Some voices on the Left are unhappy with the health care reform bill the Senate will vote on this week. They are upset about the lack of a public option. They are mad that Sen. Joe Lieberman abandoned a position he has long held in favor of a Medicare buy-in and, by doing so, got that provision tossed from the legislation. And, some contend that only a single-payer system like that in Canada would truly fix health care. They are wrong and should support the bill.
To be clear, the bill would have been stronger if it had either a public option or a Medicare buy-in. And, a single-payer system is preferable to the hodge-podge we have in many ways, starting with the fact that the legislation that set up Canada’s system was eight pages long and could be readily understood by everyone, legislator and citizen alike. The problem is that none of these provisions can win sixty votes in the U.S. Senate.
Most of those on the Left who are bemoaning the outcome are a bit wet behind the ears. They do not recall that the Voting Rights Act of 1965 was preceded by the Civil Rights Act of 1964 and that both were preceded by the 1957 Civil Rights Act. This latter measure was weak, weak to the point that some denounced it as merely a political ploy to provide cover for liberal Democrats, but it paved the way. Similarly, Medicare did not start as the nearly comprehensive health care program it is today, originally only covering hospital visits and expanding over time.
Once the current bill is enacted, Americans, all Americans, will view health care more as a right and less as a perk of employment. It will become an entitlement. It will be unassailable the way Social Security is unassailable. If, when the full reform is implemented it turns out that the subsidies are insufficient and that people now forced to buy insurance find it cost prohibitive, the political debate will focus on increasing the subsidies or lowering the costs, not on denying the right to coverage. If other states come to object to the special treatment of Nebraska’s Medicaid costs, a measure included to win over Sen. Nelson, the pressure will be on the federal government to increase its share of costs for the other states, not on denying Nebraska its special treatment.
This is not only a matter of not permitting the perfect to be the enemy of the good, although it is also that. This reform is good on the merits. It improves the current health care system. The Secretary of Health and Human Services should send a letter to all Americans the day after the bill is signed outlining some of the measures that most impact on citizens, such as the provision to end the denial of coverage for pre-existing conditions. This measure does not actually affect that many people but it has come to represent for all Americans the abusive power of the insurance companies that put profits before people. While the ban on such denial of coverage only applies to children immediately, it will apply to all citizens when the pan is fully implemented, and all citizens will have the opportunity to enroll in a catastrophic care plan immediately. The letter from HHS should state this and provide a toll-free number to call if citizens encounter continued stone walling by insurance companies. I need scarcely add that sending such a letter will help convince people that the reform effort is a good thing. That can’t hurt in the midterm elections.
The abortion issue is different, and I have yet to find anyone who has been able to demonstrate how the Senate language differs from the House language. The provision in the Senate bill that individuals who buy a plan that includes abortion must write a separate check every month for that coverage sure seems like a rider to me, and it was just such riders that the House bill envisioned but did not mandate. The House language is more clear but it seems to me that the Senate bill achieves the same effect.
So, liberals have to stop whining and get on board. Passing health care reform is not only a big achievement, it is an historic achievement. It is also a first step.
The difference is that Minion has always dissented from the USCCB and pro-life Democrats in the Stupak coalition on this point. Winters, on the other hand, claimed to oppose federal funding of abortion insurance plans IN ANY WAY, SHAPE, OR FORM, including accounting schemes, but now he has reneged on his promise when it came down to it. NOW, WHEN STUPAK NEEDED HIS SUPPORT MORE THAN EVER, WINTERS ABANDONNED HIM, just like the liberal Catholics who like Minion who lied a year ago saying they wanted a pro-life Democrat movement.
This plan takes our government from NO federal funding of plans that cover abortion and 33 states UNINVOLVED in abortion insurance, to federal funding of ALL plans that cover abortion and ZERO states uninvolved in abortion insurance. It is a government mandate that plan members pay an abortion tax, it allows HRSA to declare abortion a mandatory service in ALL HEALTH PLANS, it aborts native Americans, and fails to protect pro-life workers from forced participation in abortion. Support it if you want, but admit that being a Democrat is more important to you than being a Catholic.
