Tag Archives: Centesimus annus

Full Text: CMA Open Letter to Catholics and Catholic Organizations on health-care reform

‘We must ensure that well-intentioned efforts to bring about “change” are not exploited to create a federally controlled system that promises health care for all, but creates an oppressive bureaucracy hostile to human life and to the integrity of the patient physician relationship…’

Catholic Medical Association

Open Letter to Catholics and Catholic Organizations


September 21, 2009

Members of the Catholic Medical Association have been carefully monitoring the process and content of the health-care reform debate from our unique perspective as Catholic physicians. We are familiar with contributions made to the national debate by other Catholic organizations.

As efforts to enact health-care reform legislation intensify, we would like to share our perspective on some prudential aspects of health-care reform and work collaboratively with others to shape legislation in harmony with the Catholic faith. These thoughts reflect years of experience serving patients and families in medical practice while endeavoring to apply the full spectrum of Catholic medical-moral and social teaching.

We believe we are facing a crisis, not only in health-care financing and delivery, but in the health-care reform process itself. As is often noted, the word “crisis” can mean either danger or opportunity. The United States has the opportunity (and obligation) to craft effective, ethical responses to the crisis in health-care financing and delivery. But there also exists a real danger that misguided legislation could make our current problems even worse. This is a critical time for Catholics to work together to formulate solutions based upon authentic moral, social, and economic principles,

The failings of the U.S. health-care financing and delivery system are well-known. Many people lack consistent access to affordable health insurance and are unable to obtain appropriate healthcare services in a timely manner. Health-care services are expensive and fragmented. These problems result largely from misguided incentives in tax, employment, and government policy.

One unfortunate result of this has been increasing third-party payer intrusion into the patient physician relationship, with significantly deleterious consequences. All Catholics should agree on the fundamental ethical and social principles proposed by the Church. The question we are faced with, after decades of misguided policies, is how should we apply these teachings so as to provide universal access to quality health-care insurance and services in a cost-effective, ethical manner?

Bills passed out of committees in the House and Senate this summer rely heavily on the federal government to dictate solutions. They empower a small group of unelected government bureaucrats and committees to determine the composition and cost of health insurance policies, the reimbursement of providers, the approval of treatments, etc. We think this government controlled approach is flawed in principle and ineffective, if not dangerous, in practice. This approach clearly violates the principle of subsidiarity first articulated by Pope Pius XI in Quadragesimo anno, n. 79, and recently reaffirmed by Pope John Paul II in Centesimus annus, n. 48 and Pope Benedict XVI in Caritas in veritate, n. 47.

• This approach has been and will be ineffective. The federal government has a very poor track record of managing large programs in a cost-effective manner. Medicare will be insolvent by 2017 and faces a $37 trillion unfunded liability. Medicaid’s problems are well-known. Costs have run out of control in most states, and 40 percent of physicians no longer accept Medicaid because low reimbursement rates do not even cover the overhead expense of providing care. Adding millions of people to this flawed government system (as proposed by the Senate H.E.L.P. Committee bill) is not meaningful health insurance reform.

• This approach, moreover, is dangerous given the current Administration’s repeated failures to accord proper respect for the dignity of human life. Reversing the Mexico City Policy and providing federal funding for human embryonic stem-cell research are only the best known of a whole series of proposals denying respect for human life. In addition, the Administration seems intent upon institutionalizing such policies making it difficult, if not impossible, to overturn them in the future. While there have been some misunderstandings about provisions relating to end-of-life consultations; serious concerns remain regarding funding for care of the seriously ill and dying. All are aware that a significant percentage of health-care spending occurs in the last months of a person’s life, and we are facing a demographic tsunami of aging baby boomers. Giving the federal government the power, and primary responsibility, to contain medical expenditures could threaten the provision of medical care to the most vulnerable, the elderly and chronically ill. We believe there are better approaches to achieving meaningful health-care reform and meeting our common goal of making health-care coverage truly universal and genuinely affordable.

• We should advocate for legislation making it possible for individuals and families to purchase health insurance that meets their needs and also respects their values. This could be achieved by re-assigning the tax deduction for health insurance from employers to individuals. And bringing appropriate incentives from the market economy to health insurance companies will increase competition and correct the problem of regional insurance monopolies, thereby reducing costs of insurance and medical care. Such reforms would address the needs of the great majority of people. Congress can also tailor programs to assist those most in need, the working poor, the unemployed, and those currently uninsurable due to preexisting conditions.

• We should encourage greater individual accountability in health-care spending. Since 70 percent of health-care spending is for conditions directly influenced by personal behavior, there is considerable potential for improved health and reduced spending by encouraging healthier lifestyles with appropriate financial incentives. In general, reforms encouraging individual ownership of health insurance and personal responsibility for spending on medical care are more likely to reduce costs in an ethically acceptable manner than are those increasing the power and control of third parties.

• Before supporting the creation of another large government program, we should work to reform those already in existence and demonstrating serious difficulty in controlling costs. Medicaid needs an extensive overhaul to ensure quality care for the poor and just compensation for providers.

In conclusion, we call upon all Catholics and Catholic organizations to reaffirm their support for the foundational ethical and social teachings of the Church which provide a framework for authentic health care reform, and to unite as one in an uncompromising commitment to defend the sanctity of life and the conscience rights of all providers as essential parts of health-care reform. And we also respectfully urge all Catholics and Catholic organizations to place a greater emphasis on respecting the principle of subsidiarity across the spectrum of issues in health-care financing and delivery during the coming legislative debates. Experience indicates that medical decisions are best made within the personal context of the individual patient-physician relationship rather than within some remote, impersonal, and bureaucratic agency, whether governmental or corporate. We are convinced that if this important principle of Catholic social teaching is not correctly upheld, then short-term measures to defend the right to life and respect for conscience will ultimately fail and the patient-physician relationship will be irreparably compromised.

