Health Care Countdown

If you think you are tired of reading blog posts about health care reform, think about the 30 million Americans who lack access to adequate health care because they do not have insurance. If you wish the issue would just go away, or you are worried that further government intrusion might muck up our health care system, contemplate the fact that last year, during a recession mind you, the five largest health insurance companies raked in a profit of $12.2 billion. If you think there is a better way to reform the health care system than the plan currently taking shape in negotiations in the Congress, you are undoubtedly right, but this is the only plan with a reasonable shot at getting passed now. And if no health care plan passes now, no one will touch the issue for another twenty years.

It is shameful, as in full of shame, that some people continue to distort the proposed plan. There appear to be wildly different understandings of what precisely the competing approaches to abortion entail, with most media outlets concluding the Senate version does not provide federal funds for abortion and other groups, some of them reputable, others not so much, insisting that only the Stupak language is good enough. You can pick who you want to believe, but everyone has to admit that both the Senate approach and the Stupak approach really defeat the goal of the pro-choice forces, which was to use the health care reform debate to make it seem like abortion is just another form of health care. The pro-choice forces have failed. Now, as far as I can tell, the positions various groups are taking have less to do with the actual policy implications of the rival approaches than with political loyalty. (I do not think political loyalty is a bad thing, of course, but it is a different concern from a policy concern.) People who encouraged Mr. Stupak to go out on a limb, and watched him go, are understandably reluctant to cut that limb off with him out there. The Senate, which has fewer pro-life members, rejected the Stupak approach but nonetheless adopted an alternative, and I think preferable, approach to the issue.


Let me state again, seeing as some commentators seem to have trouble understanding the issue, what I like best about the Senate proposal. Whereas Stupak is silent on the issue of people buying insurance on the new exchanges entirely with their own money, under the Senate bill, everyone who buys insurance through the exchanges, whether they get a government subsidy or use only their own money, everyone will have to write a separate check every month for the portion of their plan that covers abortion. Those who do not want to pay for the abortion coverage are free to pick a plan that does not include abortion coverage and the bill mandates that every exchange have at least one such bill. Why is this so important? Because the didactic value of making many, many people write a separate check every month will bring home as nothing else that abortion is not health care. And this is important because the next dozen years will be the last time the society has anything to say about most abortions: When the patent runs out on RU-486, most abortions will cost $20 and be performed in the privacy of the bathroom by taking a generic pill.

My reasons for preferring the Senate bill may not be yours. And, I am perfectly content with the Stupak approach incidentally. Both strike me as victories for the pro-life movement. But, in this last week of debate and discussion about health care, can we all refrain from assessing each other’s motives? Sometimes, I read the comments and I feel like I do not have to examine my conscience before going to confession because so many of you are already doing that for me. We can, as the President insists, disagree without being disagreeable. I think those that oppose the President’s plan are wrong, but I do not think they are bad. Okay – those who talk about Medicare cuts are so hypocritical that they qualify as bad. But, I do think that at this moment in history, and provided we keep adequate restrictions against abortion funding, that we would be foolish in the extreme to miss the opportunity to finally, at long last, establish the fact that health care is a basic human right that should be extended to all within our borders. We may not get there soon. The bill might be imperfect. The law, if passed, will face unanticipated problems. But, if Americans come to see health care as a birthright the way they see Social Security, there will be no taking it away. And that will be a huge triumph for the cause of justice.

Michael Sean Winters

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James Lindsay
8 years 10 months ago
The Community Health Center issue is being resolved. It had not come to Obama's attention, as $11B is not much money when you are talking trillions. It is also warped to think that such centers will only perform abortions. Action has been promised, so this is not a reason not to vote for the bill.

