What is the Catholic view of governent-paid health insurance?

[Pieman333272]

What is the Church’s teachings regarding things like Medicare?

 

[SonCatcher]

The general teaching is that we have responsibility to care for the needs of those less fortunate. Medicare provides medical insurance to the elderly and is the de-facto source of medical coverage for all non-wealthy retirees (its sibling, Medicaid, provides medical insurance for the destitute). Effectively, Medicare is the only medical coverage available to this group since most insurance companies have no affordable option for them.

Even the healthcare reform law is 95%+ okay per Catholic standards. The main issues with that concern birth control and abortion coverage. Although, I’m not sure whether the personal mandate has been examined by canon lawyers. It may be considered improper to force the purchase of insurance or it may be merely interpreted as a tax (the theological issues are different from the secular ones).

 

[Tarpeian_Rock]

What is the Church’s teachings regarding things like Medicare?

Do you think there is a possible moral issue with a government program like this? Also, whatever else Medicare may be, it sure isn’t “government-paid.” I just enrolled, and it’s costing me several hundred dollars per month.

 

[Bohm_Bawerk]

The Church does not hold a specific view of policies like Medicare. The Church doesn’t exist to spoonfeed countries or individuals on how to run a country. At most, the Church merely advises that entities should follow the principle of subsidiarity and that actions should be directed towards the common good. Which policies adhere to these principles is a matter of debate for Catholic thinkers. Anyone who endorses or criticizes a policy(ies) is in almost all cases doing so on their own, and not by the backing of the Church.

 

[Myqyl]

Here’s Scripture’s teaching on Medicare :

[BIBLEDRB]Matthew 25:35-36[/BIBLEDRB]

God bless

 

[Pieman333272]

The general teaching is that we have responsibility to care for the needs of those less fortunate. Medicare provides medical insurance to the elderly and is the de-facto source of medical coverage for all non-wealthy retirees (its sibling, Medicaid, provides medical insurance for the destitute). Effectively, Medicare is the only medical coverage available to this group since most insurance companies have no affordable option for them.

So Catholics are encouraged to support ideas like medicare/aid, so long as they don’t give coverage for unethical practices?

 

[SwissGuard25]

Eh ain’t nothing wrong with supporting those who can’t pay for medicare. I know my I wouldn’t mind paying a little bit more on taxes to help others.

 

[Trigger06]

I’d rather keep the money I’ve EARNED. Then I can give to any charity I wish in order to help those less fortunate. Enforced charity is NOT charity.

 

[Bohm_Bawerk]

I’d rather keep the money I’ve EARNED. Then I can give to any charity I wish in order to help those less fortunate. Enforced charity is NOT charity.

The simple fact remains that if the government left you to your own devices, you would not give as much to charity as you do in taxation. As Clement Attlee, judged to be UK’s greatest Prime Minister, remarked, “Charity is a cold grey loveless thing. If a rich man wants to help the poor, he should pay his taxes gladly, not dole out money at a whim”.

One reason why I like several aspects of Church social teaching is that it isn’t as naive as to suggest that people would give to charity if all the government did was tax their income at virtually 0%. This is a myth unfortunately purported by some hardcore Republicans. It is an economic fact (homo economicus) that human beings are generally self-interested and ignore the wider implications of their decisions. It is therefore up to a government to ensure that the social implications of private decisions are taken into consideration. Taxation is useful in increasing social mobility, providing for common defence, ensuring that the poor are fed and the elderly are catered for, among many other things.

 

[markomalley]

What is the Church’s teachings regarding things like Medicare?

The “Catholic” view on it is dependent upon who you ask…in regards to their interpretation of Catholic Social Doctrine.

There are a lot here who would absolutely say that it is the responsibility of the government to provide health care.

There are those who would say that it is the responsibility of society, without regard to government, to provide for those who are in need.

