Health Insurance and Abortion

Friday, February 19, AD 2010

It seems often the case that a heated political debate causes people to suddenly focus on issues which had previously been essentially ignored. One recent example of this in Catholic circles has been the way in which the debate over the Stupak Amendment to the House health care reform bill suddenly focused scrutiny on the question of abortion coverage in health care insurance.

To recap briefly: From the beginning, one of the concerns that many pro-lifers had expressed about “government health care” was that it would result in government funding for abortion. As the various reform bills coalesced, it became clear that no “government health care” per se would be offered, but rather an exchange on which private health insurance plans which fit specific government-set criteria would be offered. Given this situation, pro-lifers (and in particular, pro-life Democrats, who clearly had the prime say here since Republicans were unlikely to support the bill either way since they saw its overall structure as detrimental to the common good) insisted that one of the stipulations for the private health insurance policies offered via the exchange (and qualified for government subsidy for lower and middle-income Americans) be that the plan not cover abortions.

Pro-choice Democrats of course hated this provision. Some progressive Catholics also seemed eager to explain why the bill would be just fine even without Stupak, doubtless in order to avoid a situation in which pro-life advocates (backed by the bishops) successfully made the case to conservative Democrats that supporting a bill without language similar to the Stupak amendment was unacceptable for Catholics and other pro-lifers. The primary argument that surfaced was, “Most private insurance policies already cover abortion, so even without Stupak’s language, the status quo does not change. More people just get health care, and that’s good, right?”

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25 Responses to Health Insurance and Abortion

  • Sounds good to me.

  • If the information about which private health insurance plans do and do not cover abortion would be a great help. For a start prolifers could offere incentives to drop insurance coverage of abortion by voting with their wallet.

  • As pregnancy is 99% a self-inflicted condition, it is unclear why the insurance companies should pay for it.

    Or as Senator Barbara Boxer once asked “since when is pregnancy a disease?”.

  • This is a great post. And it would be a very good thing if the more traditional, beltway type professional pro-lifers were able to work together with more politically liberal progressive pro-lifers on an issue which could unite them in a common purpose, rather than putting them at policy loggerheads, as often seems to happen.

  • I agree with Gabriel. Insurance is about the sharing of *risks* that cannot be managed individually.

  • Not sure I’d call my little girl a self-inflicted condition— her father might object, for starters– but it’s covered by insurance due to the hideously wide range of things that can go wrong, as a way to make sure the insurance company gets a relatively healthy new customer and, on a practical level, because even if they pay zero just having an insurance company takes off a huge chunk of the cost.

    Kit would have cost some $40,000 if billed to my husband and I directly; we literally have statements that read “charge- 1,500; negotiated price, $25” and such. As most folks can’t go by cash-only medical providers, service like this is our only option.

    That won’t be changed until health insurance, whichever section you believe causes this insane charge imbalance.
    *glares at Medicare and Medicaid’s billing practices*

  • I agree with Foxfier that pregnancy is never a solely self-inflicted condition. It is also a totally necessary condition for the survival of mankind. The costs of even routine pregnancies are high and without insurance coverage would bankrupt quite a few parents to be.

  • Getting in a car wreck is a self inflicted condition. The at fault party is given total liability for the actions he could have prevented in the ideal scenario. It is still insurance.

    When people speak of not insuring self-caused events, they are talking about the principle of moral hazard. In auto insurance, the idea is that people drive more recklessly if they are insured. In health care, the idea is that people seek ‘unneeded’ care because they don’t bear a burden. With the large expense centers in health care like heart disease and cancer, the only generally agreed upon unneeded care that the patient is competent to seek himself is an extra screening. Of course, the patient could choose to forgo regular screenings, and we’d see that as a bad thing, even though we’d see a reduction in cost.

  • I’m unclear whether Gabriel is making the argument:

    a) Pregnancy is the natural result of intercourse and so asking for your insurance to get you out of the “surprise” with an abortion is inappropriate or

    b) No pregnancy related expenses should be covered by insurance, since becoming pregnant in the first place is “optional”.

