The document discusses access to healthcare as a social justice and Catholic issue. It notes that the US spends more than double per capita on healthcare than other industrialized countries but has worse health outcomes, and that life expectancy varies greatly between US counties and is strongly predicted by wealth. Children in poverty are seven times more likely to have poor health. The Affordable Care Act aims to expand access but will still leave many uninsured. Trinity Health is a large Catholic healthcare system that serves patients regardless of ability to pay.

1. Justice & Rights Rights & Duties Liberty Rights & Claim Rights Rights in the Catholic tradition “ Human rights are the minimum conditions for life in community.” Rights are a reflection of human worth Immigration Rights & Borders

2. Passions can be helpful, but they can also blind us. Can you determine what sorts of things are behind the passions you see on this video about a topic that ordinarily tends to be pretty dry (health insurance!)? And can you identify blind spots on one or the other side (or both) based upon your reading for Tuesday, the video Sick Around America , and our discussions about social & economic injustice in general? vt

3. discuss why access to medical care is a significant issue for social justice (especially in terms of ‘what’s up to you’ vs. ‘what’s not up to you’), and consider the Catholic contribution to the healthcare debate in this country.

4. “ In the end, the kind of health care we tolerate reflects the kind of society we are or want to be.” — Dr. Edmund Pelligrino (XP, p. 139)

5. How does American life expectancy compare to other countries? (Based on 2005 data reported in the 2007 United Nations Human Development Report) Number 1 In the top 10 29th place Source: http://www.unnaturalcauses.org

6. ANSWER: C. 29th place At 77.9 years, we are tied with South Korea and Denmark for 29th – 31st place, despite being the second wealthiest country on the planet (measured by per capita GDP). Japan has the highest life expectancy at 82.3 years

7. How much does the U.S. spend per person on health care? Three quarters as much as the other industrialized countries The same as the other industrialized countries More than double other industrialized countries

8. ANSWER: C. More than double We spent $6102 per person on medical care in 2004 (estimates for 2007 are $7600). That ’s more than double the $2552 median of the 30 OECD countries. Yet our health outcomes are among the worst.

9. 7 years 15 years 22 years 25 years What is the greatest difference in life expectancy observed between counties in the U.S.?

10. ANSWER: B. 15 Years Populations in some wealthy communities live on average well into their 80s, while others in some inner city neighborhoods and Native American reservations barely scratch 60.

11. Between 1980 and 2000 the gap in life expectancy between the most and least deprived counties in the U.S: A. Declined by 12% B. Remained the same C. Widened by 60%

12. ANSWER: C Widened by 60% As economic inequality grew after 1980, so did the life expectancy gap between the rich and the rest of us. In contrast, a recent study (Krieger et al) showed that premature death and infant mortality gaps narrowed between 1966 and 1980.

13. Japanese Bangladeshis Cubans Algerians living in Paris All of the above African American males in Harlem have a shorter life expectancy from age five than which of the following groups?

14. ANSWER: E. All of the above The biggest killers of African American males in many poor, segregated urban neighborhoods are not violence nor drugs nor AIDS, but heart disease, stroke and other chronic diseases that cut men down in middle age.

15. Whether or not you smoke What you eat Whether or not you are wealthy Whether or not you have health insurance How often you exercise On average, which of the following conditions is the strongest predictor of your health?

16. ANSWER: C. Whether or not you are wealthy The wealthier you are, on average, the better your health, from the bottom all the way to the top. Genes, diet, exercise and other behaviors are important. But a poor smoker still stands a greater chance of getting ill than a rich smoker.

17. True False True or False: The gap between white and African American infant mortality rates is greater today than it was in 1950;

18. ANSWER: A. True The total number of infant deaths among both African American and white Americans has fallen since 1950. But today the infant mortality rate for African Americans is two and a half times that of white Americans, a greater gap than 60 years ago. In fact, the rate among African American mothers with college and professional degrees is higher than among white mothers who haven’t finished high school.

20. 3 times 4 times 5 times 7 times Children living in poverty are how many times more likely to have poor health, compared with children living in high-income households?

21. ANSWER: D. 7 Times Children are most vulnerable. Not only are they susceptible to sub-standard housing, poor food, bad schools, unsafe streets and chronic stress, but the impacts of childhood poverty are cumulative, leading to a pile-up of risk that influences adult health and can even affect the next generation.

22. Expands Medicaid coverage up to 133% of Poverty Line. Low-income individuals or families who make too much to qualify for Medicaid, but who are up to 400% of Poverty Line will be eligible for government subsidies to buy health insurance. Sets up health insurance exchanges in each state where individuals and small businesses can compare policies and premium prices to purchase health insurance. Will prevent insurers from denying coverage to people or for, in most cases, charging more for pre-existing conditions. Children up to age 26 can be part of their parents’ plan. Companies employing 50 or more people have to offer health insurance to their employees. Requires people not covered by Medicaid, Medicare, or other health insurance to purchase health insurance (some exceptions). Should insure about 30 million more people, leaving about 20 million still uninsured. Will either reduce the federal deficit or increase the federal deficit (!)—depends whom you ask!

23. I. Access to Health Care as a Social Justice Issue A. Consequences of not receiving health care B. Predict effects on life, job, education, etc. Pregnancy & Childbirth Early Childhood School Work Old Age & Death II. Access to Health Care as a Catholic Issue A. What does the Church teach about health care? B. Why should the Church care? Why are there Catholic hospitals? C. The Consistent Ethic of Life

24. A 2 3 4 5

25. I. Trinity Health A. Co-sponsored by the Sisters of the Holy Cross B. Fourth largest Catholic healthcare system in the U.S. C. St. Joe Regional Medical Center and the Sr. Maura Brannick, CSC, Health Center Patients ineligible for Medicaid or Medicare Unable to obtain health insurance

26. We serve together in Trinity Health in the spirit of the Gospel To heal body, mind, and spirit To improve the health of our communities, And to steward the resources entrusted to us.

27. The right to life does not end at birth. You can’t welcome life into the world and then not care about what happens to it after it gets here. In short: “We must defend the right to life of the weakest among us; we must also be supportive of the quality of life of the powerless among us: the old and the young, the hungry and the homeless, the undocumented immigrant and the unemployed worker, the sick, the disabled and the dying.” (Cardinal Bernardin)