Morality Behind Health Care Reform

A Framework for Comprehensive Health Care Reform is the magnum opus of Catholic health care reform, which the United States Conference of Catholic Bishops released the summer of 1993. It continues to dictate the criteria for moral health care reform as we end the first decade of the 21st Century. The Roman Catholic Church teaches that health care is a basic human right, which can be explicitly traced back to Pacem in Terris (1963) and Jesus' teaching to serve the least among us.

The statement sets forth the following criteria: respect for life, priority concern for the poor, universal access, comprehensive benefits, pluralism, quality, cost containment and controls, and equitable financing. There is a lot of buzz in the media about healthcare reform, especially Obama's public option, so it is worth studying how Obama's plan is or is not morally acceptable.

Obama's plan at a most basic level cannot be labelled "universal" healthcare, because it does not provide ready universal access to comprehensive health care for every person living in the United States. The public option will only end up covering about 4% of the population and leave more than 20 million people uninsured, because they cannot afford it. No public option that states or other countries have implemented have resulted in universal coverage. However, for those who are able to afford it, the public option will provide mostly comprehensive benefits (except for adult vision and dental care and long-term care).

The public option also does nothing to ameliorate the plight of the poor and vulnerable in our country. Even though it will provide decreasing subsidies as income increases (up to 400% of the national poverty line), the public option will segregate patients, with profitable ones in private plans and unprofitable ones in the public plan. Basic principles from a high school economics course will show that the free market/private insurers will never profit from caring for sick people. Therefore, the private insurance companies will continue with business as usual and the public insurance system will grow increasingly expensive and collapse.

The major deal-breaker (if the above has not yet done the job) is the sheer fiscal nightmare the public option creates. On top of the 15% of GDP we currently spend on healthcare (about one-third of which is wasted on administrative costs, profits, and advertising), the public option will cost taxpayers over half a trillion dollars over the next decade! A similar programme has already been implemented in Massachusetts and costs have increased 10% annually since its inception! The way that the public option will be financed only makes this bad situation even worse. If you do not buy health insurance, you will be fined $1000 or have a 2.5% tax imposed on your income. The public option also does not eliminate the current system of co-pays, deductibles, and premiums.

While it may appear that there is no moral health care option left on the table, there is actually an option that many countries have already implemented successfully. In fact, there is a bill in the House right now that has 85 co-sponsors that advocate for a not-for-profit health insurance system.

Americans also refer to it as Medicare-for-All, although it is officially known as single-payer. Single-payer actually fits all the criteria the American bishops outlined over 15 years ago and for which they continue to advocate.

Single-payer is the only successful insurance system that guarantees universal coverage and comprehensive benefits for every resident (regardless of age, income, health status, marital status, employment status, gender, race or location) from conception to natural death. It covers all medically-necessary services including primary care, inpatient care, outpatient care, emergency care, prescription drugs, durable medical equipment, long-term care, palliative care, mental health services, dentistry, eye care, chiropractic, and substance abuse treatment.

Single-payer significantly improves the quality of health care in the United States, because there will be a much stronger emphasis on prevention. Preventive care yields long-term benefits and is minimal or even non-existent in the current health care system, because there are no short-term profits for private, for-profit health insurance companies. Healthier citizens mean healthier students and employees, which translates into a stronger economic future for the country. Furthermore, all health care decisions are made by the patient and her/his chosen health care professional.

Single-payer contains and controls costs, because it will save $400 billion annually from administrative waste. The current Medicare system only generates 2% in administrative costs while the private insurance companies, as mentioned above, uses over 30% of all revenue on these costs.

Single-payer provides a priority concern for the poor through equitable financing. It would simplify the current bureaucracy, because it would combine Medicare, Medicaid, SCHiP, and Veterans' Affairs health funding (and other public health programmes). It would save employees money, because they would only pay 2%-3.3% in payroll taxes and never pay for medical bills again. In fact, it would even save employers money, because it would drastically reduce the amount they currently pay private insurance companies to contribute no more than a 9% payroll tax. Single-payer is so affordable that Americans (except for the Top 5%) would pay less for healthcare, with the elimination of co-pays, deductibles or premiums and there would definitely be no more bankruptcies due to medical bills.

Overall, single-payer is a public insurance system operating with private health care providers independent of the government. Patients can choose whichever doctor or hospital they want without fear of being out of their network. Most importantly, single-payer is the only moral solution to the health care crisis in the United States. It is no wonder that 3 out of 5 doctors and Americans support such a solution for universal health care.