The “On Faith” column at the Washington Post treats us to an article today entitled “Why Christians Should Support Health Care Rationing” by Fordham ethics professor Charles Camosy. I’ve read it several times, and I’m still not sure why. After noting the attitude of pro-lifers and Republicans who have a problem with the health insurance reform bill and some of its likely ramifications, he writes:
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.
His second “truth” is certainly correct. His first, however, is flawed. The fact that everyone will die does not mean we have “unlimited health care needs,” since at any given time most of the population is not sick, much less on death’s doorstep. Thus, we are not in fact trying to match infinite needs with limited resources, but limited, specific needs with limited, specific resources.
Where is he going with this? Try this example on for size:
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.
Really? How so?
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.
OK. We get it–government funding of health care is complicated and involves trade-offs. I’m not at all sure what the example of Seth Petreikis is supposed to show–I mean, if the government is going to pay for some health care, I’d think the kind that saves a person’s life, especially an infant’s life, would be the top priority. Camosy plays coy, and doesn’t suggest that Indiana should have just told his parents that they should let Seth die and not put an undue burden on the state budget, but that seems to be the implication. What the basis for that suggestion would be, ethically speaking, is a mystery.
Finally, Camosy addresses Christians:
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.
I have no idea where this is going, much less where it comes from. Pretty much everyone, Christians included, recognizes that we have finite resources and that therefore there are choices to be made. There’s stuff the feds and the states should pay for for the poor, and stuff they shouldn’t. Furthermore, most people agree that those who can take care of their own medical needs (through personal resources and/or private health insurance) should do so. But where does Camosy get off suggesting that there is something “consumerist” about a life-saving operation for a six-month-old?And beyond the reference to our “tragic, fallen state of affairs,” what does this have to do with Christian ethics?