February 18, 2005

"The religion of health."

Vatican officials criticize the rich countries of the world for luxuriating in excessive health care. We expect far too much, we overconsume, as the rest of the world goes hungry for the most basic health care:
"While millions of people in the world struggle to survive hunger and disease, lacking even minimal health care, in rich countries the concept of health as well-being figures in creating unrealistic expectations about the possibility of medicine to respond to all needs and desires," said the Rev. Maurizio Faggioni, a theologian and morality expert on the Vatican's Pontifical Academy for Life.

"The medicine of desires, egged on by the health care market, increases the request for pharmaceutical and medical-surgical services, soaks up public resources beyond all reasonableness," Faggioni said.

This is a good point. Perhaps as an ethical matter, anyone contemplating something like cosmetic surgery, ought to think again and contribute the money he or she would have spent on the surgery to a charity that provides basic health care to the poor.

But the Vatican officials take the criticism a step further: the rich countries have embraced a "religion of health."
Vatican officials ... held out Pope John Paul II's stoic suffering with Parkinson's disease as an antidote to the mentality that modern medicine must cure all, calling this a "religion of health" that is taking hold in affluent countries.

Now the problem is framed not merely as selfishly consuming more than your share, but believing in the wrong values.

There is some truth in this. I remember a TV commercial from a few years back with an ordinary woman, standing on her porch, blandly asserting, "Nothing is more important than my family's health." Taken literally, that's quite an inappropriate thing to believe. People often say, without any sense that they are saying something offensive (and idiotic): "If you don't have your health, you don't have anything." To make health one's central value is exceedingly shallow.

Is health becoming a religion? Some people make it the central value around which they order their lives. Health is worshipped. And, Lord knows, there are many rituals.

UPDATE: Reader Jim Havey writes:
I've long thought that the Catholic church offers people who are brilliant in every field except economics. Our pursuit of better drugs and procedures benefits people all over the world. Particularly in the development of pharmaceuticals: millions are spent in development of new drugs and we in the United States pay most of the cost. Once developed, those drugs are relatively inexpensive to manufacture and people in less affluent countries often get them at prices they can afford. When there are problems getting drugs to where they are needed, it isn't because we are consuming more than our share.

The maladies of impoverished countries--beyond poor healthcare -- are the result of bad government or cultures with poor priorities. Whenever I hear a representative of the Catholic Church speak about third-world poverty, it's from a zero-sum view of wealth -- we in the West can only have more at the expense of someone else.

I'm no economic expert--I'm an appellate prosecutor. But that's pretty basic.

[Is health] becoming our religion? Maybe. If my life is representative there is sin -- eating junk food and carousing -- and there is penitence -- miles run and time at the gym.

Yes, this religion of health has sinners, doesn't it?

ANOTHER UPDATE: A reader, Reginald White, writes (and I use his name with permission):
I read with some interest your comment on the cliché, "If you don't have your health, you don't have anything." While I agree (with what I think is your premise) that "[t]o make health one's central value is exceedingly shallow," I also believe that this cliché contains more truth than most.

Almost seven years ago (May 2, 1998--not that I'm counting), I was diagnosed with multiple sclerosis. In five years, what started as a numb spot about the size of quarter in my left thigh has effectively ended my career and has left me physically disabled. (This was not an easy adjustment; I graduated at the top of my class from Tulane Law School, expected a lot from myself, and was on the fast track until I physically couldn't pull the hours anymore. I also went to college to play baseball, so the physical limitations, such as the inability to walk more than a block or so, have been particularly difficult to accept).

So, the Vatican's pronouncement about health as well-being disturbs me. (As a former Catholic, such statements still carry particular weight with me). But for modern medicine and its expensive treatments (which have stabilized my health by slowing the rate of disease progression), I would be in a wheel chair or worse. The resources expended on me could have been used to provide basic health care for more than a few persons.

In Britain, the National Health Service effectively rations the immunomodulating drugs that have done so much for me. Is the Vatican providing a theological basis for rationing health care for people with chronic diseases like mine?

The entire health care debate seems to have skipped over the question of what to do about people like me. Unlike people who have acute incidents (i.e., health incidents from which people either will die or will overcome), most people with chronic diseases consume much more in health care resources and produce less economically. From a strict cost-benefit analysis, this money spent on people like me could be expended with better result elsewhere. (The Nazi realized this quickly and implemented their vile T4 program, the precursor for the Final Solution).

What is more ethical? Helping me preserve what remains of my health (and dignity for that matter)? Or spending the same money on health care for more people with less serious and more treatable ailments, conditions, etc.?

I don't know. Obviously, the way out of this dilemma is to advance the science and cure this (and other chronic diseases). I fully expect a cure sooner than later, but probably I have unrealistic expectations about the possibilities of medicine. But until then, what? Or what if it's incurable? What should society do with people like me?

First, I'm constantly impressed by the email I receive, and I'm chastened to be reminded of the things I forget to think about. Clearly, I don't mean for anything I've written to mean that White should not receive his treatment simply because the money spent on him could be distributed to provide health care for, say, several children with various, simply cured diseases. There is no reason to draw the line at health care: why don't we all only consume the bare minimum and give all the rest to charity? Isn't that what Jesus told the rich man to do? How can I buy a fancy new car, or even any car? Why don't I walk, eat only what is necessary to survive, and live in a one-room apartment, and contribute everything else to the poor? I should do that before White should give up his treatment, of course, and I don't.
Then Jesus said to His disciples, "Assuredly, I say to you that it is hard for a rich man to enter the kingdom of heaven. And again I say to you, it is easier for a camel to go through the eye of a needle than for a rich man to enter the kingdom of God." When His disciples heard it, they were greatly astonished, saying, "Who then can be saved?" But Jesus looked at them and said to them, "With men this is impossible, but with God all things are possible."

YET MORE: The Anchoress has an excellent post.

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