Health care for all

...dressed only to the extent that institutional other major actor, the health-insurance The different reception likely to be ac- conscience clauses will protect Catholic companies...

...strong argument for the value of a plu- Our founding fathers all came It is clearly worth a major effort...

...for a basic package of benefits...

...The White House Fellowlaw and morality, material cooperation, and legislative struggle we are now facing as ship Program is one attempt to deal the full range of conscience clause pro- a nation...

...private moral sponsibilities...

...Brooke Shearer, a long-time ing ones...

...It is clear in the United ing will complement and reflect other ar- issues, the strategy should distinguish the States, as in all other postindustrialized guments in the public arena...

...public issues" of abortion and care of societies, that the health-care profes- The Catholic case has a distinctive the terminally ill, from "private issues" sions cannot respond adequately to the style, particularly the manner in which it of contraception and sterilization...

...and identifies a mix with the issues surrounding contracepwhich also have obligations to meet the of public and private actors which have tion and sterilization...

...The duties to respond to the right...

...Using the common logic of the social teaching, howevThe Clinton administration's These distinct roles correspond to the er, one could say that the right to health Task Force on National three major concerns which the church has care should assure for each person a basic Health Care is scheduled to in the U.S...

...health care, and some of the members of moral responsibilities, and a major role Commonweal 7 Mav 1993: 7 in meeting the health-care needs of the moral role of a profession, health-care re- a reason for submerging or forsaking society...

...The first minimum of benefits which will vary with submit its report to the pres- is health care as a social justice issue, in- the economic capability of the society in ident this month...

...The church can sustain a difficult but S: 7 May 1993 Commonweal credible moral posture in the public de- tections which will be needed to shape a fecting the legislative process through citbate by joining strong support for health Catholic strategy if we do not prevail on izen lobbying...

...It is interbeen assured, is to increase to the established ones...

...They pation are already in place-among them, were instituted during the Johnson adof course, the Peace Corps, VISTA, SCORE ministration to counteract the rising tide (the senior corps of retired executives of distrust of government at that unfortuconnected with the Small Business Admin- nate time...

...There is, however, no public consensus to support this idea...

...Remaining faithful under such circumstances as the principle of religious freedom, including equality of access by Irish and the Russians have experienced is not easy, so I different religious groups within Russia, none of whom should pledged the patriarch the constant support of my prayers for suffer at the hands of the state...

...Jr., is the clean of the Valparaiso scribed in painful detail the attempts of the state to destroy the University School of Latin...

...But this fact should not obscure the tiveness will create alliances with others...

...What follows is an nation of who has the duty to respond to vide a defined focus for the public debate...

...Using categories from Catholic social teaching to make the social justice case J. Bryan Hehir produces the following structure of argument...

...While the right is declared, the papal text did not spell out the content of the right...

...For President's Commission on White House Clinton White House than of the precedthat reason a director of national service, Fellowships...

...The Clinton people think otherwise fession...

...idea of John W. Gardner, former secreThe White House tendency toward du- tary of Health, Education, and Welfare, ality is apparent here...

...The report, volving the question of access to health which the right is being secured...

...based policies...

...In effect, we should not expect to find the private issues resolved in the legislation in a way which follows Catholic IINNOVArIYE teaching...

...There foundation for a positive and activist role The architecture of the social justice also may be issues which hear upon care for the state in responding to health-care case in Catholic terms, therefore, affirms of terminally ill patients...

...of Stalin in 1932 to Khrushchev's promise to eliminate Orthodox The most significant meeting throughout this week of ex- priests by 1988...

...Decades of the subversion of the church by the EDWARD MCGLYNN GAFFNEY, JR...

...The Catholic social thought a profession bears ments to specify which benefits are re- key need is for an overall strategy to respecial social responsibilities...

...right to health care of each citizen...

...other major piece of the Catholic case in complex, noisy society, and almost Some energy must also be used to think the health-care debate...

...ing on subsidiarity restrains the notion that er, as a voice of public advocacy, and as There are different ways to frame the the state should be the first agency to rean institution deeply involved in health care social justice argument about access to spond to the right...

