Seeking Justice in Healthcare

By Fr. John Rausch
Herald Columnist
(From the issue of 6/24/04)

My friend, Norma, died because she was poor. Diagnosed with Type II diabetes she found no company willing to insure her because of her pre-existing condition. She skipped preventive medical care because she could not afford her prescriptions until she was hospitalized dealing with severe hypertension. When she suffered a heart attack eight months later, complications from the diabetes kicked in, and she spent 45 days in the intensive care unit at Lexington's Baptist Central Hospital as an indigent patient. Norma, age 43, had recently graduated first in her class at Eastern Kentucky University, but died before reaching her potential of service in Appalachia.

Norma fits the type of uninsured and underinsured cases that Dr. Rudolph Mueller cites in As Sick As It Gets: The Shocking Reality of America's Healthcare. His anecdotal cases include Emily who died of advanced cervical cancer three days after finally entering the emergency room because she could not afford regular pap smears. He describes Judd who declined having an X-ray of his fractured ribs after an accident because he could not afford it. Taken together the anecdotes weave a pattern resembling a worn cloth with many patches but with lots of holes.

Healthcare in the U.S. is less a system than a hodgepodge of haphazard arrangements with thousands of small players, dauntingly difficult to understand. My friend, Norma, was one of the estimated 18,000 in the U.S. who died prematurely in 2002 because they lacked access to adequate healthcare.

Industrialized countries deliver universal healthcare typically with a national health service as in the United Kingdom, or with national health insurance as in Canada. The U.S. remains the only industrialized nation without universal healthcare. Comparing the next nine largest democracies in the base year 1998, Dr. Mueller estimates that healthcare costs 58 percent more in America. Still the U.S. ranks 48th in life expectancy, lagging one to three years behind other industrialized countries, and 42nd in infant mortality by exceeding other comparable nations by two to four deaths per 1,000 live births. Although U.S. medical practice uses the most advanced technology in the world, most of the 43 million uninsured are denied the benefits these advances promise.

To a person of faith the lack of access to primary medical care, especially for the working poor and economically disadvantaged, becomes a matter of justice. The U.S. Catholic bishops in their recent "Faithful Citizenship: A Catholic Call to Political Responsibility" write: "Affordable and accessible health care is an essential safeguard of human life, a fundamental human right, and an urgent national priority" (p.23.) From a Catholic perspective healthcare must be considered a human right rather than a commodity, a healing ministry and public service more than merely a technical profession. Even the business side dealing with healthcare providers, pharmacies, or hospitals must be conditioned by the common good and not simply become a quest for self-gain and profits.

The Institute of Medicine, an independent non-profit grounded in science and dedicated to improving health, recommends in its January 2004, report, Insuring America's Health: Principles and Recommendations, that "the President and Congress develop a strategy to achieve universal insurance coverage and to establish a firm and explicit schedule to reach this goal by 2010" (www.iom.edu). Given that America could land on the moon within a few years after setting that goal, establishing U.S. universal healthcare requires only overcoming the political barriers to change. Universal healthcare needs no rocket science, just political will and moral outrage that American healthcare costs too much, excludes too many and skimps on services to many more.

Fr. Rausch is a Glenmary priest who lives, writes and organizes in Appalachia.

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