Posts tagged with: health care reform

Acton On The AirThis week has seen some pretty substantial Constitutional drama unfold in the chambers of the United States Supreme Court as the constitutionality of President Obama’s signature legislative accomplishment is put to the test. Relevant Radio host Drew Mariani called upon Acton’s Director of Research, Dr. Samuel Gregg, to give his thoughts on the course of the arguments so far and his thoughts on how Catholic social teaching applies to the issue of health care in general.

The interview lasts about 20 minutes; Listen via the audio player below:

Audio clip: Adobe Flash Player (version 9 or above) is required to play this audio clip. Download the latest version here. You also need to have JavaScript enabled in your browser.

(HT: Catholic Culture) Note: One in six patients receives care in a Catholic hospital in the United States.

February 26, 2012

What are you going to give up this Lent?

By Francis Cardinal George, O.M.I.

The Lenten rules about fasting from food and abstaining from meat have been considerably reduced in the last forty years, but reminders of them remain in the fast days on Ash Wednesday and Good Friday and in the abstinence from meat on all the Fridays of Lent. Beyond these common sacrifices that unite us spiritually to the passion of Christ, Catholics were and are encouraged to “give up” something voluntarily for the sake of others. Often this is money that could have been used for personal purposes and instead is given to help others, especially the poor.

This year, the Catholic Church in the United States is being told she must “give up” her health care institutions, her universities and many of her social service organizations. This is not a voluntary sacrifice. It is the consequence of the already much discussed Department of Health and Human Services regulations now filed and promulgated for implementation beginning Aug. 1 of this year.

Why does a governmental administrative decision now mean the end of institutions that have been built up over several generations from small donations, often from immigrants, and through the services of religious women and men and others who wanted to be part of the church’s mission in healing and education? Catholic hospitals, universities and social services have an institutional conscience, a conscience shaped by Catholic moral and social teaching. The HHS regulations now before our society will make it impossible for Catholic institutions to follow their conscience.

So far in American history, our government has respected the freedom of individual conscience and of institutional integrity for all the many religious groups that shape our society. The government has not compelled them to perform or pay for what their faith tells them is immoral. That’s what we’ve meant by freedom of religion. That’s what we had believed was protected by the U.S. Constitution. Maybe we were foolish to believe so.

What will happen if the HHS regulations are not rescinded? A Catholic institution, so far as I can see right now, will have one of four choices: 1) secularize itself, breaking its connection to the church, her moral and social teachings and the oversight of its ministry by the local bishop. This is a form of theft. It means the church will not be permitted to have an institutional voice in public life. 2) Pay exorbitant annual fines to avoid paying for insurance policies that cover abortifacient drugs, artificial contraception and sterilization. This is not economically sustainable. 3) Sell the institution to a non-Catholic group or to a local government. 4) Close down.

In the public discussion thus far, efforts have been made to isolate the bishops from the Catholic faithful by focusing attention exclusively on “reproductive” issues. But the acrimony could as easily focus next year or the year after on assisted suicide or any other moral issue that can be used to distract attention from the attack on religious liberty. Many will recognize in these moves a tactic now familiar in our public life: those who cannot be co-opted are isolated and then destroyed. The arguments used are both practical and theoretical.

Practically, we’re told that the majority of Catholics use artificial contraception. There are properly medical reasons, in some circumstances, for the use of contraceptive pills, as everyone knows. But even if contraceptives were used by a majority of couples only and exclusively to suppress a possible pregnancy, behavior doesn’t determine morality. If it can be shown that a majority of Catholic students cheat on their exams, it is still wrong to cheat on exams. Trimming morality to how we behave guts the Gospel call to conversion of life and rejection of sin.

Theoretically, it is argued that there are Catholic voices that disagree with the teaching of the church and therefore with the bishops. There have always been those whose personal faith is not adequate to the faith of the church. Perhaps this is the time for everyone to re-read the Acts of the Apostles. Bishops are the successors of the apostles; they collectively receive the authority to teach and govern that Christ bestowed upon the apostles. Bishops don’t claim to speak for every baptized Catholic. Bishops speak, rather, for the Catholic and apostolic faith. Those who hold that faith gather with them; others go their own way. They are and should be free to do so, but they deceive themselves and others in calling their organizations Catholic.