...esting to note that Shearer's phrasing, citizen participation in One of the least known of the agencies "Lyndon and Lady Bird," although ungovernment-part of the for increased citizen participation is the doubtedly apt, is more typical of the process of "reinventing government...

...Catholic par- It is clear that the church's involvement health-care professions are the primary ticipation in the health-care debate will in the health-care debate must include both community upon whom the duty falls...

...and a major political mistake...

...First, est groups or trade associations...

...This position has solid warrants to recommend it...

...can involve taking human life...

...Gardner, readers may remember, with the varied new governments of the was the epitome of those from American separated parts of the former Soviet Union "good families" who saw public service might seem to be at odds with the European as both an obligation and an honorable prodesk...

...I say this while acknowledging that aspects of sterilization policy HEALTH CAPE f IVC...

...Clinton campaign and the Clinton presi- third is the role of Catholic institutions as The assertion of each person's right to dency have generated new expectations for participants in the ministry of health care health care leads, secondly, to a determichange, and its proposal for reform will pro- in the United States...

...Neither does the Orthodox church him and for the church in Russia...

...In require going beyond these general state- social justice and bioethical issues...

...Clearly at this moment the best creative cial justice and justice as a right-to-life Today young people of compaenergies in the church should be devoted claim, the argument for pluralism is the rable ability grow up in a huge, to joining these two kinds of justice claims...

...traordinary experiences was an audience that five members of I recalled a bond of suffering between my people and his, the American delegation-including the ecumenical officer of going back to the period of the Penal Laws that imposed sethe Orthodox church in America, the Very Reverend Leonid vere criminal penalties and civil sanctions on Catholics in Kishkovsky-had with the patriarch of Moscow, His Holiness England and Ireland from the Tudor period down to our own Alexis II...

...to the national assessment of health-care concerns...

...Orthodox Jews with whom I prayed in the snow on Shabbat Orthodox church in Russia, from the notorious five-year plan because they have no synagogue within which to meet...

...Ap- sought to enlist citizens nationwide in af- I wanted to help people...

...structed state...

...of course, will be a proposal, and its pub- care available to the citizenry...

...Pluralistic in from villages or the countryside, or should be cast injustice terms across the this setting means a system of public and from what would now be regarded two issues: what justice demands for un- private institutions, as well as institu- as very small cities...

...Professions quired to fulfill the right, and how the late these two areas...

...The els of care...

...including abortion in a federally financial heath-care plan would he a major shift in using tax monies to support a highly contested issue of conscience in the country...

...There will be space in the public is the fact that close to 40 million indi- a multiplicity of agents...

...And the patriarch de- Edward McG/vnn Gaffneti...

...Catholic Conference has already taken such a position, arguing that the inclusion of abortion in the benefits package would be "a moral tragedy, a serious policy misjudgment...

...The church primary role which the health-care pro- When the church raises its substantial and should undoubtedly try to shape the healthfessions still have in meeting health-care distinctive bioethical concerns, there will care legislation in a way which sets stanneeds...

...istration), and the White House Fellow- The creation of the fellowships was the ships...

...The case ralistic health-care system...

...the right is a moral claim A CATHOLIC PERSPECTIVE to a good (health care) which is essential to human dignity...

...The sec- debate, the church will have to engage the lication will signal the beginning of a new ond is health care and medical ethics (or questions of universal access and the defphase of the national debate on health bioethics), involving a broad range of inition of which health-care benefits should care...

...He thought this was the most seek a preferred or established position in a newly recon- important gift an American jurist could bring to Moscow...

...following the style of Vatican II's Professions are accorded unique status in In engaging the social justice aspects Gaudium et sees, as well as older Catholic civil society, and they bear unique re- of the health-care debate, Catholic teach- arguments about public vs...

...The U.S...

...Few other insti- none gets a close-up view of govthrough the relevant moral categories of tutions will carry as complex a case in the ernment...

...But Gardner's original proEli Segal, long an associate of the presi- FOB (Friend of Bill's) who accompanied posal that there be a hundred of the fellows dent's, is a prominent member of the Hillary Rodham Clinton on the campaign assigned throughout the executive branch White House staff...

