By Peter J. Smith

VATICAN CITY, September 18, 2009 ( – A prominent Vatican official recently stepped into the US health-care debate, offering words of praise for President Barack Obama's health-care reforms that seem to suggest that responsibility for an individual's “health” belongs to the “central government.”  But that point is at loggerheads with the arguments of a handful of US bishops who have spoken up on the same subject.  These bishops have suggested that state-run health care violates a Church principle called “subsidiarity.”

“The health of their own citizens belongs to the authorities, to the central government,” Cardinal Renato Martino told a Catholic News Service reporter after a Vatican press conference.

Martino, a high-profile official within the Roman Curia, is the head of the Pontifical Council for Justice and Peace. He served in the United States as the Vatican's permanent observer to the United Nations from 1986-2002.  During his 16 years in America, he told the reporter, “I was wondering why a big portion of the American people is deprived, have no health assistance at all. I could never explain this.”

Between 10 – 15 percent of Americans do not have health-insurance in the United States, although all have access by law to emergency room health-care. reports that the Census Bureau puts the number of uninsured Americans at 35.92 million, although 9.1 million persons making over $75,000 per year voluntarily forgo insurance. The Census Bureau's numbers are lower than President Obama's estimate of 47 million, because it does not include immigrants residing illegally within the US.

The Vatican Cardinal opined that “everywhere in the world [health-care] is a concern of the government first of all, and after there are possibilities also on the private sector, but those who are without anything … the central government must provide to that.”

“So I cannot but applaud this initiative,” Martino concluded.

However, a number of American bishops are not applauding the Obama Administration initiative – saying that investing the central government with responsibility and ownership of an individual's health-care violates Catholic social teaching and poses grave risk to the dignity and rights of the individual.

“There is a danger in being persuaded to think that the national government is the sole instrument of the common good,” Bishop Samuel J. Aquila of Fargo told his flock. “Rather, according to the classic principle of subsidiarity in Catholic social thought, many different communities within society share this responsibility,” communities which acting together, he said, “build up a strong and cohesive social fabric that is the hallmark of a true communion of persons.”

Aquila continued, “States, towns, fraternal organizations, businesses, cooperatives, parishes and especially the family have not only legitimate freedom to provide the goods they are rightly capable of supplying, but often times do so with far greater efficiency, less bureaucracy and, most importantly, with personalized care and love.”

Bishop R. Walter Nickless of the Diocese of Sioux City has emphasized that the Church “does not teach that government should directly provide health care,” and argued that making health care “subject to federal monopolization” was a prudentially poor decision. “While a government monopoly would not be motivated by profit,” he opined, “it would be motivated by such bureaucratic standards as quotas and defined 'best procedures,' which are equally beyond the influence of most citizens.”

Bishop Doran of Rockford Illinois has also warned that Obama's overhaul does little to give real health-care to patients, but instead simply expands government control of the private sector and violate Catholic principles of subsidiarity, solidarity, and interest in the common good – all indispensable elements to positive health care reform.

“Our federal bureaucracy is a vast wasteland strewn with the carcasses of absurd federal programs which proved infinitely worse than the problems they were established to correct,” wrote Doran.

“Modern socialist governments like to control not food but the means to protect and extend life,” continued Doran, adding, “we as Catholics should take care that health care does not morph into life control.”

The Kansas Bishops also made very clear that the principle of subsidiarity also guaranteed that the individual owns his own health, and that the communities closest to him in society, not the central government, are best equipped to give him the health-care he needs.

Referring to the health care legislation advocated by President Obama, Kansas City Archbishop Joseph F. Naumann and Kansas City-St. Joseph Bishop Robert W. Finn noted, “Many of the proposals which have been promoted would diminish the protection of human life and dignity and shift our health care costs and delivery to a centralized government bureaucracy.”

Neglecting the principle of subsidiarity in health-care reform “can lead to an excessive centralization of human services, which in turn leads to excessive costs, and loss of personal responsibility and quality of care.” 

The Bishop of Cape-Girardeau and Springfield, Missouri has also stated that he cannot support President Obama's health-care reforms as they stand, because of the dangers the reforms pose, not only to life, but especially to subsidiarity, “the principle of social dignity.”

Bishop James Vann Johnston quoted the Catholic Catechism to emphasize that subsidiarity is “opposed to all forms of collectivism” and “sets limits for state intervention.” He explained, however, that “the higher order” of central government does have a role in health-care reform; but it must only play a very limited and supporting role, not a dominant one, so as not to run the risk of crushing all the other necessary functions and expressions of society and trampling on the individual.

“Government may also be needed to see that no one, especially the working poor and the most destitute and forgotten, falls through the cracks,” wrote Johnston. “But, the essential element of the principle of subsidiarity is the protection of individual freedoms from unjust micromanagement and manipulation by the state.”

See related coverage by

Bishop Doran Weighs in Against Obama Health Care Overhaul 

Kansas Bishops Criticize Healthcare over Abortion, Failure to Respect Subsidiarity 

Bishop Aquila Holds the Line against Abortion-Promoting Health Care Reform 

Bishop Nickless: “No Health Care Reform is Better than the Wrong Health Care Reform” 

Bishop Vasa: No Support for “Fatally Flawed” Obamacare Bill 


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