Before I get to the meat of this post, I just want to share a little aside: when somebody at work recently said, "It's all about semantics," one of his co-workers replied (jokingly, mercifully): "What do you have against Jewish people?!" But I digress.
MM and I had a good conversation recently. I know - husbands and wives aren't supposed to do that - but it occasionally happens around here. I told her that I've really struggled with wrapping my mind around this, and I certainly don't agree with how this idea has translated into legislation in Washington, but I do agree with the basic premise that (as our own Archbishop Chaput phrased it), "The Church regards access to basic health-care services as a right, not a privilege."
I said that I knew everyone already had the right to emergency medical care, but that I knew of a person in our town who had tried to kill himself because he was diagnosed with cancer and couldn't pay for chemo treatments, and it made me think of loved ones who have gone through that struggle or similar ones. Emergency rooms don't offer treatments for leukemia or multiple sclerosis, after all.
MM responded that, for all intents and purposes, government-run health care wouldn't either. Especially in the case of someone whose "best days are behind him or her," the treatment for MS would probably amount to pain meds and a wheelchair. And if you were lucky enough to get chemo or other more aggressive treatments for cancer, the delay in treatment would probably render them meaningless.
Then she said something that I thought was fairly profound. "Maybe," she said, "we can agree that everyone ought to have health care when they need it, but I'd rather not call it a right. If we think of it as a right or 'an entitlement,' we expect it to come from somewhere else - such as the government. If we think of it as an obligation that we have to those who can't afford it, then maybe we end up in the same place, but we get there in a whole different way."
We have something of a model for this way of thinking in our town. There is a fairly small Hispanic community here, and they do a very admirable job of looking out for one another. There are frequently Mexican food buffets to raise money to help with a family whose father needs dialysis treatments, or another who has a young child with cancer. I don't know what kind of dent these make in medical bills, but they serve as a great example for the rest of the community - and provide some hope and reassurance that someone cares whether you live or die, which the person I told MM about apparently did not have.
The whole system of Knights of Columbus life insurance actually started in pretty much the same way. Catholic immigrants to America in the 19th Century frequently held dangerous and poorly-paying jobs, and this often left widows and orphans who today would probably become essentially "wards of the state." But back then, a group of visionary men led by Fr. Michael McGivney decided that it was their obligation to provide a way for Catholic men to give their wives and children some level of support in the event of a death in the family. This did not presume that the government would "take care of them," it was a solution that they could implement on the local level through cooperation.
This is the essence of another principle cited by at least some of the Catholic bishops in regards to the healthcare debate: namely, "subsidiarity." Our Sunday Visitor recently ran an article weighing the two, possibly competing, ideas that people have a right to health care, yet we should strive to "respect the inherent dignity and freedom of the individual by never doing for others what they can do for themselves and thus enabling individuals to have the most possible discretion in the affairs of their lives," in the words of the bishops of KC, K and KC, MO.
So, this might be a good starting point. I think MM and I are both right to some degree on this: however you want to say it, people do have a right to medical treatment (as far as I'm concerned); at the same time, we would be foolish to expect this right to be fulfilled by the government. I don't think bake sales and buffets are ultimately going to make a huge impact (at least financially) on people's health expenses, and I do think there are places where government could improve the insurance system (such as limiting tort awards and allowing nationwide competition between companies), but MM's point is essential: we need to start with the assumption that we are responsible for meeting the needs of one another in our community.
From there, we "just" need to find the Fr. McGivneys of our time: people who will develop creative ways of addressing an identified problem, without expecting the nanny state to do it for us. Again, quoting Archbishop Chaput (as cited in the OSV article mentioned above), "Real healthcare reform need not automatically translate into federal programming."