Today is the feast of Saint Nuno de Santa Maria Alvares Pereira of the Order of Malta. This is taken from an article I wrote for in the recent issue of Hospitaller, the newsletter of the American Association of the Order of Malta.
The most recent member of the Order of Malta to be canonized is ironically a member who died almost 600 years ago. Additionally he will be most remembered for his sanctity as a lay brother of the Carmelites which he joined after the death of his wife and marriage of his youngest daughter. Still the life of this former Knight and Prior of our Order provides us an excellent reflection of someone who balanced the spiritual and corporal works of mercy and who most likely and equally fulfilled the precepts TUITIO FIDEI ET OBSEQUIUM PAUPERUM.
St. Nuno de Santa Maria Àlvares Pereira was a Knight of Rhodes by the age of 23, the 3rd Count of Ourem and the Prior of Crato, the headquarters of the Knights in Portugal. At this time he was appointed Constable, the commander of the military, by the new King whom he helped bring to power. Later through the marriage of his daughter Beatrice he became founder of the Bragança royal family dynasty. A majority of the Catholic royal families in Europe claim lineage from him, including Blessed Charles of Austria, another of the blesseds of our Order. Other descendants include Queen Isabella of Spain, Catherine of Aragorn and her daughter Mary Tudor.
As a Knight, St. Nuno never shared in the spoils of his victories and always treated his enemies justly. During the long war with the Kingdom of Castile, he would cross the border to bring food to the people suffering from famine and to provide for the widows and orphans of the war. Once he was so hungry he traded his horse for six loaves of bread only to encounter six English knights equally famished. In a noble gesture he gave away each of the loaves. At the Battle of Aljubarrota in 1385 his forces, greatly outnumbered, stopped an invasion by Castilian troops who supported the Avignon anti-pope. He attributed this victory to Our Lady whose name was inscribed on his sword.
Despite many achievements he hated war and his military capabilities were tempered by a deep spirituality, a profound love of the Eucharist and the Blessed Virgin, the foundations of his interior life. Totally dedicated to Marian prayer, he fasted in Mary’s honor on Wednesdays, Fridays and Saturdays and on the vigil of her feasts. His personal standard bore the image of the cross, of Mary and of the saintly knights James and George. He also spread devotion to the Rosary and brown scapular throughout Portugal.
St. Nuno believed prayer, penance and commitment to the poor and needy, to be the true calling of nobility. So following his daughter’s marriage he exchanged his worldly titles to become Brother Nuno of St. Mary and gave most of his remaining wealth to the poor and orphans. He also built several Churches including the Carmelite Monastery in Lisbon which he later entered. The Confraternity of the Holy Constable which he founded evolved into the modern Carmelite Third Order.
Saint Nuno died on Easter Sunday while the Passion was being read to him, at the words, “Behold thy Mother.” He was canonized by Pope Benedict on April 26, 2009.
More information can be found at http://www.vatican.va/news_services/liturgy/saints/2009/ns_lit_doc_20090426_nuno_en.html
http://www.insidethevatican.com/newsflash/2009/newsflash-apr-15-09.htm
Collect from the Missal of the Order
O God, who called blessed Nonius to lay down the weapons of this world and follow Christ under the protection of the Blessed Virgin, grant through the intercession of this former member of our Order that we too may deny ourselves and cling to you with all our hearts. Through the same Jesus Christ your Son, who lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen.
"Per signum S. Crucis de inimicis nostris libera nos Deus noster Jesus, Crux, et Maria sint nihi salus, custodia ex via".
01 April 2010
Feast of St. Nuno
Today is the feast of Saint Nuno de Santa Maria Alvares Pereira of the Order of Malta. This is taken from an article I wrote for in the recent issue of Hospitaller, the newsletter of the American Association of the Order of Malta.
The most recent member of the Order of Malta to be canonized is ironically a member who died almost 600 years ago. Additionally he will be most remembered for his sanctity as a lay brother of the Carmelites which he joined after the death of his wife and marriage of his youngest daughter. Still the life of this former Knight and Prior of our Order provides us an excellent reflection of someone who balanced the spiritual and corporal works of mercy and who most likely and equally fulfilled the precepts TUITIO FIDEI ET OBSEQUIUM PAUPERUM.
