Health Care is a Moral Right, a Safeguard of Human Life
"I was ill and you cared for me" (Mt 25:36)
All persons have a moral right to basic physical and behavioral health care. Access to basic health care is a fundamental human right, necessary for the development and maintenance of life and for the ability of human beings to realize the fullness of their dignity.
A fundamental measure of our society is how we care for the poor and vulnerable. It is not acceptable that millions of people in our country and hundreds of thousands in Kentucky do not have access to affordable health care. We need a new commitment in our nation and our Commonwealth to insure access to affordable health care for all in a way that reflects a priority concern for the poor.
The Church's Teaching on Health Care
For the Catholic community, health and the healing ministry are rooted in the biblical vision to heal persons who are sick, with special protection of people who are poor and needy, as well as the demands of social justice and the duty to promote the common good, the good of all people and the whole person.
"The Church has always sought to embody our Savior's concern for the sick. The gospel accounts of Jesus' ministry draw special attention to his acts of healing: he cleansed a man with leprosy (Mt 8:1-4; Mk 1:40-42); he gave sight to two people who were blind (Mt 20:29-34; Mk 10:46-52); he enabled one who was mute to speak (Lk 11:14); he cured a woman who was hemorrhaging (Mt 9:20-22; Mk 5:25-34); and he brought a young girl back to life (Mt 9:18, 23-25; Mk 5:35-42). Indeed, the Gospels are replete with examples of how the Lord cured every kind of ailment and disease (Mt 9:35). In the account of Matthew, Jesus' mission fulfilled the prophecy of Isaiah: 'He took away our infirmities and bore our diseases' (Mt 8:17; cf. Is 53:4)."
Pope John XXIII in his encyclical Peace on Earth identified a charter of human rights beginning with the right to life. Peace on Earth taught that health care was a basic right of humans flowing from the sanctity and dignity of human life. Health care is instrumental in safeguarding the right to life.
Pope John Paul II focused on the need for health care to be available and affordable to humans in his encyclical On Human Work. Further he recognized that as people we are responsible for the society we create and we must work to remove social barriers that are unjust or impede the common good. Pope John Paul II identified structural injustice or social sins as "certain situations or the collective behavior of certain social groups" that are "the result of the accumulation and concentration of many personal sins." He condemned such "social evil" and "appealed to the consciences of all, so that each may shoulder his or her responsibility seriously and courageously in order to change those disastrous conditions and intolerable situations."
The 1993 Statement of the Catholic Bishops of the United States, Framework for Comprehensive Health Care Reform reiterated the bishops' "constant teaching that each human life must be protected and human dignity promoted" and their insistence that all people have a right to health care. It found that the "existing patterns of health care in the United States do not meet the minimal standard of social justice and the common good. ...The principal defect is that more than 35 million persons do not have guaranteed access to basic health care. ...The current health care system is so inequitable, and the disparities between rich and poor and those with access and those without are so great that it is clearly unjust."
In 2005, the injustice has increased, as over 45 million persons do not have guaranteed access to basic health care. The lack of access to affordable health care for so many children and adults in our country and in Kentucky is a structural injustice that harms people and undermines the common good. "The responsibility for attaining the common good, besides falling to individual persons, belongs to the State, since the common good is the reason that the political authority exists." Like Pope John Paul II, we appeal to the consciences of all, so that each may shoulder his or her responsibility courageously in order to change the unjust conditions.
Principles for Health Care Reform
In the debate over health care, we continue to use as our guide the principles for public policy and the criteria for reform from the 1981 pastoral letter of the American Bishops, Health and Health Care, and the 1993 Statement of the Catholic Bishops of the United States, Framework for Comprehensive Health Care Reform. We affirmed these in our 1992 CCK Statement, Essential Criteria for Systematic Health Care Reform. A summary of the criteria for health care reform we apply to public policy proposals out of our faith's concern for the health of our neighbors in need is:
1) Respect for Life - preserving and enhancing human life from conception to natural death.
2) Priority Concern for the Poor - giving special priority to health care needs of the poor, ensuring that their health care is quality health care.
3) Universal Access to Comprehensive Benefits - providing universal access to comprehensive benefits sufficient to maintain and promote good physical and behavioral health.
4) Pursuing the Common Good and Preserving Pluralism - allowing and encouraging the involvement of all sectors, including the religious and voluntary sectors, in all aspects of health care, ensuring respect for the ethical and religious values of consumers and providers.
5) Cost Containment and Controls - creating effective cost-containment measures that reduce waste, inefficiency, and unnecessary care and establish incentives to users and providers to make economic use of limited resources and to control rising costs of competition, commercialism, administration and legal costs.
6) Equitable Financing - financing the delivery of basic comprehensive services through a formula that is based on ability to pay and assures full access to care for the poor and vulnerable.
7) Quality - establishing and using standards for evaluating and improving outcomes and ensuring appropriateness of health services.
Health care is a responsibility of our society. Health care is the responsibility of each individual, every family, employers, communities, health care providers, health care facilities, and state and federal governments share in the responsibility to insure health care for all and to safeguard human life.
Respect for the right of individuals to participate in their own health decisions requires that health care providers assist the individual to understand to the best of his/her ability, his/her specific condition and the courses of events that would be expected with and without the possible treatments available. All individuals have these rights regardless of literacy with the English language and cognitive ability.
