Francis Cardinal George, O.M.I.

Clarifying what’s at stake in the health care debate

Sunday, May 20, 2012

Since 1919, the Catholic bishops of the United States have taught that universal access to basic health care is a component of the common good in a fair society. In the church’s teaching on social justice, concern for universal health care takes its place with concern that everyone have sufficient food and decent shelter and an opportunity for a job with a family wage.

The Bishops’ Conference (USCCB) therefore supported the goal of the health care reform bill that was passed a year ago. It has many elements that contribute to extending health care for all: the provision that insurance companies cannot impose pre-existing conditions as a restriction on offering health insurance policies, the provision that sons and daughters can remain covered by their parents’ insurance throughout their college years, increased coverage of health benefits for mothers and their children. But these and other benefits should not be bought at the expense of religious liberty and freedom of conscience. “Rights,” if they are genuine human rights and not just legal fictions based on a particular ideology, should not be played off against each other for political purposes.

Because public discussion of the Department of Health and Human Services’ interpretation of the requirements of the health care reform legislation will remain a matter of public debate, it is important to clarify and pinpoint the Catholic bishops’ concerns in this important issue. They are two: 1) government infringement on religious liberty; and 2) restrictions on freedom of conscience.

Religious liberty means that all religions are free to identify and control their own ministries, without interference from the government. The institutional names of our Catholic ministries in Chicago are well known; for example, there are Catholic universities (like Loyola, DePaul and others) and Catholic schools (like St. Ignatius, Marian, Fenwick and others). There are Catholic hospitals and health care centers (like Resurrection, St. Anthony, St. Bernard and others). There are Catholic social service agencies (like Catholic Charities of the Archdiocese of Chicago) and Catholic child welfare institutions (like Misericordia, Mercy Home, Marillac House and many others). Under the HHS regulations, none of these institutions is Catholic. The government has unilaterally decided that it has the “right” to determine what is Catholic (or Jewish or Muslim) and what is not. Religious ministries are reduced to public services, with their identity changed by government edict. This is a novel intrusion of the government into the internal life of the church and other religious organizations. It is a First Amendment issue and will eventually be decided by the courts.

Freedom of conscience means that neither an institution nor an individual should be coerced by the government into doing or paying for an action they believe to be immoral. Institutional and personal conscience had previously been protected in federal health care legislation by the Hyde, Church and Weldon amendments. These legal protections have been removed from the health care law, and freedom of conscience has been restricted. This is a policy issue and will probably be decided by either legislative or executive action.

It will take time to decide these issues, and the public debate will be acrimonious. In an election year, it will be hard to avoid partisanship; because many people can’t seem to think beyond their affiliation with a particular political party, whether Republican or Democrat or any other. Religious liberty and freedom of conscience, however, are issues that should be bigger than politics.

Behind the current political debate there is a cultural issue that has been building for decades. For the first hundred and fifty years of our country’s history, religion was considered a positive good that contributes to the social cohesiveness and the moral education of citizens. In the past several decades, religion has come to be considered a danger that creates social divisions and that needs to be controlled. In this vision of things, churches and other religious organizations are private clubs that can motivate people to undertake public service, but public activity has to be free of religious argument and action. This is called secularization of our culture. In the long run, a society that lives publicly as if God did not exist destroys not only religious institutions but also society itself. A society that shuts out religious influence closes in on itself and becomes totalitarian. This can happen even in the name of individual “rights.”

I hope these few comments are helpful to a better understanding of what is at stake in the disputed HHS mandate. As we move forward, we will have to live more self-consciously in the kingdom of God, which is genuinely universal, while continuing to take our part as responsible citizens in our own particular country. Thank you for your life of faith in the church and of faithful citizenship in our country. God bless you.