Health Care Reform
Here are this past weeks Top-10 most visited Catholic posts from The American Catholic for June 20-26:
1. Parish Shopping by Michael Denton
2. McChrystal Should Be Fired by Donald R. McClarey
3. Sharia in Dearborn? by Donald R. McClarey
4. G.K. Chesterton on Lincoln by Donald R. McClarey
5. Healthcare Reform & the Magisterium by Chris Burgwald
6. Real Sex vs. the Contraceptive Mentality (Part 2) by Darwin
7. Toy Story 3 by Michael Denton
8. Planned Parenthood, What Happened to the Money? by D.R.M.
9. Under the Roman Sky by Donald R. McClarey
10. I Am Shocked, Shocked! by D.R. McClarey
Top 25 Catholic Blogs by Technorati Authority by John Henry
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?
I.R.S. looking for a few new agents to fulfill the new ObamaCare regulations.
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.
While pro-lifers, conservatives, and conservative pro-lifers all have different reasons for not being very pleased with Stupak and his fellow pro-life Democrats at the moment, because of their caving in to the Senate Bill abortion language and Obama’s vaporware executive order, I think it’s worth keeping in mind that if all Democrats were of the Obama/Pelosi persuasion in regards to abortion, we would undoubtedly have a “health care reform” bill which provided complete subsidies for abortion on demand for poor women, if not all women. The Senate language is not nearly as good as Stupak’s, and even with Stupak’s language included I think that the bill would have been deeply irresponsible for financial reasons. But let’s face it, the Democrats have a solid majority in the House and had until Brown’s election a filibuster-proof majority in the Senate. Without some Democrats breaking ranks with their party’s hard core pro-abortion platform, there would have been no way for the pro-life movement to keep the most extreme support for abortion possible out of the bill.
And while Stupak’s last minute flake-out is disappointing from a pro-life perspective (if he’d stuck to his guns, I would have happily donated to his re-election fund, simple because I admire steadfastness to pro-life principle, even in someone I disagree with on other issues) let’s also be honest about this: Those of us who retain a belief in fiscal responsibility and oppose statism would have been disappointed in the health care bill passing even with Stupak’s language. So while I admired his apparent steadfastness to pro-life principle, I like many other conservatives also appreciated that fact that his principle (had he stuck to it) would have resulted in the bill not passing. We can hardly be surprised that he didn’t share such a hope.
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
As it so happened, I was in Washington DC on that National Mall as congress was voting on the mess which is our “health care reform” bill. I hadn’t been to our capitol city before, and it was a simply beautiful afternoon — one on which it was hard to believe that our elected representatives were bringing us one large step closer to a major budgetary crisis point, and Representative Stupak was busy selling out the principles everyone had imagined to be as solid as the Rock of Gibraltar for a rather paltry executive order which may (or may not) come after the fact. (Call me a cynic, but I could well imagine the EO never coming. Though in a sense, why not issue it: It would have no effect and could be repealed at any time. Still, there would be a great deal of justice and truth in Obama using the old Microsoft line, “Your mistake was in trusting us.”)
Still, though sun, green grass, and stone monuments are fresh in my mind, and the largest looming problems in my mind revolve around children wailing that they need a bathroom right now while traveling on the metro (let’s just say that didn’t end well) I don’t want to seem as if I’m discounting the importance of what we’ve just seen. And there seem to be some fairly clear conclusions we can draw:
1) Stupak had no desire to be to abortion what Joe Lieberman chose to be to foreign policy. Lieberman was hounded out of his party and continues to hold office only because of people who disagree with him on nearly every other issue admired his principled stands on Iraq, Israel, etc. If Stupak had brought down the Health Care Reform bill in defense of the unborn, he would have received similar treatment from his own party to what Lieberman has received, and he clearly didn’t want to be that person. Instead, having talking himself into a corner he really didn’t want to be in, he seized upon a fig leaf when it was offered and did what he’d clearly wanted to do all along:
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?
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.
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.
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.
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.
A pair of Megan McArdle posts underline an interesting political dynamic which is applying itself to the various health care reform bills percolating in the congress.
