A reader writes:

I saw your posting on the letter from the woman who has heart trouble and no way to pay for medical care. What an awful situation. I’ve already prayed for her but have no other way to help her.

I read you regularly, have several books from you and have contributed to your tin cup rattles – we even spoke on the phone once. I really find you a breath of fresh air in our culture. When I could find no one speaking out against torture and the apparent enthusiasm on the “Catholic” (and other) right for it, I was greatly heartened by you and Zippycatholic. I am a cog in a corporate machine supporting a wife and three little ones so even had I the expertise, I did not have time to write the things you and Zippy were writing. Thanks for that.

Of course here is the inevitable but. I hear and want to agree with the teachings of the Catechism that I have seen you lay out before on healthcare as a right. But I am troubled by it. I have some background in economics and other areas that are somewhat relevant. I can get behind the idea (with some difficulty and prayer) on healthcare as a right, but honestly, I think we need to know what that means. I’m familiar with your arguments in the torture debate against those who can’t figure out what torture is. I am hoping you will not begin to apply that argument in this case. I simply think it’s more obvious what torture is than what healthcare is. Health is something I have a great deal of control over. Even some kinds of medical care are (and probably more should be) available to me over the counter.Torture, when applied to me, is not something I can control.

Additionally, torture as an open policy is something new the government has embarked upon recently. We don’t have a long history of it yet. This is not true for the medical mess we have today. This problem has been building for at least 70 years and probably more (at the very least ever since the government capped wages during WWII and essentially made employers look to other benefits (like health insurance) to compete for workers). So it’s not something we’ll solve overnight even if we can get people to agree to what the problems are.

But more critically, I guess I want someone to define what healthcare looks like. Baldly put, is the right to healthcare going to include access by all to the most cutting edge technology in service today? I do not think the Church teaching will take us that far. Is healthcare merely palliative care and if not (which I’m sure it’s not), then at what point does it become a prudential decision about who gets what care? I know we are a long way from having to make that kind of decision. I think you are going to get a lot more people listening to you when you at least talk about that kind of thing, then if you just say “healthcare is a right” as if the medical services that are available in the current structure are the place to begin. I just want someone on the “healthcare is a right” side of things to say, “You know what, you’re right, it’s pretty important that we figure out what good or service it is we are talking about when we say that person has a right to it .” I want to know where we are beginning to define the issue or else I think discourse will not go very far.

The other curious thing here is that as usual it’s really the middle class who is going to get more and more squeezed by healthcare costs. The poor will have their debts written off by the hospitals (after a long painful battle with debt collectors, but basically they won’t be any worse off than they were before and they will continue to get treatment through emergency rooms). It is illegal for a hospital to refuse service on the basis of the ability to pay. The rich of course will always have what they want. But the middle will be stuck. We have two options. Pay for the treatment and go broke leaving much less materially than we had before and likely facing future medical costs given the nature of how these things seem to work. The other option is not to get the treatment of course, but then we face the problems of the woman in your letter.

Hm. I can see that I really need to work on my people skills. To cut to the chase, when you say, “I’m familiar with your arguments in the torture debate against those who can’t figure out what torture is. I am hoping you will not begin to apply that argument in this case” I find it dismaying, since I can’t understand why anybody would think for a second I would do that. The debate about health care compared with the apologetics for torture is apples and oranges. In the latter, we had a very clear and obvious prohibition (don’t torture) coupled with a very clear and obvious command (treat prisoners humanely). All I have ever done, for six years of debate on the matter, was reiterate these two very clear guidelines in the face of people who were laboring with might and main to figure out some way to avoid them and justify obvious (and sometime murderous) policies of torture. I have been sharp-tongued and impatient with people who have pretended to seek “definition” of torture only because it was patently obvious that they did not desire definition at all, but obfuscation. Had they seriously sought the Church’s guidance, they would have been asking how to treat prisoners humanely, not how close they could get to torturing them.

When it comes to health care, it’s a whole ‘nother thang. Sure the Church describes health care as a right (rather like birth is a right). And yes, some lazy people simply regurgitate Talk Radio blather about how it’s not a right (by which they mean “state-funded health care is not a right” but, due to their unthinking laziness, wind up saying “health care is not a right at all”). But I think most Catholics get, at some level, that the Church means it when it describes it as a right.

But most Catholics (myself included) have only the fuzziest ideas about how to implement that in a practical way. So there’s all sorts of room for argumentation about how to make the provision of health care to the least of these happen. I myself, having no competence in either economics or medicine, have no plan or program whatever and have only the slightest contact with people who have thought about it, which is why I propose nothing. Who needs the opinion of a total ignoramus?

My bleat last week was not a program proposal but simply the cry of a layman who, watching a woman with heart disease confronted with a system that is inhuman, cried out to heaven against such a system. I begin with the person, not with the needs of bureaucrats for their own convenience. A system which tells a poor woman with heart disease, “Go away. We won’t help you. You need to ask if you are sinning by staying alive” is a system that is badly (and I suspect sinfully) designed and needs to be fixed. How to fix it, I don’t know. But I have not the slightest interest in “We’ve always done it that way” or “But our numbers and formulae decree X”. That’s a the voice of slavery to the machine, not of the Christian spirit that looked at slavery and said, “Screw that. Let’s change the system!” I firmly believe the system can be changed with the help of Christ so that poor women are not forced to ask if they are being selfish if they don’t die and get out of the way. How that is to be done I have no idea.

PS. Thanks for your prayers for my friend and your irenic spirit. You ask good questions. Wish I had answers, but I’m just a fat English major with a keyboard. Let’s pray that the people who do have real answers surface by the grace of God.