    I have some sympathy with the former approach, though I think it’s much wiser to make the moral than the utilitarian argument here since if one wants to get seriously utilitarian abortion is cheaper than childbirth.

    In regards to the latter — As my wife and I are currently going through the third round of paying out of pocket for a midwife deliver rather than going with the more expensive (but more troublesome) insurance paid hospital approach, I can see certain virtues towards a less insurance-heavy approach to childbirth. However, I don’t in the end think it’s a very good approach to take given anything like our current health insurance regime. Health insurance as it exists in the real world here and now does not take into account whether your medical predicament was predictable. (Say, whether bad eating habits over decades leads to expensive-to-treat strokes or heart attacks.) It simply deals with whether procedures are necessary to your health. (In regards to which, childbirth is necessary, while lasik or breast augmentation isn’t.) And whether expenses are large, which delivery at a hospital certainly is.

    Given that, there’s no practical justification for insurance not covering pregnancy related expenses — and as pro-lifers I think it should be pretty clear to us that insurance companies specifically excluding pregnancy expenses would be a very serious negative.

  • Darwin,
    I agree with you completely. I would add that the reason our health care system is in a mess is because we are using a risk sharing system (insurance) inappropriately. A four party payment system (employer pays insurer who pays provider to service a decision-making user) cannot be economically efficient. Insurance is only sensible when trying to spread unacceptable financial risks. Now, when we have a cold or flu, a simple doctor’s visit has insurance implications. That is not sensible. I would address pregnancy and child birth, but don’t have the time.

  • I’m not sure where you are finding the impossibility. There is nothing intrinsic about complex systems that causes inefficiencies. The opposite is actually the case. As bureaucracies become more complex, the cost of a standard transaction goes down. For a basic office visit, the administrative cost on the claim is, if I remember correctly, is less than what VISA and Mastercard charge. While the specifics are always dependent, generally it is better to move one’s costs to fixed from on demand. It allows for such things as specialization.

    Health insurance as it exists in the real world here and now does not take into account whether your medical predicament was predictable.
    That is simply wrong. There is no retroactive analysis, but there is a reason you give your medical history, give your height and weight, and your blood pressure. If you have a group plan, you might not have gotten into that much detail, because there isn’t the need for as much specificity with large numbers.

    It simply deals with whether procedures are necessary to your health.
    Yes, when you are coverage includes reasonable medical expenses, your plan seeks to verify that they are reasonable. People in insurance do not care if an expense is rare. They actually hate those. The only thing insurance companies care about is if an expense is predictable. That is how rates are determined. If we have three pools of a thousand people, there will not be enough variation in the number of office visits those three pools have over a year to make a real difference in rates. The ideal insurance function is a converging function where as n increases it approaches s.

  • M.Z.,
    The inefficiency is not a function of complexity. It is a function of the remoteness between the payor and the user. This is a feature of almost any insurance, and it distorts incentives and behavior. Health insurance is worse than most because a fourth party , the employer, is implicated.

  • MZ,

    I think we might be talking slightly at cross purposes. My point is not that insurance companies pay no attention to how behaviors are likely to affect your health, but rather that once they have insured someone they are not able to decide whether or not to treat a condition based on whether it was the person’s “fault” in some sense.

    Thus, for instance, a some health insurance applications ask if you drive a motorcycle, and may take that into account in your rates, but they’re not allowed to refuse to treat your injuries if you have a motorcycle accident on the theory that it’s an optional and high risk behavior.

  • If the contract excluded coverage from injuries resulting from a motorcycle accident, they would be excluded if the contract specified them. Many states proscribe insurance companies from excluding ordinary activities. If you have your health plan doc in front of you, you should see a section titled “Exclusions and Limitations of Coverage,” or something to that affect. I must confess though of being unaware of anyone claiming that Americans have higher health care costs because they participate to a greater extent in health risking activities.

