Healthcare Reform & the Magisterium
In this spring’s debate over the healthcare bill, one of the disagreements that raised eyebrows most in Catholic circles was that between the US bishops conference and the Catholic Healthcare Association and other similar groups. The bishops claimed that the healthcare bill would lead to federal funding of abortions, while CHA et al. concluded that it would not.
In my opinion and that of numerous observers (including most of my fellow contributors here at TAC), the bishops were correct and CHA was horribly, terribly wrong.
There is another question, though… was CHA disobedient? That is, were they obliged as Catholics to accept the conclusions of the bishops conference? Was the activity of the bishops conference an act of their teaching charism which American Catholics were obliged to give their assent to?
U.S. Catholic Bishops' statement on the Health Care Bill: "Profoundly flawed"
USCCB Statement on the recently-passed health care legislation (March 23, 2010):
For nearly a century, the Catholic bishops of the United States have called for reform of our health care system so that all may have access to the care that recognizes and affirms their human dignity. Christian discipleship means, “working to ensure that all people have access to what makes them fully human and fosters their human dignity” (United States Catechism for Adults, page 454). Included among those elements is the provision of necessary and appropriate health care.
For too long, this question has gone unaddressed in our country. Often, while many had access to excellent medical treatment, millions of others including expectant mothers, struggling families or those with serious medical or physical problems were left unable to afford the care they needed. As Catholic bishops, we have expressed our support for efforts to address this national and societal shortcoming. We have spoken for the poorest and most defenseless among us. Many elements of the health care reform measure signed into law by the President address these concerns and so help to fulfill the duty that we have to each other for the common good. We are bishops, and therefore pastors and teachers. In that role, we applaud the effort to expand health care to all.
Nevertheless, for whatever good this law achieves or intends, we as Catholic bishops have opposed its passage because there is compelling evidence that it would expand the role of the federal government in funding and facilitating abortion and plans that cover abortion. The statute appropriates billions of dollars in new funding without explicitly prohibiting the use of these funds for abortion, and it provides federal subsidies for health plans covering elective abortions. Its failure to preserve the legal status quo that has regulated the government’s relation to abortion, as did the original bill adopted by the House of Representatives last November, could undermine what has been the law of our land for decades and threatens the consensus of the majority of Americans: that federal funds not be used for abortions or plans that cover abortions. Stranger still, the statute forces all those who choose federally subsidized plans that cover abortion to pay for other peoples’ abortions with their own funds. If this new law is intended to prevent people from being complicit in the abortions of others, it is at war with itself.
Health Care Predictions
In the debate over the now-passed health care reform bill, a great number of statistics were brought out as to why the US desperately needed a bill like this: Numbers of bankruptcies supposedly caused by high medical costs and lack of insurance. Numbers of people who supposedly died each year because of lacking health insurance. Infant mortality rates, etc. With the bill now passed, Megan McArdle is curious to see those who supported it make some firm commitments as to what the results will be over the next five years:
1) Ezra Klein is confidently predicting that it will save hundreds of thousands of lives.
2) Nick Kristoff expects miraculous improvement in our national life expectancy.
3) Michael Moore thinks this will stop people from getting thrown out of their homes in a Medical bankruptcy.
4) At least one of you must be willing to claim massive improvements in infant mortality, after you’ve cited those statistics to me over and over.
These sorts of things should all be pretty easy to measure, and McArdle goes on to make her won eight predictions in regards to the effectiveness of the bill: Continue reading
Health Care Reform and the Great Switch
Personally, I thinks it’s fairly likely at this point, that one of the current “health care reform” bills will become law. However, though I come to this with characteristic lateness (increasing busy-ness seems to make topical blogging near impossible) I think it’s worth spending a moment on one of the fascinating contradictions which has gone mainly unremarked in the whole debate.