MSW, it sounds like you are in favor of this bill full stop, embracing its abortion provisions despite the USCCB's and Stupak's rejection of them. Under the Senate version, government agency that currently manages health coverage for federal employees will promote and help subsidize multi-state health plans that include elective abortions, and ALL individuals who participate in plans in the Exchange that include elective abortion coverage, even if they do so unwittingly, will directly pay part of their own premiums into an account that pays for nothing but elective abortions (in an amount not less than $12.00 per year under sections 1303(b)(2)(B)-(D)). We will go from 33 states not being involved in abortion insurance coverage to 0 states, overnight, with the federal government being formally involved forever. This is an abortion increase, it is federal government policy adopting abortion as health care, and the accounting scheme separating the funds is indistinguishable from the Capps proposals you said you opposed. And by the way, the plan fails to prohobit governments from discriminating against pro-life workers, and it allows HRSA to REQUIRE abortion coverage as "preventative care."
On June 14, on this page, you PROMISED to oppose federal funding of abortion health plans and to oppose the politicians who enact it. http://www.americamagazine.org/blog/entry.cfm?id=87352873-3048-741E-9131977572051964 You said "if the President or my representatives in Congress support federal funding for abortion in any way, shape or form, I will never vote for them again and I might risk my right hand in the next election by voting for their opponent."
Now, not with a bang but a whimper, you are saying everyone should support the bill and you're OK with federal funding of abortion plans.
How convenient, you don't have to oppose your party after all.
For the upteenth time, there is no "federal funding of abortion". There is a massive expansion in private insurance coverage, and some of these new recipients will sign up for plans that include abortion - exactly as is the case today for the insured. The Hyde amendment is inapplicable, because there is no new public problem.
Yes, there are subsidies, but I think the firewall is quite tight. The problem is that money is fungible, and it becomes really difficult to isolate all taxpayer funded subsidies from all abortion financing. The Nelson solution is indeed like a "rider". Is it perfect? Of course not, because money is fungible. But as I argued before, what if a person receiving unemployment benefit procures an abortion while on this income? Is it not the case that the taxpayer is implicated in this abortion? Only in the most remote sense possible.
Another, more direct, example is the use of medicaid funds to pay for abortions at the state level - Guttmacher estimates that 13 percent of abortions are paid for my medicaid, the same as private insurance. Of course, the NRLC says this is not a problem, as states must use their own funds - but this is a version the argument they are bubbing an accounting chimera in other circumstances! And besides, why is it that state taxpayer funds should be allowed to finance abortion coverage but not federal taxpayer funds? What is the moral distinction?
And, for the umpteenth time, why is no attention paid to forced funding of abortion by all who pay premiums to private insurance companies? In fact, what this bill does clearly is shine the light on this whole murky area. For the first time ever, it imposes federal restrictions on private insurance companies when it comes to abortion.
Yes, covering the uninsured is a form of the "common good"; however, there are much simpler ways to achieve this good and the current attempts by the federal government to take over the health care issue will do more harm than good. As Mr. Winters says, this is only the first step - single payer and government funding of abortion will be the final result.
Also, considering the fact we cannot afford our current entitlements (Medicare and SS will be bankrupt in the near future) and the fact that trillions in government spending and borrowing will destroy our monetary system - it does not seem the time for a new trillion dollar government entitlement.
Finally, it is not just the liberals or conservatives that are against this bill - it is the PUBLIC that the government wants to "help." All polls show the majority of the country OPPOSING this legislation that the democrats are forcing down our throats.
Just wait until 2010...
Health care is a service. Do you have a "right" to someone else's services?
The left loves to talk about rights - never about responsibilities. So everyone has a right and no one a responsibility.
This is exactly the infantilization that the government loves to foster so that it can fill the vacuum.
School time: FEHP is a clearinghouse for federal employees where they select from different private plans who apply/choose to market to federal employees. Read more here (http://www.opm.gov/insure/new_employ/index.asp) and here (http://www.opm.gov/insure/health/planinfo/index.asp-find a plan in your state). There's nothing that restricts pro-life insurance agencies from applying to be a part of the FEHB's list of eligible providers.
And the Senate plan discussed in MSW's post prohibits general/blanket abortion coverage in plans offered to subsidized seekers by insurers participating in the exchange. Hence the separate-check-for-abortion rule. Is it a perfect solution, per Morning's Minion's post? No. That's because our current rules about federal grants to health care are not perfect.
