Homework Help 1.   Demonstrate critical thinking and analysis Recognize relationships among different disciplinary approaches to the study of human cult

Homework Help 1.


Demonstrate critical thinking and analysis

Recognize relationships among different disciplinary approaches to the study of human cultures and the natural world

Integrate learning from different disciplines to illuminate intersecting topics of investigation

Week #7 Individual Assignment

Refer to the readings and videos from this week and previous weeks where necessary to answer the following questions:

 Why do you think Massachusetts’ health care reform (Chapter 58) passed almost unanimously, but the ACA was such a divisive political issue?

What are the shortcomings of Chapter 58? What does it do well?
How should liberal supporters of the ACA view GBIO’s socially active and morally tendentious arguments, given secular liberal qualms about religious arguments in public life?
In your opinion, how should we calculate a person’s or a family’s fair share contribution to the social good of health care?
Is it ethical for a government to impose an individual mandate on healthcare like the one found in the ACA?


Demonstrate critical thinking and analysis

Recognize relationships among different disciplinary approaches to the study of human cultures and the natural world

Integrate learning from different disciplines to illuminate intersecting topics of investigation

Week #7 PBL Assignment

Write a paper on both the religious and nonreligious arguments against the use of euthanasia in modern health care.


Answer all of the questions and Your submission must be double spaced with 12-point font.  The submission must be 2 – 3 pages and in APA format.



 Week #8 Individual Assignment

Learning Objective: 

Putting it all together: seeing the new vision for healthcare as essentially ethical and seeking the Common Good

You should do a Question/Answer format, not a formal paper.

Week #8 Individual Assignment

Explain the six values from the Oregon project (p 216 Health Care as a Social Good).
Compare these values to those guiding their commendations in Chapter 10 of Stakeholder Health.
Describe the key features of the Costa Rican health care system.
Watch the videos of Dr. Paul Farmer and find some information about the impact of his work.


Answer all of the questions and submit Your submission must be double spaced with 12-point font.

Learning Objective:  

Putting it all together: seeing the new vision for healthcare as essentially ethical and seeking the Common Good in relation to a particular health concern

Week #8 PBL Assignment

Use COVID-19 to compare three health care systems: the US, the UK and Costa Rica.

What is the scope of the problem globally? In each of the countries listed above.?
What systems are in place to address it? Who are the actors?
How does this problem affect the Common Good?
Evaluate each country’s response as a) medically effective, b) socially just, and c) economically efficient.


Answer all of the questions and submit Your submission must be double spaced with 12-point font.  The submission must be 2 – 3 pages and in APA format. Health Care as a Social Good

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Health Care
as a

Social Good
Religious Values and American Democracy

D AV I D M . C R A I G


Washington, DC

� 2014 Georgetown University Press. All rights reserved. No part of this book may be
reproduced or utilized in any form or by any means, electronic or mechanical, including
photocopying and recording, or by any information storage and retrieval system, without
permission in writing from the publisher.

Library of Congress Cataloging-in-Publication Data

Craig, David Melville, 1965– author.
Health care as a social good : religious values and American democracy / David M. Craig.

p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-62616-138-2 (hardcover : alk. paper)
ISBN 978-1-62616-077-4 (pbk. : alk. paper)
I. Title.
[DNLM: 1. Health Care Reform—United States. 2. Public Policy—United States.

3. Religion—United States. 4. Social Justice—United States. 5. Social Values—United States.
WA 540 AA1]


�� This book is printed on acid-free paper meeting the requirements of the American
National Standard for Permanence in Paper for Printed Library Materials.

15 14 9 8 7 6 5 4 3 2 First printing

Printed in the United States of America

To my parents,
Ann and Norman Craig

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C o n t e n t s

Acknowledgments ix

Introduction: Hearing Health Care Values 1

The Moral Languages of US Health Care

Chapter 1: Health Care as a Private Benefit or Private Choice 27

Chapter 2: Health Care as a Public Right 54

Chapter 3: Health Care as a Social Good 85

Religious Values in Health Policy, Markets, and Politics

Chapter 4: Modeling Community Benefits: Social Contract, Common
Good, Covenant 123