One of the primary arguments put forward by advocates of health care reform over the last 2-3 years has been, essentially, that health insurance companies are evil. People froth at the industry term of “medical losses” for when insurance companies pay out for medical expenses. (Something which, in fact, happens with over 80% of the monies collected in the form of insurance premiums.) Others rail against how the profit motive has destroyed health care and driven costs to astronomical levels — apparently oblivious to the fact that there are several major not-for-profit insurers, and they don’t provide care any more cheaply than for-profit ones. And yet, despite these and many other rhetorical assaults on the whole idea of health insurance as a commercial product, the centerpiece of the proposed health care reform bills was to legally require everyone in the US to purchase health care insurance, and then provide government subsidies for those who couldn’t afford the premiums. (Thus “shoveling” government money into the insurance industry in the same way in which Medicare Part-D, which all good progressives are now against, did with the pharmaceutical industry.)
Why in the world did a movement which had so long railed against private insurance suddenly decide to require and subsidize it, rather than pushing for the government or non-profit approaches to health provision which had so long appealed to it?
Continue reading
Poll Shows Americans Would Like to Have Their Cake and Eat It Too
The Washington Post has a new poll out which will please both political parties, since the American people in the main agree with both of them. A majority of people want Congress to scrap the current Health Care Reform bills, and a majority also think Obama has done a bad job of handling the health care issue. Yet a majority also want Health Care Reform passed this year and blame Republicans for lack of progress.
Solid majorities think that the current HCR bills are too complex and too expensive, but majorities also approve of the main components: require employers to provide insurance, require people without insurance to buy it, subsidize people who can’t afford insurance, and require insurance companies to give everyone insurance regardless of their medical histories or problems. So basically, people would love the bill as is, so long as it didn’t cost anything and wasn’t complex.
And in the results most likely to give legislators pause: People say they’re looking for new candidates of incumbents in the next congressional election by a 56 to 36 majority. 71% of people disapprove of how congress is doing its job. And of the 62% of the population that has private insurance (15% have MediCare, 3% have Medicaid and 17% have no insurance) 74% trust their insurance companies to do a “good” or “great” job of processing their claims fairly.
If people like the idea of health care reform, but don’t want it to cost anything or be complex, while distrusting congress and trusting their insurance companies, it sounds to me like nothing is likely to happen on the health care front this year.
Health Care Conference
It appears that Democratic leadership is going to forgo the customary conference process to reconcile the House and Senate health care reform bills. Instead it will be negotiated between Democratic leaders from both chambers and the Obama administration, to the exclusion of Republican lawmakers.
See the following headlines:
With Few Options, GOP Continues Health Care Fight
Dems intend to bypass GOP on health compromise
Health talks resume with W.H. meet
C-SPAN CEO to Democrats: Televise the Health Care Reform Negotiations
Political Doublethink…Again.
The epidemics of amnesia, Alzheimer’s, schizophrenia, self-hypnosis, and intellectual doublethink are on the rise in Washington—rising faster, by the calculation of some spectators, than our national debt.
It goes without question that there are things on record some would prefer to forget or never have mentioned again. Republican lawmakers, influenced by political expediency or historical confusion, presented themselves in the latter part of this year as the champions of Medicare. The glaring absurdity of GOP Medicare scare-tactics somehow passed under the radar of the majority of critics, who most certainly had their eyes fixed on the Democrats.
Just recently Senator Hatch (R-Utah) decided that he would not let the year close without displaying one more case of Republican intellectual doublethink—one so incredible that is absolutely mind-boggling to the habitual political observer who realizes that the GOP is going to ride to victory in 2010 not just on the failures of Democratic leadership, but on the sweeping epidemic of American political amnesia. Continue reading
Fact Checking Republican Medicare Scare-Tactics
Where is the so-called liberal media?
Not too long ago, I pointed out the (more than) obvious lies of the Republican Party as it relates to Medicare and seniors. Just this past week, I was watching C-SPAN as the Senate debated and voted on a few amendments. In the course of events, Senator John McCain (R-AZ) led the charge as a number of Republican legislators demonstrated a politically common, but unfortunate, phenomenon coined as “doublethink”—that is to hold two contradictory realities to be simultaneously true. It is either this, or they are consciously and flagrantly lying. There are no other possibilities. So here we go again… Continue reading
Commentary on a New York Times Opinion Piece
Trading Women’s Rights for Political Power
By KATE MICHELMAN and FRANCES KISSLING
A grim reality sits behind the joyful press statements from Washington Democrats. [The health care bill passed. What is so grim?] To secure passage of health care legislation in the House, the party chose a course that risks the well-being of millions of women for generations to come. [Are women not being allowed to have health care coverage or something?]