St. Nuno de Santa Maria Àlvares Pereira was a Knight of Rhodes by the age of 23, the 3rd Count of Ourem and the Prior of Crato, the headquarters of the Knights in Portugal. At this time he was appointed Constable, the commander of the military, by the new King whom he helped bring to power. Later through the marriage of his daughter Beatrice he became founder of the Bragança royal family dynasty. A majority of the Catholic royal families in Europe claim lineage from him, including Blessed Charles of Austria, another of the blesseds of our Order. Other descendants include Queen Isabella of Spain, Catherine of Aragorn and her daughter Mary Tudor.
As a Knight, St. Nuno never shared in the spoils of his victories and always treated his enemies justly. During the long war with the Kingdom of Castile, he would cross the border to bring food to the people suffering from famine and to provide for the widows and orphans of the war. Once he was so hungry he traded his horse for six loaves of bread only to encounter six English knights equally famished. In a noble gesture he gave away each of the loaves. At the Battle of Aljubarrota in 1385 his forces, greatly outnumbered, stopped an invasion by Castilian troops who supported the Avignon anti-pope. He attributed this victory to Our Lady whose name was inscribed on his sword.
Despite many achievements he hated war and his military capabilities were tempered by a deep spirituality, a profound love of the Eucharist and the Blessed Virgin, the foundations of his interior life. Totally dedicated to Marian prayer, he fasted in Mary’s honor on Wednesdays, Fridays and Saturdays and on the vigil of her feasts. His personal standard bore the image of the cross, of Mary and of the saintly knights James and George. He also spread devotion to the Rosary and brown scapular throughout Portugal.
St. Nuno believed prayer, penance and commitment to the poor and needy, to be the true calling of nobility. So following his daughter’s marriage he exchanged his worldly titles to become Brother Nuno of St. Mary and gave most of his remaining wealth to the poor and orphans. He also built several Churches including the Carmelite Monastery in Lisbon which he later entered. The Confraternity of the Holy Constable which he founded evolved into the modern Carmelite Third Order.
Saint Nuno died on Easter Sunday while the Passion was being read to him, at the words, “Behold thy Mother.” He was canonized by Pope Benedict on April 26, 2009.
More information can be found at http://www.vatican.va/news_services/liturgy/saints/2009/ns_lit_doc_20090426_nuno_en.html
http://www.insidethevatican.com/newsflash/2009/newsflash-apr-15-09.htm
Collect from the Missal of the Order
O God, who called blessed Nonius to lay down the weapons of this world and follow Christ under the protection of the Blessed Virgin, grant through the intercession of this former member of our Order that we too may deny ourselves and cling to you with all our hearts. Through the same Jesus Christ your Son, who lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen.
The most recent member of the Order of Malta to be canonized is ironically a member who died almost 600 years ago. Additionally he will be most remembered for his sanctity as a lay brother of the Carmelites which he joined after the death of his wife and marriage of his youngest daughter. Still the life of this former Knight and Prior of our Order provides us an excellent reflection of someone who balanced the spiritual and corporal works of mercy and who most likely and equally fulfilled the precepts TUITIO FIDEI ET OBSEQUIUM PAUPERUM.
St. Nuno de Santa Maria Àlvares Pereira was a Knight of Rhodes by the age of 23, the 3rd Count of Ourem and the Prior of Crato, the headquarters of the Knights in Portugal. At this time he was appointed Constable, the commander of the military, by the new King whom he helped bring to power. Later through the marriage of his daughter Beatrice he became founder of the Bragança royal family dynasty. A majority of the Catholic royal families in Europe claim lineage from him, including Blessed Charles of Austria, another of the blesseds of our Order. Other descendants include Queen Isabella of Spain, Catherine of Aragorn and her daughter Mary Tudor.
As a Knight, St. Nuno never shared in the spoils of his victories and always treated his enemies justly. During the long war with the Kingdom of Castile, he would cross the border to bring food to the people suffering from famine and to provide for the widows and orphans of the war. Once he was so hungry he traded his horse for six loaves of bread only to encounter six English knights equally famished. In a noble gesture he gave away each of the loaves. At the Battle of Aljubarrota in 1385 his forces, greatly outnumbered, stopped an invasion by Castilian troops who supported the Avignon anti-pope. He attributed this victory to Our Lady whose name was inscribed on his sword.