Chapter 5: Assessing Market-Driven Reforms: Economy without
Solidarity 153

Chapter 6: Building Solidarity: Religious Activism and Social Justice 183

Conclusion: Religious Values and Community Care 214

Bibliography 239

Index 257


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A c k n o w l e d g m e n t s

This project began years ago in a conversation with my cousinCurt Williams about Catholic hospitals and economic justice.
Although my research expanded into many other conversations, I hope that
Curt’s passion for justice shines throughout the book. My interest in ethics and
public policy dates back even further to family dinner conversations in my
youth. My parents’ engagement with public affairs and their dedication to the
common good informed my desire to join the health care reform debate. Ann
and Norman Craig’s reflective commitment to living out their religious values
is a model for the dialogue and work I foresee in the years ahead. I dedicate this
book to them. My wife Jocelyn Sisson gave her constant support—intellectual,
editorial, and soulful—throughout the project. Our daughters Claudia and Eliza
Craig kept me going with their lively dinner banter and their cheerful inquiries
into their father’s mood and the book’s progress.

I have more people to thank than I can name and an even longer list of
people to thank whom I cannot name. This book would not be possible without
my anonymous interviewees who patiently and vividly explained the complexi-
ties of health care and health policy. As a scholar, I am frustrated not to be able
to credit people for their revealing anecdotes, arresting phrases, and keen
insights. I extend to all of my interviewees this indirect expression of gratitude
for their time, experience, and candor. I hope they hear their voice in the book,
one part in a searching and morally serious civic dialogue about the present and
future of health care in the United States.

My colleagues in IUPUI’s Religious Studies Department encouraged me to
write for a broad public. I thank Matthew Condon, Edward Curtis, Tom Davis,
Johnny Flynn, Philip Goff, Kelly Hayes, Andrea Jain, Ted Mullen, Peter
Thuesen, Joseph Tucker Edmonds, and Rachel Wheeler for reading chapters
and offering clarifying pointers. Marc Bilodeau, Aaron Carroll, Carrie Foote,
Greg Gramelspacher, Anne Royalty, Rich Steinberg, Richard Turner, and Mark
Wilhelm stretched my thinking into health economics and policy, philanthropy


x Acknowledgments

and ethnography. Kevin Cramer sharpened my arguments with his usual dis-
cerning questions. Sarah Hamang masterfully annotated the latest health policy
research, and Richard Clark connected me to local religion and healthy commu-
nities initiatives. Diana Embry and Debbie Dale expertly transcribed the inter-
views. I am grateful for a sabbatical leave from IUPUI, along with research
support from the IU Center on Philanthropy and the IU School of Liberal Arts
at IUPUI, which allowed me to conduct the interviews. I thank Bill Enright
and the Lake family’s generosity for the opportunity to serve as the Thomas H.
Lake Scholar in Religion and Philanthropy, which enabled me to write the book.

I thank Richard Brown at Georgetown University Press for believing in and
seeing my vision of the book through to the end. I appreciate the comments of
the anonymous reviewers who helped focus and tighten the arguments. Chapters
4, 5, and 6 are based, respectively, on my articles ‘‘Religious Health Care as
Community Benefit: Social Contract, Covenant, or Common Good?’’ Kennedy
Institute of Ethics Journal 18, no. 4: 301–30; ‘‘Catholic and Jewish Ethics in the
Health Care Market,’’ Journal of the Society of Christian Ethics 28, no. 2:
223–43; and ‘‘Everyone at the Table? Religious Activism and Health Care
Reform in Massachusetts,’’ Journal of Religious Ethics 40, no. 2: 335–58. I thank
the current editors of these journals and Johns Hopkins University Press,
Georgetown University Press, and Blackwell Publishing for permission to


I’m half-kiddingly but half-seriously saying that we’re going to bring the
capitalists and the socialists into a room, and then we’re going to have a battle
royale because it’s meaningless for me to go into the public policy arena saying
I’m for universal coverage and that’s all I can say. We’re going to wake up one
of these days, and health care reform in the market is going to have to happen.
If you don’t want that, if you don’t like the entirely individualistic model, if
you think it’s going to leave out the poor, you should be concerned about who
we are. So now is the time to engage. What are we for?