Health Care Reform Update
The Senate version of the health care reform legislation has been unveiled. It has been scored at $849 billion and Senate Majority Leader, Harry Reid is expected to bring it up vote for its first procedural vote this Saturday.
If the Senate takes up the bill, the debate is expected to begin on November 30, after the U.S. Thanksgiving holiday next week, and last for at least three weeks. Senior Democratic senators, however, have said it is unlikely Obama will have a completed bill on his desk by the end of the year.
Click here if you wish to write your Senators and voice your opinion.
Life Under Health Care Reform
Time being scarce the last few weeks, I’d originally planned on writing a post of this format about one of the Senate bills, but since the House bill (HR 3962: Affordable Health Care for America Act) is currently the one in the news, I’m focusing on that. The purpose here is to try my best to cut through the hysteria and hype coming from both sides and take a realistic look about what changes we would notice as US citizens if the House health care reform bill becomes law.
The first thing to keep in mind is that nothing much happens until 2013. This could probably called the “keep incumbents from being hurt by this act, especially Obama” provision. Whether the long term effects of the bill are good or bad, change often causes pain and confusion at first, and one of the key ways of getting legislators on board for the bill is to assure them that they’re unlikely to be immediately booted out of office by voters upset about their premiums. This kind of cynicism is hardly unique to this one bill or to either party — it just is what it is. So take the below as a discussion of how thing would be under HR 3962 in the period 5-6 years from now, assuming that is passes and there are no changes made between now and then.
The bill provides several new regulations on insurance companies and on you, which you’ll notice quite clearly.
1) You will be legally required to purchase insurance. If you don’t (and unless you fit criteria for financial hardship as defined in the bill) you will be fined either 2.5% of you income, or the average cost of the plans in the lowest tier of the health insurance exchange. So, if you make 40k/yr, you would be fined $1000. If you make 60k/yr, you would be fined $1500. If you refuse to pay your fines, you’ll be treated exactly like any other tax evader (which means you can potentially be sent to jail.) The Senate bill specifically exempted non-payers from being sent to jail, but the House bill fails to differentiate those who refuse to pay health care fines from those who refuse to pay other taxes, so it is believed that standard tax evasion rules would apply. There will also be penalties placed on employers who do not offer their employees health insurance.
Continue reading
What's the Matter with Washington?
40 “progressive” Democrats in the House of Representatives have sent a letter to Nancy Pelosi vowing to vote “no” on health care reform the next time around if the Stupak amendment is not stripped from the bill.
Remember all of those commentaries after the 2004 elections deriding conservative voters for placing their “values” ahead of self-interest? All over the country “progressives” asked “What’s the Matter With Kansas?” to get to the bottom of the matter.
I think what we are obviously seeing now is, at least from the standpoint of the American public that supports the current health care reform effort, a group of legislators who are irrationally placing their most deeply held moral and spiritual values ahead of – not their own self-interest, since they have money – but the interest of the people who sent them to office.
I have long believed that abortion is the most important sacrament in the religion of secular humanism. In their own language the sexual revolutionaries and the radical feminists have declared it the cornerstone of women’s liberation (and as I have argued, men’s “liberation” from parental responsibility as well). The idea of having to take responsibility for sexual behavior is almost like being sent to hell. Thus the importance of this sacrament. For a materialist-hedonist, it is the gateway to salvation.
But I wonder if all of those Democratic voters who were counting on health care reform will see it the same way if the bill does come back to the House with the Stupak amendment in-tact.
Did Health Care Reform Help Massachusetts?