Despite many achievements he hated war and his military capabilities were tempered by a deep spirituality, a profound love of the Eucharist and the Blessed Virgin, the foundations of his interior life. Totally dedicated to Marian prayer, he fasted in Mary’s honor on Wednesdays, Fridays and Saturdays and on the vigil of her feasts. His personal standard bore the image of the cross, of Mary and of the saintly knights James and George. He also spread devotion to the Rosary and brown scapular throughout Portugal.
St. Nuno believed prayer, penance and commitment to the poor and needy, to be the true calling of nobility. So following his daughter’s marriage he exchanged his worldly titles to become Brother Nuno of St. Mary and gave most of his remaining wealth to the poor and orphans. He also built several Churches including the Carmelite Monastery in Lisbon which he later entered. The Confraternity of the Holy Constable which he founded evolved into the modern Carmelite Third Order.
Saint Nuno died on Easter Sunday while the Passion was being read to him, at the words, “Behold thy Mother.” He was canonized by Pope Benedict on April 26, 2009.
More information can be found at http://www.vatican.va/news_services/liturgy/saints/2009/ns_lit_doc_20090426_nuno_en.html
http://www.insidethevatican.com/newsflash/2009/newsflash-apr-15-09.htm
Collect from the Missal of the Order
O God, who called blessed Nonius to lay down the weapons of this world and follow Christ under the protection of the Blessed Virgin, grant through the intercession of this former member of our Order that we too may deny ourselves and cling to you with all our hearts. Through the same Jesus Christ your Son, who lives and reigns with you and the Holy Spirit, one God, for ever and ever. Amen.
30 March 2010
Refuting the Purveyors of Hate of the Church
Obviously there have been numerous news reports coming from the secular press and the usual Catholic dissidents personally attacking the Pope over the sex abuse crisis and their search for the "smoking gun" that will rid them of the greatest obstacle in their grail quest of moral relativism. Their fanatical hatred of the Pope is perhaps only eclipsed by their hatred of George Bush. In true fashion they haven't allowed anything like the Truth spoil their hysteria. I don't need to reinvent the wheel so here are three well written articles refuting the errors they keep spewing forth. And remember to not lose heart over this which fittingly takes place during Holy Week. As Jesus suffered during his earthly life, the Church must likewise suffer and we too are called to offer our sufferings united to Christ's.
Rebuttal by Fr. Raymond J. de Souza in National Review Online
Article by George Weigel in First Things
Article by Jimmy Akin in the National Catholic Register
Rebuttal by Fr. Raymond J. de Souza in National Review Online
Article by George Weigel in First Things
Article by Jimmy Akin in the National Catholic Register
Refuting the Purveyors of Hate of the Church
Obviously there have been numerous news reports coming from the secular press and the usual Catholic dissidents personally attacking the Pope over the sex abuse crisis and their search for the "smoking gun" that will rid them of the greatest obstacle in their grail quest of moral relativism. Their fanatical hatred of the Pope is perhaps only eclipsed by their hatred of George Bush. In true fashion they haven't allowed anything like the Truth spoil their hysteria. I don't need to reinvent the wheel so here are three well written articles refuting the errors they keep spewing forth. And remember to not lose heart over this which fittingly takes place during Holy Week. As Jesus suffered during his earthly life, the Church must likewise suffer and we too are called to offer our sufferings united to Christ's.
Rebuttal by Fr. Raymond J. de Souza in National Review Online
Article by George Weigel in First Things
Article by Jimmy Akin in the National Catholic Register
Rebuttal by Fr. Raymond J. de Souza in National Review Online
Article by George Weigel in First Things
Article by Jimmy Akin in the National Catholic Register
29 March 2010
Pray the Rosary on Good Friday Between 12 - 3
Are you aware there is an initiative to unite all Catholics in prayer on Good Friday between Noon and 3pm?
Everyone is aware of the downward moral spiral we are all caught up in which seems to be touching every aspect of our lives. Please consider praying with us to bring peace to the world and protection to those who are most in need of our protection, like the homeless, the elderly, children and young people, and the unborn. [I would also include an intention for the Church and the Pope who is being aggressively attacked by his enemies.]
There is a great deal to gain and absolutely nothing to lose!
Imagine what might happen if every Catholic in the world would pray a Rosary on the same day! We have an example in October of 1571, when Europe was saved from the invasion of the mighty Turkish fleet, by the praying of the Rosary by all Christians!
So, on Good Friday, let us all pray a Rosary for peace in the world and the return of moral values into our communities. If possible, please pray your Rosary between Noon and 3:00pm.