Government affairs director, West Coast Catholic health system

Imagine a legislature or a town hall meeting where the ‘‘capital-ists’’ and the ‘‘socialists’’ were not allowed to leave until they came
to some agreement about the main goals and policies of health care reform. This
scene seems impossible in the United States. The continuing debate over the
2010 Patient Protection and Affordable Care Act is less a ‘‘battle royale’’ than a
battle without end. Despite surviving judicial review by the US Supreme Court
in 2012, the law’s implementation remained beset by partisan rancor. A con-
structive step forward would be for partisans on both sides to agree that the
labels capitalist and socialist might be used in jest behind closed doors but not
in public statements driven by anger, ideology, or political gamesmanship.
Instead of labeling people, I propose that it is more productive and accurate to
name the different ideas of health care in the national debate. Whereas many
conservatives believe that health care is a private choice, many liberals believe
that it is a right. Both understandings of health care can legitimately claim to
serve important values, and each one is backed by a distinct vision of justice.

The health care reform debate in the United States is a debate about the kind
of society that Americans want. Describing the debate in such elevated terms


2 Introduction

may seem too charitable. Some liberals presume that the sole motivation behind
conservative resistance to universal health coverage is crass selfishness, as if the
sentiment ‘‘I have mine and you don’t’’ is the crux of all conservative opposition
to the Affordable Care Act (ACA). Similarly, some conservatives describe the
push for health care reform as a power grab by ‘‘takers’’ whose only motivation
is to enjoy a free ride at the expense of ‘‘makers.’’ Ascribing bad motives to one’s
opponents is commonplace in politics, but it ignores how high the stakes are in
this debate.

The stakes are high because of the extreme cost of US health care and because
of the extreme vulnerability that makes it essential at times. The United States
devotes a much larger percentage of its annual spending to health care than do
other advanced economies, and the rate of spending increase continues to out-
pace inflation. As escalating costs absorb more and more of family income and
government budgets, Americans face basic questions not only about the coun-
try’s fiscal welfare but also about its political character. One certainty is that
controlling health care costs has to become a national priority. At the same time
there is a widely shared recognition that health need is not restricted to people
with health insurance. As a result, compassion requires making some provision
for uninsured people to have access to the vast health care resources in this
country. The challenges are societywide: how to control costs and how to ensure
at least decent care. Recognizing how high the stakes are may help Americans
find the charity needed to push past angry words and listen to the sincere values
on both sides of the political debate.

I have taken the epigraph to this introduction from a government affairs
director at a Catholic health care system on the west coast. He was one of a
hundred people I interviewed during a journey through US health care.1 The
journey took me across the country as I listened to health care insiders who
worked for nonprofit providers with a religious affiliation and to religious activ-
ists who participated in an interfaith coalition that lobbied for the 2006 Mas-
sachusetts health care reform law. The common denominator among my
interviewees was their participation in an organization serving religious values.
Of interest to me were both the religious language that shaped their discussions
about how to deliver and reform health care and also the shared commitment
to seeing their discussions through whatever disagreements arose along the way.

Judaism and Christianity—the two traditions I encountered on my jour-
ney—offer a range of powerful visions of responsibility, justice, and commu-
nity.2 Putting these visions into practice in a religious congregation, an interfaith
coalition, or a religious health care organization can help participants identify
who they are, celebrate what values they stand for, and cooperate on behalf of

Hearing Health Care Values 3

their commitments. The same objectives inspired the government affairs direc-
tor’s wish to corral his organization’s leadership team long enough for them to
hear each other out on the ethics and the economics of US health care. Who
are we? What are we for? Given our mission and values, how should we deliver
health care in a competitive marketplace?

These questions presuppose a ‘‘we,’’ a congregation, coalition, or organiza-
tion with which one associates by choice. Mutual understanding and construc-
tive compromise are hard enough to foster in an association, let alone in public
deliberation about such divisive issues as reforming US health care. The motiva-
tion for this book, however, is the recognition that all of the leading arguments
in the reform debate answer to visions of responsibility, justice, and community
that represent the views of large numbers of Americans. The book’s premise is
that listening to—and actually hearing—the values of people with whom we
disagree can change the conversation and chart a path toward meaningful and
lasting reform.


