In the present time, what has been called the “medical–industrial insurance complex” in the United States needs reform. As health insurance in the United States remains inaccessible to millions of people, and as prices continue to rise, questions arise about the most moral ways to ensure delivery of health care especially to the most vulnerable populations. In this essay, I offer a virtue analysis of the moral implications of health insurance mandated by the US Government in contrast to an increasingly popular alternative to insurance, namely, healthcare sharing ministries. In part 1, I list some of the moral problems entangled with US Government-mandated health insurance, including injustice, disrespect for patient autonomy, limitations on patient freedom, exploitation of patients for profit, undermining of conscience rights, cooperation with evil, and scandal. In part 2, I discuss the issue of risk and then list some potential moral advantages to healthcare ministries, including respect for patient autonomy, conscience, and the religious freedom to witness to the Catholic faith in charity and solidarity.
Summary:
Mandated health insurance the United States presents some moral challenges for conscientious Catholics, whereas healthcare sharing ministries appear to ameliorate some of these issues. Ultimately, the individual should have freedom to choose either insurance or healthcare sharing, given the different benefits and risks entailed by both.
AndersonGerard F.2007. “From ‘Soak the Rich’ to ‘Soak the Poor’: Recent Trends in Hospital Pricing.” Health Affairs26, no. 3: 780–89. doi: 10.1377/hlthaff.26.3.780.
2.
Antoninus of Florence. 1740. Summa Theologica: Pars Secunda. Verona, Italy: Augustus Caratonius.
3.
ArcherDavid L.2017. “Will Catholic Hospitals Survive without Government Reimbursements?” The Linacre Quarterly84, no. 1: 23–28.
4.
AustriacoNicanor. 2011. Bioethics and Beatitude: An Introduction to Catholic Bioethics. Washington, DC: Catholic University of America Press.
5.
AquinasThomas. 1955. Summa Theologiae. Rome, Italy: Editiones Paulinae.
6.
BabcockPaul. 2019. “Paralyzed by Prices: An Analysis of Price Theory within the Context of Health Care.” The Linacre Quarterly86, no. 1: 89–102.
7.
BaiGeAndersonGerard F.. 2015. “Extreme Markup: The Fifty US Hospitals with the Highest Charge-to-Cost Ratios.” Health Affairs34, no. 6: 922–28. doi: 10.1377/hlthaff.2014.1414.
8.
BaiGeYehiaFarahAndersonGerard F.. 2020. “Charity Care Provision by US Nonprofit Hospitals.” JAMA Internal Medicine180, no. 4: 606–07. doi: 10.1001/jamainternmed.2019.7415.
9.
BeauchampTom L.ChildressJames F.. 2009. Principles of Biomedical Ethics, 6th ed. Oxford, UK: Oxford University Press.
10.
BelkDavidBelkPaul. 2020. The Great American Healthcare Scam: How Kickbacks, Collusion and Propaganda Have Exploded Healthcare Costs in the United States. New York: Scamwatch.
BenestadJ. Brian. 2017. “Foundations of Authentic Medical Care.” In Catholic Witness in Health Care: Practicing Medicine in Truth and Love, edited by TravalineJohn M.MitchellLouise A., 3–30. Washington, DC: Catholic University of America Press.
Catholic Health Association. 2014. “CDF Principles for Collaboration with Non-Catholic Health Care Entities: Ministry Perspectives.” Health Care Ethics USA22, no. 3: 24–34.
Catholic University of Valencia, Bioethics Observatory—Institute of Life Sciences. 2017b. “Involuntary Euthanasia Increases in Holland as in the Other Countries That Has Been Legalized.” Bioethics Obervatory—Institute of Life Sciences—UCV(Blog). https://bioethicsobservatory.org/2017/11/involuntary-euthanasia-increases/23467/.
Cohen-AlmagorRaphael. 2015. “First Do No Harm: Intentionally Shortening Lives of Patients without Their Explicit Request in Belgium.” Journal of Medical Ethics41, no. 8: 625–29. doi: 10.1136/medethics-2014-102387.
20.
DavisHenry. 1943. Moral and Pastoral Theology: Volume Two: Commandments of God, Precepts of the Church, 4th ed. New York: Sheed and Ward.
