BY GRACE-MARIE TURNER
Regardless of political ideology, most Americans share a common goal to further the common good by assuring that no one is left behind in accessing quality healthcare. There are, however, divergent approaches to achieve this goal:
Some argue that:
- Only government can be relied on to make sure healthcare is delivered fairly and equitably;
- Healthcare decisions are too complex for patients alone, and government intervention is essential to organize choices;
- Healthcare is costly, and governments must control pricing so companies and professionals don’t reap profits from providing healthcare.
But experience has shown that the expansion of government-dominated healthcare has adverse effects, including:
- Disrupting the doctor-patient relationship by inserting bureaucratic authority that creates barriers to care;
- Inserting political edicts that may violate the values and consciences of physicians;
- Weakening the ability of families to express responsibility in managing their own healthcare;
- Reducing the incentives for innovative coverage and care solutions and for physicians to build community by offering charity care.
The U.S. healthcare system has been sliding toward centralized government control over healthcare by way of taxpayer-financed programs such as Medicaid, Medicare, the Children’s Health Insurance Program, the Affordable Care Act, and many more. Employer-based health insurance also centralizes control over health coverage decisions since most firms offer employees a “choice” of only one plan. All of these programs and systems rob individuals of their authority and dignity to make their own decisions about care and coverage for themselves and their families.
Despite this, there are windows of optimism with innovative options such as Direct Primary Care, health sharing ministries, transparently priced surgical centers, and account-based savings options that allow individuals to select the care arrangements of their choice. These patient-centered options provide a foundation to begin to move away from a socialized system that would further increase dependency and, instead, afford individuals the dignity of choice and responsibility, with better protections for the most vulnerable in society.
At the end of the day, the levers of power over healthcare decisions will be controlled either by individuals and their families, based upon their values, faith, and moral guidance, or by centralized bureaucracies, either public or private. The structure of healthcare financing determines who controls these levers. Economic policies do matter in healthcare and have profound effects.
The poor, with few if any options to opt out, are most disadvantaged by a system that robs them of their freedom to make their own decisions about their healthcare. We have an obligation to work together on solutions that move us closer to the goal that advances the common good by respecting the dignity, the freedom, and the sanctity of human life.
It is essential that a coalition of leaders anchored in faith lead the way into a new era of thinking about healthcare solutions. Fortunately, there is a consensus plan built around initiatives that faith-based leaders within the Catholic Medical Association and others are supporting.
Building Consensus Around Faith-Based Initiatives
I started the Galen Institute 25 years ago to do two things: Create healthcare proposals that put doctors and patients, not bureaucrats, in charge of medical decision-making, and help market-based health policy experts unite around core principles of patient-centered medicine.
We formed the Health Policy Consensus Group, starting with a core group of seven policy experts. We have produced books, conferences, countless policy statements, policy recommendations to Congress, presidents, and states, and we have forged a community of people who exchange ideas, co-author papers, and even found new organizations to advance shared ideas. The group now numbers more than 250 policy experts, medical leaders, and others who meet regularly, mostly by Zoom, to continue our conversations, information exchanges, and collaboration around ideas.
We have found that when people with similar belief systems join our voices in a chorus rather than singing solo, we can reach larger audiences and be heard more clearly. Government’s role in the health sector had been expanding for decades before we began. We believe that, were it not for our efforts, the slide toward government-controlled healthcare would have been an avalanche.
Much like the call for evangelization in the Church, we know we must reach out with our ideas and not just talk to ourselves. Like the Consensus Group, a coalition of faith-centered organizations can provide a core to spread ideas to their members and beyond through networking. But first, this group must be inspired and united around some core principles, ideas, and solutions.
CMA President Dr. Michael Parker explains, “A firm commitment to human dignity, subsidiarity, solidarity, and the common good is integral to healthcare reform. Authentic Catholic healthcare defends life and religious liberty and ensures access to affordable medical care especially for the socioeconomically disadvantaged and marginalized. Also, integral to healthcare reform are the free-market principles of voluntary exchange between willing parties with minimal government intervention.”
