Laurie Zoloth-Dorfman, Ph.D.
Professor of Social Ethics, San Francisco State University
Summary of Presentation:
The Silence in the Public Square:
Universal Coverage and Social Responsibility
Presented at
Envisioning Ethical Atlernatives in Health Care
9 December 1996
Summary:
The first task of any theology is to remember that it is the brokenness of the world itself that calls us to the
work of repair, it is to speak truth to power.
In America, nearly 45 million of our citizens do not have access to heath care services—not even to the 7 minute office visit or the reduced formularies. This figure does not begin to include the sojourners who are not citizens, and this is not to speak of the growing inability of even the insured to acquire the attention they need when they are ill, elderly or disabled.
This number has grown steadily, and nothing in the reorganization has reversed this trend. When health care costs began to make a small, slow drop in 1995, the cost savings may have pleased employers, but they as a group did not claim that they then could re-benefit employees who they did not previously cover. In large part the reason that fewer children are covered by healthcare than at the inception of managed care is that one way that employment benefit packages are reduced, and healthcare spending lowered, is to not insure dependents, or to institute large co-pays for them.
Bioethicists are being diverted by sensational ethical issues affecting a few. The economics of health care is now oriented to profit. Meanwhile, ethical and religious specialists are invited to comment on many complex and minute medical-ethical dilemmas and this diverts us from speaking about hundreds of thousands of people who have just lost their health coverage.
Religious leadership must raise its ethical and prophetic voice for the fundamental ethical principle of secure access to health care for all persons living in the United States.
In two years, the entire health care climate in California has been revolutionized far more radically than we would have dared. Patient choice, the closure of hospitals, the advance of home care, the role of the family, the income and the ability to make unilateral decision by the physician: all are dramatically changed.
The Biblical text is that of the outsider and its theological claim is for the stranger and the powerless that dwell in our gates. It is the role of the religious community and of ethics to insist on the priority of meeting the needs of the community of others. We should have one clear, attainable goal: universal access as a first premise, that can re-center justice in this debate.