Home / David W. Cooney / Distributism and Health Care Reform III


(continued from Part I and Part II)

In this part, I would like to present some aspects of the discussion that are sometimes overlooked and then begin to present alternatives that I believe are compatible with Distributism. Due to length, some of these alternatives will extend to Parts IV and V.

However, before addressing potential Distributist alternatives to Obamacare and to the proposals put forth by its opponents, I think it would help to clarify exactly what we are discussing. This has been called a debate on “health care.” This is a deliberately misleading label. The debate was never about health care; it was about the economic aspects of paying for health care – specifically through health insurance reform and taxation. By labeling it “health care,” however, those who shoved Obamacare down our throats claimed the right to accuse those who opposed the bill of being opposed to health care itself. This is a very old tactic they use all the time. The conservatives and libertarians were, as usual, duped by this move. Lacking any substantial philosophical foundation, they allowed themselves to be tricked into making statements which, upon further reflection, no reasonable person can support; even going so far as saying that health care is not a human right.

There is a difference between human rights and the means to secure them. We have a right to earn a living, to have food and shelter, to employ weapons in defense of ourselves and others, and, yes, a right to health care. However, the existence of these rights does not constitute a guarantee of their accomplishment. The acknowledgment of these rights is merely the foundation for establishing a social order in which they can be accomplished. In other words, everyone has a right to health care, but that doesn’t mean they have a right to health insurance, for that is only one of many ways of securing our right to health care; nor does it mean they have a right to force others to pay for their health care.

Another thing that needs to be understood in this discussion is the nature of health insurance. What exactly is insurance? How does it work? It was once explained to me by someone inside the industry in a way that made it so clear, and looks so obvious, that I remain amazed that more people don’t see it. Insurance is nothing more than legalized gambling. In the case of medical insurance, you and the insurance company are actually placing bets regarding your health. The truly stunning aspect of this is what each side is betting. The insurance company is betting that you won’t get sick, and you are betting that you will. The insurance company, being the gambling institution, gets to set the odds. As with all legalized gambling institutions, the insurance companies win the bet the vast majority of the time. However, when they lose, they often pay out much more than they were paid by that policy holder.

Now, I know that there are those who want the discussion to move away from insurance – at least from private insurance – and to the idea of health care that is covered by the government. The “public option” is believed to be the real desire of those who advocated Obamacare, and they worked hard to get it included in the bill. However, even with this option, we are still discussing the economics of accessing health care and whether or not everyone should be paying for everyone’s health care through their taxes.


Some alternatives that, if properly implemented, could be compatible with Distributism were put forth during the process of passing Obamacare. Republicans, for example, proposed allowing small businesses to pool together in associations to provide more affordable insurance, discouraging “junk” lawsuits by limiting non-economic damages, preventing insurers from unjustly canceling policies, and giving employers greater flexibility to financially reward employees who adopt healthier lifestyles. I also heard other conservative and libertarian commentators advocate allowing different coverage options like annual checkups plus catastrophic illness; which would allow people to afford insurance for the catastrophic illness by opting to pay for other services out of pocket.

So what solutions can Distributism offer to our current problems with acquiring health care? As I list my own thoughts on this, remember that the issue is not health care itself, but the means of acquiring it.

The problem of those who truly cannot afford health insurance

Just methods of taxation are another topic for discussion, but Distributism would, at the very least, revoke laws that establish barriers to charitable medical services. Distributists generally recognize that tax laws would need to be changed gradually in order to avoid completely disrupting economic society. Some initial steps in those changes could be more tax breaks for individuals and companies to contribute time, money, and supplies to charitable medical institutions. These institutions would then grow and more of them could come into existence. They would be better able to provide quality medical care for those who cannot afford insurance, and would do so much more effectively and efficiently than any program run by the government.

The refusal of our government to allow the providers of alternative treatments and medicines to make medical claims about these alternatives also hurts the poor. I can already hear people loudly proclaiming that the developed drugs are better than alternative or natural treatments. If you believe that’s true, then why not have the studies to prove it? However, the point is not always what medicine is the best, but what is sufficient. If a manufactured drug is twice as effective as an alternative treatment, but the alternative treatment works and costs one tenth as much as the manufactured drug, why deny the poor the opportunity to save some money while still getting the treatment they need? If the alternative works, it should be readily available through the medical community. As long as alternatives are denied the opportunity to make medical claims of their effectiveness, as long as research is only funded by private corporations with a vested interest in selling their products, the poor will be forced to pay more than necessary for sufficient treatment of their ailments.

Coming in Part IV: The problem of insurance monopolies and the high cost of health care.


About the author: David W. Cooney


David W. Cooney serves on the Editorial Board of The Distributist Review. His articles have appeared in Gilbert Magazine and he has also contributed to The Hound of Distributism, a book of various authors. Originally from Southern California, he now lives with his wife and two children in Western Washington state where he works as a network administrator.


Recent posts in David W. Cooney



  1. But wait! Didn’t you already decide the issue when you said insurance is legalized gambling? The church shouldn’t gambling and neither should we. The only alternative is using statistical analysis to asses costs and distribute those costs through taxation.

  2. Well, I understand that the Church doesn’t condemn gambling outright – otherwise bingo night is out for good. In regard to insurance, theologians like St. Thomas Aquinas have given approval in many cases and condemnation in others. I also disagree that your suggestion would be the only alternative. You seem to be forgetting the role of charitable services, the ability of guilds and cooperatives to provide for members and community, etc.

  3. The biggest gamblers are those who gamble on the government providing the health care they need, when they need it. Now that’s a sucker’s bet!

  4. Curious. I thought all those years, growing up in Europe, I was receiving it. And just as efficiently as I do now, here in the States.

  5. Well, with all of the complicated rules set up by our monopolistic insurance agencies, it’s not that different. Some things are better and some things are not. The problem is when you have a centralized management of services that looks at budget first and the well being of the patient second. That happens just as much with the big private insurance companies as it does with government run plans. Private insurance companies try to maximize profit and government programs try to minimize costs. The end result is very similar.

  6. My uncle, who is a health insurance broker, notes that one of the problems with health insurance is that it really doesn’t act like insurance; that is, it doesn’t follow the “gambling” model that Mr. Cooney correctly notes is the normal course of insurance.

    After all, things like an annual check-up or a dental cleaning are not possible outcomes that may or may not happen; they are regular “maintenance” activities. A broken bone or a cancer or some other major disease or injury is really what an insurance model is designed for; but the insurance model is being twisted to fit these non-catastrophic medical activities.

    In other words, since insurance is not the only way to provide the means for health care, and it seems not to be the best way, perhaps we should look at other models altogether.

    For the record, I’m not sure what the solution is. My uncle is a big proponent of Health Savings Accounts.