CNA\/EWTN News<\/a>).- Another effort to repeal and replace the Affordable Care Act seems on the verge of failure, after three Republican senators stated that they would not support a pending Senate bill. As next steps for health care reform are considered, how should Catholics approach health care policy, according to Church teaching?<\/p>\n\u201cThe Church really, clearly teaches that health care is a right, that one has a right to be able to obtain such health care as is reasonably possible for one to obtain,\u201d Dr. Kevin Miller, a professor of moral theology at the Franciscan University of Steubenville, told CNA.<\/p>\n
On Monday, the Catholic Medical Association released a letter of public support for the latest GOP health care proposal, the Graham-Cassidy bill. In recent months, House and Senate Republicans have proposed several health care bills to repeal and replace the Affordable Care Act, but none have been able to pass both houses of Congress. The Catholic Medical Association wrote the offices of U.S. Senators asking them to support the latest proposal.<\/p>\n
However, by Monday evening, with Republican senators announcing their opposition to the Graham-Cassidy bill, it seemed unlikely to pass the Senate, unless the bill was amended or senators changed their vote.<\/p>\n
The Catholic Medical Association explained its support for the bill through the lens of several core Catholic principles of health care, saying that the bill would put those principles into practice.<\/p>\n
The benefits of the bill, they said, included protections against taxpayer funding of abortions in health care plans via subsidies and tax credits, as well as blocking Medicaid reimbursements of abortion providers like Planned Parenthood.<\/p>\n
The bill would have also set up conscience protections for employers, and individuals in health care, against mandates that they \u201cpurchase policies that include morally offensive \u2018preventive services\u2019,\u201d the Catholic Medical Association\u2019s letter argued.<\/p>\n
Also, by repealing certain regulations and limiting federal Medicaid funding for states, the bill transferred more power and decision-making in health care to lower levels in the Catholic principle of subsidiarity and \u201cpreferential option for the poor,\u201d the group said.<\/p>\n
According to the letter, \u201cthe ACA created literally dozens of boards and commissions and imposed thousands of pages of new regulations, many of them injurious to the work of Catholic health care providers and additions to the cost of care.\u201d<\/p>\n
The changes to Medicaid gave the opportunity for \u201cpublic and private entities closest to the people to experiment with options that maximize the ability of patients to choose providers who share their convictions regarding Hippocratic medicine.\u201d<\/p>\n
Under the old Medicaid system, the letter said, states that chose to expand their Medicaid pools and receive more federal funding also were restrained by the government in the care they could provide to vulnerable populations.<\/p>\n
However, leading U.S. bishops recently sent a letter on behalf of the United States Conference of Catholic Bishops to all senators, asking them to change the Graham-Cassidy bill \u201cwhile retaining its positive features,\u201d because it would result in harm to the poor and chronically ill.<\/p>\n
The changes to Medicaid could cut coverage for people relying on the program, the bishops said, or it could burden some states with additional costs and responsibilities that they may not be equipped to handle. If a state is facing a budget deficit and federal Medicaid funds are cut, state programs for low-income populations could also be cut, the bishops said.<\/p>\n
The pro-life provisions are laudable and must be kept if the bill is amended, the bishops added.<\/p>\n
Miller explained that the bill raises important questions for American Catholics: when a Catholic is considering health care policy, what are the principles of health care that the Church teaches, and how should a Catholic understand statements by the U.S. Conference of Catholic Bishops, as well as other Catholic groups?<\/p>\n
When the U.S. bishops\u2019 conference releases a statement on a \u201cprudential application of the Church\u2019s teaching,\u201d there is \u201cmore leeway\u201d to respect a statement without feeling obliged to assent to it, Miller said.<\/p>\n
However, while bishops\u2019 conferences themselves do not \u201cshare in the Church\u2019s magisterium,\u201d he said, typically they \u201cdraw from what is already the established teaching of the Church\u201d on topics like human rights.<\/p>\n
When Catholic groups of laity issue a statement on policy, he said, \u201cless deference is required, because by definition you\u2019re not dealing with the magisterium at that point.\u201d<\/p>\n
On the question of health care, \u201cthe Church really, clearly teaches that health care is a right,\u201d Miller said, and Pope St. John XXIII clearly stated this in his encyclicals Mater et Magistra (1961) and Pacem in Terris (1963).<\/p>\n
Paragraph 2288 of the Catechism of the Catholic Church also lists providing health care as among the obligations of a society to its citizens:<\/p>\n
\u201cConcern for the health of its citizens requires that society help in the attainment of living-conditions that allow them to grow and reach maturity: food and clothing, housing, health care, basic education, employment, and social assistance.\u201d<\/p>\n
If one cannot work to obtain these essential things, Miller said, \u201cyou have a right to have these provided for you in some other way.\u201d And, he said, \u201cI think the same thing would easily apply to health care.\u201d<\/p>\n
This doesn\u2019t necessarily mean one has a \u201cright\u201d to the \u201cmost advanced, most expensive forms of treatment,\u201d Miller said, but it would probably mean one has a right to care \u201ctypically available to those who have kind of normal health insurance.\u201d<\/p>\n
The Church does not state how, specifically, health care must be made available to everyone, Miller said, and so the question to be decided is \u201cwhat\u2019s going to work?\u201d<\/p>\n
Also significant, the Church does not say that the state cannot be involved in the financing of health care, Miller said. \u201cThe Popes have sufficiently made it clear,\u201d he said, \u201cthat at least sometimes, the state has a necessary role to play in these kinds of matters.\u201d<\/p>\n
He pointed to Pope St. John Paul II\u2019s encyclical Centessimus Annus (1991) in which the Pope said that the state had, \u201cunder certain kinds of circumstances,\u201d a role in providing \u201cSocial Security-type assistance for its citizens,\u201d and this \u201cwould include in the area of health care.\u201d<\/p>\n
Governments in many countries are heavily involved in health care financing, and the Church has not spoken out against those policies, he said.<\/p>\n
Although the Church does not endorse a certain system of health care, it teaches that such a just system should involve various sectors of society, and should make a \u201ctypical standard of health care available.\u201d<\/p>\n
If one cannot obtain this care, \u201cthen, morally-speaking, we have a problem,\u201d he said.<\/p>\n
Regarding the principle of subsidiarity of Catholic social teaching, it is \u201cwidely misunderstood,\u201d especially in the health care debate, Miller said.<\/p>\n
The Catechism explains that according to the principle of subsidiarity \u201ca community of a higher order should not interfere in the internal life in the community of a lower order\u2026but rather should support it in case of need.\u201d\u00a0 Thought sometimes understood to mean that the federal government should simply stay out of the affairs of state and local governments, that is not necessarily true, Miller said.<\/p>\n
Rather, \u201cit\u2019s a question of larger communities playing the role of helping smaller communities be ever more fully themselves,\u201d he said, \u201cproviding them with assistance of various kinds\u201d without \u201ctaking over.\u201d<\/p>\n
Again, he said, there are examples of countries where the government is involved \u201csomewhat heavily\u201d in the area of health care, and it is indeed \u201can option\u201d under the Catholic principles of health care, provided the state does not mandate the provision of any care or procedures that would be immoral, like euthanasia or abortion.<\/p>\n
\u00a0<\/p>\n
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