The public discussion in the United States about health care is carried out on the level of dialectical opposites and there is confusion about elementary terms. This article is a brief attempt to clarify what is truly at stake in the current health care discussion and discuss real issues, not political talking points. The dialectical opposition is between the alleged “right to health care,” which is, in fact, an entitlement to health care, and the freedom of patients to choose and pay for health care. So universal access to health care means less choice, and less choice means fewer will be covered. But if we truly understand the right to health care as the Catholic Church understands it, it can be easily shown that we can have both access and choice, both health care and freedom to choose. The key is this: the freedom to choose can be enshrined in the law, but the actual delivery of health care services must center on the patient-physician relationship and involve far more than the state controlling and managing the health care system.
Right vs. Entitlement
One side claims that all have a right to health care. Certainly, in Catholic social teaching, health care along with education, clean water, food, and a multitude of other things are “rights,” that is, such things are owed to the human person by virtue of their very existence. Such rights, as the founders of our beloved country recognized, come from God alone and cannot be violated by government (1). Specifically, the right to health care is implied in the protection of life itself, also of liberty and property, because without health there cannot be life or liberty or property. But while both agreeing that health care is a right and a gift from God to individual human persons, neither the Catholic Church nor the Founders of the United States ever suggested or believed that there is a right to health care vis-à-vis the government. On this point, Catholic social teaching and the founding principles of the United States are in complete agreement. It must be understood that the right to health care does not mean and cannot possibly mean that the government has an affirmative obligation to pay for everyone’s health care, which would transform the right to health care into an entitlement to health care. The U.S. Constitution does not give the federal government control over health care, rather, the control remains with the people (2). Likewise, the Catholic principle of subsidiarity prohibits the assumption by the state of powers that can be exercised at a lower level and involve the cooperation of local communities.
This transformation of health care into an entitlement as is the case in most of Europe, is not without consequences for religious freedom. With money and the responsibility to pay for anything comes power; surely there are few truths better witnessed in the history of humanity than that money and power are inseparably connected. So the responsibility of government to pay for health care necessarily accompanies the power of government to decide what health care to pay for, and for whom. This is why Charlie Gard recently died in a UK Hospital, because the entitlement to health care in the UK gives the UK Government power to decide what is in the best interests of Charlie Gard (3). Here, the state and not the parents determine what is in the best interests of a child. The foundational principle of Catholic social teaching that the family and its rights are to be respected by the state falls by the wayside. The family as the “sanctuary of life,” (4) the place where life is welcomed and protected, becomes helpless against the state who usurps parental and family rights in the name of the “best interests of the child.” Let us be clear: there is no way to wholesale delegate health care to the government and protect religious freedom.