Fungibility is impossible to prevent. All you can do is seek to minimize it. The Senate's pro-life Dems have been faithful to the minimization premise. - TL
There's nothing wrong about the analysis that in this respect, and the other components I mentioned, this is an unprecedented, large, federal expansion of involvement in funding abortion coverage, which means an expansion of numbers of abortions and a quantum leap forward for the abortion industry itself, which will now have the federal government's weight behind it AS health care.
Yes, but the solution is not government control of health care! No one is getting turned away at hospitals (esp Catholic ones that make up 16 percent of the total) - there are already programs to cover the poor, the elderly, children etc.
The reason why health care is so expensive is because the govt. already controls 60% via medicare, VA, and medicaid. There is no incentive to control cost and this bill does not provide them - it simply expands a already broken system.
This is how it works: the government gets involved with good intentions and then creates systemic problems which it then says can only be cured with more government involvement!
This is not about health care, it is about power and control - just like the abortions it will fund...
That should make clear that the goal is to get a health-care bill that is as good as it can be from our standpoint, while recognizing that it won't agree totally with our principles. I don't think it's helpful to that cause to keep looking for ways in which the bill doesn't work exactly as we would like and then claiming that any difference at all means that we cannot support the bill.
If the USCCB is wiling to support a bill that pays for abortions in the case of rape, inces
t and danger to the life of the mother, what is there remaining in this bill that is so much worse than that that we must oppose it? I don't see anything.
The reconciliation of the House and Senate bills will be a political battle. I think it's good strategy for the USCCB to keep complaining about the Nelson amendment compared to Stupak and that may lead to some improvement in conference. But I wouldn't interpret that political posturing as meaning that, in the end, we should oppose the final bill. Providing health care to millions of currently uninsured people is too important for that.
If I shared Mr. Winters' political leanings, though, I still wouldn't support this bill. It's longer than Proust's In Search of Lost Time, and the only thing it really accomplishes is that it subsidizes plans for a fraction of the currently uninsured to get them coverage. Why not just subsidize some people's insurance without putting in hundreds of pages of unnecessary measures (which few in the Senate have actually read) that only make the whole system more confusing?
Why not say that if you make under a certain amount of money, you get a certain subsidy towards the plan of your choice, as long as that plan meets certain loose criteria (covers emergency care and certain other basic treatments, doesn't cover abortion, and perhaps certain other elective procedures). That bill could be at least as effective in covering the uninsured, wouldn't change insurance coverage for those who already have it, and could be easily understood and explained, all from a bill no longer than "The Lemoine Affair."
Your words.
The underinsured are not the poor and elderly but the working poor and many regular middle class folks. Yes, people can go to the ER for emergency treatment, but the ER does not provide chemo.
Yes, people ARE turned away from life saving treatment because of lack of adequate health coverage.
Yes, people do die because they have inadquate or no health coverage.
Are we a pro life people, or are we not?
Access to affordable heath care is a RIGHT. That's the position of the USCCB:
''In our Catholic tradition, health care is a basic human right. Access to health care should not depend on where a person works, how much a family earns, or where a person lives. Instead, every person, created in the image and likeness of God, has a right to life and to those things necessary to sustain life, including affordable, quality health care. This teaching is rooted in the biblical call to heal the sick and to serve ''the least of these,'' our concern for human life and dignity, and the principle of the common good. Unfortunately, tens of millions of Americans do not have health insurance. According to the Catholic bishops of the United States, the current health care system is in need of fundamental reform.''
http://www.usccb.org/healthcare/position.shtml
I agree with your sentiment; however, the question is how to best cover those without insurance without causing new evils such as federal subsidization and, therefore, expansion of abortion.
The problem requires reform of the system and the perverse incentives that it creates (namely high levels moral hazard in spending)- the govt. plan will only expand the current crisis, will increase abortion, and will pass on the bill to future generations as they will borrow to find the money for this program.
Are these the moral, Christian outcomes we hope for - even in the name of allievating suffering? No.
There are better ways to address this problem. This cure will be worse than the disease.