We noted above that we face not only a crisis in health-care financing and delivery, but a crisis in the current legislative process. We must ensure that well-intentioned efforts to bring about “change” are not exploited to create a federally controlled system that promises health care for all, but creates an oppressive bureaucracy hostile to human life and to the integrity of the patient physician relationship. It would be better to forgo long-needed changes in health-care financing and delivery in the short-term if these would lead to a long-term, systemic policy regime that is inimical to respect for life, religious freedom, and the goods served by the principle of subsidiarity. Rather than accept such an outcome, we should take the time required to implement reform measures that are sound in both principled and practical terms.

Thank you.


Louis C. Breschi, M.D.


Catholics and Socialism by Stephanie Block


       One of the interesting discussions following the wake of this year’s political campaign has been about Catholics and socialism. Is it OK to be a Catholic socialist? (Wonder what sparked this line of thought?)

       Despite Pope Pius XI saying, back in the 1930s, that “No one can be at the same time a sincere Catholic and a true Socialist”, some Catholics want to argue the point. They claim the “Christian socialism” described in Acts, in which “All those who had believed were together, and had all things in common; and they began selling their property and possessions, and were sharing them with all, as anyone might have need,” is the inspiration for the “scientific socialism” espoused by Marx and Engels. After all, Marx and Engels say it is.

       Well, of course Marx and Engels say their inspiration for the socialist ideal was early Christianity. It gives their theories authority and respectability. As Saul Alinsky drily exhorts young radicals, “… you do what you can with what you have and clothe it with moral garments.” [Rules for Radicals] Marx and Engels are simply clothing socialism with Christianity, the wolf in a sheepskin.

       At the blog called Catholic America: A closer look at Church, Culture and Change, which is a feature of Newsweek/Washington Post, writer Anthony M. Stevens-Arroyo recognizes that the salient component of “Christian socialism” is choice. He glosses over this, however, and only a paragraph later is reminding the reader that he must also bear in mind another Christian principle, namely that “the needs of the many outweigh the needs of the few.” We see where this is going.

       And so here it is: “At stake in contemporary Catholic America is a growing awareness that the U.S. economic system has serious flaws.” OK, Mr. Stevens-Arroyo, hold on there just a minute. Yes, the U.S. economic system has serious flaws but that’s the human condition. There has never been and never will be an economic system without serious flaws. But the US economic system, for all its flaws, has been the envy of the world…and has brought prosperity to the majority of its citizens.

       Stevens-Arroyo continues: “In addressing the financial system, “socialism” is not a dirty word for Catholics.” Um…yes, it is. Re-read the Pius XI quote, above. Or, read John Paul II, who, without any illusions about its imperfections, writes, “it would appear that, on the level of individual nations and of international relations, the free market is the most efficient instrument for utilizing resources and effectively responding to needs.”

       John Paul is not so generous with socialism. “[I]n today’s world, among other rights, the right of economic initiative is often suppressed. Yet it is a right that is important not only for the individual but also for the common good. Experience shows us that the denial of this right, or its limitation in the name of an alleged ‘equality’ of everyone in society, diminishes, or in practice absolutely destroys the spirit of initiative, that is to say the creative subjectivity of the citizen.”

       Referring to Pope Leo XIII, he says: “His words deserve to be re-read attentively: ‘To remedy these wrongs (the unjust distribution of wealth and the poverty of the workers), the Socialists encourage the poor man’s envy of the rich and strive to do away with private property, contending that individual possessions should become the common property of all…; but their contentions are so clearly powerless to end the controversy that, were they carried into effect, the working man himself would be among the first to suffer. They are moreover emphatically unjust, for they would rob the lawful possessor, distort the functions of the State, and create utter confusion in the community’. The evils caused by the setting up of this type of socialism as a State system – what would later be called ‘Real Socialism’ – could not be better expressed.” [Centesimus annus]

       It gets worse. The pope continues, “Socialism considers the individual person simply as an element, a molecule within the social organism, so that the good of the individual is completely subordinated to the functioning of the socio-economic mechanism. Socialism likewise maintains that the good of the individual can be realized without reference to his free choice, to the unique and exclusive responsibility that he exercises in the face of good or evil. Man is thus reduced to a series of social relationships, and the concept of the person as the autonomous subject of moral decision disappears, the very subject whose decisions build the social order.”

       Benedict XVI has some hard words for socialism, too. “Let us recall the fact that atheism and the denial of the human person, his liberty and his rights, are at the core of the Marxist theory…Moreover, to attempt to integrate into theology an analysis whose criterion of interpretation depends on this atheistic conception is to involve oneself in terrible contradictions. What is more, this misunderstanding of the spiritual nature of the person leads to a total subordination of the person to the collectivity, and thus to the denial of the principles of a social and political life which is in keeping with human dignity.”

       Why are we even discussing this? The answer is that you have a large body of people – the Catholics living in the US – who, if they knew their Church teachings, rather than what other Catholics say they say, might rebel at incoming socialist incursion. Socialism – the unchosen, forced-onto-society, “scientific” version that has martyred hundreds of thousands – is a really dirty word to Catholics.

Ahem. Let me try that again. Socialism is a really dirty word.