Can a Health Care Market Be Moral?

Book excerpt: Since the 1970s health care costs in the United States have doubled, insurance premiums have far outpaced inflation, and the numbers of the uninsured and underinsured are increasing at an alarming rate. At the same time the public expects better health care and access to the latest treatment technologies. Governments, desperate to contain ballooning costs, often see a market-based approach to health care as the solution; critics of market systems argue that government regulation is necessary to secure accessible care for all. The Catholic Church generally questions the market's ability to satisfy the many human needs intrinsic to any care delivery system yet, although the Church views health care as a basic human right, it has yet to offer strategies for how such a right can be guaranteed. Mary J. McDonough, a former Legal Aid lawyer for medical cases, understands the advantages and disadvantages of market-based care and offers insight and solutions in Can a Health Care Market Be Moral? Drawing on Catholic social teachings from St. Augustine to Pope John Paul II, McDonough reviews health system successes and failures from around the world and assesses market approaches to health care as proposed by leading economists such as Milton Friedman, Regina Herzlinger, Mark Pauly, and Alain Enthoven. Balancing aspects of these proposals with Daniel Callahan's value-dimension approach, McDonough offers a Catholic vision of health care in the United States that allows for some market mechanisms while promoting justice and concern for the least advantaged.