Somebody already quoted Matthew 25, so I won’t. The one thing that I would point out is Matthew 25:32 (which was not cited above):
[BIBLEDRB]Matt 25:32[/BIBLEDRB]
The word “nations” comes from the Greek word ἔθνος (ethnos), from where we get the word “ethnic”. If you prefer Jerome’s Latin to the Greek, it comes from the word, gentes, meaning “race”

There is a separate word, βασιλεία (basileia) used in the NT for “kingdoms” (in other words, the State). (Or “regnum” in Latin: “the rule of a king”, i.e., the territory under the control of a king)

In other words, he is gathering together all peoples, all societies, and separating them. Distinguishing between the use of the word “nation” / “society” versus the word “State” is very important…because not making that kind of distinction can lead one down the wrong path.

The implication from this is how a “people” treat their poor, etc.

That is the imperative from the Word of God. HOW that happens is not so explicitly mandated. There are allusions in both the OT and NT…(OT: not stripping fields bare, so that the poor could glean; NT: selling off excess and giving the proceeds to the apostles for distribution)…but I don’t interpret either as being mandates on the only way that things could be done.

There are principles from Catholic Social Doctrine as taught since the beginning of the Industrial Age that are useful in discerning the how…but, even then, they don’t mandate specific technical responses.

Those principles are summarized in the Compendium of the Social Doctrine of the Catholic Church (available online here). If you really want to develop the knowledge of how to discern issues like Medicare (or welfare), I would suggest that you study both that document and the documents that are cited in the Compendium’s footnotes.

I will, however, cite one example:

In recent years the range of such intervention has vastly expanded, to the point of creating a new type of State, the so-called “Welfare State”. This has happened in some countries in order to respond better to many needs and demands, by remedying forms of poverty and deprivation unworthy of the human person. However, excesses and abuses, especially in recent years, have provoked very harsh criticisms of the Welfare State, dubbed the “Social Assistance State”. Malfunctions and defects in the Social Assistance State are the result of an inadequate understanding of the tasks proper to the State. Here again the principle of subsidiarity must be respected: a community of a higher order should not interfere in the internal life of a community of a lower order, depriving the latter of its functions, but rather should support it in case of need and help to coordinate its activity with the activities of the rest of society, always with a view to the common good.100

By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending. In fact, it would appear that needs are best understood and satisfied by people who are closest to them and who act as neighbours to those in need. It should be added that certain kinds of demands often call for a response which is not simply material but which is capable of perceiving the deeper human need. One thinks of the condition of refugees, immigrants, the elderly, the sick, and all those in circumstances which call for assistance, such as drug abusers: all these people can be helped effectively only by those who offer them genuine fraternal support, in addition to the necessary care.

John Paul II, Centesimus Annus, 48.2-48.3​

 

[goldangel]

The John Paul II quote was interesting and I’m going to quote only part of it, from the prior post:

It should be added that certain kinds of demands often call for a response which is not simply material but which is capable of perceiving the deeper human need. One thinks of the condition of refugees, immigrants, the elderly, the sick, and all those in circumstances which call for assistance, such as drug abusers: all these people can be helped effectively only by those who offer them genuine fraternal support, in addition to the necessary care.

In reality, in many cases this support costs money. There is some benefit from using free peer support for people with drug addictions, mental illness, etc. but people often need professional help. Laypeople just don’t have the training to effectively address issues like mental illness and drug addiction, so psychotherapy is often required, in addition to medication.

Many refugees come here with severe trauma histories due to past war or persecution or poverty and they require psychological help in addition to practical help. This is according to a relative of my husband’s who works as a welfare case worker in New York state.

On the other hand, there is a strong trend in American society to stop listening to people and reduce them to ideas about brain chemistry or whatever. For that reason, I agree with John Paul II’s attitude. However he is essentially talking about the power of community support. Community support for the mentally ill has gone down drastically in the last 30 years as the psychiatric hospitals were closed, length of stay shortened to about 5 days on average, and people dumped on the street. The promised community support did not materialize.