There already IS rationing, here, now, today. It's called "inadequate health coverage". It's people dying because they have no access to early screening or preventive care. It's people being turned down by their health insurance when they need chemo or life saving drugs that the insurance companies decide not to cover.
Look, I don't know if this bill is the answer or not, I have not studied it enough. But we have a serious problem with health care costs and health care coverage in this country. When you hear of someone bankrupted by medical bills, it really is a case of "There but for the grace of God go I."
For the sake of argument, we are forced to buy car insurance, because if we hit another person, we need to guarantee that we can pay for the damage, right?
Arguably, the uninsured cost all of us money, because they wind up in crisis in the ER, and the cost is passed on to us, or their care is subsidized through write-offs, and the hospitals and doctors charge us insured folks more to make up for the deficits.
Again, I hear you, and I'd be far happier with getting rid of insurance companies all together, having the government offer catastrophic care insurance, plus coverage for the poor, and let the rest of us pay out of pocket. We'd get the monthly insurance premium payments back in our paychecks, and doctors, MRI clinics, drug companies, etc., would be forced to compete for our dollars.
This is not an area of expertise of mine, by any stretch, but that's how I see it these days.
I understand the bankruptcy situations you describe and they are terrible. I believe under the Bankruptcy Code, however, that those whose uncovered medical bills make them insolvent can have them discharged in bankruptcy. The person emerges from the bankruptcy owing nothing to the given hospital or physician.
This is a situation, I fear, where the cure will be far worse than the disease. Every other country who has done what the Democrats in Congress are trying to do has experienced a deterioration of their medical systems. There is a reason why foreigners fly here to get treated and it isn't the scenery.
But we have a problem when American citizens are denied even the basics. Why on earth should someone who works 60 hour weeks cobbling together part time jobs not be able to afford basic health care?
We have a problem when the best we can do is shrug and say, Well, once these folks are bankrupt, the charges go away, or Everyone can access the ER when things get really bad.
We have a problem, and it's a moral one, and we Catholics need to address it. It's not enough to say Don't cover abortions. We need to insist that all people have access to affordable heath care. I wish I knew the best way, I don't, but I hope we can all agree with the bishops that heath care reform is needed, and that everyone has a RIGHT to affordable health care. It is not merely a ''service''. It is not a ''priviledge''. It is a RIGHT. Otherwise, valuing the ''right to life'' winds up being pretty hollow.
If it was not addressed to me, ignore.
No one is forced to buy auto insurance. You can choose to walk. Also, and here is the big distiction, driving and auto insurance is not a basic human right! Access to health care is! Question, if you believe in what I said how can you support this bill if not out of blind allegeance or willful ignorance?
One post script question since you will not or cannot answer any of my other questions: You state, ''Why on earth should someone who works 60 hour weeks cobbling together part time jobs not be able to afford basic health care? '' I ask again, how does this bill help? Let me geuss, he is forced to a private insurance company, under penalty of law, to buy a policy. Where is the social justice in that?
Did you even read my comment through before replying? This is very frustrating.
Mark quotes: “A review of the Senate language indicates a dramatic shift in federal policy that would allow the federal government to subsidize insurance policies with abortion coverage” -Rep. Bart Stupak (D-Mich)"
Both the House and Senate versions allow the government to provide a subsidy to people who buy health insurance that pays for elective abortions. The amount of the subsidy is the same whether or not elective abortion coverage is provided.
The House bill, requires buying two different policies. The Senate bill requires making two different payments.
Is that difference enough to justify rejecting a bill that will provide health insurance to 31 million poor people who have no health insurance now?
I don't believe so.
Please note that both plans provide that there will always be a plan available that does not include elective abortion coverage
The Senate bill MAKES SURE there is aborton coverage (the things Winters calls "riders"). Now Kathleen Sebelius points out another obvious difference, which she thinks is praiseworthy because it is pro-abortion: in the Senate version, "everybody in the exchange would do the same thing, whether you’re male or female, whether you’re 75 or 25, you would all set aside a portion of your premium that would go into a fund" for abortion. http://www.youtube.com/watch?v=uCmFFDyDrv8&feature=player_embedded
EVERYONE in the exchange pays for abortion in the Senate version. This is IMPOSSIBLE in the House version, since abortion coverage would only come through the abortion-insured person. Yet in the Senate version, not only do we have federal funding to plans that cover abortion, the federal government takes it upon itself to FORCE A BROAD SWATH OF PEOPLE TO PAY FOR OTHER PEOPLE'S ABORTIONS.