    Mike Petrik,
    I recognize a moral hazard argument when I see one. The major premise of such an argument is that a person receiving a benefit would not seek that benefit were it not present. With national parks we do not see people widely exploiting them to their detriment despite not directly paying for them. My problem is that you seem to believe that the hazard is widespread and costly and therefore leading to inefficiency. I do not believe the numbers support the argument.

  • With national parks we do not see people widely exploiting them to their detriment despite not directly paying for them.

    I’m afraid you’re quite wrong at that– it just doesn’t get as much attention. I’ve got pictures here of what’s left after some folks exploited a park for “enjoyment.”

  • If the contract excluded coverage from injuries resulting from a motorcycle accident, they would be excluded if the contract specified them. Many states proscribe insurance companies from excluding ordinary activities. If you have your health plan doc in front of you, you should see a section titled “Exclusions and Limitations of Coverage,” or something to that affect.

    Um, well, yes. But I’m not sure how that relates to my point in response to Gabriel, which was that excluding pregnancy care from insurance as a general practice was neither in keeping with the general way insurance works in the US nor a good idea.

    I think you and I are basically in agreement on that, aren’t we?

    I must confess though of being unaware of anyone claiming that Americans have higher health care costs because they participate to a greater extent in health risking activities.

    I’ve heard people argue that Americans have a lower life expectancy and poorer health care outcomes as a result of higher rates of violence, auto accidents, and unhealthy living — but I don’t think I’ve heard anyone argue that’s a major source of our higher health care expenses.

    Not sure how we got on the topic though…

  • I’ve never understood why health insurance providers aren’t friendlier towards midwife care as it would cut down their costs considerably. Are they not covering it at all now? All my midwife-managed births were covered, though on occasion I had to do a little educating to get bills paid.

  • I think it depends, cminor; my dad’s masseuse is a registered midwife, but she often has to work in a hospital because of the risks.

    Getting gov’t less involved in hospitals might be a good idea– I know that Sacred Heart in Spokane just got permission, after five years, to add five maternity beds to their design. They’d asked for 15.

  • They’re willing to pay for midwife services in a hospital or some birthing centers, but not for a homebirth midwife — which as you say is odd because the ~2.5k cost is much less than they pay for a hospital delivery.

    After dealing with hospitals the first couple time MrsD was tired of that routine, and our babies tend to come so fast that staying put it much more reassuring. It’s expensive, but paid over seven months it’s doable.

  • MZ,
    I don’t know what “numbers” you’re talking about, but if you think that people would make the same medical decisions (e.g., opt for the same number of MRIs and CT scans) if they were using their own money then we just disagree. Both doctors and patients are influenced by the fact that the patient has little financial interest in selecting options. I find it hard to believe that there are “numbers” that can demonstrate otherwise. Many common medical decisions involve lifestyle considerations. For instance many knee and hip replacements are elective in the sense that a relatively normal life can often continue without them. The decision to have these procedures is often influenced by the degree to which the patient will not bear the cost. People do make decisions based on costs and benefits, and the costs they weigh are only their own.

  • Foxfier,

    Child abuse isn’t evidence that parents don’t generally love their children. Certainly there instances of abuse and destruction of public resources as there are of private ones.

    Petrik,
    I’m more interested in decisions that are in their best interests. The RAND Institute has found that people will choose less care when they have to directly pay for it. The same study showed that they did not discriminate between needed care and unneeded care.

    Doctors do have an interest in not ordering more and unnecessary tests. It is called the insurance exclusion for charges that are not reasonable and customary. Good luck to the doctor recovering a claim denied for U&C. Such isn’t to claim that greater efficiencies couldn’t be wrung.

    I hope you are never a candidate to have a knee or hip replacement. This is of course another area that isn’t breaking the medical system.