This book argues that religious values are vital to this public conversation for
two reasons. First, US health care is already shaped by the many religious health
care nonprofits that operate and deliver care in response to their mission and
values. Accounting for the practical effect of those values on public policy is the
purpose of the second half of the book.3 More important for now, I propose
that religious values can open a space in public discussions where liberals and
conservatives may be able to move past the static battle lines of sound-bite
politics to the motivating moral and political visions that are the principal source
of the passions in this debate. But will inviting more passions into the debate
help? If some of the passions are generated by visions of human dignity, moral
responsibility, and a good society that look to scriptural and traditional authori-
ties not shared by every American, how can religious values advance the national
debate or shape public policies binding on all Americans?

This question about the proper role of religious arguments in American
democracy is a polarizing subtext to many contemporary debates. In the stan-
dard media storyline and in many Americans’ assumptions, when religious argu-
ments enter the public forum, they unequivocally support the conservative
position on a wide range of issues from embryonic stem cell research to gay

4 Introduction

marriage to climate change. Simply put, religious values favor conservative poli-
tics. Admittedly, it is the case today that liberals are more likely than conserva-
tives to be skeptical about and even hostile toward religious arguments in public.
But equating religious values with conservative causes is historically myopic. In
the decades leading up to the civil rights movement, left-leaning religious argu-
ments held much greater sway in American public life.4 Just as we need to
disturb the battle lines of sound-bite politics, we should also question assump-
tions about how Americans’ religious and secular values play out in public

The divisiveness of contemporary public debates has been diagnosed as a
‘‘culture war,’’5 implying that Americans’ value conflicts are so entrenched as to
be foundational to their sense of being and belonging. In the culture war frame-
work, the more that public debates cross into moral terrain, the more apparent
it becomes that Americans are grouped into factions with dueling visions of the
good society. To borrow a biblical motif, liberals and conservatives, progressives
and traditionalists, are on divergent moral journeys to their own Promised
Lands. Not only do the imagined destinations differ, but getting there requires
marching in step with fellow travelers and orienting all of one’s ethical judg-
ments toward the truth of one’s goal. Thus each group’s moral reasoning
becomes so culturally insular that it is unintelligible to outsiders. Americans may
speak the same words—justice, dignity, community—but it is as if they were
consulting the dictionaries of different languages, for which no translations are

Acknowledging the threat of a culture war, some secular liberals argue that
collective moral journeys have no place in public discussion or political delibera-
tion.6 On this secular liberal reading of the US Constitution, We the People
agree from the outset to put aside our communal moral journeys in debating,
legislating, implementing, and adjudicating the laws of the land. For secular
liberals, the terms of politics should be defined by a dictionary of neutral legal
terms, supplemented perhaps by scrupulous political histories of the United
States. The apparent neutrality of this position is shadowed, however, by two
questionable premises. Secular liberals focus on religion as the source of those
troublesome moral journeys, and they disavow any desire to take the country
on a moral journey toward their vision of the good.7

The ongoing debate over the Affordable Care Act may appear to confirm
these secular liberal premises. On the one hand, liberals have long argued for
universal coverage in the secular languages of individual rights and cost-benefit
analysis. Liberals claim that health care is a human right essential to people’s

Hearing Health Care Values 5

ability to participate in and contribute to their society. Their economic argu-
ments support paying the cost of universal coverage both to offer poorer patients
the benefits of regular care and to avoid the wasteful expense of delivering pri-
mary care through emergency rooms and delaying treatment for chronic dis-
eases. On the other hand, in the debate over the ACA, the United States
Conference of Catholic Bishops, evangelical Protestants, and other conservative
Christians raised religious objections to potential federal funding of abortion
and to federal mandates that employer-sponsored health insurance cover birth
control.8 These religious objections were so pronounced that they threatened to
derail the ACA until President Obama issued an executive order tightening the
ACA’s restrictions on abortion funding. He later conceded that insurers, not
employers, were responsible for covering birth control, a concession that offered
little relief to those religious organizations objecting to the mandate that also
self-insure their workers.9

