Solidarity and responsibility” “

The recent declarations of Chancellor Gerhardt Schroeder on the need for some essential reforms of federal welfare policies have re-ignited the debate on healthcare and social services in Germany. The president of the German Episcopal Conference, Cardinal Karl Lehmann, and the chairman of the episcopate’s Commission for social and charitable problems, Bishop Joachim Reinelt of Dresden, commented on the problem on presenting the document: “Solidarity involves a personal assumption of responsibility. Guidelines for a healthcare system for the future”. Ethical guidelines of the reform. “Never before – said Cardinal Lehmann – have the changes taking place in the social structures and the constant progress of medicine had such an influence on the costs and on the nature itself of the healthcare system. No one has any intention of denying that so complex a system needs to be reformed”. The problem is how to ensure “that such reforms do not end up by generating a situation of insecurity and injustice”. For her part, the Church intends to appeal directly “to those responsible, to politicians, but also to simple citizens” “to evaluate and support the reforms” and renounce “positions of mere defence of existing privileges”. Without directly specifying “individual measures or making specific comments on the reform programme”, the Church intends to recall – in the words of the Cardinal – that “the reforms, however necessary, must be subservient to the human person, to his potential and his needs”. It is clear, continued Lehmann, that “with limited resources we need to conduct ourselves in a more parsimonious way, and that implies that the system be run as efficiently as possible. But this in itself is not enough. Nor is it conceivable that steps be taken that would undermine the very basis of social security”. Society in fact, by its very nature, “must absorb those risks that the individual person cannot himself tolerate. The solidarity of everyone must come into play wherever the individual is overburdened”. Protection of the person. The right balance needs, in short, to be struck between the economic needs of the system and the rights and needs of the individual. “The question is how to change the healthcare system in such a way as to pose correctly the need to ensure the well-being of each and every citizen”. The document presented by Cardinal Lehmann thus indicates some criteria for addressing the problem; they make reference to the papal encyclical “Centesimus Annus” and can be reduced to some basic concepts, such as the “redistribution of financial resources, the subservience of the bureaucratic aspects to social responsibility, and the rejection of the market logic that imposes productivity and competitiveness at all costs”. What needs to be done in substance is to “defend those suffering from chronic diseases, the elderly, and the economically disadvantaged”. Lehmann concluded with the axiom: “If we want the solidarity of everyone to reach where it is most needed, we must reform the healthcare system in such a way that it is not squandered where it is not needed”. Avoiding a public handout mentality. In his comments Bishop Reinelt recalled the “historic” importance of the German welfare system and especially “the principle that the individual person in need and families must be relieved of the burdens that illnesses and infirmities involve”. That – he stressed – is “the strength of our system in a world in which risks and pressures of every kind are growing day by day”. To limit every possible excess of a public handout mentality, the bishop proposed that the reform be inspired by “the principle of subsidiarity to establish the right balance between what the individual must and can do for his own health, and what he or she should properly expect from the community”. Other principles that need to be respected: the safeguard of social justice and the transition from a policy aimed at combating disease to one based on the preventive protection of health”.