Subsidiarity and Health Care
By Bishop Robert Finn: In August of 2009, Archbishop Joseph Naumann, of Kansas City, Kansas, and I co-authored a joint pastoral statement, “Principles of Catholic Social Teaching and Health Care Reform.” The full text can be found on the Catholic Key Blog, and other places.
The United States Bishops had issued several statements about what would eventually become “Obama Care,” or the Affordable Care Act. As neighbor bishops serving Missouri and Kansas, we took a slightly different approach, appealing, first, to the Catholic understanding of subsidiarity. I cite a section of the Letter:
“This notion that health care ought to be determined at the lowest level rather than at the higher strata of society, has been promoted by the Church as “subsidiarity.” Subsidiarity is that principle by which we respect the inherent dignity and freedom of the individual by never doing for others what they can do for themselves and thus enabling individuals to have the most possible discretion in the affairs of their lives. (See: Compendium of the Social Doctrine of the Church, ## 185ff.; Catechism of the Catholic Church, # 1883) The writings of recent Popes have warned that the neglect of subsidiarity can lead to an excessive centralization of human services, which in turn leads to excessive costs, and loss of personal responsibility and quality of care.
Pope John Paul II wrote, “By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending.” (Centesimus Annus #48)
And Pope Benedict XVI, “The State which would provide everything, absorbing everything into itself, would ultimately become a mere bureaucracy incapable of guaranteeing the very thing which the suffering person—every person—needs: namely, loving personal concern. We do not need a State which regulates and controls everything, but a State which, in accordance with the principle of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need. … In the end, the claim that just social structures would make works of charity superfluous masks a materialist conception of man: the mistaken notion that man can live ‘by bread alone’ (Mt 4:4; cf. Dt 8:3)—a conviction that demeans man and ultimately disregards all that is specifically human.” (Deus Caritas Est #28)
The Federal Government is clearly required to lead in areas such as national defense, international diplomacy and trade. Initiatives such as health care, education, business and commerce, the distribution of charitable assistance, and some other areas, are most meaningfully executed at appropriate lower levels of responsibility.
As the New Administration and Congress proceeds, necessarily, with the repeal and replacement of this program of national health care, the study of time tested Catholic social principles such as subsidiarity, solidarity, and the inviolable value of human life, will be worthy guides to the formulation of a meaningful model.