Since 1915, the Catholic bishops of the United States have taught that basic health care should be accessible to all in a just society. Two years ago, we asked that whatever instruments were crafted to care for all, the Hyde and Weldon and Church amendments restricting funding for abortion and respecting institutional conscience continue to be incorporated into law. They were excluded. As well, the present health care reform act doesn’t cover entire sections of the U.S. population. It is not universal.

The provision of health care should not demand “giving up” religious liberty. Liberty of religion is more than freedom of worship. Freedom of worship was guaranteed in the Constitution of the former Soviet Union. You could go to church, if you could find one. The church, however, could do nothing except conduct religious rites in places of worship-no schools, religious publications, health care institutions, organized charity, ministry for justice and the works of mercy that flow naturally from a living faith. All of these were co-opted by the government. We fought a long cold war to defeat that vision of society.

The strangest accusation in this manipulated public discussion has the bishops not respecting the separation between church and state. The bishops would love to have the separation between church and state we thought we enjoyed just a few months ago, when we were free to run Catholic institutions in conformity with the demands of the Catholic faith, when the government couldn’t tell us which of our ministries are Catholic and which not, when the law protected rather than crushed conscience. The state is making itself into a church. The bishops didn’t begin this dismaying conflict nor choose its timing. We would love to have it ended as quickly as possible. It’s up to the government to stop the attack.

If you haven’t already purchased the Archdiocesan Directory for 2012, I would suggest you get one as a souvenir. On page L-3, there is a complete list of Catholic hospitals and health care institutions in Cook and Lake counties. Each entry represents much sacrifice on the part of medical personnel, administrators and religious sponsors. Each name signifies the love of Christ to people of all classes and races and religions. Two Lents from now, unless something changes, that page will be blank.

The observance of Lent reminds us that, in the end, we all stand before Christ and give an accounting of our lives. From that perspective, I ask lay Catholics and others of good will to step back and understand what is happening to our country as the church is despoiled of her institutions and as freedom of conscience and of religion become a memory from a happier past. The suffering being imposed on the church and on society now is not a voluntary penance. We should both work and pray to be delivered from it.

>> Source

“If there was ever any doubt about one of the Obama Administration’s key philosophical commitments,” writes Acton Research Director Samuel Gregg in a new article in the American Spectator, “it was dispelled on Jan. 20 when the Department of Health and Human Services informed the Catholic Church that most of its agencies will be required to provide employees with insurance-coverage for contraceptives, sterilization, and abortifacient drugs: i.e., products, procedures, and chemicals used to facilitate acts which the Church and plenty of others consider intrinsically evil.”

Gregg writes that “modern liberalism has a long history of trying to exclude consideration of the proper ends of human action from public discourse in the name of tolerance. But neither liberalism nor secularism are as neutral about such matters as they pretend.” In fact, that neutrality looks more and more like coercion. Gregg:

And here we come face-to-face with the essence of what a certain Joseph Ratzinger famously described in an April 2005 homily as “the dictatorship of relativism.” Most people think of tyrannies as involving the imposition of a defined set of ideas upon free citizens. Benedict XVI’s point was that the coercion at the heart of the dictatorship of relativism derives precisely from the fact that it “does not recognize anything as definitive.”

In this world, tolerance no longer creates the safety for us to express our views about the nature of good and evil and its implications for law and public morality. Instead, it serves to banish the truth as the reference point against which all of us must test our ideas and beliefs. The objective is to reduce everyone to modern Pontius Pilates who, whatever their private beliefs, wash their hands in the face of obvious injustices, such as what the Obama administration has just inflicted upon not only Catholics, but anyone whose convictions about the truth requires them to abstain from cooperating in acts they regard as evil per se.

Of course, modern liberals do have their preferred ends, which (despite all their endless chatter about reason) reflect their profoundly cramped vision of man’s intellect. Here they follow the eighteenth-century Scottish philosopher David Hume. He argued that “reason ought to be the slave of the passions.” Reason’s role, in other words, is not to identify what is rational for people to choose. Instead, reason is reduced to merely devising the means for realizing whatever goals that people, following the profound moral reasoning of a five year-old, “just feel like” choosing.

Read Samuel Gregg’s “Obama and the Dictatorship of Relativism” on the website of the American Spectator.