Also, please e-mail this message to every Catholic on your address list, and ask them to pass it along to every Catholic on their lists. Let's unite in praying one of the most powerful prayers in existence, for these intentions, on one of the holiest days in our Church year.
Everyone is aware of the downward moral spiral we are all caught up in which seems to be touching every aspect of our lives. Please consider praying with us to bring peace to the world and protection to those who are most in need of our protection, like the homeless, the elderly, children and young people, and the unborn. [I would also include an intention for the Church and the Pope who is being aggressively attacked by his enemies.]
There is a great deal to gain and absolutely nothing to lose!
Imagine what might happen if every Catholic in the world would pray a Rosary on the same day! We have an example in October of 1571, when Europe was saved from the invasion of the mighty Turkish fleet, by the praying of the Rosary by all Christians!
So, on Good Friday, let us all pray a Rosary for peace in the world and the return of moral values into our communities. If possible, please pray your Rosary between Noon and 3:00pm.
Also, please e-mail this message to every Catholic on your address list, and ask them to pass it along to every Catholic on their lists. Let's unite in praying one of the most powerful prayers in existence, for these intentions, on one of the holiest days in our Church year.
Pray the Rosary on Good Friday Between 12 - 3
Are you aware there is an initiative to unite all Catholics in prayer on Good Friday between Noon and 3pm?
Everyone is aware of the downward moral spiral we are all caught up in which seems to be touching every aspect of our lives. Please consider praying with us to bring peace to the world and protection to those who are most in need of our protection, like the homeless, the elderly, children and young people, and the unborn. [I would also include an intention for the Church and the Pope who is being aggressively attacked by his enemies.]
There is a great deal to gain and absolutely nothing to lose!
Imagine what might happen if every Catholic in the world would pray a Rosary on the same day! We have an example in October of 1571, when Europe was saved from the invasion of the mighty Turkish fleet, by the praying of the Rosary by all Christians!
So, on Good Friday, let us all pray a Rosary for peace in the world and the return of moral values into our communities. If possible, please pray your Rosary between Noon and 3:00pm.
Also, please e-mail this message to every Catholic on your address list, and ask them to pass it along to every Catholic on their lists. Let's unite in praying one of the most powerful prayers in existence, for these intentions, on one of the holiest days in our Church year.
Everyone is aware of the downward moral spiral we are all caught up in which seems to be touching every aspect of our lives. Please consider praying with us to bring peace to the world and protection to those who are most in need of our protection, like the homeless, the elderly, children and young people, and the unborn. [I would also include an intention for the Church and the Pope who is being aggressively attacked by his enemies.]
There is a great deal to gain and absolutely nothing to lose!
Imagine what might happen if every Catholic in the world would pray a Rosary on the same day! We have an example in October of 1571, when Europe was saved from the invasion of the mighty Turkish fleet, by the praying of the Rosary by all Christians!
So, on Good Friday, let us all pray a Rosary for peace in the world and the return of moral values into our communities. If possible, please pray your Rosary between Noon and 3:00pm.
Also, please e-mail this message to every Catholic on your address list, and ask them to pass it along to every Catholic on their lists. Let's unite in praying one of the most powerful prayers in existence, for these intentions, on one of the holiest days in our Church year.
25 March 2010
Denying Communion to Pro-Abort Pols
There is a reluctance on the part of some (many?) Bishops to deny Communion or impose other penalties upon pro-abortion politicians. Instead they prefer to wait patiently for the pol's conversion and recognition of their error. However well intentioned their excellencies motives may be, any parent with children knows that it is very imprudent to allow a child to remain disobedient without any threat of punishment. Oftentimes it is not until some tragedy occurs that we realize our mistake.
It is important to recall that the purpose of discipline is to help an individual recognize that they are in error and motivate them to correct their bad behavior, not as some form of vengeance for wrongdoing. Any person who receives Holy Communion unworthily commits sacrilige and brings further condemnation upon oneself. With that in mind I thought that this scene from Indiana Jones - The Last Crusade was apropos.
UPDATE! Dr. Ed Peters has written an excellent article on why it is time Bishops begin enforcing canon 915. Read the article here.