There’s been a lot of talk about how lack of sufficient health care is a major cause of bankruptcy in the US. Some of this is based on a couple of very bad studies, which essentially assumed that anyone who declared bankruptcy who had any outstanding medical bills at all must have done so because of medical costs, regardless of the relative size of their medical and other debts. But there’s also a legitimate aspect to this, though it doesn’t have to do with medical costs. Bankruptcy is often the result of some sort of unexpected circumstances (lost job, divorce, medical problems) which drastically increases expenses or lowers earnings. Obviously, if you come down with major medical problems, you may well end up earning less regardless of your medical bills, and this can cause bankruptcy.
Illustrating this is a recent study commissioned by the Canadian government investigating the high prevalence of bankrupty among older Canadians. (via Megan McArdle) The finding: medical problems is the number two cause of bankruptcy among Canadians aged 55-65, the group with the greatest propensity to declare bankruptcy. (see pages 18-19) Continue reading
Pro-life liberal Catholic writer Michael Sean Winters of the National Catholic Reporter argues that because Catholic conservatives find themselves opposed not only to a universal health care bill that funds abortion, but also to the idea of centralized health care in general, they are in fact playing into the hands of the pro-abortion lobby.
It is strange indeed to see conservative Catholics unwittingly aiding and abetting the agenda of the pro-abortion organizations they oppose. And stranger still that conservatives who spent the last election cycle saying that no political issue mattered as much as abortion are suddenly putting their idolatry of the market before adopting a sound strategy for keeping abortion coverage out of the health care reform effort. They have provided ample reason for the administration and Congress to ignore their pleas on abortion. The may see themselves as the “loyal opposition” but they are not being loyal to the pro-life cause they espouse. They are undermining it.
His argument is basically that since health care reform is currently on the table, if conservative pro-lifers do not promise to support it if it doesn’t fund abortion, then they are therefore helping those who want it to fund abortion. I can’t help like feeling that this is a bit like the old National Lampoon cover: “If you don’t buy this magazine, we’ll kill this dog.”
Blackadder pointed out elsewhere that for all of the insistence that people cannot wait and absolutely need reform right now in order to alleviate the suffering of the uninsured, the health care bills currently under consideration are designed not to begin to go into effect until 2013, conveniently after the next presidential election. It is, I’m sure, a matter of opinion whether this is a cynical political attempt to avoid the consequences of people actually experiencing one’s health care reforms, or if its the necessary time to enact all 1100+ pages of regulations in the current plan. Either way, perhaps there’s a better way if people are really serious about helping people quickly and avoiding partisanship.
By most counts, there are actually around 12-15 million Americans who are uninsured for more than a few months, do not have the financial ability to buy their own insurance (make less than 75k), are legal residents, etc. This 12-15 million includes some people who are simply poor and can’t afford insurance (perhaps it’s not provided by their employers, or perhaps they’re unemployed) and others who are middle class (but without employer coverage) and have medical conditions which make it impossible to get individual health care insurance.
Let’s assume it’s 15 million. If we also assume that they’re fairly expensive to insure ($5000/person/year) the cost of simply paying to buy them all private insurance would be $75 billion per year, or $750B over ten years — actually less than the estimated cost of the current health care reform bill. (Heck, you could pay for the first 4-5 years by canceling all stimulus spending which is not scheduled to happen until after 1-1-2010.)
In a post on the topic of health care rationing (responding to a progressive post which argued that denying care to people unlikely to see much return was one of the benefits of a centralized health system) Megan McArdle of The Atlantic makes the following observation:
There’s another intuition that at least libertarians have, which is that it is not as bad to have undesirable things result from an impersonal process than from an active decision. It is bad if someone’s house burns down and they couldn’t afford insurance. It’s worse if someone’s house burns down, and they were in the class of people deemed unworthy by a bureaucrat of having their house rebuilt.
I think almost all progressives have the opposite intuition. They think it’s better to try to produce an optimal result, even if that results in individual injustices (which it will–government rules are very broad brush, and will always involve error at the margins). I’m not sure how to bridge that intuitive gap.
It strikes me this is indeed one of the determining differences between those skeptical of and those confident in the ability of a centralized beaurocracy to actually improve the administration of health care (as opposed to its availability, which obviously could be improved simply by throwing enough money around.)
Given the range of viewpoints found around here, I’m curious what others think of this. Is this indeed one of the major dividing lines between progressive and libertarian/conservative viewpoints?