The Morality of a Single Payer Health Care System

[vincexjt]

I do not believe single payer is evil. I do have serious reservations about the government being in charge of all health care. Usually monopolies are not as good as competition.
Single payer in a civilized, first world country did not work well for Charlie Gard.

 

[vincexjt]

I do not believe single payer is evil. I do have serious reservations about the government being in charge of all health care. Usually monopolies are not as good as competition.
Single payer in a civilized, first world country did not work well for Charlie Gard.

 

[GEddie]

I do not believe single payer is evil. I do have serious reservations about the government being in charge of all health care. Usually monopolies are not as good as competition.
Single payer in a civilized, first world country did not work well for Charlie Gard.

In all fairness, no system will do well for end-of-the-line needs such as his. In a land without single payer, they would have run up against inability to pay and the result would have been identical.

ICXC NIKA

 

[jeannetherese]

In all fairness, no system will do well for end-of-the-line needs such as his. In a land without single payer, they would have run up against inability to pay and the result would have been identical.

ICXC NIKA

But it seems to me, that the state, through its state run health care system, went to court to force Charlie to die on their schedule.
The parents, were able to raise funding for an alternative treatment and the possibility of extending his life.
The issue of the state intervening to encourage death, and the financial pressures which may drive such interventions (abortion, euthenasia, in utero testing and abortion counseling for potential birth defects) which lead me to question single payer health.
An issue which comes up in private and public health care debate is limited resources vs. demand. How should resources be allocated.
current trends (abortion, euthenasia, some countries extending euthenasia to mentally ill or those are depressed) has me wondering about the way that those who are less likely to generate wealth seem to be more disposable than those able to more fully participate in waged labor markets.
Encouraging the government to consolidate power in this area seems risky to the marginalized (preborn, infirm, elderly).

cnn.com/2017/07/28/health/charlie-gard-death/index.html

 

[Kaninchen]

England has single payer and few were impressed with Charlie Gards situation.

Which had absolutely nothing whatsoever to do with the NHS itself (that’s coming from somebody who thinks that the UK health care system should be organised and financed differently).

I have no opinion whatsoever as to how Americans run your healthcare but having watched you (ie Americans) debate the subject over many years, I do think it would help all sides to stop discussing ‘invented for the purposes of argument’ versions of the systems of other countries.

 

[o_mlly]

Hey, everyone. I have wondered about this for quite some time. What would the Catholic stance be on a single payer healthcare system here in the United States (or anywhere else for that matter)? The Catholic Church is against socialism …

The Church is not against socialism per se. To wit:
Bureaucratic socialism, technocratic capitalism and authoritarian democracy are showing how difficult it is to solve the great human problem of living together in justice and equality. How in fact could they escape the materialism, egoism or constraint which inevitably go with them? This is the source of a protest which is springing up more or less everywhere, as a sign of a deep-seated sickness … (#37)
Octogesima Adveniens A Call to Action Pope Paul VI, 1971
Can it perhaps be said that, after the failure of Communism, capitalism is the victorious social system, and that capitalism should be the goal of the countries now making efforts to rebuild their economy and society? …
The answer is obviously complex. If by “capitalism” is meant an economic system which recognizes the fundamental and positive role of business, the market, private property and the resulting responsibility for the means of production, as well as free human creativity in the economic sector, then the answer is certainly in the affirmative, …
But if by “capitalism” is meant a system in which freedom in the economic sector is not circumscribed within a strong juridical framework which places it at the service of human freedom in its totality and sees it as a particular aspect of that freedom, the core of which is ethical and religious, then the reply is certainly negative. (Official text, #42)
Centesimus Annus The Hundredth Year Pope John Paul II, 1991
Either system, socialism or capitalism, as economic and political constructs can cause injustice.

and a single payer healthcare system would be a form of socialism so would it be an immoral form of health care or would it be something that would be good? Has the USCCB ever spoken on the subject of single payer healthcare systems? Have any Popes (including Pope Francis) ever said anything? Has the Vatican or the Magisterium in general ever said anything on the subject? I would just really like to know whether this is something that is compatible with Catholic teaching because I think it is something I would support if it is compatible with Catholic teaching.