Denying Communion to Pro-Abort Pols
There is a reluctance on the part of some (many?) Bishops to deny Communion or impose other penalties upon pro-abortion politicians. Instead they prefer to wait patiently for the pol's conversion and recognition of their error. However well intentioned their excellencies motives may be, any parent with children knows that it is very imprudent to allow a child to remain disobedient without any threat of punishment. Oftentimes it is not until some tragedy occurs that we realize our mistake.
It is important to recall that the purpose of discipline is to help an individual recognize that they are in error and motivate them to correct their bad behavior, not as some form of vengeance for wrongdoing. Any person who receives Holy Communion unworthily commits sacrilige and brings further condemnation upon oneself. With that in mind I thought that this scene from Indiana Jones - The Last Crusade was apropos.
UPDATE! Dr. Ed Peters has written an excellent article on why it is time Bishops begin enforcing canon 915. Read the article here.
22 March 2010
A Christian Approach to Healthcare Reform
For better or worse, well its definitely worse, but it looks like barring Divine intervention we are going to have a national healthcare program. However unless we want to see the inevitable bankruptcy to the country caused by such a program we ought to still work to influence the ultimate direction healthcare reform takes. Dr. Robert Condit has a well written article on A Christian Perspective for Healthcare Reform. We would have been better off if this were followed before the passage of the Bill from Hell but we cannot give up the fight.
How should health care in the United States be reformed? The principles of social justice outlined in Catholic social teaching can be considered by all those of good will as guidelines for ethical health care reform. Those principles, are the dignity of the human person, the common good, solidarity, and subsidiarity. These four social-justice principles provide a foundation for a virtuous and economically sound improvement in medical resource allocation; a Christian prescription for health care reform.
It is clear that we have a duty to improve access, affordability, and quality of care for all citizens because of their human dignity. Frequently missing from the discussion of health care reform is the role of personal responsibility. Pope Benedict XVI has emphasized the point: “In the name of freedom, there has to be a correlation between rights and duties, by which every person is called to assume responsibility for his or her choices.” [This is a huge issue than will not be resolved simply by giving people a health insurance card and telling them to go see a doctor when they are sick. Some time back I quoted the late Fr. McNabb O.P. on this same issue where he said it is time we stop hearing about the rights owed us and instead start recognizing the duties we owe to God.]
Behavior and responsibility for the consequences of personal health choices need to be linked for significant health care reform. If patients participated more directly, at the point of service, in paying for their care or for their medical insurance, medical resource consumption would diminish. More health care resources could be used for prevention of disease than spent on chronic illness associated with modifiable risk factors. The 38 percent of American deaths caused by the behaviors of smoking, diet, physical inactivity, and alcohol use could be mitigated. Patients with stronger incentives to stay healthy could decrease expenditures associated with smoking, obesity, diet controlled diabetes, atherosclerotic heart and peripheral vessel disease, strokes, alcoholism, and osteoporosis, to name a few. Two-thirds of Americans are overweight, which directly correlates with chronic disease and increased health care spending. [A couple years ago the Belgian Minister of Public Health gave a talk at the Brookings Institution which highlighted among other issues the significant obesity problem in America compared to Belgium and the rest of Europe. This factor must be taken into account when trying to draw comparisons to the national healthcare programs in other countries. He also said that America has to deal with the issue of tort reform, something ardently fought against by the Democrat Party beholden to trial lawyers. In Belgium everyone is expected to pay something, regardless of income, on a sliding scale]
Christ’s teachings on justice did not omit discussion of personal responsibility. “He will repay all according to his conduct” (Matt. 16:27). Contemporary platforms for health care reform can neither neglect nor discount personal behavior and accountability. [I have seen numerous times people calling 911 for respiratory distress only to arrive and find them smoking endlessly with a full ashtray and their oxygen tank humming along beside them. Never mind the obvious danger of mixing smoking and oxygen but again this type of behavior will not change simply because people have access to nationalized healthcare since many of them were already on Medicare/Medicaid.]
Patients’ paying for health care at the point of service are more prudent purchasers of health care than those perceiving health care benefits as an entitlement. They would spend less on health care if they took better care of themselves for modifiable conditions. They seek to be more informed and ask more questions about quality, outcomes, and cost. Furthermore, as consumers, they are more motivated to negotiate regarding costs of elective treatment decisions. Medical inflation would improve. Patients’ directly paying insurance premiums, rather than indirectly through foregone wages or by taxes, would lead to stronger demands and competition for quality of service from insurance companies.
