Answer in responses of ~2 paragraphs:
What is justice? What is the difference between the definitions of justice discussed in the text. Which definition do you most agree with and why?
What is the Catholic Church's stance on Health Care Reform. Why has this been such a complicated issue for the Church?
What are some of the problems that Health Care Reform and the ACA intended to fix? Has the ACA been effective in addressing these problems?
Justice, in its broadest sense, is the principle that people receive that which they deserve, with the interpretation of what then constitutes "deserving" being impacted upon by numerous fields, with many differing viewpoints and perspectives, including the concepts of moral correctness based on ethics, rationality, ..
Justice is one of the most important moral and political concepts. The word comes from the Latin jus, meaning right or law. The Oxford English Dictionary defines the “just” person as one who typically “does what is morally right” and is disposed to “giving everyone his or her due,” offering the word “fair” as a synonym. But philosophers want to get beyond etymology and dictionary definitions to consider, for example, the nature of justice as both a moral virtue of character and a desirable quality of political society, as well as how it applies to ethical and social decision-making. This article will focus on Western philosophical conceptions of justice. These will be the greatest theories of ancient Greece (those of Plato and Aristotle) and of medieval Christianity (Augustine and Aquinas), two early modern ones (Hobbes and Hume), two from more recent modern times (Kant and Mill), and some contemporary ones (Rawls and several successors). Typically the article considers not only their theories of justice but also how philosophers apply their own theories to controversial social issues—for example, to civil disobedience, punishment, equal opportunity for women, slavery, war, property rights, and international relations.
For Plato, justice is a virtue establishing rational order, with each part performing its appropriate role and not interfering with the proper functioning of other parts. Aristotle says justice consists in what is lawful and fair, with fairness involving equitable distributions and the correction of what is inequitable. For Augustine, the cardinal virtue of justice requires that we try to give all people their due; for Aquinas, justice is that rational mean between opposite sorts of injustice, involving proportional distributions and reciprocal transactions. Hobbes believed justice is an artificial virtue, necessary for civil society, a function of the voluntary agreements of the social contract; for Hume, justice essentially serves public utility by protecting property (broadly understood). For Kant, it is a virtue whereby we respect others’ freedom, autonomy, and dignity by not interfering with their voluntary actions, so long as those do not violate others’ rights; Mill said justice is a collective name for the most important social utilities, which are conducive to fostering and protecting human liberty. Rawls analyzed justice in terms of maximum equal liberty regarding basic rights and duties for all members of society, with socio-economic inequalities requiring moral justification in terms of equal opportunity and beneficial results for all; and various post-Rawlsian philosophers develop alternative conceptions.
Western philosophers generally regard justice as the most fundamental of all virtues for ordering interpersonal relations and establishing and maintaining a stable political society. By tracking the historical interplay of these theories, what will be advocated is a developing understanding of justice in terms of respecting persons as free, rational agents. One may disagree about the nature, basis, and legitimate application of justice, but this is its core.
The Patient Protection and Affordable Care Act is a U.S. federal statute signed into law by President Barack Obama on March 23, 2010. It is the principal health-care reform legislation of the 111th U.S. Congress. It reforms certain aspects of the private health insurance industry and public health insurance programs, increases insurance coverage of preexisting conditions, expands access to insurance to over thirty million Americans, and increases projected national medical spending while lowering projected Medicare spending. It is expected that each of these promises has or will be broken. The Catholic Medical Association, representing Catholic physicians as well as other concerned Catholic health-care professionals, has and will continue to focus on the harm that such a vast, vague legislation brings to the task of ongoing moral and ethical delivery of health care.
The Patient Protection and Affordable Care Act (PPACA) was presented to the public making three significant promises:
1)
Americans’ health insurance costs would be reduced;
2)
The PPACA would reduce the rate of spending on health care and would not add to the national deficit; and
3)
People satisfied with their current health insurance plans could keep them.1
Each one of these promises has been or will be broken.2 The reason is that the administration did not address the underlying causes of healthcare problems, but focused on increased access to health care. They seek to accomplish this by mainly adding to Medicaid, a system already strained by inadequate funding and staffing. In addition, the national insurance mandate, a component of the PPACA, which has raised constitutional issues, is now in the courts.3
The Catholic Medical Association, representing Catholic physicians as well as other concerned Catholic health-care professionals, has focused primarily on the harm that such a vast, vague legislation brings to the task of ongoing moral and ethical delivery of health care. Since the discussion of Obamacare began in 2009, the Catholic Medical Association has taken the position of advocating for defeat of the PPACA, because it was a slipshod, partisan bill that ultimately was passed against the will of the American people. The PPACA fails to respect fundamental ethical, constitutional, and social principles. Since the passage of this bill in 2010, we believe the results support the Catholic Medical Association position.4
The issue of funding for abortion is paramount and has been addressed by Anthony R. Picarrell Jr., J.D.5 A second very serious concern is the lack of protection of conscience rights for health-care professionals.6Regulations enacted under the Bush Administration to uphold federal conscience protection laws (the Hyde and Weldon Amendments for example) are expected and may have already been revoked by the current administration. President Obama began the process of rescission two years ago, March 10, 2009, when he signed a notice of a proposed rule to rescind the Bush Conscience Protection Act.7
A third major social and ethical principle that has not been addressed but is very important to health-care ethics is that of subsidiarity. The Catechism of the Catholic Churchdefines subsidiarity in the following way:
A community of a higher order should not assume the task belonging to a community of a lower order and deprive it of its authority. It should rather support it in case of need. Excessive intervention by the State can threaten personal freedom and initiative.8
Pope Benedict XVI wrote in his 2005 encyclical Deus Caritas Est,
We do not need a State which regulates and controls everything, but a State which, in accordance with the principle of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need.9
This principle argues for a health-care reform solution that fortifies individual family responsibility for health-related decisions. The doctor-patient relationship should be strengthened and protected rather than threatened by distant bureaucratic panels. Local- or community-level initiatives should receive priority over increasing the role of more distant employer/government control. The need for health-care reform is unquestionable. But is the near total disregard of the present system in one gigantic bill appropriate? The size and complexity of health care as we know it in this country does not lend itself to such a sweeping change.
