Aug 192009

By Frank Wessling

Sickness and accident is a different experience for poor people than it is for those of us with good insurance. They can’t get needed care with the same confidence and dignity. They might not even seek some needed medical care for fear of the cost.

This is why the American Catholic bishops support reform of the way health care is done in this country so it “provides access to quality care for all, with a special concern for immigrants and the poor.”

The bishops say health care is “a basic right belonging to all human beings.” So the poor woman in a city housing project, an undocumented immigrant cleaning motel rooms, and the wife of Bill Gates have the same right to the medicine and care they need. This is the God’s eye view on this subject.

What God may see as a basic right equally spread around humanity is not, unfortunately, available in that way. God’s way is abundant generosity. The human way is limited. No matter how generous we might feel, we experience scarcity and fear of scarcity. There is never enough of anything we make or do for everyone to have an adequate, equal portion. There could be, as a matter of physical distribution — to take food as an example — but we don’t yet have the collective moral maturity to make it happen.

We’re like the children in a large family sharing a jar of peanut butter. Sure, there’s enough to go around, in a fashion. But the bigger, faster ones get first and most. The little ones take what’s left — and learn how the game is played.

Medical care in this country is like that peanut butter jar. There’s something for everyone: gold-plated insurance, adequate insurance, emergency rooms, Medicaid and care spread thin and with some gaps so there’s money left for the rent.

When the bishops say there should be “quality care for all,” they mean something better than that. They don’t say what something better should look like; only that we’ll know it when everyone in this country has what we can agree is “quality” care.

The health care forums held around the country this month by members of Congress probably haven’t helped in pursuit of that goal. Rather than civil conversations about a need for the equality of quality in medical care, the sessions were too often used as battleground between forces protecting big players in the status quo and those who see a “public option” among insurance plans as necessary.

Moral issues such as abortion, conscience protection and end-of-life care bring other elements of controversy into the issue. Unfortunately, these points are often brought up as part of delay tactics to kill real reform rather than honest moral concerns. The proposed public option in insurance isn’t helped by including abortion among the services it would cover. Nor does it help the entire reform effort when federal subsidies to low-income people will become part of what pays for abortion coverage in any of their insurance plans. This lets abortion funding slip in the back door and has nothing to do with real reform. Everything looks much better with abortion funding excluded.

But the key to a better medical care system remains “quality care for all.” If that means substantial adjustment in the insurance business, the goal is worth it. If it means a different way of doing business for drug companies, the goal is worth it. If it means different ways of compensating doctors, the goal is worth it.

And if we’ll make a goal of better quality in our personal lives, we citizens will quit some of the bad habits that make us sick. That would be reform with real bite.

When the country wrestled with the problem of poor care for elderly Americans almost a half-century ago, controversy was fierce. Out of it came Medicare. Now there are people who think that program is God’s own untouchable plan rather than part of our evolving self-government.

If we work carefully and honestly today on new reform, there’s no reason why we can’t do as well: produce change that will draw gratitude from our children and grandchildren.

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