I think anyone who really thinks private charity can take the role of government support needs to look at what has happened to the mentally ill in America. In DC they have been dumped on the streets since the 1980s. When the hospitals closed there were many promises that support at the state and local level would fill the gap and for the most part that did not happen. There are more programs available now as doctors are filling the gap but it’s a lot of hard work.

reference: Crazy by Pete Earley, Washington Post journalist and father of mentally ill son. from amazon:

Former Washington Post reporter Pete Earley had written extensively about the criminal justice system. But it was only when his own son- in the throes of a manic episode-broke into a neighbor’s house that he learned what happens to mentally ill people who break a law.

This is the Earley family’s compelling story, a troubling look at bureaucratic apathy and the countless thousands who suffer confinement instead of care, brutal conditions instead of treatment, in the “revolving doors” between hospital and jail. With mass deinstitutionalization, large numbers of state mental patients are homeless or in jail-an experience little better than the horrors of a century ago. Earley takes us directly into that experience-and into that of a father and award-winning journalist trying to fight for a better way.

amazon.com/Crazy-Fathers-Through-Americas-Madness/dp/0425213897/ref=sr_1_1?s=books&ie=UTF8&qid=1321823838&sr=1-1

 

[goldangel]

double post -

community support can help significantly. the thing is, the lesson I take from the mental health disaster is that it needs to be in place before federal support is lowered/withdrawn, and the money and other resources need to be committed. from another article:

jhsph.edu/publichealthnews/press_releases/PR_1999/community_care.html

Community care programs that offer severe mentally ill patients a full range of services around the clock, seven days a week, may be able to reduce the odds of those patients having to be hospitalized by as much as forty percent. In a study of the Program for Assertive Community Treatment (PACT) model of treating non-emergency psychiatric patients worked, researchers at the Johns Hopkins School of Public Health, the Medical University of South Carolina, and Duke University found that patients enrolled in a PACT were admitted to the hospital less often. Their decreased use of costly (name removed by moderator)atient services resulted in significant savings.

The PACT model provides a full range of medical, psychosocial, and rehabilitative services seven days a week, 24-hours a day. It can be a viable alternative to hospital treatment, particularly for patients with severe and persistent mental illnesses, such as schizophrenia or bipolar disorders. For those patients, a PACT can keep them from “recycling” in and out of in-patient mental institutions. PACT programs were designed to keep patients in the community and reduce their number of hospital stays.

For the mentally ill, in my opinion a stable source of funding needs to be in place, as well as the resources. This costs money whether at the state and local or Federal level. I’m in support of what works, what respects the human dignity of people, and if local support comes along with more personal care, that’s great, but the money has to be there.

 

[markomalley]

On the other hand, there is a strong trend in American society to stop listening to people and reduce them to ideas about brain chemistry or whatever.

True. You are correct that the tendency is to reduce problems down to a set of mathematical variables. That tends to dehumanize the person.

For that reason, I agree with John Paul II’s attitude. However he is essentially talking about the power of community support.

Actually, he’s talking about the power of treating individuals with the dignity that is inherent with their status as human beings.

Community support for the mentally ill has gone down drastically in the last 30 years as the psychiatric hospitals were closed, length of stay shortened to about 5 days on average, and people dumped on the street. The promised community support did not materialize.

Actually, that is a rather distorted statement on the treatment of the mentally ill.

There are actually three issues here that should not be confused one with another.

Mental asylums (that essentially warehoused the mentally ill) were actually closed back in the early 60s (or shall we say drastically scaled back during that time) as being offensive to human dignity. The idea was, back then, to attempt to reintegrate people into the community through “Community Mental Health Centers” – the problem is that nobody would fund it. The states would not pick up the tab and the federal government had other things to spend their money on…like Vietnam. The question here comes to one of the source of funding: the federal government or the state governments.

Secondly, there was a shift in attitude about who could be involuntarily committed to a mental institution. Again, we have an issue of human dignity involved. Does the State have the right to **force **medical treatment on an individual who does not wish to receive that treatment? The standard evolved from being able to involuntarily commit one who is severely mentally ill to the “threat to self or others” standard. And that had to be proven in court.