Dr. Steven White, chair of CMA’s Health Care Task Force, offers 12 principles to guide decisions about health policy proposals that are anchored in the core tenets of Catholic beliefs. These principles are consistent with a set of policy proposals that are the product of many months of collaboration by the Health Policy Consensus Group, “Health Care Choices: A vision for the future.”
The Consensus Group developed this set of reform proposals in collaboration with CMA physicians and other medical professionals, and their collaboration was essential in shaping the ideas in the proposal and demonstrating to policymakers we had input from the medical profession. This support shows solidarity and also creates momentum so elected officials see the proposal has broad support, increasing its likelihood for success.
The Health Care Choices plan is also designed to address core problems in the U.S. health sector to lower costs, promote personalized care with doctors and patients in charge of decisions, provide more and better health coverage options, and perhaps most importantly, provide a better and more dignified safety net for the most vulnerable in our society. As the CMA principles say, “A health sector that respects the integrity of the patient-physician relationship best protects the dignity of the human person.”
More than 80 healthcare leaders have signed on to the Health Care Choices plan, including Dr. Parker, Dr. White, and many others in the Catholic Medical Association and faith-based communities.
The plan does not attempt to re-engineer the healthcare system with another trillion-dollar top down, government-run, Washington-knows-best scheme. Instead, it gets government out of the way to free and empower doctors, patients, hospitals, innovators, and every other player to reform our health sector to respond to the ever-changing needs of millions of Americans for continued access to quality healthcare. And most importantly, it is foundationally designed to protect life and advance subsidiarity and solidarity.
It also is consistent with foundational Catholic beliefs that our faith directs us to reach out and care for the most vulnerable. Too many inside and outside the Church believe they are best served through government programs, especially Medicaid. But those on Medicaid and other public healthcare programs seldom have a choice over what healthcare is available to them, and they often have the most difficulty obtaining quality care, especially specialty care. Decisions still are made for them by lawmakers and bureaucrats. We believe that must change through giving everyone options of where and from whom they receive their healthcare and coverage.
The importance of collaboration cannot be overstated with regards to the opportunities for success in advancing this faith-centered set of policy proposals. The support and involvement of medical professionals like those of CMA and others is essential.
Grace-Marie Turner is president of the Galen Institute, a non-profit health policy research organization that focuses on ideas to restore power and control over medical decisions to doctors and patients. She also serves as a volunteer policy adviser to the Catholic Medical Association and other organizations.
Health Care Choices Plan at a Glance
- It has built-in protections for life by assuring the federal funds cannot be used to pay for abortions.
- It provides dignity and better care and coverage for the most vulnerable, who are too often relegated to programs that are centrally controlled and underfinanced, by giving the poor equal access to choices of care and coverage.
- It respects the dignity of the individual and the centrality of the family by allowing them to control decisions involving their healthcare, including market-based and faith-based coverage. People have many different needs and preferences for healthcare and coverage, and having a range of options will mean more people will have coverage they choose rather than being relegated to a centrally controlled system catering to the lowest common denominator.
- Healthcare solutions will be most effective and enduring if they are built around subsidiarity, fitting the needs and resources of families and communities. As we have seen following the passage of the Affordable Care Act, the federal government with its centralized power can suppress the rights and beliefs of doctors and patient and suffocate voluntary communal charity.
- By devolving power away from Washington and diffusing it through the states to doctors and patients, doctors will not be in a centralized, federally run system that would have the power to coerce them to violate their consciences, faith, values, and medical judgement.
- The plan also would create new funding mechanisms with built-in incentives for individuals, families, employers, and states to get the best value for their spending. This is crucially important for young people who otherwise face the prospect of massive, unchecked government entitlement spending that could seriously compromise their chances for future prosperity.
© 2021 The Pulse of Catholic Medicine
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