Dear Dr. Luckey, I am a well educated Catholic down in the economic trenches as it were, working for nearly twenty years in accounting. I received my BA from Thomas Aquinas College where I was first introduced to Catholic Social teaching on Economics. I have read a decently large scope on the subject over the last several years from Capitalism to Communism to Distributism. For the last several years I have been in Healthcare at a for-profit hospital that is part of a large hospital chain as one of the head bean counters, and I have been trying to figure out just how to solve the growing economic disaster that is looming in healthcare. What do you think could be done to improve the healthcare system in this country along the lines of Catholic social teaching?

You ask an interesting question about how to prevent the looming economic disaster in healthcare in the United States.  However, your question is much too vague.   What I can do is to give some aspects of the financial problem.
Is there a Catholic social teaching side to the financial aspect of healthcare?   As followers of Jesus Christ, we all want to see people get “adequate” health care.  But the first problem we encounter is, “How much is adequate?”  The United States has the best health care system in the world.  Medical care is much more available and of more high quality than when I was young.  In those days, a diagnosis of “cancer” was a death sentence for most people.  Not so today.  Preventive medicine is much more widely practiced than ever before.  On-site trauma care, as well as emergency room procedures, is absolutely astounding.  Lastly, the law in most jurisdictions requires that patients, who call an ambulance and insist on being taken to the emergency room, must be taken and treated as least until they are stable.  This has given rise to what paramedics call “frequent flyers,” those without health insurance who go to the hospital for colds, headaches and the like.

Unfortunately, as one famous economist said, “There is no such thing as a free lunch.” Every bit of service must be paid for by someone.  The “frequent flyer” trips to the emergency room are paid for by the paying patients of the hospital and their insurance companies (meaning higher premiums passed on to the consumer).  Like every other thing, the price of a medical service is auctioned off to those who want it most, i. e., to those willing to pay the most.  This is because medical care is a scarce good—scarcity meaning that our desire for it would never be satisfied, not because there is not really enough.  Since it is scarce, it needs to be economized. 

But more and more people claim the right to get the best, high-tech treatment the system can offer.  If you have insurance or can pay out of pocket, you can have it.  If not, you have to do without.  This is not much different than a poor man who would like to drive to work in a nice, reliable BMW, but keeps a 1970’s AMC Gremlin alive because he has little money.  How much health care is he entitled to if he cannot afford the higher level stuff?  How much health care is he entitled to if his medical conditions are caused by his lifestyle choices, like smoking, too much liquor, fattening foods and no exercise, or his failure to take his $6.00 per month high blood pressure pills which then results in renal failure.

The question is, then, how do we help those at the bottom?  The first thing is that Catholics, who are notoriously stingy, need to open their pockets to support clinics which give poor people medical care.  Secondly, there are already government programs in place which pay for some care, like Medicare and Medicaid.   The poor need to be aware of these.  Medical savings plans are a new and interesting development.  If when you are young and healthy, you get one of these and save up, when you are older, you will have money socked away for the bigger expenses.  Physicians need to get back into the habit of volunteering some time at clinics, and the trend to more low level health care providers, such as physicians assistants and nurse practitioners need to be expanded.  More medical schools would lower the physicians’ income through competition, and therefore the cost of treatment.  Lastly, tort reform (don’t get me started).

These are some things that point to a solution.  Socialized medicine is a false solution, but I’ll have to save that for another day.   Meanwhile, there is no quick fix. Maybe we should focus on really desperate areas like Africa, where in some places there is no health care at all? 

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