  • MZ-
    you’re assuming that what I posted pictures of was out of the norm, rather than just a very visual example of the norm.
    Check out Chief Joe’s grave some time– if you can find it, in all the trash. Talk to the folks who do upkeep on state campgrounds. Look at a park that hasn’t had grounds keepers on it recently. For fun, look at how much of it is only a few steps from an empty garbage can.
    There’s a reason that I tend to defend pigs when folks say that humans are pigs– pigs are clean if they’re given a chance.

    Shoot, go on one of the bike trails– you’ll find piles of human fecal matter in the middle of the trail, and I wish I was joking.

  • Well, also, a lot of national and state parks either aren’t free or are free but only allow a certain number of people into the park each day. Unless society has massively reformed from my boy scout days, the parts of national parks that people could actually get near without at least an hour or two of hiking tended to be rather threadbare. (And the bloody Sierra Club with their mules carrying supplies for Yosemite “hikers” who had too much money and didn’t want to carry their own food made the trails pretty foul for those of us doing real back packing.)

    Doctors do have an interest in not ordering more and unnecessary tests. It is called the insurance exclusion for charges that are not reasonable and customary. Good luck to the doctor recovering a claim denied for U&C. Such isn’t to claim that greater efficiencies couldn’t be wrung.

    True, but there’s a wide range of what doctors can get away within the range of what is “necessary” and “customary”. Obama, at least, certainly seemed to think in a number of his early talks on cost control that doctors are incented to defer towards extra care — and the studies on how salaried doctors prescribe less care for equal outcomes also suggest there’s some sort of effect going on there.

  • With national parks we do not see people widely exploiting them to their detriment despite not directly paying for them.

    People abuse the commons, which is why use of the commons is regulated.

  • They’re willing to pay for midwife services in a hospital or some birthing centers, but not for a homebirth midwife — which as you say is odd because the ~2.5k cost is much less than they pay for a hospital delivery.

    Can’t believe I didn’t remember this before– at least in Washington state, the insurance company really wants to minimize even the most out-there risks for the baby because the baby MUST be covered by the mother’s insurance for something like a month after birth.

Senator Nelson Sells Out Unborn, Health Care Bill Heads to Vote

Saturday, December 19, AD 2009

(Updates at the bottom of this article.)

Harry Reid was able to make huge concessions to the state of Nebraska and bought Senator Ben Nelson’s vote a la Mary Landrieu.  The vote seems headed to the floor with all 60 votes secured to impose on American’s draconian laws that would hike insurance rates and begin the downward slope towards European style socialism.

Nelson secured full federal funding for his state to expand Medicaid coverage to all individuals below 133 percent of the federal poverty level. Other states must pay a small portion of the additional cost. He won concessions for qualifying nonprofit insurers and for Medigap providers from a new insurance tax. He also was able to roll back cuts to health savings accounts.

What’s in the bill that I’m aware of?  I’ve broken down the Washington Post article almost verbatim below:

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29 Responses to Senator Nelson Sells Out Unborn, Health Care Bill Heads to Vote

  • Senator Nelson said this, this morning:

    “Let me be clear. This cloture vote is based on the full understanding that there will be a limited conference between the Senate and the House.

    If there are material changes in that conference report different from this bill that adversely affect the agreement, I reserve the right to vote against the next cloture vote.

    Let me repeat it: I reserve the right to vote against the next cloture vote if there are material changes to this agreement in the conference report. And I will vote against it if that is the case.”

    I am not thrilled with his decision. I am happy that his mailbox is full and so is Senator Casey’s. But this is not a done deal. The legislation has to be reconciled — the slightest appeasement of liberals in the House can kill this thing in the Senate. Better yet, the abortion language is not going to fly well in the House. The first go round there were 64 Democrats to vote for the Stupak amendment and at the end of the day with 39 Democrats voting “NO”. To see this thing fail, there needs to be merely 2 upset Democrats to vote the other way.

    This isn’t over.

    Moreover, I am not surprised. Recent stories in the press suggest that Senator Nelson was being threatened. Maybe they were true. Maybe they weren’t.

    Either way, hopefully this will not succeed.