Update, Feb. 2: the Assembly of Bishops issued a press release to “adamantly protest” the HHS mandate.

On the Observer blog of the American Orthodox Institute, I look at the non-reaction of the Assembly of Canonical Orthodox Bishops of North and Central America to the recent Obama administration mandate that forces most employers and insurers to provide contraceptives, sterilization, and abortifacient drugs free of charge. More specifics here. The Assembly of Bishops, charged with the “common witness” for Orthodox Christians in America, was also missing in action during the 2012 March for Life.

Towards the conclusion of this article, I say:

… we can’t dismiss this problem by saying that the Orthodox, broadly speaking, don’t get institutionally involved in politics. Far from it. How else can you explain the churches’ long membership in the World Council of Churches and the National Council of Churches, Protestant-dominated bodies that exist to put a patina of theological legitimacy on leftist economic and political ideologies?

Patriarch Bartholomew is all too ready to talk about how the Church invented hospitals more than 1,600 years ago, as he did in a 2009 speech sponsored by the Center for American Progress and Georgetown University in Washington. He even noted that these Byzantine hospitals were “public institutions, free of charge and created for the public good.” Although the patriarch stopped short of backing the Obama administration’s health care initiative before this liberal/progressive audience, he endorsed the notion that “every member of society, from the greatest to the least” deserves the best quality healthcare.

But Patriarch Bartholomew and his lobbyists are nowhere to be found when 21st Century American hospitals are feeling the heat from an administration trampling on conscience protections. We’re talking about hundreds of hospitals founded by Catholics, Jews and Protestants and serving people in real need — today and not in some idealized forever-gone past.

In stark contract to the Orthodox bishops, some 135 Roman Catholic bishops in the United States — and counting — have spoken out on this mandate.

Also see this reaction from Albert Mohler, president of Southern Baptist Theological Seminary, on Associated Baptist Press: “Mohler says insurance mandate not just ‘Catholic’ issue”.

Read “Orthodox Bishops Assembly Silent on Moral Issues” on the Observer blog of the American Orthodox Institute.

Dr. Donald P. Condit, the author of the Acton monograph A Prescription for Health Care Reform, responds to the Obama administration’s mandate that most employers and insurers must provide contraceptives, sterilization, and abortifacient drugs free of charge. For more on this issue, see Acton’s resource on “Christians and Health Care.” Sign up for the free, weekly Acton News & Commentary newsletter here.

An Unconscionable Threat to Conscience

By Donald P. Condit, M.D.

In May 2009, President Obama delivered the commencement address at the University of Notre Dame where he proclaimed, to naïve applause: “Let's honor the conscience of those who disagree with abortion, and draft a sensible conscience clause, and make sure that all of our health care policies are grounded not only in sound science, but also in clear ethics … ”

What a difference a few semesters make. Last week, Health and Human Services (HHS) Secretary Kathleen Sebelius ordered most employers and insurers to provide contraceptives, sterilization, and abortifacient drugs free of charge.  Taxpayers and premium payers are complicit in paying for these “preventive health services” whether they object or not. 

Sebelius deferred, until after the 2012 election, the deadline for religious employers to comply. Meanwhile they must provide instructions so that employees can obtain abortions and services only considered “treatment” if one considers pregnancy a disease. 

With the passing of time, it has become painfully obvious how relativistic and clouded are this administration’s sense of ethics.  The subsequent threat to our liberty is crystal clear and faith leaders representing diverse traditions are speaking out against the White House’s assault on religious freedom in the most forceful way.

Cardinal-designate Timothy Dolan of New York, president of the U.S. Conference of Catholic Bishops (USCCB), did not pull any punches:  “Never before has the federal government forced individuals and organizations to go out into the marketplace and buy a product that violates their conscience. This shouldn’t happen in a land where free exercise of religion ranks first in the Bill of Rights.”

Archbishop Dolan met the challenge of this HHS edict: “To force American citizens to choose between violating their consciences and forgoing their healthcare is literally unconscionable. It is as much an attack on access to health care as on religious freedom. Historically this represents a challenge and a compromise of our religious liberty.”

Last month, in advance of the ruling, a group of more than 60 Protestant and Orthodox Jewish religious were out front on this issue when they released a letter to President Obama. The religious leaders pointed out that, “It is not only Catholics who object to the narrow exemption that protects only seminaries and a few churches, but not churches with a social outreach and other faith-based organizations that serve the poor and needy broadly providing help that goes beyond worship and prayer.”