The Medicare Trust Fund is expected to become insolvent by 2019. Medicare patients are going to have to bear more financial responsibility for their health care decisions, particularly for elective procedures. Presently, physicians and hospitals rarely are asked about the cost of care by patients and families when they expect insurance to cover their bills. Definitions of extraordinary care could consider financial expenditure. Medical resources are not unlimited. Less futile end-of-life spending could potentially increase resource availability for more preventative and basic care, while at the same time promoting greater respect for human dignity. This is an area in which the Church’s teaching offers invaluable guidance. Cases of withholding ordinary care have rightly garnered national attention and provoked outrage, but it is also true that the technological extension of life by extraordinary means can absorb significant resources without enhancing the prospects for a dignified and natural death.
The affluent elderly could bear more financial burden for their health care. The established social contract where workers’ taxes provide for medical expenses of those over sixty-five has to be reconsidered given demographic changes as well as advances in expensive technology and specialty care. Fewer workers are paying taxes to support the ever expanding percentage of the population that is retired.
Some argue that medical care demand is inelastic; the quantity of care demanded is not sufficiently influenced by prices, and increasing consumer responsibility for payment will not curb health care spending. However, much of health care is not emergent. Many patients are sophisticated enough to become informed health care consumers, as they are for other goods and services. Primary care physicians can assist their patients and families in cost-conscious decision-making, in addition to encouraging lifestyle and diet changes that can have tremendous impact on preventable or modifiable chronic disease. There is opportunity for a more just allocation of the two trillion dollars spent annually on health care in the United States. Half of the United States population spends very little on health care, while 5 percent of the population spends almost half of the total amount. The RAND Health Insurance Experiment, completed in 1982, identified considerable price elasticity, wherein some personal financial responsibility for health care did not significantly affect quality of care.
What if consumers choose not to purchase, or cannot afford, health insurance? Should someone be denied care because they cannot pay? It is reasonable to seek to agree on primary care services or basic safety-net coverage that might be provided to all citizens; for example, children’s health, pregnancy care, and emergent and urgent conditions. Market forces would identify fundamentally desired health care service more effectively than committees or bureaucracies. Furthermore, incentives need to be created to encourage patients to avoid emergency rooms for non urgent conditions. As a society, we cannot turn our backs on the indigent. However, unlimited procedures and treatments are not possible. Patient participation in the cost of their care, even a small percentage, is a more just situation than abdicating total control of payment and what is provided, or denied, to a third party. Human dignity is promoted by reforms respecting both duties to others and personal responsibility.
A Christian Approach to Healthcare Reform
For better or worse, well its definitely worse, but it looks like barring Divine intervention we are going to have a national healthcare program. However unless we want to see the inevitable bankruptcy to the country caused by such a program we ought to still work to influence the ultimate direction healthcare reform takes. Dr. Robert Condit has a well written article on A Christian Perspective for Healthcare Reform. We would have been better off if this were followed before the passage of the Bill from Hell but we cannot give up the fight.
How should health care in the United States be reformed? The principles of social justice outlined in Catholic social teaching can be considered by all those of good will as guidelines for ethical health care reform. Those principles, are the dignity of the human person, the common good, solidarity, and subsidiarity. These four social-justice principles provide a foundation for a virtuous and economically sound improvement in medical resource allocation; a Christian prescription for health care reform.
It is clear that we have a duty to improve access, affordability, and quality of care for all citizens because of their human dignity. Frequently missing from the discussion of health care reform is the role of personal responsibility. Pope Benedict XVI has emphasized the point: “In the name of freedom, there has to be a correlation between rights and duties, by which every person is called to assume responsibility for his or her choices.” [This is a huge issue than will not be resolved simply by giving people a health insurance card and telling them to go see a doctor when they are sick. Some time back I quoted the late Fr. McNabb O.P. on this same issue where he said it is time we stop hearing about the rights owed us and instead start recognizing the duties we owe to God.]