Single-payer as a question of finance does not and should not interest the Church.

However, as a means of allocating scarce resources, a single-payer system does contain moral issues. Health care is a good/service limited in supply in the short-term. The demand for this particular good and service is always greater than its supply. Who gets the heart transplant and who dies? Do you want a bureaucrat to decide? Do you want the size of one’s bank account to decide?

Third party pay schemes (single payer) have never worked well because of human nature. To the user, the good or service appears free and, reasonably, he demands his providers order all that is available. The providers (sellers) realize the user does not care what the real costs are since he’s not paying and raise prices to an indifferent user. The result, inflated prices for all users and inefficiently allocated scarce resources.

Someone or something must act as gatekeeper. Is “someone” (bureaucrat) preferable to “something” (bank account)?

 

[GEddie]

But it seems to me, that the state, through its state run health care system, went to court to force Charlie to die on their schedule.
The parents, were able to raise funding for an alternative treatment and the possibility of extending his life.
The issue of the state intervening to encourage death, and the financial pressures which may drive such interventions (abortion, euthenasia, in utero testing and abortion counseling for potential birth defects) which lead me to question single payer health.
An issue which comes up in private and public health care debate is limited resources vs. demand. How should resources be allocated.
current trends (abortion, euthenasia, some countries extending euthenasia to mentally ill or those are depressed) has me wondering about the way that those who are less likely to generate wealth seem to be more disposable than those able to more fully participate in waged labor markets.
Encouraging the government to consolidate power in this area seems risky to the marginalized (preborn, infirm, elderly).

cnn.com/2017/07/28/health/charlie-gard-death/index.html

They were able to raise funds because their trials with the nationalized system made world news.

Babies die every day, often more evitably than in this one instance, but without making world news, and there is no indignation.

ICXC NIKA

 

[jeannetherese]

That is true, GEddie,
What especially stood out to me was the way the state intervened to force the baby to remain in hospital against the wishes of the parents. Baby Charlie would die, either way.
However, his mom and dad effectively had their parental rights taken away over a disagreement over proffered access to treatment, as the state exerted authority.

The possibility of not being allowed to leave the hospital, once admitted should, I would think, be of concern to many. How much authority should the state have in deciding our time or place of death?

 

[GEddie]

That is true, GEddie,
What especially stood out to me was the way the state intervened to force the baby to remain in hospital against the wishes of the parents. Baby Charlie would die, either way.
However, his mom and dad effectively had their parental rights taken away over a disagreement over proffered access to treatment, as the state exerted authority.

The possibility of not being allowed to leave the hospital, once admitted should, I would think, be of concern to many. How much authority should the state have in deciding our time or place of death?

Good point and to my mind, that should be the only issue. Not that the system was nationalized, nor that it saw fit to let a terminal illness run its course, but that it took control of someone it already saw fit to let die. What misapplication of the laws allowed that? Can it be corrected, before this happens to someone else?

ICXC NIKA

 

[Kaninchen]

That is true, GEddie,
What especially stood out to me was the way the state intervened to force the baby to remain in hospital against the wishes of the parents.

The ‘state’ did nothing of the sort.

 

[Viki63]

But every human body is certain to fail catastrophically and expensively.

ICXC NIKA

Not necessarily. If we don’t insist on state of the art tech to keep us alive no matter what, once our bodies are clearly wearing out, the end of life could be much simpler.

And [rant] if we ate healthfully instead of artificial junk, and fasted occasionally as we are designed to do, we would live much longer and would need fewer nursing homes and extended stays in hospitals. [/rant off].
Of course this doesn’t apply to everyone as many people do have unavoidable illnesses and accidents, but you can’t ignore your health your whole life and then expect medical miracles at enormous cost to rescue you.

.

 

[rossum]

That is true, GEddie,
What especially stood out to me was the way the state intervened to force the baby to remain in hospital against the wishes of the parents.

Not the state, the doctors in the hospital. Whatever the overall health system, there will still be doctors and hospitals. Sometimes the wishes of the parents conflict with the wishes of the doctors. If they cannot resolve things between themselves, then the courts may be brought in as a last resort.

