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A Catholic physician's perspective on the health care debate Print
Guest column
Thursday, Mar. 25, 2010 -- 12:00 AM

Guest Column

Here are several points to consider from a Catholic family physician regarding the health care debate that I do not hear very often.

Stupak amendment is compromise

First, news, and even Catholic news, venues often refer to the Stupak amendment as something good in prohibiting funding of abortions except in limited circumstances. However, what is often not mentioned is that in those circumstances, which include rape, incest, and threats to the mother's life, there is an innocent living infant fetus who is murdered.

Let me just be clear as a physician -- there is never a need for an abortion even in these cases. Other medical means exist to help the mother as well as the infant fetus. There are two lives and two patients whose health must be balanced and neither one sacrificed.

So even the much-acclaimed Stupak amendment, fighting for its life as the best moral option on the table, is not a good thing. It is a compromise sacrificing SOME lives with the intent to help others. This is an intrinsic evil and must be opposed on moral grounds with faith, that if we hold to our grounds, God will provide the solution that is not easily seen at this time.

Don't need federal system

Second, despite Mr. Magliano's good editorial, "The State of the Union -- Catholic Style," in the February 25 edition of the Catholic Herald, he and others are wrong in several areas but particularly in assuming that health care reform for America must include a federal health care bill that covers every person in America (including illegal immigrants). We cannot afford this.

Catholic teaching does NOT require the providing of health care to everyone, but rather reasonable and affordable access to healthcare for everyone as a right. Rights are not provided; they exist and should not be obstructed.

Thus, fulfilling this right does not require a federal healthcare system. Such a system will be subject to corruption on a large scale because of the power that will be given to a relative few over everyone's care. It will also be inflexible, inefficient, and costly, not to mention violating the principle of subsidiarity that requires issues to be resolved at the most local level possible. Why? Because the local level is more efficient, flexible, and limited in the extent of corruption that can occur.

Better, simpler systems

Better and much simpler systems can be created to achieve improved access to healthcare. Look at Our Lady of Hope Clinic in Madison, not the first of its kind in the country, which provides outpatient healthcare by bringing together those who can and those who cannot afford it on the private local level without insurance.

Look at the generic cash programs for medicines at Walmart, Kmart, and other pharmacies where many of my patients receive good, effective generic drugs at very affordable prices without the use of insurance.

Freeing ourselves from everyday use of insurance for common expenses will do more to lower prices than the current health care bills. Why? Insurance was designed to have a big pool of contributors for a much smaller pool of relatively rare utilizers, which is how home, auto, and life insurance function. This is the way you keep costs down. You have less people taking out of the pot, and only those who need to take out because of the relatively rare severity of their circumstances.

You don't use car insurance every time you fix your car, change the oil, or fill up with gas. If you did, the cost would be astronomical.

The current health insurance system fails as affordable insurance because the two pools, contributors and receivers, are virtually the same size. Even worse, there is an ever-expanding costly administration sucking up even more money just to run it in its ever-growing complexity.

Administrative costs are currently estimated at around 30 percent of the cost of health care now and continue to grow. While this is already happening in the private semi-regulated health care sector, think what will happen to the cost of administration when the government gets more centrally involved?

Name one federally managed program that has not grown over time in size and cost, and you will be naming a very rare animal indeed. Until you couple care with cost at the level of the consumer who makes the choices and more reasonably share responsibility for decisions (tort reform), you will never get cost under control.

Situation in other countries

A question often asked at this point is "Well, then, how do the Europeans do it?" First, the Europeans are less religious, more socialized, and sacrifice much more of their freedom and responsibility for individual and collective charity to the state -- which in the case of Europe is becoming more and more secular and immoral. No longer are individual and collective sacrifice and charitable action needed: "The state can handle it for us" is their cry -- the apparent free lunch. But this is just an illusion.

Second, it is not clear that the Europeans and Canadians really do do it any better than we do. Many of our "poorer outcomes" can be traced to poorer lifestyles and our excessive thirst for more in all spheres, including health care, even when it does not really produce proven better outcomes.

But if you put cost directly back into the equation at the time of individual choice, you find that the level of care rises only to the collective will and affordability for that care. The alternative is rationing. That's the European and Canadian model. Someone else makes the decisions for you.

Caring for the poor

What about the poor? Significant individual and foundational charities must provide. They have always been more efficient than government. But they must be given the means to provide just as the government must be given when it provides.

If people and businesses are not drained in their means of charity by having to pay high insurance premiums and taxes, and if expectations are changed to encourage and expect more charity at all levels, then the false perception of the need for government to provide will disappear.

Michael Robiolio, MD, is a family physician in Darlington.