EhrenreichBarbara. 1970. The American Health Empire: Power, Profits, and Politics. New York: Random House.
23.
EijkW. J.HendriksL. M.RaymakersJ. A.FlemingJohn I., eds. 2014. Manual of Catholic Medical Ethics: Responsible Healthcare from a Catholic Perspective, English Edition. Translated by Regina van den BergSr. M.RaymakersJ. A.. Ballarat, Australia: Connor Court.
FinnDaniel K.2010. “The Unjust Contract: A Moral Evaluation.” In The True Wealth of Nations: Catholic Social Thought and Economic Life, edited by FinnDaniel K., 143–64. Oxford, UK: Oxford University Press.
JupiterJesseBurkeDennis. 2013. “Scott’s Parabola and the Rise of the Medical–Industrial Complex.” Hand8, no. 3: 249–52. doi: 10.1007/s11552-013-9526-5.
33.
LargentMark. 2007. Breeding Contempt: The History of Coerced Sterilization in the United States. New Brunswick, NJ: Rutgers University Press.
34.
LawrenceJane. 2000. “The Indian Health Service and the Sterilization of Native American Women.” American Indian Quarterly24, no. 3: 400–19.
35.
LawrenceRyan E.RasinskiKenneth A.YoonJohn D.CurlinFarr A.. 2011. “Adolescents, Contraception, and Confidentiality: A National Survey of Obstetrician-Gynecologists.” Contraception84, no. 3: 259–65. doi: 10.1016/j.contraception.2010.12.002.
MakaryMarty. 2019. The Price We Pay: What Broke American Health Care and How to Fix It. New York: Bloomsbury.
39.
MaloneyF. P.1998. “The Emerging Medical/Industrial Complex. The Industrialization of Medicine.” Physician Executive24, no. 2: 34–38.
40.
ManninenB. A.2006. “A Case for Justified Non-Voluntary Active Euthanasia: Exploring the Ethics of the Groningen Protocol.” Journal of Medical Ethics32, no. 11: 643–51. doi: 10.1136/jme.2005.014845.
41.
McHughJohn A.CallanCharles J.. 1958. Moral Theology: A Complete Course Based On St. Thomas Aquinas and the Best Modern Authorities, Volume II. Revised and Enlarged by FarrellEdward P.. New York: Joseph F. Wagner.
42.
McKalipDavid. 2016. “Achieving Moral, High Quality, Affordable Medical Care in America through a True Free Market.” The Linacre Quarterly83, no. 4: 423–44.
MilneC.-P.KaitinK. I.. 2010. “Impact of the New US Health-Care-Reform Legislation on the Pharmaceutical Industry: Who Are the Real Winners?” Clinical Pharmacology and Therapeutics88, no. 5: 589–92. doi: 10.1038/clpt.2010.167.
45.
PatelPriti. 2017. “Forced Sterilization of Women as Discrimination.” Public Health Reviews38:15. doi: 10.1186/s40985-017-0060-9.
46.
PCJP (Pontifical Council for Justice and Peace). 2004. Compendium of the Social Doctrine of the Church. Washington, DC: USCCB.
RosenthalElizabeth. 2017. An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. New York: Penguin.
49.
RougeauVincent D.2010. “Just Contracts and Catholic Social Teaching: A Perspective from Anglo-American Law.” In The True Wealth of Nations: Catholic Social Thought and Economic Life, edited by FinnDaniel K., 117–42. Oxford, UK: Oxford University Press.
SgrecciaElio. 2012. Personalist Bioethics: Foundations and Applications. Translated by Di CamilloJohn A.MillerMichael J.. Philadelphia, PA: National Catholic Bioethics Center.
53.
SilverCharlesHymanDavid A.. 2018. Overcharged: Why Americans Pay Too Much for Healthcare. Washington, DC: Cato Institute.
54.
SmithWesley J.2003. Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder, Revised, updated ed. Dallas, TX: Spence.
55.
SternAlexandra Minna. 2005. “Sterilized in the Name of Public Health.” American Journal of Public Health95, no. 7: 1128–38. doi: 10.2105/AJPH.2004.041608.