The Charlie Gard case is not relevant to the type of health care system. I am sure that there are sometimes similar cases in the US, which does not have a single payer system.

rossum

 

[Theo520]

The UK NHS is the largest employer in all of Europe.
In fact, they are the 5th largest employer in the whole world, with 1.7m employees.

When people talk about single payer, I notice they don’t realize it means making everyone in healthcare a Govt employee.

 

[mikekle]

The UK NHS is the largest employer in all of Europe.
In fact, they are the 5th largest employer in the whole world, with 1.7m employees.

When people talk about single payer, I notice they don’t realize it means making everyone in healthcare a Govt employee.

The insurance companies would never let that happen, it would destroy their entire industry overnight.

 

[Kaninchen]

I wonder what the equivalent figures for the healthcare sector are in the United States?

 

[Brendan]

My biggest problem is that, they are, by definition, governmental, and thus do very little to enact heath care as a right.

I do a lot of mission work in Tanzania. I have been to villages where the only health care option is the footlocker of first aid supplies that the priest keeps in his hut. The government does not have enough money to provide health care. In areas where the average family income each year is $600 USD, raising taxes isn’t going to gain much at all.

Health care, being a human right, and thus not dependent on nationality or location, cannot, therefore be dependent on a government. British NHS, Canadian OHIP or even ObamaCare offered nothing to the young girl I helped treat that required stitches (we used superglue). Or the post-partum mother with an infection ( Fr used his limited stock of antibiotics)

An organization like the Church is the only real option. Something that transcends borders with a real and honest love for humanity.

 

[Rau]

…But every human body is certain to fail catastrophically and expensively.

So the only way to make money insuring the human body is to exclude almost everybody. The system comes out of the box broken…

No, that’s not right. Not broken, simply burdened with a minimum built in cost that each insured person must pay the cost of -viz. the average cost of end of life care. The actual costs of end of life care for an individual is highly variable (hence insurable) and the rest of lifetime health care is highly variable and hence insurable.

 

[Rau]

That is true, GEddie,
What especially stood out to me was the way the state intervened to force the baby to remain in hospital against the wishes of the parents. Baby Charlie would die, either way.
However, his mom and dad effectively had their parental rights taken away over a disagreement over proffered access to treatment, as the state exerted authority.

The possibility of not being allowed to leave the hospital, once admitted should, I would think, be of concern to many. How much authority should the state have in deciding our time or place of death?

Parental rights are not absolute. A court order, or the actions of those who brought a court action, cannot be criticized merely on the grounds they sought to cause or prevent the exercise of an action claimed to be a “parental right”.

 

[Vonsalza]

I do a lot of mission work in Tanzania…

…British NHS, Canadian OHIP or even ObamaCare offered nothing to the young girl I helped treat that required stitches (we used superglue). Or the post-partum mother with an infection ( Fr used his limited stock of antibiotics)

As you weren’t in Britain, Canada or the US, I wouldn’t imagine that they would have been available for assistance.

If something is a “right”, verily it falls upon the government to enforce that.

An organization like the Church is the only real option. Something that transcends borders with a real and honest love for humanity.

As it was in Europe in centuries past! That is probably the most fundamental reason “Healthcare for Profit” was never really the default model in the “Old World”. Tribal shamans passed the torch to the Roman State which passed the torch to the Catholic Church - all largely not-for-profit models.

But with the modern separation of Church and State, the Church can no longer compel you to tithe in the same way the state compels you to pay your taxes. As such, the Church doesn’t have the money for it.

Governments do.

 

[Rau]

…Later still, Medicare was approved, and I had a hard time believing that the government would pay for all my Dad’s health care. Now, health insurance is the standard, but it wasn’t always so. Once, when I was between jobs, my wife was struck with a very serious illness. She was in the hospital for 30 days. We had no insurance. After I was again employed a few weeks later, we paid off both the hospital and the doctor out of pocket by making monthly payments over the course of two years.)

I find nothing wrong in a collective commitment to care for (pay for the medical care of) each other in society. In fact, if freely accepted, it would seem to be a charitable act. Of course, economic efficiency needs to be managed in bureaucracies.

No doubt you are grateful that you had the skills to be employed in an adequately paying job, such jobs were available and that your wife’s medical care was not of a kind costing 10 times as much!