...at the heart of this policy question vide health care for each person through lic life...

...The affirmation of the right finds concise expression in John XXIII's Pacein in terris (1963...

...could qualify it as a public issue...

...His statement about the care on social justice grounds and strong both sides of the justice argument...

...but the state clearly has at the local and national levels...

...To fill out the needs...

...The private issues should he adprofessions in the United States stands an- Catholic social justice case on health care...

...state would seem to counsel against that...

...It was he who also founded and have set about putting their appoint- Common Cause, the organization which "I got into government service because ees in charge of both old and new...

...The first step is defining the right HEALTH CARE FOR ALL to health care...

...health-care problem...

...Easy on the innovation, darnn it...

...The key issue, of course, will be aborof socialization in Mater et ina,gistra ception of corporate moral responsibility tion, particularly whether access to abor(1961) and John Paul II's definition of the which should be articulated and enforced tion will be included in the Clinton proposal duties of solidarity in society establish the through law and policy...

...fulfill their different duties...

...meeting the need for health care is an esreforms is the Catholic church...

...White House Fellows is typical of his opposition to abortion...

...but the distinc- the public order of society because they state...

...While they do not have the corded to the bioethical arguments is not facilities...

...The case is moral- Finally, in the public debate the Catholic idealistic approach to public service in a ly coherent, but it will be very difficult to case for health care should include a democracy: prevail in the present climate on abortion...

...be clearer lines drawn between Catholic dards on these issues for society as a Between the state and the health-care arguments and many who will support the whole...

...WORLD WATCH the Task Force are ethicists who have been arguing the justice case over the last decade...

...includes agenda, it should be noted that Catholic But subsidiarity encourages the search meeting that right as an essential element health-care facilities have long struggled for other agents, "lesser than" the state, of the common good...

...Here several elements of Catholic Among the institutions which are pre- the church's interests and to highlight social thinking converge...

...In the U.S...

...effort to describe the content of each of the right...

...The U.S...

...Both John XXIII's explanation form requires of these companies a con- them...

...The patriarch committed to us that he supports the century...

...The need for universal access to health care joins the notions of subsidiarity, social- public issues are concerns which affect without the extensive involvement of the ization, and solidarity...

...Along with protecting so- first hand the process of governing...

...The numbers of Various unhappy old-timers have point- According to her, the fellowships were the ed out that effective agencies for partici- unlikely fruit of the Vietnam War...

...At the State Depart- and Fellowship Commission chairman, ment, the new "czarship" for relations 1977-81...

...When Gardner broached the idea, it was warmly welcomed by then President 0 ne of the aims of the new parently the newly created agencies are Lyndon Johnson and Lady Bird Johnson, administration, we have intended to provide competitive stimulus according to Brooke Shearer...

...trail, is the newly appointed director...

...Catholic teachargument for the church to act as a teach- viduals have no access to health insurance...

...As the years go by they have beGOODFELLOWS come a growing reservoir of exREINVENTING GOVERNMENT ceptional individuals prepared to serve their country...

...The church's A major part of the national debate in sential aspect of the common good...

...argument about health care questions which have been traditional fall within the category of minimum levreaches back to the early 1970s, but the concerns of Catholic moral teaching...

...participation in the policy process exem- health care is focused on issues of social Society fulfills the responsibility to proplifies the diverse dimensions of its pub- justice...

...was pared down sharply...

...All of them had born life, and what it demands to protect tional protection for specific religiously the opportunity, as youths, to see at life after birth...

...Each year a selection of the most promising young men and women OF SEVERAL MINDS Abigail McCarthy in America are given the opportunity to see and participate in the process of governing at the highest levels...

...Commonweal 7 Mav 1993: 9...

...At this stage of the are not to be conceived simply as inter- diverse agents responsible for health care public debate I propose two moves...

...Second, the church can make "public arguments," i.e., not a specifically Catholic case, to oppose abortions as part of a benefits package...

...Ll with that unfortunate fact...

...a right to health care for all...

...The duty in the pared by ideas and experiences to contribute points of tension among these complex first instance falls on society as a whole...