Third, we have the issue of voluntary hospitalizations. This is a decision from the medical actuarial community. This is the community that statistically determines the amount that the insurance companies (including governmental provided insurance like Medicare and Medicaid) will reimburse providers for certain procedures (as examples, knee replacement= 3 nights, heart transplant = 7 nights, psychotic episode = 5 nights, etc.). This has, over time, become increasingly draconian for all (name removed by moderator)atient situations, not just mental health. This is a product of what John Paul II was talking about in paragraph 48.3 – we reduce things down to statistics and the human factor is removed. That is the problem with any huge institutional solution: be it private or government. In order to manage it, tools such as operating procedures and metrics must be used, rather than looking at human beings. You should look up the history of DRGs to see the epitome of this trend (particularly appropriate considering the topic of this thread). You might find this paper interesting in that regard.

This is the problem. Governments tend to be able to acquire (through taxation) the resources needed to deal with the large social problems. They, in theory, tend to be able to gather those resources over a wide population rather than develop dependence on a small population of benefactors (as is the case with private charities).

On a practical basis, though, the solutions imposed by governments tend to dehumanize both the large-population benefactors and the large-population recipients. Hopefully it is fairly obvious how both are impacted, so I won’t waste bandwidth in this post on that.

But consider this: the specific social principles of “participation” and “solidarity” need to be considered, not just on a national basis but on an individual basis. The antitype of participation was Cain’s response to God after he slew Abel: “Am I my brother’s keeper?” We should regard the Matthew 25 extract as a personal responsibility.

I will agree, in general, with your statement from your second post, community support can help significantly. the thing is, the lesson I take from the mental health disaster is that it needs to be in place before federal support is lowered/withdrawn

Indeed, the problem is a cultural one. The question comes down to “how do we put the genie back in the bottle?” This is a teaching issue: how to get people to recognize that it is their responsibility to care for the least of them and not a responsibility that can be shoved off to others so that they can keep their hands clean.

As long as we have people who claim to speak authoritatively on the issues of faith and morals teaching that the moral obligation is resolved by arms-length solutions, the problem will never be solved. Perhaps that’s why we were warned of this by Pius XI way back in 1931:

Just as it is gravely wrong to take from individuals what they can accomplish by their own initiative and industry and give it to the community, so also it is an injustice and at the same time a grave evil and disturbance of right order to assign to a greater and higher association what lesser and subordinate organizations can do. For every social activity ought of its very nature to furnish help to the members of the body social, and never destroy and absorb them.

Quadragesimo Anno, 79​

 

[davidmlamb]

The simple fact remains that if the government left you to your own devices, you would not give as much to charity as you do in taxation. As Clement Attlee, judged to be UK’s greatest Prime Minister, remarked, “Charity is a cold grey loveless thing. If a rich man wants to help the poor, he should pay his taxes gladly, not dole out money at a whim”.

One reason why I like several aspects of Church social teaching is that it isn’t as naive as to suggest that people would give to charity if all the government did was tax their income at virtually 0%. This is a myth unfortunately purported by some hardcore Republicans. It is an economic fact (homo economicus) that human beings are generally self-interested and ignore the wider implications of their decisions. It is therefore up to a government to ensure that the social implications of private decisions are taken into consideration. Taxation is useful in increasing social mobility, providing for common defence, ensuring that the poor are fed and the elderly are catered for, among many other things.

OUTSTANDING POST! If private charity alone was enough to take care of the poor working class then there would not be 50 million Americans without health care, and millions more filling bankruptsy because they have medical bills larger then their mortgages. This being the case how horrible would things be for the elderly if Medicare did not pass in 1964 and the elderly had to rely on private donations to take care of them? The implication from scripture is that we are to support a civic society that supports the common good and charity is to be administered both public and privately.