  • Eric,

    I think you’re absolutely right on this. I think Stupak and the pro-life Dems in the House will hold the line on this.

  • Let’s see. The Democrats, if they can pass this stripped down bill through the Senate, still have to convince the House Dems to scrap their much more ambitious bill. Then there will be a huge fight over the Stupak amendment.

    If this bill passes it will then not be fully implemented until 2014, coincidentally, I am sure, two years after the Presidential election of 2012.

    I do have to hand it to the Dems if they pass this for doing what I considered impossible. They have crafted a bill which is opposed by a majority of the American people, liberal Democrats and virtually all Republicans. They have all the signals known to political man flashing red and saying that this is a one way ticket to a crushing defeat in 2010. Passage of this bill will depress liberal Democrats, the base of the Democrat party, unify and inflame Republicans, and cause Independents to desert the party of the donkey en masse. Never has a political party in my lifetime labored so strenuously to implement a policy that guarantees them an extended vacation in the political wilderness. Democrats have nothing on Lemmings at the moment when it comes to survival instict.

  • I am actually more surprised that Lieberman is voting “Yes.”

    Actually I am shocked they killed the public option.

    ALL THIS POLITICAL AMNESIA DRIVES ME CRAZY!

    We have Republicans defending Medicare (since when?!) and Democrats supporting insurance companies offering national plans that do not have to adhere to state laws (what the…?)

    Our Congressmen need to have their heads examined.

  • Wait…how do they expect to get a bill without a public option through the House?

  • lol Eric, good question. You already have some Dems who pledged to vote it down if abortion funding was scrapped… imagine what they will do with no public option!?

    This whole thing is going to fall apart.

  • I’m trying to understand the bill. So states will able to prohibit subsidized plans from covering abortion. In those states that will allow abortion coverage, individuals will be able to purchase abortion coverage on top of their regular coverage.

    If that’s right, I don’t see what’s so objectionable. Sure, it’s not as good as barring coverage altogether but this is not bad. Those who want abortion coverage will have to pay extra for it. In practice, few would buy the supplemental abortion insurance.

  • I am not sure if that’s how it works. I read something a moment ago suggesting people would have to send two checks — one for abortion coverage, the other for the whole policy. I think it is still account gymnastics.

    I am not sure.

  • So it depends on whether it’ll be the individual’s choice or the insurer’s choice. If the individual gets to choose whether to send that abortion check, this bill isn’t so bad. If everyone has to pay the same premium and the insurers segregate it, that’s unacceptable.

    Need more clarity.

  • Any reaction from the USCCB on this one???

  • Your blog managed to list on google search for reaction to the health care debate.

    As an Irish Catholic who use to be republican, its always distressing to encounter members of holy church who have been utterly beguiled by the evangelical right, I pray for such folks.

    While the issue of abortion is a serious moral lapse in our society, the lies and deception of the GOP and evangelicals pose a more serious danger to both the republic and freedom of faith.

    Pettifogging health care as an element of the debate over abortion is rank hypocrisy and not worthy of big or little C catholicism.

    One can only hope other Catholics who have followed the disciples of the lie into the modern GOP tent will like Paul have their eyes opened to the reality they adhere to a political theology crafted by the Father of lies and promoted by his agents in the GOP.

  • Republicans as agents of Satan? Mr. Keller, it is never a good idea to blog drunk.

  • Mr. Keller would appear to be Gerald L. Campbell’s doppelganger.

  • When I stop Chuckling, Mr. McClarey I assure both lucidity and habitual tea tootling, Nor did I offer implication all republicans serve as agents of the diabolical any more than all members of the German Army were responsible for the Holocaust,

    Art Deco’s reference to Campbell is pithy oh so pithy still I wish you both a merry Christmas

  • Well Mr. Keller, now we have Republicans compared to members of the Wehrmacht and the Holocaust. As I have said to some of my clients when they have committed some felony or misdemeanor sober, “I would prefer that you would at least have had the small excuse that you did this drunk”. And the merriest of Christmases to you.

