Posts tagged with: health care

This week’s Acton Commentary:

Healthcare reform – it’s one of those causes almost everyone favors, but which almost automatically produces sharp arguments when we ask what it means and how it might be realized. You would have had to be living in a cave for the past eight months to be unaware that Americans are deeply divided on this matter, and that the division runs clean through the middle of many communities. That includes Catholic America.

Of course, there are a small number of non-negotiables for Catholics, whatever their politics, when it comes to healthcare reform. These principally concern any provisions that facilitate or encourage the intentional termination of innocent human life, or which diminish existing conscience exemptions.

Without question, these are the primary issues for Catholics who take their Church’s teaching seriously when it comes to healthcare legislation. They dwarf everything else.

No matter how good the rest of the legislation might be in, for example, widening access to affordable healthcare, it is a stable principle of Catholic faith – and natural law – that you cannot do evil in order that good may come from it. St Paul insisted upon this almost 2000 years ago (Romans 3:8), and it is constantly affirmed by Scripture, Tradition, and centuries of magisterial teaching. Try as they may, no amount of rationalization by the usual suspects can get around this point.

For this reason, much of the Catholic contribution to the healthcare debate, especially that of Catholic bishops, has focused on these issues. We’ve yet to see what impact this might have on whatever eventually arrives on the floor of Congress.

But let’s hypothesize. Imagine the healthcare legislation submitted to Congress involved a massive expansion of government involvement in healthcare. Let’s also suppose that the same legislation was stripped of any provisions that violated non-negotiables for Catholics. Would Catholics be obliged to support passage of such legislation? (more…)

Blog author: sgregg
posted by on Tuesday, October 13, 2009

The Detroit News published my commentary on Catholics and health care reform in today’s newspaper. A slightly longer version of the article will appear in tomorrow’s Acton News & Commentary:

Catholic America is about as divided about health care reform as the rest of the country. But there are a small number of non-negotiables for Catholics that principally concern any provisions that facilitate or encourage the intentional termination of innocent human life or diminish existing conscience exemptions.

These issues dwarf everything else for Catholics who take their church’s teaching seriously when applied to the health care legislation. No matter how good the rest of the legislation might be in widening access to affordable health care, it is a principle of Catholic faith and natural law that you cannot do evil so good may come from it. St. Paul insisted upon this almost 2,000 years ago (Romans 3:8), and it is constantly affirmed by Scripture, tradition and centuries of magisterial teaching.

For this reason, much of the Catholic contribution to the health care debate, especially that of Catholic bishops, has focused on these issues. But imagine the health care legislation involved a massive expansion of government involvement that didn’t promote abortion or other non-negotiables. Would Catholics be obliged to support passage of such legislation?

The answer is no. Catholic moral teaching has held that the realization of good ends (such as making health care more affordable and accessible) mostly falls into the realm of prudential judgment. The church has always recognized that faithful Catholics can disagree about such matters.

Read the entire article here.

I still haven’t quite gotten to a thorough fisking of “Exhibit B,” yet, and will have to be satisfied with arguing the following thesis in the meantime:

It is impossible to increase insurance coverage in America without increasing medical spending.

We cannot save enough on bureaucratic reform and government-induced “competition” to offset the new costs associated with an influx of 40+ million new participants. Certainly the newly mandated premiums, paid by those who have determined for themselves that it is not worth it to pay in to health insurance, will also offset some of the new costs. But how many of those 40+ million uninsured have voluntarily opted out?

If even a large minority, say 1/3 of the uninsured, is made up of those that have been denied coverage outright or cannot afford it because of various health factors (many estimates place that number far higher), then guaranteeing coverage to 15 million new patients will certainly surpass any of the potential gains seen in those other revenue sources. The very reason that so many of these folks do not have insurance coverage is because private firms have determined them to be too risky (that is, too expensive) to cover.

How can we mandate coverage of this group and not increase health care spending? It seems like an impossible promise.