Government leaders can and must enact health-care legislation that respects our deepest human and constitutional rights—the right to life, respect for conscience, and religious freedom; that respects the patient-physician relationship and fosters innovation and quality in health-care services; that respects the principle of subsidiarity in decision making across the spectrum of choices in health insurance and health-care services; and that ensures that all people have access to health care, particularly the poor and vulnerable. Finally, this should be done in a way that is economically sound and sustainable. Currently, this is not attainable with the PPACA.
So where do we go from here?
First, good health-care legislation should strive to make the highest quality health care affordable both to patients and society.
Second, the dignity of each person must be protected from conception to natural death. Neither abortion nor abortifacient contraceptives should be subsidized.
Third, the legislation should strive to promote the common good by working to improve social conditions that make insurance affordable and available.
Fourth, such legislation should support the principle of subsidiarity by supporting efforts to enable individuals and families to obtain health care in the marketplace, not a government bureaucracy.
Finally, virtually all right-to-life organizations have been supportive of either voiding the current health-care legislation or making proper, significant changes. The official Catholic position needs to be uniform and total in support of the principles outlined. The U.S. Conference of Catholic Bishops position of opposition to the PPACA, unless significant amendments and conscience issues are included, is a strong position.10 The Catholic Medical Association concurs with the bishops’ position and supports recognition of the principle of subsidiarity. This collaboration is, regrettably, incomplete in our Catholic health-care system. This disunity leads to confusion among the laity and in the messages to politicians. May the Holy Spirit guide us to achieve these worthy goals together
The ACA has been highly controversial, despite the positive outcomes. Conservatives objected to the tax increases and higher insurance premiums needed to pay for Obamacare. Some people in the healthcare industry are critical of the additional workload and costs placed on medical providers.
Pros
More Americans have health insurance
More than 16 million Americans obtained health insurance coverage within the first five years of the ACA. Young adults make up a large percentage of these newly insured people.
Health insurance is more affordable for many people
Insurance companies must now spend at least 80 percent of insurance premiums on medical care and improvements. The ACA also aims to prevent insurers from making unreasonable rate increases.
Insurance coverage isn’t free by any means, but people now have a wider range of coverage options.
People with preexisting health conditions can no longer be denied coverage
A preexisting condition, such as cancer, made it difficult for many people to get health insurance before the ACA. Most insurance companies wouldn’t cover treatment for these conditions. They said this was because the illness or injury occurred before you were covered by their plans.
Under the ACA, you can’t be denied coverage because of a preexisting health problem.
No time limits exist on care
Before the ACA, some people with chronic health problems ran out of insurance coverage. Insurance companies set limits on the amount of money they would spend on an individual consumer.
Insurance companies can no longer maintain a preset dollar limit on the coverage they provide their customers.
More screenings are covered
The ACA covers many screenings and preventive services. These usually have low copays or deductibles. The hope is that if you’re proactive in your healthcare, you can avoid or delay major health problems later.
Healthier consumers will lead to lower costs over time. For example, a diabetes screening and early treatment may help prevent costly and debilitating treatment later.
“The ACA is going to help all Americans have higher quality and less costly healthcare in the decades to come,” says Dr. Christopher Lillis, an internist in Virginia and a member of Doctors for America.
Prescription drugs cost less
The ACA promised to make prescription drugs more affordable. Many people, particularly senior citizens, are unable to afford all their medications. The number of prescription and generic drugs covered by the ACA is growing every year.
According to a Centers for Medicare and Medicaid Services press releasefrom 2017, Medicare beneficiaries have saved over $26.8 billion on prescription drugs under Obamacare.
Cons
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