The Church and Health Care

An Appeal to the Silent Bishops


The political debate taking place in the United States regarding health care, as Juan Donoso Cortés wrote regarding all political questions, is ultimately a theological or religious question. A century ago American Catholic author James J. Walsh, in his book The Thirteenth: Greatest of Centuries, devoted a chapter to the theme of “City Hospitals – Organized Charity.” In it he showed how the Church in the Middle Ages created organized medical care, in the form that the modern world now knows and from which it continues to benefit. Even in the United States, a non-Catholic country, Catholic hospitals constitute a major sector of the nation’s health care system. This factor has made Catholics in the United States a central participant in the debate regarding how health care should be provided.

However, there has been much confusion in the debate about the respective roles of the Church and private charity on one hand, and the role of government, on the other hand, in providing health care to a nation’s citizens. In the Catholic Middle Ages government played a relatively minor role. But today, the turning of the entire management of health care over to government, as various modern governments have been demanding, and with Catholic leaders at times acquiescing, is contrary to the centuries-old practice of the Church, and led recently to the death of the baby Charlie Gard in England – when socialized medicine assumed authority over the life and death of a helpless infant, causing untold grief to his parents, as socialism denied them their parental rights over their child.

In 1976, Brazilian Catholic leader Plinio Corrêa de Oliveira published a book about the escalation of the Communist threat against the Church and Christian Civilization, a theme that some might think is a problem of the past, two and a half decades after the fall of the Soviet Union. But the British case of government control over the life of an infant demonstrates the continuing threat of socialism, and the spreading of the errors of Russia foretold by Our Lady at Fatima. Plinio Corrêa de Oliveira’s 1976 book added a subtitle of central significance in the present debate: An Appeal to the Silent Bishops. The author recognized that there were divisions within the hierarchy of the Church regarding the contemporary threat, and he asked those bishops who might otherwise remain silent to lead the faithful in a time of crisis. His analysis revolved around the appearance and influence of the national episcopal conferences during the twentieth century, and the danger that individual bishops would forego the exercise of their own authority out of a fear of opposing a majority opinion, an opinion competing with their own, but one that does not replace the authority of individual bishops to speak out against the moral evils of our time.

Turning our attention from Brazil to the United States, we find a clear example in the matter of health care. In 1919 the American bishops, through what was then called the National Catholic War Council, issued a document titled “Program of Social Reconstruction” on February 12 of that year, followed by a joint Pastoral Letter on September 26. The first of the two documents addressed the question of the role of insurance in caring for the nation’s citizens. That document of nearly a century ago has been misunderstood today, even among bishops themselves within the national conference of bishops, as an episcopal endorsement of national health care managed by the government. But the bishops in 1919 in fact took an entirely different position, indicating that insurance was not primarily the role of government, but rather that of businesses in providing for their employees. This episcopal policy of a century ago calls to mind the guild system of the Middle Ages, in which the individual guilds provided insurance for their members. As James Walsh’s book clearly indicated, insurance and health care were “organized charity” in a most profound way – a work of charity inspired by the Church and private initiatives, whereby medical care was managed efficiently through activities begun and guided by the Church, and not controlled by a centralized national State driven by the false principles of socialism.

In order to provide perspective on the role of the Church and individual Catholics in the debate on health care, we are posting on our web site – for reading online or for downloading – Chapter XXI of Dr. James Walsh’s book, in order to demonstrate how it came about that the Church, and not the central government, was the ultimate inspirer of proper health care for a nation’s citizens. In doing so we appeal to the priests, and ultimately to the bishops, to lead the faithful by providing a proper understanding of our Catholic history, and therefore of the tradition of the Church. Currently the United States Conference of Catholic Bishops has assumed a position that is not consistent with the position of the American bishops in 1919, but contrary to it. Rather than favoring a centralized national health care system, such as the British system that resulted in the recent death of the infant Charlie Gard, the American bishops in 1919 held that “any contribution to the insurance fund from the general revenues of the state should be only slight and temporary,” and that “all forms of state insurance should be regarded as merely a lesser evil, and should be so organized and administered as to hasten the coming of the normal condition.”* In other words, the bishops in 1919 saw the “normal condition” as the work of charity and justice on the part of the private sector, not a centralized program of socialized medicine. History teaches us that medical care was a work of the Church before being a work of government, and that if Catholics were to surrender their role of leadership to a centralized government program, this would favor the usurping by the State of the role of the Church in society.

We call attention once again to three of our titles that address the question of the Church’s role in society in the face of the modern threat of socialism – while we make available also the historical analysis of Dr. James Walsh, written a century ago, an analysis of the Church’s historical role in establishing organized health care, the Catholic alternative to the modern systems of socialized medicine.


*Father Hugh J. Nolan, ed., Pastoral Letters of the United States Catholic Bishops, Vol. I 1792-1940 (Washington, D.C.: United States Catholic Conference, 1984), pp. 265-266.


For reading online, or free download:

Chapter XXI, “City Hospitals – Organized Charity,” from
The Thirteenth: Greatest of Centuries by Dr. James J. Walsh

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Catholicism, Liberalism and Socialism

by Juan Donoso Cortés

demonstrating how every political question
is ultimately a relgious or theological question

School of Darkness

by Bella Dodd

her account of how she drifted away from the Catholic Faith of her childhood, joined the Communist Party, then returned to the Church and exposed the Communist threat throughout the world

Fatima and the Third Secret:

A Historical Examination based on a Letter of
Sister Lúcia & the Carmelite Biography

how the false theory of a “fourth secret,” or an alleged missing part of the Third Secret, has turned attention away from Sister Lucia’s interpretation of the Third Secret in a letter to Pope John Paul II – her explaining that the Third Secret describes the fulfillment of Our Lady’s prophecy in the Second Secret, that Russia would spread its errors throughout the world