The contention really cannot be that we can spend just as much as we are right now and extend the same qualitative and accessible health coverage to everyone. The honest situation is that we would have to spend more to guarantee coverage, and as a nation we need to decide whether that public good requires governmental mandates, regulations, and administration or if it doesn’t.

There will be new costs. We need to determine whether and how they ought to be borne.

In a column in this past Saturday’s religion section, Charles Honey reflects on the second great love commandment in the context of the national health care debate.

Honey’s piece starts out on a very strong note, detailing the perspective of Dr. John Vander Kolk, director of a local non-profit initiative focused on the uninsured:

“Where would we see Jesus in our culture?” asks the member of Ada Bible Church. “He would be down there with his sleeves rolled up, helping the people that don’t have any access (to health care). That’s what we’re being called to do.”

An editorial published this month by George Barna takes a similar point of departure.

In short, Jesus Christ showed us that anyone who follows Him is expected to address the most pressing needs of others. You can describe Jesus’ health care strategy in four words: whoever, whatever, whenever, wherever. Whoever needed to be healed received His healing touch. Whatever affliction they suffered from, He addressed it. Whenever the opportunity to heal arose, He seized it. Wherever they happened to be, He took care of it.

But it is after this shared perspective that the respective pieces on health care and the Christian faith part ways.

Honey’s piece continues to argue, in the vein of the Forty Days for Health Reform, that the gospel imperative is best met through government action. “For many, it’s about treating others as you would want to be treated — seeing to it that they get the decent medical care you and I would expect. It’s just not that complicated.”

Barna, however, ends on a note of personal challenge. He writes,

Government clearly has a role in people’s lives; the Bible supports its existence and circumscribed functions. It is unfortunate that when God’s people, collectively known as the Church, fail to exhibit the compassion and service that He has called us to provide, we are comfortable with the government acting as a national safety net. In a society that has become increasingly self-centered and self-indulgent, we simply expand our reliance upon the government to provide solutions and services that are the responsibility of Christ followers. Some Christians have heeded the call, as evidenced by the medical clinics, pregnancy centers and even hospitals across the nation that were initiated and funded by small numbers of dedicated believers who grasped this responsibility. Imagine what an impact the Church would have on society if it truly reflected the model Jesus gave us of how to care for one another!

This echoes the words of Abraham Kuyper, who in an address on the social question of poverty, wrote, “The holy art of ‘giving for Jesus’ sake’ ought to be much more strongly developed among us Christians. Never forget that all state relief for the poor is a blot on the honour of your Saviour.”

Blog author: jwitt
posted by on Friday, September 18, 2009

If it doesn’t faze you that

  1. Uncle Sam badly mishandled the stimulus porkanaza
  2. Congress would have directed bazillions to a surreally corrupt Acorn but for these two young heroes
  3. Michael Moore’s Sicko is Wacko
  4. Canadians will no longer have a free market healthcare system to flee to
  5. Government-run health care will look and smell and feel like the Department of Motor Vehicles … with sharp needles and bedpans
  6. If none of this has convinced you that a government-run healthcare system is a bad idea, then spend some time perusing Jay Richards’ thoughtful blogging work on health care here at The Enterprise Blog.

And have a blessed weekend.

In this week’s commentary I argue that the shape of the debate over the public health care option over the next four years should focus on the critical role played by mediating institutions of civil society: charities, churches, and voluntary organizations.

While President Obama’s health care speech last week was in part intended to dispel myths about the proposed health care reforms, it perpetuated some myths of its own. Not least of these is the idea that “non-profit” must mean “governmentally-administered,” or that we do not already have non-profit competitors for profit-driven corporations in the health insurance industry.

The president ended his speech by appealing to the compassion of the American public, and I support this wholeheartedly. But compassion is apparent most obviously in those deeds we undertake voluntarily and selflessly. It’s apparent in efforts like healthcare sharing ministries (HCSMs), which would face elimination under proposals for a federal health insurance mandate.

