The Original Single-Payer System

January 5, 2017

The election is over and somebody won.

Some are fearing, and others breathlessly anticipating, the advent of a kind of libertarian social polity. It is impossible to know if they are right at this point, but we do know that there is at least some basis for thinking that the availability of health coverage for millions might well disappear. After all, the repeal of the Affordable Care Act has been for years the top priority of the party about to assume complete control of the federal government, and they have proposed no replacement plan that would cover as many people.

It’s not only the Affordable Care Act that is in danger, of course. Voucherizing Medicare has been high on the agenda of House Speaker Paul Ryan for some time, and now he will confront no Democratic Senate to block his efforts. But whether he will face the danger of a veto from incoming president Donald Trump remains to be seen. Mr. Trump said that he would leave both Medicare and Social Security alone, and the vice-president elect, Mike Pence, recently gave us assurances that this promise would be kept. [1] Still, the fact that this has long been a priority of such a prominent member of the Republican leadership, who can control the legislative agenda of the House of Representatives, may force Mr. Trump to compromise on the issue, or even capitulate. We’ll see.

There are sincere Catholics among us who say that this sort of danger was a legitimate price to pay for bringing an end to legalized abortion in the United States. (I leave aside the question of whether the end of legal abortion in the United States is truly on the horizon.) There are other Catholics, of whose sincerity I decline to judge, who insist that concerns such as medical care for those who cannot afford it is not a proper concern of government. None of this comes from magisterial sources, of course, but you will hear these things from people who put themselves forward as authoritative Catholic commentators.

I’ll leave for another time the discussion of whether such views really do comport with Catholic teaching. What I will do now is assume some truth to those positions. I certainly can’t argue with someone who votes in a way that he thinks will bring an end to abortion. But when we say that we are casting our votes with such philosophic underpinnings, we ought to understand the ramifications of our position. I speak not only of natural and probable outcomes, but also of the implications of how Catholic people, and the Catholic Church, ought to be engaging with the world.

Very often I encounter people who will say, on constitutional grounds, that the social safety net isn’t the concern of the federal government. But, when they are pressed, I find that they’re not so keen on the idea of state governments getting involved with it either. Sometimes I run into people who say that the social safety net should be the work of private charities, and that no level of government should be involved with it. Now, of course, if no government involved itself with the safety net, then private charity would be the only game in town.

So let’s suppose the libertarians finally get their way, and the safety net is eliminated at all levels of government. Good people would donate, and not-so-good people would not, and it is unlikely that there would be a significant correlation between the abilities of individuals in this regard and their actual donations. That would be unfair to the good people, to be sure.

But there is one group of people who shouldn’t be concerned about whether it would be fair.

No theologian I, but I was under the impression that the Catholic Church is supposed to be carrying out the mission of Jesus. What is that mission? Well, when he was on earth he went about “preaching the gospel of the kingdom and healing every disease and every infirmity among the people.” (Matthew 4:23) So, isn’t that what we Catholics should be doing? And isn’t this especially true of those Catholics who think that it’s not the business of government to ensure that everyone gets the medical care they need, or that it is a secondary concern?

That’s right, I’m saying that it is the business of the Church to heal the sick, every bit as much as it is to preach the gospel; and if we’re not doing it, then we are failing at our mission. And if the government is going to get out of the business, for good or for ill, then it is up to us Catholics to pick up the slack. It doesn’t matter if other people are required to do it. We are. Getting government out of it doesn’t relieve us of this duty. On the contrary, it enhances it. Sure it will cost the Church a lot of money. So what? It is our assigned mission. Pony up.

Here’s another thing. When Jesus sent the Apostles out to “to heal every disease and every infirmity,” (Matthew 10:1) he also said, “You received without pay, give without pay.” (Matthew 10:8) So not only is it our duty to heal the sick, we’re not even supposed to charge for it. This is the original single-payer healthcare system, where the single payer is the Church.

Come to think of it, we are always hearing about people in the United States not getting the healthcare they need because they don’t have the money for it. That’s odd. Don’t we have a Catholic Church in the United States?

Louis Rose

Scripture quotations are from The Catholic Edition of the Revised Standard Version of the Bible, copyright © 1965, 1966 National Council of the Churches of Christ in the United States of America. Used by permission. All rights reserved worldwide.