Last week, the National Association of Evangelicals said it was "deeply disappointed" by the administration’s ruling. “Freedom of conscience is a sacred gift from God, not a grant from the state,” said Galen Carey, NAE Vice President for Government Relations. “No government has the right to compel its citizens to violate their conscience.  The HHS rules trample on our most cherished freedoms and set a dangerous precedent.”

On the Huffington Post, Romanian Orthodox priest Fr. Peter-Michael Preble, an early supporter of President Obama, said the HHS ruling was a “direct attack” on religious freedom in America and the beginning of more attacks on the faith of Americans. He’s also changed his mind about the president. “Well I now feel I was duped and his brand of change is not what America needs at all,” Preble wrote.

The Catholic Medical Association also responded: “This latest attack by the Obama administration on religious freedom and free speech rights should be of grave concern to all Americans because it is destructive of individual rights and of the common good. It should be challenged and resisted by all legitimate means.”

This HHS decree tremendously threatens the liberty and consciences of organizations across the United States that provide vital health care, social services, and education – to people of all faiths, and no faith – to millions of people by hundreds of thousands of employees.

The scope of these services in the American Catholic world is immense. One in six patients receives care in a Catholic hospital in the United States. There are more than 50 Catholic health care organizations with more than 750,000 employees. More than 150,000 professional  educators serve more than 2 million students a year in Catholic primary and secondary schools.  There are more than 200 Catholic colleges and universities that   educate more than 900,000 students annually.

Pope Benedict XVI’s diagnosis seems prescient.  As Dean of the College of Cardinals, his 2005 homily at the Papal Conclave warned that, “We are building a dictatorship of relativism that does not recognize anything as definitive and whose ultimate goal consists solely of one's own ego and desires.”

President Obama’s relativistic ethos obscures the truth behind the right to life, the right to conscience protection, and the right to free speech.  His administration’s apparent compulsion for re-election and control over so many foundational elements of our society has led to oppressive policies. This HHS mandate is another tangible example of the threat of relativism.

Let us pray for, and work toward, restoration of consciousness of truth in this country. 

It has been over a year since the passing of the Affordable Care Act, and we are still discovering problems with it. Supporters claimed passing the bill will help everyone, especially the vulnerable. However, the Affordable Care Act ironically does just the opposite by placing the elderly in a very dangerous position. Dr. Don Condit, author of the Acton monograph a Prescription for Health Care Reform, explains how the Affordable Care Act negatively impacts the elderly and its violation of subsidiarity in this week’s Acton Commentary. Get Acton News & Commentary in you email inbox every Wednesday. Sign up here.

A Sugar Coating for the Bitter Pill of ObamaCare

By Dr. Don Condit

Remember Mary Poppins singing, “A spoonful of sugar helps the medicine go down in the most delightful way”?

If so, be concerned, because you or your parents are probably on Medicare – or will be soon — and last week the Department of Health and Human Services (HHS) proposed regulations for Accountable Care Organizations (ACOs).

The sugar-coated rhetoric in this announcement from HHS cannot disguise the bad medicine in this part of this part of the Affordable Care Act, which intends to bureaucratically cut as much as $960 million in Medicare spending over three years. This ObamaCare prescription  threatens patients, the physicians who care for them, and the common good. The only clear winners are the consultants and lawyers busy trying to decipher this 429-page tome of acronyms and encrypted methodology that will compromise the doctor-patient relationship and is contrary to the principle of subsidiarity.

Medicare beneficiaries will be “assigned” to 5,000 patient-minimum organizations to coordinate their care. While HHS Secretary Kathleen Sebelius talks about improvement in care, the politically poisonous truth is that Medicare is going broke and ACOs are designed to save money. The words “rationing” or “treatment denial” or “withholding care” are not part of her press release, but reading the regulations reveals intentions to “share savings” with those who fulfill, or “penalize” others who fall short of, the administration’s objectives. The administration’s talking points include politically palatable words which emphasize quality improvement and care enhancement when the real objective is cost control by a utilitarian calculus.

