Access to Health Care and Rationing
PROVISION OF HEALTH CARE REPRESENTS A CHALLENGE OF great and growing importance for contemporary societies. Whereas health care in centuries past was inexpensive but largely ineffective, in our time medicine can do remarkable things to save and enhance lives—but at considerable cost. How should that cost be apportioned, and how should societies decide what to guarantee to individual citizens? Although historically few religious thinkers addressed questions of access to health care and rationing, these newly important concerns touch on values and responsibilities that are central to Judaism and Roman Catholicism.1
In this chapter I examine Jewish and Roman Catholic approaches to issues of access to health care and rationing. I present and compare substantive positions, with attention to methodological approaches, as well as ways in which treatment of these issues reflects and sheds light on broader characteristics of the faith traditions. As with other issues examined in this book, to an impressive extent moral thinkers in both traditions frame the issues in similar ways and identify similar sets of specific concerns. Writers in each tradition support the guarantee of universal access to at least a basic level of health care for all members of society. This guarantee is grounded in the shared values noted in the introduction—such as the intrinsic dignity of human persons, created in the image of God; the responsibility of a just society to offer needed support to its members; and a divine mandate to provide healing to people in need. Thinkers in the two traditions express generally similar understandings of God, humanity, and the world, often citing the same scriptural texts. Catholic writers are more likely to frame their arguments in terms of the common good. Partly for this reason, Catholic writers tend to be somewhat more accepting of rationing that denies beneficial health care to some persons.