  • Last one Donald, may I call you Donald? I’m in Phoenix and have to get ready as I prefer Saturday mass, Clients, felony? are you an attorney Don?

    Funny if you are as I find it difficult to distinguish between modern republican leaders and lawyers, both have the tendency when they lack points of authority or a cogent argument to pound the table and besmirch the character of the opposing advocate.

    Please trust me when I say unlike politicians, I will accuse directly when the occasion calls for it.

    Oh I hear the GOP has invited the John Birch society back into the fold, yea that will help.

    Really I try to treat all people as individuals worthy of respect but every time I hear Glen Beck or Sister Sarah Palin speak I think of Forest Gump, White trash is as White trash does, yea that’s going to cost a few hail Mary’s but it had to be said but at least the Merry Christmas was sincere

  • “both have the tendency when they lack points of authority or a cogent argument to pound the table and besmirch the character of the opposing advocate.”

    I am an attorney. The legal saw you are recalling is that when the facts are against you, you argue the law, when the law is against you, you argue the facts, and when both are against you, you pound the table and abuse your opponent. Mr. Keller, as you called Republicans agents of Satan and compared them to members of the Wehrmacht during the Holocaust I would suggest that it is you who have been pounding the table. Of course we also have your charming White Trash reference.

    As for the John Birch society, I can imagine few organizations with less significance for the Republican party. Back in the Fifties William F. Buckley wrote them out of the conservative movement after they accused Ike of being a Communist. Their influence on the conservative movement and the Republican party has been nil since then.

  • Yeah, it’s Campbell.

  • Oh, and Campbell’s referring to CPAC (not the GOP, but who needs facts when you have a hatchet?) having the Birchers as one of their many sponsors. They also have a gay lobbying group as a sponsor this year, so I wonder how he’d process that.

  • Well Mr. Keller or Gerald Campbell or whoever you are, I’ve deleted your last comment since it was an attempt to hijack this thread as part of your effort to convince people that Republicans are evil incarnate. Due to the content of your posts I am also banning you from this blog. Mere invective simply leads to futile combox feuds and we try to avoid that on this blog.

  • “Passage of this bill will depress liberal Democrats, the base of the Democrat party, unify and inflame Republicans, and cause Independents to desert the party of the donkey en masse.”

    I hope so, Don, but I wouldn’t count on it; never underestimate the ability of the GOP (particularly in Illinois, but this is true elsewhere also) to snatch defeat from the jaws of certain victory.

  • In Illinois Elaine I grant you, although even here I think the Republicans will gain two house seats and make take the Senate seat. As for the rest of the country, I think the Democrats are in worse shape than they were in going into the 1994 elections when the Republicans took Congress

  • This will go-down in history as but a Pyhrric victory where political costs outweigh the benefits to the Democrats… if people weren’t pissed at the power-drunk Dems before, they likely are now…

    These tools like Nelson will soon regret the day they did this for Obama, he’ll pull all these fools right-over the abyss with him… and the coming GOP majority will rescind it anyway…

  • At this stage there will be a bill with features somewhere between the House and Senate bills. Illinois will see the Dems pick up Kirk’s seat, the GOP pick up one, and even odds for the pro-choice Republican senate candidate beating the Dem.

  • I see the GOP in Illinois picking up Halvorson’s seat, Bean’s seat and Foster’s seat. They will probably lose Kirk’s seat. I think they have a decent chance of picking up Hare’s seat also. Kirk is a pro-abort which is why I oppose him in the primary and will not vote for him in the general election.

  • Eric Brown writes Saturday, December 19, 2009:
    “Our Congressmen need to have their heads examined”.

    I am at a loss to understand that a college education has failed to make an impression. A simple review of the behavior of Congress throughout the 19th and 20th Centuries would demonstrate that these behaviors are par for the course.

    Senator Nelson was bribed. So also was Senator Landrieu. What’s new about the behavior of “our only professional criminal class”?