Stupak has said he favors neutrality, which is what Nelson and Stupak do. They did not promise that no subsidies would ever go to abortion under the tax code - indeed, such subsidies have existed as long as abortion has been legal. The fact that Douglas Johnson does not know this shows the depth of confusion at the NRLC.
8 years 10 months ago
I'm glad that my kids and I can count on my birthright, Social Security.  I feel so much more secure!
8 years 10 months ago
"Why is this so important? Because the didactic value of making many, many people write a separate check every month will bring home as nothing else that abortion is not health care."
Who cares how many checks people write!
The point is that under the senate plan millions of federal tax dollars will also be going to subsidize those who cannot afford coverage and this subsidy will INCLUDE plans with coverage for abortion.
This will allow for a massive expansion of the abortion industry AND allow for federal funding of the procedure though this economic aid for manditory coverage. 
This new intrusion into private life by the regime in Washington is just another form of utopian social engineering that will have catastrophic effects if passed.
Gabriel Marcella
8 years 10 months ago
Agreed that "adequate restrictions against abortion funding are key." Yet the New Times reports this morning that the Senate bill differs from the House bill in this respect: "A major one (difference) has to do with $11 billion that Obama wants to pump into community health centers serving low-income people and the uninsured. As the bill is currently written, those funds are not explicitly covered by the Hyde amendment." The article goes on to say that Obama does not want to expand abortion coverage beyond the current restrictions. Should we trust him and a Senate that is more inclined to support abortion?
Brian Thompson
8 years 10 months ago
I read this morning that Stupak is open to more discussion on his abortion provision, which may be good if, and only if, they find a way to satisfactorally accieve his goals without slight of hand or tricks but a simple expicit reassertion of Hyde with appropriate mentions of how the policy will affect the programs created by he bill. 
I do not like the bill itself, I think it spits in the face of subsidiarity and is recklessly expensive and fertile ground of inefficiency, restriction of freedoms, and corruption. However, those dangers are not realized yet and thus they may be avoided if we are prudent (good luck, but hope springs eternal). However, I would be willing to bite the bullet and go with an imperfect reform bill for the sake of the poor, but not if it at the same time enables killing people. I think there are much better ways to supply decent healthcare, and perhaps we must mandate it to make it happen, but imperfection is acceptable so long as there is no evil.
8 years 10 months ago
I've lost count of the inconsistencies in this article.  First off is the idea that the health care bill is about covering 30 million people rather than "bending the cost curve." This has been a basic confusion for the Democrats since Day 1 of this debate & that confusion just trickles out to create a sense of uneasiness about the 2,000+ page bill.
You say 30 million? But that number includes people who, for perfectly good reasons, have chosen not to purchase health insurance (and who can be care for from high risk pools at the state level) or aliens who are not legally entitled to health benefits.
You say no one would touch the issue in 20 years.  Maybe instead we would get an incremental, pragmatic, prudent approach to addressing the problems rather than the one-size-fits-all, let's get a Democratic triumph for the ages.  
And on the issue of Stupak & abortion, I honestly no longer know where you stand on this issue.  Way back when, you drew a line in the sand over Stupak.  Now, you seem willing to live without Stupak.  But your problem is that Stupak himself doesn't accept the Senate language.  He flatly said on Meet the Press this Sun that the Senate bill allows for funding for abortion.  I mean if you don't know what's in your own bill, that's not exactly promising.  Stupak isn't Robby George or any of your other favorite whipping boys, he's a Democrat from Michigan.  If you can't convince him that abortion isn't funded by the Senate language, how are you going to convince anyone?
You last sentence re: health care as a birthright and victories for justice are so vague as to be meaningless.  Do you mean Americans should see health insurance as a birthright?  Because if you're calling out people for "distorting" the plan, then surely you know to suggest that people cannot get medical treatment in this country is a distortion of its own.  Not to mention the biggest the distortion of all - that the funding mechanism for this plan (the $1 trillion dollars excise tax) is totally pushed off until 2018.  I can't imagine a bigger distortion than that.  No, the bigger distortion has been the unfortunate harm the President and his party have done to the American public this past year by greedily taking on this woe-begotten "reform" in the midst of the Greatest Recession in 70 years.
James Lindsay
8 years 10 months ago
Health care is not a "normal good" which you can cut back on because of price. Health care is provided as needed (or should be in a civilized society) with cost recovery shared among the individual and the community.

Subsidiarity must work in concert with solidarity. Federal involvement in the issue does not violate subsidiarity because there is already a federal tax benefit for the purchase of health insurance (and it covers abortion and always has - any statement to the contrary is simply ignorant). Both Stupak and Nelson will make sure that no federal dollar under the bill will go toward abortion services cost pools and that individuals can buy insurance where no money at all will go toward abortion. If the use of exchanges to purchase health insurance increases, eating into the current insurance market, either Stupak or Nelson will impact subsidized coverage to those who don't initially get a subsidy - which is why Stupak could not pass the Senate - it would eventually end coverage of abortions now subsidized through Federal taxes. While this would be a good thing, it is not "abortion neutral." Saying that it is is bearing false witness against Obama and Nelson.

Whether those who don't mind will actually write a check for abortion services is doubtful, since the move toward automatic bill payments will make such arrangements a one-time event. The fact also remains that most people write a check for the entire cost of the abortion rather than relying on insurance coverage - so this is a tempest in a teapot.
Think Catholic
8 years 10 months ago
Winters is willing to have the federal government give $11 BILLION to abortion "community health centers," and fund abortion insurance plans, and force plan enrollees to pay for other people's abortions, and violate the conscience rights of pro-life health workers, all because the Senate bill when funding abortion insurance requires separate checks.  STUPAK REQUIRES SEPARATE CHECKS TOO, because it requires that any abortion insurance be completely separate from any federally funded plan. And Stupak requres this REAL SEPARATION without forcing anyone to pay for someone else's abortions.  In every way that Winters like's the Senate bill on abortion, Stupak is better for those exact reasons, and the Senate bill is funding abortion for those exact reasons.  Winters promised in July on this blog not to support any funding of abortion through phony "fund segregation," and now he is not only breaking his promise, he is giving reasons that prove his position to be incoherent.
Michael, you're not "content" with the Stupak approach.  He is trying to get House members to vote no, and you are trying to get them to vote yes.  You are trying to defeat Stupak, to saw off that branch he is standing on AT YOUR BEHEST as someone who said he wanted pro-life Democrats.  Telling him how great he is while you are stabbing him in the back makes it worse.


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