A World Without Health Insurance?

A South Portland doctor is joining a growing community of doctors who refuse to deal with the insurance companies any longer. He refuses all insurance, posting his prices for services online, and working with patients on an individual basis if they have a problem paying. He's lost some patients who are very dependent on their insurance to pay their bills, but most of his patients have been understanding.

In this world where health insurance is too often synonymous with healthcare, this is scary. People without insurance don't get care until it's too late. Those who do have insurance often have to weigh in the question, "what will my insurance cover and how much?" when making healthcare decisions. The Catholic Church holds that basic healthcare is a right. Not a privilege or a benefit, a right.

This question of insurance, however, brings into play a much misunderstood, ignored and abused Catholic concept called "subsidiarity." Catholics will often treat this concept as it supports or condemns their individual political views. What does it actually mean and how important is it?

The Catechism of the Catholic Church has this to say about "subsidiarity":

1882 Certain societies, such as the family and the state, correspond more directly to the nature of man; they are necessary to him. To promote the participation of the greatest number in the life of a society, the creation of voluntary associations and institutions must be encouraged "on both national and international levels, which relate to economic and social goals, to cultural and recreational activities, to sport, to various professions, and to political affairs." This "socialization" also expresses the natural tendency for human beings to associate with one another for the sake of attaining objectives that exceed individual capacities. It develops the qualities of the person, especially the sense of initiative and responsibility, and helps guarantee his rights.
1883 Socialization also presents dangers. Excessive intervention by the state can threaten personal freedom and initiative. The teaching of the Church has elaborated the principle of subsidiarity, according to which "a community of a higher order should not interfere in the internal life of a community of a lower order, depriving the latter of its functions, but rather should support it in case of need and help to co- ordinate its activity with the activities of the rest of society, always with a view to the common good."

Basically, it means that problems are best handled by those closest to the problem. The government oversteps its bounds when it tries to micromanage. When it was originally introduced by Pope Pius XI in his encyclical Quadragesimo Anno, it was meant as a middle ground between communism and unbridled capitalism.

The foundation of all Catholic thought is the inherent dignity of the human person. From that flows pretty much everything the Church teaches. So, as humanity is the most important of God's creation and all people are created, beloved, and redeemed by God, human organizations are supposed to work for the good of people, not for the almighty dollar or someone's ego.

What does this have to do with health insurance? Insurance companies and money have too much control over people's health. The most foundational right that a person has is the right to life. If they get subpar health care, that undermines their right to life.

As long as this doctor in South Portland and others like him are truly flexible with those who cannot pay, their decision to no longer take insurance is a laudable one. He has shown in the article how cutting out the middle man dropped the prices of some of his most basic services like simple routine office visits. If this is true and can be replicated without completely destroying our economy, maybe his decision should be imitated.

A Catholic social teaching equal to and intimately related to "subsidiarity" is "solidarity." We need to do what we can to help those in poverty. If taking insurance out of the equation ultimately leads to more poor people getting the help they need, I'm cool with it.

"Subsidiarity" was introduced as a middle way between two extremes, neither of which are truly in line with the dignity of the human person. I would also say that "subsidiarity" itself should not be taken to an extreme. We cannot completely eliminate the all of the bigger organizations or make them completely impotent because that could lead to chaos which also does not serve the good of humanity.

For more information, here is a very informative article on Catholic Culture.org.