Physicians and other health care providers will find themselves in conflict with the traditional ethos of duty to patient within ACOs. Ever increasing numbers of doctors are leaving private practice and becoming employed by hospitals, due to a variety of challenges inherent in these uncertain times. The hospitals are the most likely recipient of bundled payments for caring for Medicare patients. Doctors will face agency conflicts between the time honored primary duty to patient, which may conflict with hospital administration, and ACO goals of fiscal savings. Medical care providers will receive incentives for controlling spending, and penalties if they do not. “No one can serve two masters” (Matthew 6:24). Not even physicians.

The physician’s ACO conundrum is illustrated in the language where these regulations proclaim that, “Providers should be accountable for the cost of care, and be rewarded for reducing unnecessary expenditures and be responsible for excess expenditures.” Yet the very next sentence stipulates that, “In reducing excess expenditures, providers should continually improve the quality of care they deliver and must honor their commitment to do no harm to beneficiaries.” (page 14)

The principle of subsidiarity guides policy makers to empower decision making and scarce health care resource allocation at the doctor-patient level. However, the Affordable Care Act moves in the opposite direction. It increases bureaucratic power and responsibility. This is not the antidote needed to reform health care in the United States. The complexity, cost, and confusion of implementing these ACO regulations defy comprehension. We can only hope ACOs will follow “just say no” HMOs into the historical ash heap of misguided health policy.

There is no question that significant – and scarce — health care resources are consumed in the Medicare population toward the end of life. ACOs intend to limit this spending — the government way. The Ethical and Religious Directives by the United States Conference of Catholic Bishops suggest a better path forward:

While every person is obliged to use ordinary means to preserve his or her health, no person should be obliged to submit to a health care procedure that the person has judged, with a free and informed conscience, not to provide a reasonable hope of benefit without imposing excessive risks and burdens on the patient or excessive expense to family or community. (32)”

The patient must be the focal point of concern. They, or their surrogate, with the help of their physician, need to become informed. They must also participate in the expense of their care, which will better allocate resources for the community than would more distant bureaucratic panels or regulation.


A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community (57).

Enabling all patients, with and without means, to “proportionally” participate in the cost of their care will better allocate scarce health care resources than further sugar-coated, and non-delightful, misguided administrative policies.

By the way, if you didn’t recognize the Mary Poppins song, that’s OK. Worry instead about your grandparents for now, and consider how your generation will counter-reform ObamaCare in the future.

Dr. Donald P. Condit, MD, MBA is an orthopaedic surgeon specializing in hand surgery in Grand Rapids, Michigan. After graduating with a BS in Preprofessional studies at the University of Notre Dame he attended the University of Michigan Medical School. At the Seidman School of Business of Grand Valley State University his emphasis of study was economics and the ethical allocation of scarce health care resources. With his family, he serves annually with Helping Hands Medical Missions in El Salvador. He also volunteers at Clinica Santa Maria and for Project Access, for the uninsured, in Kent County. He is the author of A Prescription for Health Care Reform and is a Clinical Professor of Surgery at Michigan State University.


Despite a promise of “complete and fair coverage of health care for everyone for free,” the Greek state-controlled system is broken and corrupt, the Athens daily reports. Predictably, Greeks have taken it upon themselves to build a private health care sector:

Despite hikes in Greece’s health spending between 2000 to 2008 being among the highest of all OECD countries, this has not been matched by growing life expectancy rates, the report added. Turning to the hospital system, corruption has grown due to poorly run operations and an improper organisation structure with about one in five Greeks admitting to having paid a bribe in order to receive medical treatment at a state hospital. These problems have contributed to growth in the private healthcare industry which provides crucial services but also enjoys the benefit of not having any competition, the report added.

In the UK, the National Health Service has been using hospital beds as housing for senior care, to the detriment of people who actually need hospital beds. From the Telegraph:

If current trends continue, almost 100,000 of 170,000 NHS beds will end up being filled by elderly people who are well enough to be in residential care. This will cost the health service millions of pounds and throw its day-to-day operations into chaos, says the report by Bupa, the health insurance and care provider. It blames the looming crisis on a “17-year legacy of under-funding in the care home sector”. The next few years will see the problem getting progressively worse, the report’s authors predict, despite a Coalition pledge that local authorities will have an extra £2 billion to spend on adult social care over the next four years.

For more on this issue, see Acton’s Health Care resource page.