To be sure, there is deceit, half-truth telling, and rumormongering running rampant in this health care debate. But this goes not only for the opponents of the president’s plans but also for his supporters, an accusation popularized by Joe Wilson’s shameless outburst at the president.

From the transcript: AUDIENCE MEMBER: You lie! (Boos.).

For exhibit A, see this Facebook video of Robert Reich, who says that the public option’s “scale and authority” and “bargaining leverage” do not amount to a governmental subsidy: “The public plan would not be subsidized by the government or have the government set the rules for anyone.” Of course, as I note in the commentary, relying on governmental bureaucracy and authority is most certainly a form of subsidy.

And why wouldn’t groups other than the government have this “scale and authority” or “bargaining leverage” to negotiate lower prices? Because their power doesn’t ultimately lie in the threat of coercion and they can’t arbitrarily raise taxes to increase revenue. This is of course the same reason that so many corporations and businesses go rent seeking; the government’s coercive regulatory power is the ultimate trump card. A gun is a great bargaining tool.

For a more thorough fisking of exhibit B, check back with the PowerBlog later.

I’m becoming more and more convinced that the talk of health care as a ‘right’ is so vague as to border on willful and culpable obfuscation. I certainly advocate a rich and complex description of ‘rights’ talk, such that simply calling something a ‘right’ doesn’t end the ethical or political discussion. Some ‘rights’ are more fundamental and basic than others, and various ‘rights’ require things of various actors.

But when it is asserted that access to health care is a ‘right,’ what precisely is the claim? Is it analogous to the claim that access to food and water, too, are rights? Very often these rights are equated in contemporary discussions: food and water, shelter, and health care.

One the one hand, however, it’s very odd to assert that health care, at least as practiced in its modern form (with X-ray machines and flu shots) is a right, at least in the sense that it is something that the human person qua person has a claim upon. If that’s the case, then all those millions of people who lived before the advent of the CAT scan were all the while having their rights ‘denied’ them (whether by God, fate, cosmic chance, or oppressive regimes bent upon keeping us from advancing medical technologies). It would also follow that all of those living today without access to these advanced technologies, simply by basis of their geographical and cultural location, are having their rights similarly denied. (This raises the troubling implication, not to be explored in any detail here, that the debate about health care in the industrial and post-industrial West amounts to a series of tantrums by the coddled and privileged about the requisite level of health care, which by any standard already dwarfs what is available to the global poor, who do not have access to what has the best claim upon ‘rights’ talk, even the most basic health care services.)

This raises the further question, if it be granted that health care is in some sense a right (which I am not opposed to granting), “What precisely does that right entail?” Clearly we can’t mean, in the context of the history of humankind, that this is a right to arthroscopic surgery or titanium hip replacement. That would be a bit like saying my right to food means that I have a claim to eating filet mignon. Just because someone else can afford to eat filet mignon doesn’t mean that my right to not starve gives me a similar claim upon filet mignon.

Similarly, just because some people can afford the greatest medical care available in the history of humankind (whether by the providence of God, fate, or cosmic chance), it doesn’t follow that I have a right to health care in that particular form. My basic claim to health care merely on the basis of my humanity is something more like the right to ramen noodles than it is to filet mignon.

This only describes what I am due by rights. It’s the least that’s required by the standards of justice.

And what might love require? “He went to him and bandaged his wounds, pouring on oil and wine. Then he put the man on his own donkey, took him to an inn and took care of him.”

I take a look at the way corn subsidies skew our eating habits — and not always for the good of our health — in this week’s Acton Commentary. Excerpt:

Government policy-makers regularly prove themselves to be unwise decision-makers by continuing to introduce arbitrary agricultural price distortions that create incentives for producing unhealthy food through farm subsidies. Perhaps the most effective national health care initiative moving forward would be allowing markets to function so that people can make better food choices.