The fact not only of payment for others' abortions but federally mandated payment illustrates the degree to which the Senate version constitutes Federal Abortion Promotion, while the House version continues the federal tradition of staying OUT of abortion insurance.
There are many good arguments why healthcare is best treated at the national level. For a start, it maximizes the risk pool and supports solidarity. Remember, subsidiarity without solidarity is utterly sterile. Subsidiarity also allows for interactions at the same level. The Exchanges will make sure that people cannot be exploited by the insurance companies as they are today in the individual market. Here's something I cannot understand - why do people invoke subsidiarity against a government role in healthcare and not against a healthcare system dominated by a few large unregulated private insurers, that are allowed to refuse and drop coverage at a whim?
This position is not controversial in most of the Catholic world. Cardinal Martino, head of the Pontifical Council for Justice and Peace, said that, on healthcare "everywhere in the world it is a concern of the government first of all, and after there are possibilities also on the private sector, but those who are without anything… the central government must provide to that". Abp. Marx of Munich and Freisling, friend of the pope, spoke in favor of "a welfare state that works: insurance for the unemployed, benefits for those laid off, support for those with odd jobs, public health care." This is all uncontroversial....except in Calvinist USA!
If you really want the working poor to not resort to abortion, make sure that everyone (not just homeowners) get a housing subidy by ending the mortgage interest and property tax deductions and expanding the Child Tax Credit to $500 per child per month (payable with salary) with a $12 per hour minimum wage and expanded paid education benefits for any who lose their job in the transition. Also, take college costs out of the hands of parents and shift them to employers. You will hardly find anyone having an abortion if you do these things.
In other words, put your money where your mouth is on abortion or shut up.
NRLC, Burke, Chaput and company should keep their heads down if they don't want them smacked.
Go talk to the working families who can't afford health coverage and tell them they have no right to affordable care.
Smacks of ''I've got mine'' libertarianism.
I would opine health care reform should do two things: Reduce health care costs and Grant full access to health care or health insurance to those uninsured (yes, that includes the unborn and illegal immigrants). Anyone disagree or feel somethings missing please note. How does this bill do either? Specifics please! If it doesn’t, why support it? On the word “if?” Again, no thank you!
One final note: If you’re from a state with a democratic senator and he didn’t “hold out” for millions of dollars in pork and special interest money that Senator is a chump as are you for voting for him!
"The abortion issues will be worked out in conference." Yes, meaning the Senate's abortion increase and mandate of federal and citizen involvement in abortion will be imposed as the final bill, take it or leave it. Which means people who claim to be opposed to abortion can either oppose this final bill, or just admit that being Democrats is more important to them than being pro-life Catholics. Anyone now claiming that it's OK to support the bill anyway is admitting that they don't care about preborn children (and that everybody should shut up about human rights abuses that aren't in their partisan portfolio).
On the DC issue, the removal of the Hyde abortion rider was about local control, not abortion. The right to life movement can work in DC, where there are quite a few conservative pastors, just like it works in other jurisdictions. The dirty little secret of Hyde in DC is that for most of its history, abortions were covered by the medical charities fund. The control board stopped this for a while, but I suspect that such a prohibition was a temporary matter. This is not much covered.
Hyde does not really prevent many abortions. In states where abortion is mostly available it is mostly funded locally. In states where it is not funded locally, abortion services are not readily available anyway. Federal employees, who are also covered under Hyde, mostly pay cash for abortion services, just like most people with insurance.
This all leads me to conclude that all the shouting about abortion is about Catholic identity politics rather than actually protecting the unborn. The only way to protect the unborn is to make life better for the working poor - and that includes passing this bill.
Matt Bowman wrote "June 14, on this page, you PROMISED to oppose federal funding of abortion health plans and to oppose the politicians who enact it. http://www.americamagazine.org/blog/entry.cfm?id=87352873-3048-741E-9131977572051964 You said "if the President or my representatives in Congress support federal funding for abortion in any way, shape or form, I will never vote for them again and I might risk my right hand in the next election by voting for their opponent."