Let us re-focus on our core values. I recently had some personal exposure to the modern healthcare system, and as I witnessed the system in action I reflected on the sixth tenant of the Church: human life is not inherently sacred or special. I still feel uncomfortable discussing this tenet because it is so “taboo” and “radical” in modern society that it certainly makes the Church a monster in the eyes of most people.
And yet…
As I observed these dedicated hospital workers using the marvels of modern technology to treat an elderly patient– one who is very closely related to me, I might add, lest you think I am some apathetic hypocrite that would sing a different tune if it affected me personally — I couldn’t help but also consider the sheer amount of physical waste that is produced, the tremendous effort and energy that is expended, and the ultimate financial cost that is incurred.
It is no secret that the healthcare system is tragically broken . People will lay the blame on for-profit insurance (rightfully so) or on the absurdly astronomical prices of healthcare goods and services (also very much to blame). But as with most of society’s ills, if we are to look at this dispassionately and rationally, perhaps we will realize that the underlying issue stems from our own personal behaviors and is simply excacerbated by a perverse capitalist system.
Our societies– and Western societies in particular– are taught to believe that human life is the most precious thing there is. Outside of martyrdom, every major religion and philosophy asserts that human life is sacred. So that we can move past it, let me quickly point out the glaring hyprocrisy of our indifference to gun violence, poverty and famine, pollution, climate change, genocide, and the countless other preventable causes of death on massive scales… Let’s just focus on their stated ideals.
Between these deep-seated beliefs and our own physiological survival instinct, we demand that medical science preserve our life (or the life of our loved one) at any cost and consequence… ventilators, feeding tubes, catheters, advanced dementia or vegetative, most of us will continue to prolong a life far beyond what is rational or compassionate. It’s not even the hope of a miraculous recovery in many cases, it is simply the stance that existence in any level of abject misery is still somehow preferable to non-existence. And so medicine has no choice but to oblige, and devises new pharmaceuticals and operations that will buy a few more heartbeats at ever-increasing cost.
People aged 55 or older account for more than half of all health expenditures while being less than one-third of the population[source]; that ratio continues to increase as people get older or nearer to their end of life. Most studies peg costs for the final year of patients’ lives at around 20% of Medicare spending[source].
Insurance, whether privatized or public, is a type of socialized risk management. Everyone pays into the system a little bit, so that when one person needs a lot, the system can use the collective funds to cover the expenses for that person. This is a sound strategy, but only when the use of insurance resources is lower than the amount that is paid in. However, as the population gets more unhealthy while also demanding increasing longevity of life, this creates a problem of solvency. Private health insurance rations care by denying claims or refusing coverage, whereas public insurance (Medicare) rations only by availability but ultimately passes on the rising costs to taxpayers.
Now of course, insurance companies continue to post record profits, which indicates that even with the burden of increased demand, they are still exploiting the system to their advantage. UnitedHealthcare reported $14 billion in profit in 2024, so maybe discussing this in terms of financial burden is undue. Luigi did nothing wrong.
Putting aside monetary cost, the healthcare industry is also grossly wasteful in terms of resources. Everything is disposable, everything comes in layers of packaging to maintain sanitation, things must be kept at specific temperatures during global transport and storage, items have exceedingly short shelf-lives for fear of denaturing, things are disinfected and laundered regularly… the list goes on. To try and estimate the carbon footprint of even a single overnight hospital stay would be staggering; estimates say the healthcare industry is responsible for 4-5% of global greenhouse emissions annually.
Then there is the intangible cost of human dignity and comfort. Modern medicine is dedicated to “fixing” bio-technical problems and preserving life, with little regard for the quality of that life. It is only very recently that this has begun to change, with slightly more attention being given to what a “life worth living” means to each person. Atul Gawande’s Being Mortal is a beautiful exploration of the topic, discussing in very compassionate and personal terms the difficulties we all face as we (and our loved ones) near their end of life.
To be clear, the Church recognizes that mortality is a difficult subject, and that our innate survival instinct and preservation of life are valid impulses. There is no clear answer to the question of the worth of a human life, nor do I even have a clear thesis to my thoughts on this matter. But reflecting on the amount of effort we exert and the amount of resources that we expend to potentially save even a single human life is remarkable… and very possibly unsustainable.
