Where is Thy Sting?
A Senate Committee voted yesterday on a proposal for universal health insurance. They approved it, predictably, along party lines, 13 to 10. The vote escalates a debate over health care reform that is taking on increasingly ethical overtones. Central to this ethical debate is the issue of “rationing.” A public health insurance option, according to its opponents, would put the government in the position of denying certain highly expensive treatments to the elderly or those with terminal illnesses in order to avoid bankruptcy. Princeton ethicist Peter Singer gives a terrific explanation of the necessity of rationing and the way our system already rations according to economic levels in the New York Times Magazine.
The debate centers around the difficult questions of how we would pay for universal health insurance and how we would distribute its funds. In interesting ways, the debate also intersects with ongoing discussions about end of life care. Do the very old want to extend their lives to the utmost technologically-assisted lifespan? How much does the ability to sustain meaningful relationships matter in decisions about medical intervention? Most Christians are against euthanasia, and many were appalled at news that, otherwise healthy, British conductor Sir Edward Downes decided to end his life alongside his terminally-ill wife in Switzerland on Tuesday.
Yet many Christians are also inspired by stories like those of the Sisters of St. Joseph, who face death with acceptance and (usually) with limited technological intervention. LaVonne Neff (writer and wife of Christianity Today Editor-in-Chief David Neff) brought some of these strands together when she pondered in a blog
(For more in-depth discussion of ethics at the end of life, see the Patheos Public Square.) over “the near certainty that if health care is extended to all Americans, older people will get less of it.” She surprisingly concluded that, “this could be a good thing.” Neff (61) continued, “I don’t want a prolonged, high-tech death. On the other hand, I don’t want a pill and a plastic bag either. Even apart from the ethical implications, both extremes suffer from fantasies of control, and death has a way of resisting control–often in ways that hurt the person whose death is supposedly being controlled.” It may be that the conversation about universal health insurance, mired in outrage over abstract “rationing,” could benefit from this kind of lived wisdom.