Peace Be With You,

David

 

[markomalley]

OUTSTANDING POST! If private charity alone was enough to take care of the poor working class then there would not be 50 million Americans without health care, and millions more filling bankruptsy because they have medical bills larger then their mortgages. This being the case how horrible would things be for the elderly if Medicare did not pass in 1964 and the elderly had to rely on private donations to take care of them? The implication from scripture is that we are to support a civic society that supports the common good and charity is to be administered both public and privately.

Peace Be With You,

David

First, there are not 50 million Americans without health care. There were 46 million people in the country without health insurance in 2009. Out of those 46 million, 14,8 percent were under 18. 1.3 percent were over 65. All children under 18 are eligible to be covered by SCHIP. Seniors over 65 are eligible to be covered by Medicare. Regardless of your opinion of the program, I ask why are these people not enrolled in the programs they are eligible for. 31% are below the poverty line. Why do they not enroll in Medicaid?

According to the St Petersburg TImes, The Census Bureau breaks out that information and reports that 9.7 million of the uninsured are noncitizens. Are we obliged to provide health insurance for non-citizens now? (Try that in a country with socialized medicine…if you aren’t a citizen, you pay cash)

Well, there are those millions and millions with pre-existing conditions who can’t get coverage? According to the Huffington Post, only 19 thousand have signed up for the vaunted Pre Existing Condition Plan that was part of Obamacare (as of last May…when the program had been in place for a full year). You’d think there’d be tens of millions who would rush toward that plan once it was in place. But no.

Seems like the government-sponsored plans that are in place aren’t doing what they are supposed to be doing, either.

Do you know that a doctor cannot deduct his costs of charitable care from his income taxes? He still has to pay his employees for their time dealing with the poor patient, he is still malpractice-suit liable, he still has the costs of supplies…but he can’t deduct his costs as charity…And, yet, there are still doctors who do just that. It’s called “charitable care.”

At the same time, the doctors are getting squeezed with lower insurance reimbursements. And, with budget sequestration, it’s going to get a lot worse (reimbursement rates for Medicare, which are the principle driver for the remainder of health insurance, are going to plummet).

You say charity doesn’t work. I say we, as a society, do everything possible to discourage charity.

 

[Boulder257]

OUTSTANDING POST! If private charity alone was enough to take care of the poor working class then there would not be 50 million Americans without health care, and millions more filling bankruptsy because they have medical bills larger then their mortgages. This being the case how horrible would things be for the elderly if Medicare did not pass in 1964 and the elderly had to rely on private donations to take care of them? The implication from scripture is that we are to support a civic society that supports the common good and charity is to be administered both public and privately.

Peace Be With You,

David

Isn’t this argument a double edged sword? Considering the fact that medicare passed in 1964 doesn’t it take away from your argument that the government plans are working? Don’t get me wrong, I agree that taxation is necessary, but I think this particular argument doesn’t work for either side. Both could point at it and say, “see, it doesn’t work.”

 

[Boulder257]

The simple fact remains that if the government left you to your own devices, you would not give as much to charity as you do in taxation. As Clement Attlee,** judged to be UK’s greatest Prime Minister**, remarked, “Charity is a cold grey loveless thing. If a rich man wants to help the poor, he should pay his taxes gladly, not dole out money at a whim”.

What authority “judged” him to be the UK’s greatest Prime Minister? Does this make him infallible in all arguments?

 

[davidmlamb]

First, there are not 50 million Americans without health care. There were 46 million people in the country without health insurance in 2009. Out of those 46 million, 14,8 percent were under 18. 1.3 percent were over 65. All children under 18 are eligible to be covered by SCHIP. Seniors over 65 are eligible to be covered by Medicare. Regardless of your opinion of the program, I ask why are these people not enrolled in the programs they are eligible for. 31% are below the poverty line. Why do they not enroll in Medicaid?