    I suggest that we make a point of asking our senators if they voted for this “compromise” [lege sell-out. Think Munich] what they got for it for their states.

  • It is curious to consider that this bill scheduled to be signed on the day of the Holy Innocents:
    “Then what was said through the prophet Jeremiah was fulfilled: “A voice is heard in Ramah, weeping and great mourning, Rachel weeping for her children and refusing to be comforted, because they are no more.”

  • Very well said Gabriel for something so tragic and sad.

Church and Health Care

Sunday, October 25, AD 2009

I have been on the sidelines in the huge health care debate, I find so many good and bad effects in all the proposals I have seen up to now. The first thing to note is that I am swamped by health care bills- one-third of my gross income goes straight to United Health, and then add in co-pays, and some recent Mayo Clinic extra’s, and you get the idea- “Help!”.  I can see how many good people with fulltime jobs and HMO health insurance coverage, are still at risk of bankruptcy if they or their kids get struck down with anything approaching serious or chronic medically.

The problem is compounded by the very real situation of how almost all of us are in some or a lot of danger when it comes to being laid-off from that full-time work- and many Catholics like myself- have wives that are home by choice to better nurture our kids. Ugh! Lose your job, lose your insurance or pay for COBRA which you can’t afford because you don’t have a job- Double Ugh!

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9 Responses to Church and Health Care

  • That is a really interesting idea.

    The K of C has developed a remarkable life insurance program that strikes me as a reasonable model for your idea. Add to your idea the existence of so many hospitals, hospices, facilities for the aged, and counseling centers and you have a significant start already.

    Hmmm…

  • I would favor insurance being totally divorced from employment. With that in place, there could be other ideas at work. It could be a part of severence if laid off. It could be included in unemployment insurance by the government so that you wouldn’t lose it between jobs.

  • You miss an important point. The bishops want greater government involvement in health care so they can back out of it and spend less money and resources on it themselves – and if the names and identity of “Catholic” is still attached, all the better. They don’t *want* to be more involved. It’s expensive and bothersome and a liability.

    Bishops are not go-getters and innovators. They are protecters and retreaters.

  • Surely much confusion would be cleared away were one to refer to the proposals as “insurance for health care”.

    It is about money, not about health care.

    Where are the provisions for new hospitals, new medical schools,more doctors, more nurses. Nowhere.

    And the efforts to control liability suits have gone nowhere. The trial lawyers are among the biggest donors to the Democratic Party.

    I am uncertain that our bishops should be involved. They can barely control “their” own efforts. Consider the years of donating to such outfits as ACORN. And Catholic Charities is [rightfully] spurned by parishes throughout the country.

  • Mark,

    You have a good point about the bishops — but why should the bishops be the ones behind it? Why not a lay initiative? Why not expand the KoC program to be open (for only slightly higher fees) to non-Knights? Or why not start an entirely new program on our own?

    The trick is to get a handful of laypeople with the capital and the know-how to get it done. Any takers?

  • P.S. I know the Christian Brothers run an insurance-type thing for a number of religious congregations. Maybe we should look at them, too, to see what the possibilities are.

  • “Big gov” vs “Big HMO’s” is a HUGE misunderstanding. The HMO was forced on America BY the US Congress.

    I think focusing on “ObamaCare” is not only foolish, but hands the victory over without contest. All argument about it has focused on public funding of abortion and euthanasia.

    The reality is that any kind of a government run system will make not only health insurance worse, but health care overall worse. America’s health care system is the envy of the world.

    The focus on abortion funding amounts to arguing over whether we should gut the best health care system in the world WITH abortion funding or WITHOUT it.

    That said, yes, health insurance SHOULD be divorced from employment, which is yet another reason government should be forced to stay out of it entirely.

    Government regulation is the entire reason that health insurance is employer based, and the reason that it is nearly impossible for people to find & get decent health insurance on their own.

