MM – I do not think it means universal health insurance. And there’s nothing in Catholic Social Teaching that says I am wrong. Catholic Social Teaching is more about ends than it is about means.

I do not believe universal insurance is possible. I’m also not even sure it would be desirable. I think that the pedagogical effect of instituting health care as a right given to us by the government will have bad consequences for not only our health care but also our politics. I think it would be foolish to put something as important as our health under democratic control.

Not true at all. Food has always existed in the forms of meat, vegetables, nuts, and fruit. Modern healthcare — down to vaccinations, antibiotics, most forms of surgery, and certainly any sort of electronic tests — simply didn’t exist at all prior to the past 100 years or so. It’s not that the people of 1500 had more primitive antibiotics or heart surgery; they had almost nothing that we would call “healthcare” at all. Let alone health “insurance.”

In a society in which insurance is needed to be guaranteed health care, insurance is a need.

This would have to be heavily amended to be true, so heavily that it wouldn’t do the work that you intend. To wit: “In a society where people are guaranteed access only to emergency health care, and wherein people lower than middle class need insurance to have slightly more ready access to routine health care, albeit mostly consisting of treatments that didn’t exist at all prior to the last few decades, insurance is a ‘need.’”

The USA is the only Western country without universal healthcare, this discussion would not be had anywhere else. The main problem is that “insurance” is not tied to the person but to the job, resulting in frequent changes in providers, doctors and the lovely “pre-existing conditions” (for all people who weren’t “born yesterday”). This is a relic from World War II.

As far as differences are concerned ? My wife had to apply to a dozen different companies/agencies as a provider, rather than to one agency. Many insurance co. won’t take new doctors to begin with. Billing all these behemoths makes one need therapy oneself. MediCare, for example, has taken 8 months to go through the motions and still isn’t done. The best, as in: paying on time, has been TriCare, which handles military personnel. There’s plenty of PTSD to go around. Government is viewed as welfare, and government facilities therefore feel like that. In Europe, there’s a stronger sense of pride in public institutions, and a sense of solidarity.

In Vienna, there’s a central city-run agency that accredits doctors, administers care etc., the public hospitals are excellent. Sick leave lasts for as long as you’re sick (novel concept, I know). Health care doesn’t vanish with your job. There are many Catholic hospitals, they are part of the city’s health system. I’ve noticed that Austrian patients get to stay in the hospital a lot longer than in the US. For those who want a little extra (such as bringing a doctor of your choice to any hospital, having a private room etc.) there are private insurance options to add on to the universal insurance.

American health insurance is not insurance, it’s nothing more than a pre-payment plan. If you compare health insurance to auto insurance, the differences are astounding.

The problem with health care is the insurance companies and pharmaceutical companies control the entire industry. Many doctors are now opting out of accepting any type of health insurance. This way they can charge less and give better service to their patients.

As to Sam’s point on accountability, it seems to parallel MacIntyre, and hence, introduces some of my issues with him. It is one thing to argue that our functional influence as shareholder or voter approaches zero. It is another thing to argue that it is zero. The latter in my mind is functional nihilism. If I can organize 200 people in my congregational district, I can get a meeting with my congressman and likely influence him. That my voice might not receive as much reception if I simply call his office doesn’t speak to his lack of accountability to me. It takes significant inertia to move large bureaucracies. I’m not sure having our government be reactionary is all that desirable.

As to how this applies in real life, consider that an act of Congress was passed in an attempt to save Schiavo’s life. Just one person. That has to count somewhere on the accountable scale. There are stories of corporations reversing decisions based on media coverage. That is also evidence of accountability. Granted, it helps to be white and beautiful to get the media’s attention, but that’s beside the point.

Sloppy logic, I think. People cannot survive without their health. Health care obviously has taken different forms, but the fact that “health care as we know it” didn’t exist until recently does not change that people need health care. By your logic, food is not a necessity, because food “as we know it” hasn’t existed until recently.

Health care is a want…

How do you square this with the church’s view that health care is a human right? Does the church often demand that mere “wants” are a matter of human rights?

But it might be wrong to be obsessed with our physical health and freedom from death.

That’s easy for a relatively health person in the First World to say.

Health care is a want – people want to be liberated from physical pain and from death. They seek this in health care. I am not saying the desire for health care or for physical health is wrong. But it might be wrong to be obsessed with our physical health and freedom from death.

The main scandal is that in the USA health insurance is tied to the job and that one frequently has to start from scratch, incl. the sad “pre-existing condition” joke. Having to switch doctors is just icing on the cake, Limit on sick leave is also sweet. (my Dad had a hip replacement this year, 3 months sick leave (paid), including spa retreat for 3 weeks.
The lack of fully paid maternity leave (4 months in Austria) is just one of the reasons the US would be barred from joining the EU.

The fact that people disagree about where to draw the line between wants and needs does not mean that the distinction does not exist, as you implied.

It’s a funny thing: most people tend to think that the distinction between wants and needs is absolutely clear, yet they differ greatly as to what counts as a want and what counts as a need. Such differences are often obscured by the use of amorphous terms (e.g. “living wage,” “basic health care” etc.), but they are nonetheless real.