We cannot be good stewards of our bodies or nature if we do not have accurate information. Prices help to convey that information. For example, what would happen if the market determined actual corn prices? Not subsidizing corn would cause a needed price correction. Perhaps our hamburger value-meals would adjust in price creating disincentives to eat fast-food. Without corn and other agricultural subsidies, maybe the price of meat would adjust to a point encouraging different choices benefiting us all in the long-run. Maybe, for example, eating a 72-once steak at the Big Texan restaurant in Amarillo, Texas would be too expensive to consider.

While individuals are ultimately responsible to exercise good stewardship in choosing what and how much to eat, incentives can be distorted by government meddling in the market. Dr. Barry Sears, author of Toxic Fat: When Good Fat Turns Bad, argues, “The problem lies with America’s continually subsidizing of corn and soybean production.” Government subsidies generate “an oversupply of cheap refined carbohydrates and cheap vegetable oils that when combined give rise to increased diet-induced inflammation.” This inflammation in turn “activates the genes in people who are genetically predisposed to gain weight with relative ease,” giving rise to all the health problems connected to excessive weight. Medical spending for obesity is estimated to have reached $147 billion in 2008, an 87 percent increase in the past decade.

Read “Too Much Government Makes Us Sick” on the Acton Web site and come back here for comments.

[UPDATE BELOW] I discussed the creepy side of President Obama’s “science czar” here. But there are more creepy things in the cabinet. The Wall Street Journal reports that the president’s health policy adviser, Dr. Ezekiel Emanuel, wants to implement an Orwellian-sounding “complete lives system,” which “produces a priority curve on which individuals aged roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated.”

The WSJ piece continues:

Dr. Emanuel says that health reform will not be pain free, and that the usual recommendations for cutting medical spending (often urged by the president) are mere window dressing. As he wrote in the Feb. 27, 2008, issue of the Journal of the American Medical Association (JAMA): “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely ‘lipstick’ cost control, more for show and public relations than for true change.”

True reform, he argues, must include redefining doctors’ ethical obligations. In the June 18, 2008, issue of JAMA, Dr. Emanuel blames the Hippocratic Oath for the “overuse” of medical care.

Now a freer healthcare market could take care of rationing much more simply, while providing increased incentives for healthcare providers to provide better value to choosey consumers. The problem is, a freer healthcare market wouldn’t route power through Washington.

And yes, it is more about power than about wanting to spread scarce healthcare services around more equally. Otherwise, the government would pursue something like healthcare tax credits for lower and middle income Americans. And they would pursue meaningful tort reform to curtail wasteful defensive medicine and the regressive transfer of wealth from consumers (who pay higher medical costs) to wealthy trial lawyers.

And no, I’m not proposing that these power-hungry politicians are monsters. Most are probably sincerely convinced that their increased power will help them pursue the greater good down the road. It’s just that others have been down this road before, and it isn’t pretty.

UPDATE: Longtime medical ethicist Wesley J. Smith has a nuanced look at Dr. Emanuel here. The post concludes:

[H]e explicitly advocates rationing based on what appears to be a quality of life measurement. From the piece [in the Hastings Center Report]:

This civic republican or deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia.

A lot of people are frightened that someone who thinks like Emanuel is at the center of an administration seeking to remake the entire health care system. Having read these two articles, I think there is very real cause for concern.

ABC is refusing to air a national ad by The League of American Voters, featuring a neurosurgeon asking the question, “How can Obama’s plan cover over 50 million new patients without any new doctors?”

ABC justified the decision by pointing to a long-standing policy against running partisan commercials. Dick Morris, a onetime advisor to former President Bill Clinton and chief strategist for the League of American Voters, called the ABC decision “the ultimate act of chutzpah.” As he explains:

“ABC is the network that turned itself over completely to Obama for a daylong propaganda fest about health care reform,” he said. “For them to be pious and say they will not accept advertising on health care shuts their viewers out from any possible understanding of both sides of this issue.”

Fox News reports that NBC may also choose not to run the ad.

I suggest we respond to this abuse of the public airwaves by creating a little homegrown balance. Forward the commercial to friends and family, and while you’re at it, steer them to Acton’s health care page, which includes this piece on “The Problem with Socialized Government Healthcare.”