A Time to Choose

H o\v does one criticize care of the poor without sounding like a Charles Dickens novel? Very carefully! The approach of the U.S. Catholic health ministry to care of the poor is generous but shortsighted anil 100 narrowly conceived. The ministry's current practice primarily treats symptoms, even though its social justice tradition points it toward root causes—the systems and structures of health policy. If the ministry were to address root causes, it would find itself plunged into health care reform. We believe that the relationship between care of the poor and health care reform has received far less recognition—both conceptually and practically—than it deserves. On one hand, most people involved in Catholic health care agree that service to the health care poor is essential to the ministry. For the delivery of that care, the ministry is equipped with a vision, a philosophy, ,md concepts for understanding. It also possesses a detailed infrastructure with which to implement this care: committees, goals, budgets, and systems of accountability. On the other hand, however, the ministry has nothing similar to help it deal with health care reform.