Behavior and responsibility for the consequences of personal health choices need to be linked for significant health care reform. If patients participated more directly, at the point of service, in paying for their care or for their medical insurance, medical resource consumption would diminish. More health care resources could be used for prevention of disease than spent on chronic illness associated with modifiable risk factors. The 38 percent of American deaths caused by the behaviors of smoking, diet, physical inactivity, and alcohol use could be mitigated. Patients with stronger incentives to stay healthy could decrease expenditures associated with smoking, obesity, diet controlled diabetes, atherosclerotic heart and peripheral vessel disease, strokes, alcoholism, and osteoporosis, to name a few. Two-thirds of Americans are overweight, which directly correlates with chronic disease and increased health care spending. [A couple years ago the Belgian Minister of Public Health gave a talk at the Brookings Institution which highlighted among other issues the significant obesity problem in America compared to Belgium and the rest of Europe. This factor must be taken into account when trying to draw comparisons to the national healthcare programs in other countries. He also said that America has to deal with the issue of tort reform, something ardently fought against by the Democrat Party beholden to trial lawyers. In Belgium everyone is expected to pay something, regardless of income, on a sliding scale]
Christ’s teachings on justice did not omit discussion of personal responsibility. “He will repay all according to his conduct” (Matt. 16:27). Contemporary platforms for health care reform can neither neglect nor discount personal behavior and accountability. [I have seen numerous times people calling 911 for respiratory distress only to arrive and find them smoking endlessly with a full ashtray and their oxygen tank humming along beside them. Never mind the obvious danger of mixing smoking and oxygen but again this type of behavior will not change simply because people have access to nationalized healthcare since many of them were already on Medicare/Medicaid.]
Patients’ paying for health care at the point of service are more prudent purchasers of health care than those perceiving health care benefits as an entitlement. They would spend less on health care if they took better care of themselves for modifiable conditions. They seek to be more informed and ask more questions about quality, outcomes, and cost. Furthermore, as consumers, they are more motivated to negotiate regarding costs of elective treatment decisions. Medical inflation would improve. Patients’ directly paying insurance premiums, rather than indirectly through foregone wages or by taxes, would lead to stronger demands and competition for quality of service from insurance companies.
The Medicare Trust Fund is expected to become insolvent by 2019. Medicare patients are going to have to bear more financial responsibility for their health care decisions, particularly for elective procedures. Presently, physicians and hospitals rarely are asked about the cost of care by patients and families when they expect insurance to cover their bills. Definitions of extraordinary care could consider financial expenditure. Medical resources are not unlimited. Less futile end-of-life spending could potentially increase resource availability for more preventative and basic care, while at the same time promoting greater respect for human dignity. This is an area in which the Church’s teaching offers invaluable guidance. Cases of withholding ordinary care have rightly garnered national attention and provoked outrage, but it is also true that the technological extension of life by extraordinary means can absorb significant resources without enhancing the prospects for a dignified and natural death.
The affluent elderly could bear more financial burden for their health care. The established social contract where workers’ taxes provide for medical expenses of those over sixty-five has to be reconsidered given demographic changes as well as advances in expensive technology and specialty care. Fewer workers are paying taxes to support the ever expanding percentage of the population that is retired.
Some argue that medical care demand is inelastic; the quantity of care demanded is not sufficiently influenced by prices, and increasing consumer responsibility for payment will not curb health care spending. However, much of health care is not emergent. Many patients are sophisticated enough to become informed health care consumers, as they are for other goods and services. Primary care physicians can assist their patients and families in cost-conscious decision-making, in addition to encouraging lifestyle and diet changes that can have tremendous impact on preventable or modifiable chronic disease. There is opportunity for a more just allocation of the two trillion dollars spent annually on health care in the United States. Half of the United States population spends very little on health care, while 5 percent of the population spends almost half of the total amount. The RAND Health Insurance Experiment, completed in 1982, identified considerable price elasticity, wherein some personal financial responsibility for health care did not significantly affect quality of care.
What if consumers choose not to purchase, or cannot afford, health insurance? Should someone be denied care because they cannot pay? It is reasonable to seek to agree on primary care services or basic safety-net coverage that might be provided to all citizens; for example, children’s health, pregnancy care, and emergent and urgent conditions. Market forces would identify fundamentally desired health care service more effectively than committees or bureaucracies. Furthermore, incentives need to be created to encourage patients to avoid emergency rooms for non urgent conditions. As a society, we cannot turn our backs on the indigent. However, unlimited procedures and treatments are not possible. Patient participation in the cost of their care, even a small percentage, is a more just situation than abdicating total control of payment and what is provided, or denied, to a third party. Human dignity is promoted by reforms respecting both duties to others and personal responsibility.
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This blog and the opinions are all my own and in no way imply the endorsement from any organization. Nor does a recommendation of another blog or web site imply my agreement or endorsement of everything found on their site.
