatening the Hippocratic ethics to which the profession has historically been bound. The latter prohibits medical professionals from harming the patient, while as noted above, “harm” will now be defined by the state. In particular, it prohibits euthanasia and abortion. Medicine is “the most intimate and personal” of professional relationships, she claimed, in which the doctor is trusted with his patients’ lives. Under collectivized care, however, the physicians’ decisions are substantially determined by the government. Time with patients would also be rationed. She favors instead “direct primary care,” which involves a physician visiting homes.
As an example, Turner pointed to a recent case in Vermont in which a nurse was required to participate in an abortion against her conscience. HHS has issued a notice of violation to the University of Vermont Medical Center, and the case is illustrative of “where we are likely to be going” in medical care, with the Trump Administration’s HHS receiving 1,300 conscience complaints from health care providers so far. In the specific case Turner referred to, after having made it clear that she would not participate in abortions, the nurse was told she would be caring for a miscarriage, which turned out to be an elective abortion. HHS indicated in accepting the case that freedom of religion and conscience is the first civil right guaranteed in the Constitution.
In response to a question, Brown agreed with recent Democratic Presidential contenders that “health care is a human right.” But he believes that it involves the defense of life at all stages. He also believes that rather than the government guaranteeing medical care, it can “be secured through the social safety net” but also through family and the church. But Turner said that government should not guarantee the right to a doctor or medical facility’s resources; people in need of care are in fact served even if they cannot pay. Duane added that the bureaucracy involved in even existing government regulation of medical care may increase the cost of a service many times over.
In response to another question regarding medical alternatives for affordable care, Brown said that socialism has pernicious effects because “it removes God out of the equation and replaces him with the state.” In particular, it replaces the love involved in voluntary and individual treatment with the power of the state, or more succinctly, it converts love into power. Voluntary action also has the advantage of providing service closer to the patient and with personal knowledge of the patient. Solidarity (concern for the well-being of all, especially the weak) and subsidiarity (service by private parties rather than a central government) both contribute to service closer to the patient. Turner added that “government and politicians are enormously threatened by that.” She said that “the next election is going to be pivotal” in determining whether health care is returned to doctors and families or taken over by the government. The latter possibility will end religious and conscience freedoms. Duane added that the private provision of medical care threatens government control of health care, and thus, it might be added, government’s ability to establish what a good and healthy life is. She also said that the direct primary care that she practices, in contrast to concierge care, is affordable, and can be structured to include an additional payment to support the same care for low income persons. This restores beneficence (focus on individual physician judgment to cure illness) to medicine, and “takes the government out of the equation.”
Finally, the panel was asked what an abortion mandate, with no conscience protections, would mean. The response was that it would first mean going to court. Brown observed that if litigation was unsuccessful, Catholic (and other pro-life) ob-gyn practices would have to be shut down, as would Catholic hospitals. He said that people need to be clear about the threat, because Catholic health care is “not only consistent with the Catholic faith, but also the best health care.” And so, Turner responded, “it really matters who’s in control of the government.” Duane added that this is a very personal issue, because with state run health care, decisions about what to do with a “poor pre-natal diagnosis … a child with a serious illness or injury,” or a debilitating illness, will rest with the state, not the doctors or patient. Turner said that “the information age enables so many solutions to people’s healthcare problems.” Among these solutions, health care “can be so much more affordable.” Additionally, Duane said that “doctors are tired of being told what to do,” leading to burnout. This, she hopes, will lead to other alternatives than a collectivized medical system. In light of the grave threats to Christian and pro-life medical care, Brown urged that the concerned public needs to stay engaged in the conflict, since important national decisions about whether to collectivize medical care will soon be made.