Ezra Klein has a post up trumpeting a new paper from MIT economist Jon Gruber which purports to show that Massachusetts significantly reduced individual health care premiums through its 2006 health care reform bill — which in many ways was similar to the Democratic proposals currently moving forward in congress. (Needless to say, this would be contrary to what most people who have actually experienced health care in Mass., even this liberal speech writer, have experienced.) However, looking at all the findings is key:
In their December 2007 report, AHIP reported that the average single premium at the end of 2006 for a nongroup product in the United States was $2,613. In a report issued just this week, AHIP found that the average single premium in mid-2009 was $2,985, or a 14 percent increase. That same report presents results for the nongroup markets in a set of states. One of those states is Massachusetts, which passed health-care reform similar to the one contemplated at the federal level in mid-2006. The major aspects of this reform took place in 2007, notably the introduction of large subsidies for low-income populations, a merged nongroup and small group insurance market, and a mandate on individuals to purchase health insurance. And the results have been an enormous reduction in the cost of nongroup insurance in the state: The average individual premium in the state fell from $8,537 at the end of 2006 to $5,143 in mid-2009, a 40 percent reduction, while the rest of the nation was seeing a 14 percent increase.
Re-evaluating American Health Policy: A Catholic Democrat’s Perspective (Part II)
Dr. Peter Pronovost is a distinguished physician known for his efforts to decrease the frequency of deadly hospital-borne infections. His remedy to the problem is surprisingly simple: a checklist of ICU protocols that directs physician sanitary practices (e.g. hand-washing). Hospitals that have put Pronovost’s checklist into practice have had immediate success, reducing hospital-infection rates somewhere between (estimates vary) well over a third to a whopping two-thirds within the first few months of its adoption. Yet as the story goes, many physicians have rejected this solution and Pronovost has struggled to persuade hospitals to adopt his reform.
The Centers for Disease Control and Prevention estimates that nearly 100,000 American deaths are caused or contributed to by hospital-borne infections. Blood clots following surgery or illness are the leading cause of avertable hospital deaths in the U.S., which by the most liberal estimates might contribute t o the death of almost 200,000 patients annually. Given such a hideous fact, why exactly does a doctor need to travel about and emphatically seek to persuade other medical institutions to adopt, in effect, a cost-free idea that could save so many lives?
How is that an industry which stridently decries the high cost of liability insurance or the absolute injustice of our tort system(which does need reform) need such petitioning to embrace such a simple technique to save thousands of lives? Moreover, in the United States it is not unheard of for a whole business to shut down due a single illness from some suspicious food—yet, we tolerate the killing-via-negligence on such a grand scale in our hospitals? Medical mistakes and institutional carelessness do not qualify as some must-be-accepted inevitability.
This reality has been almost entirely been neglected in the discourse on health care reform. Beyond the structure and financing troubles of our medical system, the institutional practice and governance of hospitals are in need of severe criticism. For example, in what alternate dimension does the peculiar scheduling of hospital work shifts in any way benefit the patient? A few weeks at the hospitals virtually guarantees a never-ending string of new personnel assigned to one patient’s care. If this can be avoided, should it not? It seems quite reasonable to presume that passing patients off from doctor to doctor, or nurse to nurse, might increase the chance of someone making a mistake? The effect of changing such a seemingly small problem could be huge. Or, take for example, the “sanitary” environment of hospitals in general, which contribute to the nearly 100,000 annual American deaths. Anyone who has ever worked in “corporate America” or in a large building in general might note that the trash is picked up once daily. Is it any different in a hospital? It takes some sort intellectual schizophrenia to insist on ICU sterility in a building if one has not the slightest care over how many times trash (never mind what is in it) is picked up in a day.
Any array of complaints about institutional malpractice must lead to the inevitable question: how is it that the most technologically advanced medical institutions in the industrialized world miss out on a just as modern, just as recent, revolution of quality control and customer-service that has pervaded every other consumer-based industry? The answer to this question is telling. Continue reading
Republicans Should Find an Approach to 'Universal Health Care' They Like
I’m not sure that I like this line of thinking, but I’m starting to think that it’s true, so I’ll put it out there and see what people make of it in debate.
It’s starting to look fairly certain that while a bill called “health care reform” will pass the congress and be signed some time before the 2010 elections (because the administration needs to sign something, even if it’s a fig leaf that does little and doesn’t go into effect until after 2012) what passes will not in any sense be a “comprehensive” health care reform package. Given the people who would be in charge of designing it if it made it through right now, I think that’s probably a pretty good thing.



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