The reasonableness of these concessions lies in the eye of the beholder. Liber-
als cite the constitutional principle of equal protection to argue that federal rules
about mandated health insurance policies must apply the same to all Americans.
If the ACA’s minimal coverage standards include effective contraception, as jus-
tified by a right to privacy, then equal access to this benefit must be secured
for everyone regardless of whether one’s employer is a secular or a faith-based
organization. From this perspective, allowing expressly religious organizations to
waive the mandate to cover contraception is reasonable, but equality-in-coverage
guarantees must then be enforced on insurers. For conservatives this policy com-
promise is a case of pragmatic moral selectivity. Liberals couch their commit-
ments to privacy and reproductive freedom in appeals to secularity while ruling
other moral arguments out of bounds because of their religious overtones. It is
understandable, therefore, that conservatives question whether liberals’ resis-
tance to religion in public life is more a matter of constitutional scruples or
political advantage.

Mandating coverage for birth control is politically popular but socially con-
tentious. I raise the issue not to resolve it but to foreground the social dimen-
sions of disagreements over the proper direction of health care reform. Health
care is so expensive, complex, and vital to our lives that health policy decisions
tie Americans’ choices and responsibilities more closely together than in other
arenas of public policy. This social sharing of health benefits, risks, and costs is
reflected in the hybrid character of US health care, which liberals and conserva-
tives both overlook. The push for solutions that rely exclusively on either public
mandates or private markets ignores the longstanding public-private partner-
ships that built and continue to fund the country’s health care infrastructure and

6 Introduction

medical research and training programs. Also obscured is the role of nonprofit
organizations in delivering care. The many providers with a religious name—
Jewish, Baptist, Methodist, Presbyterian, Adventist, the countless Catholic
saints, and so forth—testify to the historical importance of religious communi-
ties serving their values by establishing hospitals to train caregivers, provide
health care, and include the excluded.10 Nonprofit providers with both a reli-
gious history and an active religious mission are central to this study of how
religious values shape US health care and why admitting the full range of these
values into the national debate can help move health care reform ahead in the
years to come.

The health care reform debate provides a case study of why and how the
national conversation needs to change. Americans should neither resign them-
selves to the hopelessness of an endless culture war nor reject religious values as
the source of unreasonable sectarianism in political debates. Policing collective
moral journeys out of political deliberation will not do. Instead we need to look
for civic spaces in which people are engaged in values-driven conversations about
how to join their efforts in pursuit of good health care while seeking constructive

Religious nonprofits actively serving their mission and values resemble com-
munities engaged in moral dialogue. In this they are similar to the interfaith
coalition I visited. As these organizations deliver care or agitate for reform, parti-
cipants continually discuss and debate the practical applications and moral
urgency of their values. Recognizing these conduits of religious values into US
health care has two implications. First, it cautions against dismissing a religious
health care nonprofit’s core values—for example, Catholic reverence for life on
the issue of contraceptive coverage.This public disregard may weaken the organi-
zation’s motivation to serve its other values, such as caring for poor and vulnera-
ble patients, which the public encourages through tax exemptions.11 Second, it
highlights the quasi-public status of the religious values that these organizations
enact, not by proof-texting biblical passages or imposing divine fiat on others,
but by deliberating about an organization’s shared history and religious values as
its members grope their way toward constructive compromise in implementing a
common mission. Simply put, religious health care providers and religious activ-
ists are on moral journeys of a sort, but their religiously informed visions of
good health care have a civic status and public accessibility that seem out of
place—and out of bounds—in a secular liberal ideal of reasonable political

Progressive health care reform seeks continued progress toward guaranteed
coverage for everyone in the United States. In addition to full inclusion, progres-
sive reform requires fairness, efficiency, and sustainability to realize the goal of

Hearing Health Care Values 7

affordable, quality health care for all. Yet secular arguments for universal health
coverage have proven weak in motivating reform in the United States, as dem-
onstrated yet again by the deep political ambivalence toward the ACA. In my
judgment, liberals have failed to persuade the American public partly because
they cede values talk—particularly about religious values—to conservatives upon
entering the public sphere.

The avoidance of religious values when discussing health care is especially
shortsighted. Health care touches our human vulnerability, and it heightens our
interdependence in mutual aid. Religious teachings, stories, symbols, and rituals
foreground vulnerability and interdependence in community as secular political
principles do not. In liberal traditions of politics, rights inhere in individuals as
powers. Social provision for fellow citizens requires prior consent of the gov-
erned. These democratic protections of personal liberty are essential to the sys-
tem of limited government in the United States, but they also reinforce the
individualizing tendencies of secular political philosophies on both the left and
the right. They also distract attention from the hybrid character of US health
care and the solidarity in community required for progressive health care reform.

