Why Christians Should Support Rationing Health Care
Perhaps you thought that after the passage of health care reform—especially after the long, bruising, political and social battle that got us there—we could move onto other things.
You would have been mistaken.
The new House of Representatives appears to have the votes to repeal health care reform, and Senate Republicans are eager to use every procedural tactic (many of which involve defunding strategies) to slow the implementation process and perhaps even to stop it. Lacking control of the Senate and the presidency, of course, means they cannot actually repeal health care reform—but GOP leadership will almost certainly make this into a central issue in the 2012 elections.
Sadly, they will likely be able to appeal to a base of Christians who are skeptical of health care reform in part because of the ‘rationing’ that will be done under the new system. After all, anyone would supports the dignity of the human person—as all Christians do—would have to be against ‘death panels’, right?
But this approach fails to take into account two inescapable features of human existence:
- We have virtually unlimited health care needs. (We will all die some day.)
- We have limited health care resources. (There is a finite amount of ‘stuff’ out there.)
Attempting to escape rationing health care is like attempting to escape the finite nature of our resources and, indeed, of our very being. Unsurprisingly, we are rationing care already: Medicare and Medicaid come up with a ‘CMS rate’ to determine what kinds of bills will be paid and at what percentage, and private insurance companies use this same rate as a baseline for determining their own rationing policies.
And in a new book from W.B. Eerdmans Press entitled, "Too Expensive to Treat?—Finitude, Tragedy, and the Neonatal ICU," I argue that Christians, instead of attempting to run away from this tragic, fallen state of affairs, should be among the best at bravely attempting to face its reality with courage and boldness. We should be able recognize, perhaps better than most, the false idol present in the consumerist mantra that we can have as much as we want of whatever we want. We should always have the most vulnerable as our primary focus. Temporary self-preservation to the exclusion of justice for them, of course, lands us with the goats rather than the sheep.
And if we agree that this is true, for how long can we live with tens-of-millions of our most vulnerable brothers and sisters—all of them representing Christ for us—without the basic health services that the privileged take for granted? In deciding that this is an unacceptable state of affairs, we should not back away from the tragic fact that, yes, this will of necessity mean rationing health care. But we are already rationing and we will never not be rationing. It is part of our fallen human condition.
Christians, therefore, should support explicit rationing of health care when it is ordered to justice for the most vulnerable and should reject it when ordered to an idolatrous worship of a market which favors the Rich Man over Lazarus.
Charlie Camosy is an assistant professor of Christian ethics at Fordham University and a member of the NEP advisory board.