The Working Catholic: Health Care
by Bill Droel
Larry Keogh, a fellow teacher at our community college, began each semester by telling his students: “Life is not fair.” He used various techniques and examples to make this point. To master his course (social science) our students needed this maxim, Keogh believed. They likewise needed it to navigate their careers and their personal lives.
Atul Gawande is a surgeon in Boston and author of best-selling Being Mortal (Picador, 2014). He recently interviewed a couple in his Ohio hometown. The 47-year old wife had health problems since high school graduation. She had a medical discharge from the Army because of fatigue. Doctors were not getting at her precise ailment. They prescribed opioids for her joint pain. She became addicted and had to start withdrawal treatment. Then her liver began to fail. Finally, doctors at the famous Cleveland Clinic named the problem and found effective medication. This woman, Gawande reports, “got her life back.” Meanwhile her husband fell and was out of his job as an electrical technician for six months.
The couple has “amazing insurance,” says the wife. Maybe so, writes Gawande in The New Yorker (10/2/17). But their policy has “a $6,000 deductible and hefty co-pays and premiums.” During their setback, the annual health care costs to the family reached $15,000. They did not tell their extended family that they had to file for bankruptcy; which brings us to the curious part of this story.
Bankruptcy is “a personal failure,” says the husband, even though medical costs caused the bankruptcy. “Everybody should contribute for the treatment they receive,” the husband says. His wife is ambivalent about the Affordable Care Act, but she does not think adequate health insurance is a human right. “I work really hard,” the wife says. “I deserve a little more than the guy who sits around.” For this couple, any articulation of a right is accompanied by unwanted government regulation and allocation. They are also convinced that many people cheat the government. They have anecdotal “evidence.”
This couple’s “feelings are widely shared,” says Gawande. Many people in our country are uncomfortable with human rights talk. They are adverse to government programs. And in a defining characteristic of their thinking, these people make a distinction between the deserving poor and the undeserving poor.
Modernity teaches that hard work leads to success; failure is at least partially related to a personal defect. For example, John Calvin (1509-1564), one of modernity’s influential leaders, wrote in a typical Scripture commentary: “Adversity is a sign of God’s absence; prosperity of his presence.” This thinking is deep in our culture. TV talk show hosts, preachers, self-help writers, political candidates, technology entrepreneurs, sports stars, education gurus and more, all tell us that we are responsible for the outcome of our lives. Life is what we make of it, or don’t make of it. Some people might experience an unfortunate, temporary setback. They deserve help. But others create their own misery. They do not deserve help.
It is common in a bar, a barbershop, a neighborhood restaurant, a church club, a family gathering to hear in so many words: “Being charitable is important to me but I don’t owe assistance to anyone. Some people need a handout, but my taxes should not go into assistance programs.”
Is health insurance a corollary to the right to life? That is, something that is unalienable and not hinged to one’s social status or lifestyle. Or is health insurance a privilege, something that some people deserve more than others? That is, health insurance is not unalienable and is only begrudgingly extended to the careless. Is life fair?
Droel’s booklet, What Is Social Justice?, is available from National Center for the Laity (PO Box 291102, Chicago, IL 60629)