    The root of the problems we see today are based in the fact that health care costs are ever increasing, while the “cure” is always new ways to try and hide the cost. There are a few alternative health plans out there (like that would actually start addressing some of the core problems that drive up the cost of health care, such as H.R. 3400.

    That’s not the only alternative bill out there, either. There have been more than 2 DOZEN health care proposals made in Congress & the Senate, all of which have been repeatedly buried because they have been Republican proposals that would not ruin the health care system in America by nationalizing it.

    Here are just a few:
    H.R. 77, H.R. 270, H.R. 502, H.R. 1086, H.R. 1118, H.R. 1441, H.R. 1468, H.R. 1658, H.R. 1891, H.R. 2520, H.R. 2607, H.R. 2785, H.R. 2786, H.R. 2787, H.R. 3356, H.R. 3372, H.R. 3400, H.R. 3454, …….

  • The idea of an organizational (Catholic Church) based insurance entity is very appealing to me as it could answer both the availability and affordability problems with health care today. Additionally, It could be a model of non-profit status and could lower administrative costs significantly if it were really treated as a new way of doing health care insurance.

    The availability solution could be built into the plan’s charter with no pre-existing exclusion and open enrollment.

    How it charges for coverage could also improve availability and level the playing field for individual buyers with group buyers. For example, right now groups are usually priced by the major health care companies on the basis of an employee census as to age. Then the health care company may apply certain actuarial credits to reflect wellness programs, etc. or in some cases just to be competitive. The rate then is averaged and the 25 year old pays the same as the 62 year old in terms of what comes out of their pay. If the same 25 year old got individual coverage they would pay probably 10% of what the 64 year old pays. The new group could work the same way as a large group plan works now and eliminate or ameliorate the built in old age “tax” of individual coverage. Just as an aside, this may seem unfair to the 25 year old, but they will reap the benefits as they age much like social security.

    More importantly non-profit status would allow cost savings and with a new entity costs could be cut significantly with real simplification of contracts and no or little paperwork. As it grows in size it would be able to really negotiate with providers to lower costs which are currently sacred cows to government (because of lobbying) and major health companies because of kickbacks and deals (sorry if it sounds paranoid, but it is real life). An example would be prescription drug costs – if Canada can do it the new group should be able to also if it can stay independent.
    THE OTHER SIDE
    Unfortunately, there is a lot working against the idea. Some of the problems have been mentioned above as cultural within the church but there are some other things that could hurt on a macro basis.

    To be really effective and wring costs out of the system the current employer based system would have to be replaced largely with an individual based system. This creates some substantial problems as a large portion of the workforce is not going to take kindly to losing these benefits. Longer term this may become more viable as more and more employers are dropping or reducing benefits but the last holdouts may be the government sponsored autoworker unions.

    The current health insurance companies may not be overjoyed at this prospect either. At first the new group would probably have to use the current markets unless they are capitalized in some different form and can work out their own discounts with healthcare providers. Eventually, though, they will know that they are going to be removed from the equation. I suspect they will put up many roadblocks.

    The government could also be a major hurdle as there could be some definite constraints based on the “not invented here” concept. We’ve seen how this works when government forms an insurance carrier and does not allow competition such as Workers Compensation Insurance in several states such as Ohio.

    To be really effective there would also have to be a few other things that may only be able to come from government such as mandatory coverage and Tort Reform (assuming this can be done without being overturned by the Supreme Court). Additionally, regulations would have to be changed to allow for interstate operations and possibly establishment of specialized insurance entities.

    Overall, I like the idea and it is something that I have suggested before although not in the context of a faith based group. It is a major alternative to government plans and could eliminate much of the inflated medical costs that are overburdening us now. Real life, though, is that it has some significant hurdles and few real advocates.

  • Thanks Paul for the detailed consideration- I am hoping against hope that instead of having our church and the bishops taking a position of negativity toward the inevitable government “reform” of health care coverage, we should take the bull by the horns and provide an alternative that doesn’t require government takeovers or bow to the powerful private for-profit interests – you overcome evil with good, not mere rhetorical complaint.