According to the St Petersburg TImes, The Census Bureau breaks out that information and reports that 9.7 million of the uninsured are noncitizens. Are we obliged to provide health insurance for non-citizens now? (Try that in a country with socialized medicine…if you aren’t a citizen, you pay cash)

Well, there are those millions and millions with pre-existing conditions who can’t get coverage? According to the Huffington Post, only 19 thousand have signed up for the vaunted Pre Existing Condition Plan that was part of Obamacare (as of last May…when the program had been in place for a full year). You’d think there’d be tens of millions who would rush toward that plan once it was in place. But no.

Seems like the government-sponsored plans that are in place aren’t doing what they are supposed to be doing, either.

Do you know that a doctor cannot deduct his costs of charitable care from his income taxes? He still has to pay his employees for their time dealing with the poor patient, he is still malpractice-suit liable, he still has the costs of supplies…but he can’t deduct his costs as charity…And, yet, there are still doctors who do just that. It’s called “charitable care.”

At the same time, the doctors are getting squeezed with lower insurance reimbursements. And, with budget sequestration, it’s going to get a lot worse (reimbursement rates for Medicare, which are the principle driver for the remainder of health insurance, are going to plummet).

You say charity doesn’t work. I say we, as a society, do everything possible to discourage charity.

You’re making a straw man argument here. If there were only 10 million Americans without healthcare that would mean private charity has failed to take care of the disadvantages. Doctors who take care of poor patients for free or at a reduce cost are few and far between so again private charity fails. Finally, your argument that we do everything to discourage charity is bogus. Charity for life sustaining issues is a pro life issue. Again I ask you what would be happening with the elderly if Medicare did not pass in 1964? We would be judged for it!

Charity is best and most effectively administered to cover the most people when it is administered publicly. Those Christians who truly love their neighbor as they love themselves would gladly pay for a Medicare system that covers everyone with a progressive premium that is rated at income level with a reasonable cap. Matthew 25:30-46 applies here. We will be judged by how we treated others. God instituted governments for a reason (see Romans 13:1-6 and CCC 1897-1912). How many Canadians and Europeans combined are without health care and how many combined are going bankrupt from medical bills? The answer is ZERO! Why is it ZERO? Because they are more prudent and charitable then we are! We as a nation are the goats. It’s time to put on sack cloth and ashes and repent.

David

 

[markomalley]

You’re making a straw man argument here. If there were only 10 million Americans without healthcare that would mean private charity has failed to take care of the disadvantages. Doctors who take care of poor patients for free or at a reduce cost are few and far between so again private charity fails. Finally, your argument that we do everything to discourage charity is bogus. Charity for life sustaining issues is a pro life issue. Again I ask you what would be happening with the elderly if Medicare did not pass in 1964? We would be judged for it!

Charity is best and most effectively administered to cover the most people when it is administered publicly. Those Christians who truly love their neighbor as they love themselves would gladly pay for a Medicare system that covers everyone with a progressive premium that is rated at income level with a reasonable cap. Matthew 25:30-46 applies here. We will be judged by how we treated others. God instituted governments for a reason (see Romans 13:1-6 and CCC 1897-1912). How many Canadians and Europeans combined are without health care and how many combined are going bankrupt from medical bills? The answer is ZERO! Why is it ZERO? Because they are more prudent and charitable then we are! We as a nation are the goats. It’s time to put on sack cloth and ashes and repent.

David

My suggestion is to move to Europe.

You might try Greece.

Or Italy.

Curious how in those countries, where society is so “Christian”, that the Faith is virtually dead. And the population is dying out.

But, hey, if that’s how you think the Faith should be lived, let me hold the door for you on the way out.

 

[oneGODoneCHURCH]

I beleive that the church teaches that we should look out for those that are unable to look after theirselves. I do not see that programes like medicare would violate any church teaching unless they also mandated the coverage of things that are against church teaching. That said the goverment pays for nothing. the goverment has no money. We the collective citizens pay for everything. And it is time that the goverment realizes it has no money and we the people need to wake up and quit asking the government to pay for things.