Americans prize independence, which quickly falters when health crises hit.
At these times it becomes vividly, and sometimes painfully, clear how much our
life journey depends on others. The cost and complexity of health care mean
that family and friends are not sufficient. The mission and values of religious
providers offer evocative testimony to the need for a more encompassing collec-
tive moral journey in health care. Caring for the poor and the vulnerable, stew-
arding resources to build up a common good in health care, fulfilling the
covenantal duties of the health professions, treating patients with the respect
and justice that human dignity deserves—these phrases capture some of the
ways that Catholic, Protestant, Jewish, Muslim, and other religious health care
organizations have put their values into practice.12 Religious values are made
practically concrete as employees work them out in the delivery of care. They
take on a civic significance as administrators and caregivers with differing politi-
cal perspectives debate and implement their organizational values together. Sim-
ilarly, when activists pursue their religious values in serving communities or
lobbying for public policies, they give public expression to the values of a reli-
gious group. By listening in on the dialogues occurring inside religious health
care organizations and among interfaith activists, I learned how US health care
and health policy both serve and frustrate a wide range of values—secular and
religious, moral and economic.

In this book I examine all of the leading arguments in the health care reform
debate, taking seriously their visions of justice and their core values. A careful

8 Introduction

examination reveals that none of them matches how US health care has been
structured. Health care has not been organized as a private benefit, a private
choice, or a public right so much as a social good.13 Simply put, the social
pooling of resources and costs, the social lottery of risks and needs, and the
social priorities of wellness, prevention, and access to cost-effective care reflect
the ways that US health care is already a social good, however incomplete.
Listening to the religious values of health care leaders and activists is a first step
toward clarifying the visions of justice behind conservative and liberal
approaches to reform. The next step is learning how religious health care
employees and religious activists are acting on their values. Both groups have
created civic spaces in which people come together to enact shared values and
are sometimes transformed in the process. Readers can assess the fruits of their
efforts and, I hope, invest themselves in turning the hidden ways that US health
care already operates as a social good into explicit public priorities. By assessing
how religious values might figure in the coming decades of health care reform,
this book critically examines the ethical foundations of conservative arguments
for market reform and liberal arguments for health care rights. Finding both
approaches wanting, I develop a moral basis for a progressive vision of health
care as a social good.


The best way to name the competing ideas of health care in the reform debate
is to start with the language of ordinary Americans. I identify three moral lan-
guages that Americans speak in talking—and thinking—about health care. I call
them ‘‘moral languages’’ because, in naming what health care is, people make
assumptions about how it should be provided, paid for, and delivered. In the
United States health care is viewed as (1) a private benefit, (2) a public right,
and (3) a private choice.

The everyday expression ‘‘private health benefits’’ remains Americans’ pri-
mary moral language, and it reveals much of the moral history of health care in
the United States. The private benefits idea is so familiar that Americans do not
realize how curious it is. Its origins lie in the institution of employer-sponsored
health insurance in the United States. Starting in the middle of the twentieth
century, a growing number of employers began offering more generous health
insurance benefits to their employees. The term ‘‘benefits’’ simply designates
that employer-paid insurance premiums are in addition to employee wages. The

Hearing Health Care Values 9

term ‘‘private’’ describes the voluntary basis of these insurance policies: employ-
ers and employees contract certain benefits, and employers and insurers contract
the coverage terms or, increasingly, the service provisions. Although Americans
have become accustomed to the institution of private health benefits, it is unique
among industrialized countries.

The private benefits idea is also an odd fit with today’s US health care system.
The idea that work earns benefits continues to operate as a powerful moral norm
in public debates, even though only half of Americans (49 percent) were covered
through an employer in 2010.14 The hold of this norm is clearest in the misper-
ceptions surrounding the federal Medicare program. Despite being a social
insurance system, in which generations of younger workers support senior citi-
zens’ health care, Medicare is popularly viewed as a private benefits system, in
which …

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