Given the political environment and economic challenges, prudence dictates an incremental approach to reforming health care. An initiative embraced by the Catholic Health Association in 2004 acknowledges this challenging dynamic but presses for reform in coverage for children, assistance to small employers insuring their employees, and tax credits or subsidies for individuals purchasing health insurance.
Catholic Health Care in Kentucky
Health care services are of particular significance for the Catholic Church in Kentucky because they are integral to our faith's healing ministry. The Church is also a major provider of health care services through many organizations, and is a major purchaser of health care insurance for its employees. Care by Catholic hospitals, long term care facilities and health agencies in Kentucky, is done with much moral muscle. This care reveals God's grace in ordinary, daily events, especially through the healing ministries. The way the care is provided reveals the Catholic identity. "Solidly rooted in charity, Christian health care institutions continue Jesus' own mission of caring for the weak and the sick."
Catholic health care is an important element of the health care delivery system that people in Kentucky rely on every day. Catholic hospitals and nursing facilities provide a range of services to Kentucky citizens, including inpatient and outpatient care, home health, skilled nursing, hospice, low-income housing, psychiatric care and assisted living. Catholic health care in Kentucky comprises: 17 acute care hospitals; 30 long-term care nursing facilities; and many other Catholic-sponsored service organizations including hospice, home health, assisted living, and senior housing. Catholic health care ministries have a long history of serving those in need and speaking for those whose voices often go unheard. Catholic health ministry is committed to providing quality health care to all people in our communities and to using our resources to the greatest community benefit. The ministry is committed to serving those who have the least access to health care services and who are the most in need. Each year, Catholic hospitals in Kentucky provide inpatient care to thousands of Medicare and Medicaid beneficiaries, and to thousands of the medically indigent. Catholic facilities annually provide significant charity care in the tens of million dollars for which there is no reimbursement. Catholic health care is also a significant employer in Kentucky.
We encourage, wherever possible, that parishes establish Health and Wellness Ministries to assist parishioners and their families to take responsibility for their own health by providing educational opportunities, by promoting skills for communicating with health care providers, and by providing opportunities for health care monitoring such as blood pressure screening.
We are grateful for Kentucky's Catholic health care institutions, for their leaders and staff, for their service to the community and for their commitment of care to the health of Kentuckians. We seek to insure that this health care service is continued so that human life is safeguarded.
Medicaid and Kentucky Children's Health Insurance Program
Through a system of shared federal and state responsibility, our national and state governments have long been committed to meeting the basic health care and long-term care needs of low-income Americans through Medicaid and, more recently, for children through Kentucky Children's Health Insurance Program (KCHIP). Kentucky must be accountable for the efficient expenditure of federal and state funds. The shared responsibility should continue and Kentucky and the federal government should provide the funding to insure health care for the poor adults and children. In order to safeguard the health of children and poor people, Medicaid and KCHIP should be strengthened. The federal and state governments must continue to fulfill their role in guaranteeing health care for the poor through Medicaid by providing the necessary resources as a priority. "The State of KY should seek and maintain revenues sufficient to meet the basic needs of all, especially the poor and vulnerable." Medicaid should provide preventative care, smoking cessation treatment, and substance abuse treatment. With 44% of births in Kentucky covered by Medicaid, preventative health care for a pregnant woman is critical to nurture not only her health but also the health of the unborn. Preventative health honors the dignity of the person and promotes the common good as it reduces health care costs in the future.
Health Care for Persons without Health Insurance
In Kentucky, over 100,000 children are uninsured and a total of 577,650 people lack health insurance. Nationally, over 45 million children and adults do not have health insurance.
Affordable and accessible health care for those not covered by Medicaid is an essential safeguard of human life, a fundamental human right, and an urgent state and national priority. Reform of the state's and nation's health care system rooted in values that respect human dignity, protect human life, and meet the needs of the poor and uninsured is a moral imperative.
A New Commitment to Health Care Needs
"Health care is more than a commodity; it is a basic human right, an essential safeguard of human life and dignity. We believe our people's health care should not depend on where they work, how much their parents earn or where they live... In our view, the best measure of any proposed health care initiative is the extent to which it combines universal access to comprehensive quality health care with cost control, while ensuring quality care for the poor and preserving human life and dignity... This is a major political task, a significant policy challenge, and a moral imperative."
The Ethical and Religious Directives for Catholic Health Care Services (Fourth edition 2001) confirm service to and advocacy on behalf of the marginalized as integral to the mission of Catholic institutions in the field of health care ministry. In this spirit, we urge Catholics, people of good will and our national and state leaders to look beyond special interests and partisanship and to unite our state and nation in a new commitment to meet the basic physical and behavioral health care needs of our people, especially the poor and vulnerable, pregnant women, the mentally ill, mentally retarded, children and adults in low-income families, the elderly, the disabled, immigrants and the undocumented. This effort acknowledges the moral right of all to healthcare, that health care is a safeguard of human life, and our obligation to work toward healthcare for all.
Adopted on December 6, 2005 by the Catholic Conference of Kentucky
+Archbishop Thomas C. Kelly, O.P. - Archdiocese of Louisville
+Bishop John J. McRaith - Diocese of Owensboro
+Bishop Roger J. Foys - Diocese of Covington
+Bishop Ronald W. Gainer - Diocese of Lexington