By CHARLES CAMOSY

It’s coming.  Health care reform, Round II.

Republicans pledged to do it as part of their manifesto during the midterm election campaigns.  And House Speaker John Boehner, less than a day after the elections, vowed that the GOP would “do everything we can to try to repeal this bill and replace it with common sense reforms to bring down the cost of health care.”

But why was this such a high priority?  The lack of cost controls?  Unfunded state mandates?  Questions surrounding federal funding of abortions?  Well, yes, but the go-to critique of health care reform can be summed up in one word:

Rationing.

Recently, as part of a response to the FDA revoking its approval for a late-stage breast cancer drug, several key Republicans criticized this kind of rationing, but set their sights on a much bigger target:

“Unfortunately, this is only just the beginning,” they continued. “The new health reform law — the so-called Patient Protection and Affordable Care Act — creates 159 new boards, commissions and agencies that will destroy the doctor-patient relationship and replace it with federal bureaucrats deciding who gets care and what treatments they can receive,” The Hill’s Jason Millman reported.

And the GOP will have backing in this effort from a pro-life Christian base crying out against ‘euthanasia’ and ‘death panels’ in the new health care law.

But this attitude refuses to admit two undeniable truths about human existence:

We have virtually unlimited health care needs. (All of us will die some day.)

We have limited health care resources. (There is a finite amount of ‘stuff’ out there.)

We will never not be rationing health care.  Any other conclusion misunderstands the human condition.

Consider Indiana Medicaid and six-month old Seth Petreikis as a case in point.  Without a very rare ‘thymus transplant’ Seth would die within a few months, but his family couldn’t afford the $500,000 price tag.  At first, Indiana Medicaid called the treatment ‘experimental’ and denied their claim. But perhaps because of media and other social pressure, and also because the treatment (though not yet formally approved by the FDA) could hardly be called experimental given its 73% success rate, the procedure was eventually approved .  Obviously the family was overjoyed:

“I got the call and when I heard her say it was approved, I just fell down on the floor crying,” said his mother Becky Petreikis, a Dyer resident. She called her husband, Tim, who was driving home from his job in Chicago, and shared the news with their 3-year-old daughter, Julia. “The phone’s been ringing off the hook,” she said.

Great, right?  The cold, unfeeling government defeated in favor of the vulnerable and desperate child.

Well, not so fast.  From an ethical point of view it’s more complicated.

Medicaid works from fixed budgets and the hundreds of thousands of dollars needed to perform this transplant are resources that now cannot be used to serve other Medicaid patients.  Indiana has a budget crisis caused in large part by medical costs.  Their need to cut Medicaid is so great that they are even telling parents of disabled children that Medicaid funding is no longer an option–and perhaps they should leave their children at a homeless shelter  if they cannot care for them at home.  Indeed, states all over the country are scrambling to cut Medicaid costs–Arizona also recently made headlines by refusing to fund life-saving transplants. Physicians’ flight from Medicaid patients, already problematic because of poor reimbursement rates, will only get worse with the new health care plan.

Attempting to escape health care rationing has exactly the same chance of happening as we have of escaping the finite nature of our resources and, indeed, of our very being.

None.

Sadly, the effort that many Christians are leading against rationing misunderstands what it means to be pro-life in a fallen world riddled with tragedy.  We should never, ever claim that any human being is of ‘less worth’ than another, nor should we ever directly aim at the death of an innocent human person. But neither should we engage in self-deception about the kind of world in which we live. Instead of pretending that this tragic, fallen state of affairs does not exist, Christians should be among the best at bravely attempting to face its reality. We should be able to recognize the false idol present in the consumerist mantra that we can have as much as we want of whatever we want.  And we should soundly reject it.

We live in a fallen world–one riddled with tragedy.  But in the interests of justice we must have the courage to make the difficult and even heart-breaking choices such a world requires.

Charles C. Camosy is Assistant Professor of Christian Ethics at Fordham University in the Bronx, New York and is author of Too Expensive to Treat? with Wm. B. Eerdmans Press.