Advocates Assess Prospects for Reform

As Congress gears up for this summer’s debate on health care reform, there is a real hope among advocates that a substantive legislative proposal will come up for a vote by the end of the season’s legislative session. "We're very hopeful that significant health reform is going to happen," said Jeff Tieman, senior director for health reform initiatives at the Catholic Health Association. "But it's not a home run yet. We're cautiously optimistic."

Two of the primary movers of health care reform in Congress are Senators Max Baucus, D-Mont., and Chuck Grassley, R-Iowa, who heard more than a dozen witnesses at an April round-table discussion on reforming the U.S. health care delivery system. Baucus and Grassley are chairman and ranking member, respectively, of the Senate Finance Committee. "We're going to go somewhere with this," said Baucus at the close of the round table. "Something's going to happen here."

But what that something is remains very much in question. President Barack Obama has outlined only the general principles for what he would like to see in a health care reform plan, and his administration is leaving the drafting of legislation to Congress.

The biggest debates focus on the so-called "public option"—the inclusion of a government-financed health plan that would compete with private insurers to provide coverage. "The 'public option' is presented as a means to promote competition and choice but would prove fatal to both," according to Mike Leavitt, who was secretary of health and human services under President George W. Bush. According to Leavitt, employers would stop providing health coverage for their employees if they could opt out.

The U.S. Conference of Catholic Bishops has never taken a public position on a public option, according to Kathy Saile, director of the USCCB office of domestic social development. In fact, according to Saile, what the bishops have insisted on has not changed much since they outlined key principles during the debate over President Bill Clinton's health reform plan in 1993: they want to see a health system that makes care available to all in a way that "enhances and respects life," exhibits particular concern for the poor and vulnerable, respects pluralism and conscience in providers' and consumers' choices, and is financed equitably, Saile said.

Similarly, Catholic Health Association leaders spelled out their expectations in the 2008 document "Our Vision for U.S. Health Care." It calls for a system that is available and accessible to everyone; health- and prevention-oriented; sufficiently and fairly financed; transparent and consensus-driven in allocation of resources; patient-centered and designed to address health needs from conception to natural death; and safe, effective and high-quality.

The Health Security Index survey commissioned by Catholic Healthcare West, a San Francisco-based system of 41 hospitals in California, Arizona and Nevada, found that concern about health care is growing. For the first time since the annual survey began two years ago, the majority of respondents said the U.S. health care system is getting somewhat or much worse. Despite the nation's dire economic situation, nearly twice as many U.S. adults were concerned about the rising cost of health care than were concerned about losing their jobs.  More than four in five respondents (83 percent) said making health care affordable for every member of society should be one of Congress' top priorities for the coming year. The margin of error for the survey was plus or minus 3 percentage points.

"Today's headlines are justifiably focused on the overall economic crisis, but our Health Security Index findings show that health care affordability is a significant and enduring concern," said Lloyd H. Dean, president and CEO of Catholic Healthcare West and current president of the CHA board of trustees.  "Simply put, health care costs too much," Dean added. "Change is clearly overdue and the need for improvement is undeniable."

Tieman said it is important for Catholics to contact their representatives in Congress to tell them to "keep the health reform issue front-burner" and to "lend a faith-based voice to the debate." It's also crucial to keep informed about developments in the discussions, he said. "So much misinformation gets out there," Tieman added. But when specific legislation is about to come up for a vote, he said, those who "stay on top of" the debate "will understand whether they support it or not."

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