OP-ED

Why Christians Should Support Health Care Rationing

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.

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InterestingBob HertztimJohn R. Morrow "The Ratings Guy"Peter Recent comment authors
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Interesting
Guest
Interesting

This is the first thing the Nazis did. They rationalized not providing medicine to certain very sick people. Then they did the same with the retarded. Then went the criminally insane. Then wen the disturbed. The elderly followed. Certain “lesser” children followed them. Read a little bit about the T4 program. Humans are not rational or logical beings. Once we instate a principle–that it is ok to deny a benefit for some–it is not uncommon for a recursive and iterative process to take place, extending the rationale beyond its original intentions. This is especially the case when a country is… Read more »

Bob Hertz
Guest

I cannot even pretend to any expertise in medical ethics, What I can question, however, is whether some of the ‘super-expensive procedures’ really need to be so expensive. What if we had price controls on drugs with no substitutes (like other industrial nations).? Then a cancer drug or an anti-rejection drug would not cost $1,000 a day. The cost of a transplant could be cut by up to $200,000 right away. What if a patient who needed 60 days in the hospital could be housed in an empty bed in the VA system? (which the government has already paid for)… Read more »

Interesting
Guest
Interesting

Good points.

Charlie
Guest

Let’s be careful about lumping millions of people together like this. I’m Roman Catholic, but I sit on the advisory board for this wonderful group of evangelical Christians:
http://www.newevangelicalpartnership.org/

Peter
Guest
Peter

“What would be your proven solution absent government intervention?”
If you listen to evangelicals, Christians don’t need medical care, they just need to pray more (and send donations for the healthcare plans of their leaders) and all their problems will go away. Pat Robertson would say that if you get sick it’s God’s message that you aren’t being a good Christian.

Margalit Gur-Arie
Guest

We do not have a scarcity of resources in health care. There are plenty of doctors, more than enough hospitals, plenty of drugs and devices, too many MRI machines and it seems that half of the glass building in my town are Orthopedic Centers. We are just being gouged when it comes time to purchase services from these resources, because other than directly, and rather nicely, supporting those who provide actual services, we also have to pay to a bewildering array of middlemen who contribute very little to actual medical care delivery, and everything is market up by orders of… Read more »

steve
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steve

@tim- Yet you ignore the other side of the issue. Even a cursory reading of the New Testament illustrates the importance Christ placed upon caring for the needy, including the sick. What would be your proven solution absent government intervention? If one is truly a Christian, one should honestly answer that question. I dont think it suffices to assume that they will just somehow get care. Our history suggests that is no the case.
Steve

Peter
Guest
Peter

Can’t see where your arguments are connected. “Rationing is done where supply is limited in order to keep prices artificially low.” Like WWII where it was done actually because there was scarcity of resources needed elsewhere and price had nothing to do about it – just ensuring supply and fairness of distribution – cause we’re all in this together. During water shortages is rationing designed to keep prices low? “Traditional economists argue that high prices act to reduce waste of the scarce resource.” Like healthcare? Show me where this is happening in U.S. healthcare? High prices keep access limited so… Read more »

DeterminedMD
Guest
DeterminedMD

Per Tim, sums it up fairly well for me! Just like the Tucson incident, per the Democraps/liberal dialogue of late, don’t talk politics on our terms, you are stoking the fires of hate and injustice! In other words, just do as we say, not as we do. This is the kind of mentality you want health care decisions based on? Again, anyone saying yes, you deserve the representation you seek and embrace. And that is not just aimed at Democraps, but equally to Repugnocants as well! Any political legislation to manage health care needs non political input. Comeon, who provided… Read more »

tim
Guest
tim

I love it. A theological argument for government programs.
Jesus’ injunction to “love your neighbor as yourself” gets mutated, in the hands of the Left, into “happily send more money to government officials you’ll never know so they can give part of it to people you’ll never know (and waste the rest), using rules you’ll never completely understand and can’t influence anyway…and if you resist all this, by argument or vote, you are not a Christian, you are evil and greedy.”
Uh, no.

John R. Morrow "The Ratings Guy"
Guest

Wow, Religion, politics and health care all together in one furry ball. I am glad this isn’t a cocktail party! Maybe the debate should exclude one from the other. If I might just weigh in on one point, I really don’t think we need to add “rationing” to Death and Taxes as being the only things certain in life. Rationing is done where supply is limited in order to keep prices artificially low. Traditional economists argue that high prices act to reduce waste of the scarce resource. Examples of real rationing include; rationing of ventilators in NY State during a… Read more »

Peter
Guest
Peter

We’ll always have rationing of the “other guy” as long as we are not all included in the same health care payment/benefit plan. That’s why there is so much opposition to healthcare reform because we want someone else rationed, not us.

Craig "Quack" Vickstrom, M.D.
Guest
Craig "Quack" Vickstrom, M.D.

This is a very good article and discussion. Patients do need to be held personally responsible for their deleterious behavior. Third-party diversion of funds does need to be stopped. Physicians are responsible for providing quality care. We have far more needs/wants than we do resources. We already ration health care. We do it by social class. The rich get it, the poor don’t. How we ration needs to change to a more egalitarian method.

DeterminedMD
Guest
DeterminedMD

What reality are you living in, Ms G-A? Your argument is foolish, turning it solely on the role of ending profit to free up “resources” to then provide all these services to make care ration-free. Nothing is infinite, and that is why arguments like yours are just annoying in the end. Considerate yet empty or unrealistic promises are not better than lies and deceit. Let’s sell the realistic message about the health care debacle that is US health care as of 2010: it is the combination of responsible patient actions, invested and involved providers and other health care supports, accountable… Read more »

nate
Guest
nate

but since private individuals have not stepped up and come through for dozens of millions of the most vulnerable in the United States, it seems like government is the only place to turn to protect them. Who are these dozens of millions? There are dozens of millions that take help they don’t need. The number of people that truly need help is actually pretty small, unfortunetly for political reasons we have programs that help the politicians not those in need. I’m surious do you accept there is a difference between opposing rationing and opposing government rationing? Can you link to… Read more »

BobbyG
Guest

I’m with Margalit on her above points.