Acton Institute Powerblog

‘Medicare for All’ is not pro-life

President Donald Trump made history on Friday when he became the first president to address the March for Life in person. As I watched the moment unfold, I was taken aback by a poster I saw held by one of the attendees: “Medicare for All. Abortion for None.”

A sticker at the bottom read, “Democratic Socialists of America. Pro-life caucus.”


At first blush, one would be tempted to take this as a prank. Unfortunately, I know firsthand that some in the pro-life leadership support single-payer healthcare. I was mildly taken aback when I heard Canadian pro-life leaders doggedly insist that “national healthcare can be pro-life.”

At least three features make national healthcare systems anti-life by their very nature. First, all current “Medicare for All” policies would compel taxpayers to fund abortion-on-demand and open the door to physician-assisted suicide. Second, the ideology of socialism naturally promotes the expansion of abortion. Third, because of its failed economic model, national healthcare demands rationing that inevitably denies care to the weakest and most vulnerable citizens.

The most prominent “Medicare for All” proposal, sponsored by Senator Bernie Sanders, would fund abortion through all nine months of pregnancy. As the Democratic Socialists of America (DSA) – which has no “pro-life caucus” – enthused:

Sanders’s Medicare for All bill mandates “comprehensive reproductive care,” including abortion. Mandated equal access to abortion care in federal legislation would mean nullifying the Hyde Amendment, which is the legislation that gets passed yearly preventing Medicaid programs from providing federal funds for abortions except in dire circumstances. There would then be no basis for Hyde’s annual passage, since preventing federally mandated abortion access is the reason Hyde exists.

This is no small step. The Hyde Amendment has “saved over 2 million unborn children” by restricting taxpayer-funded abortion under the guise of healthcare, according to Michael New, Ph.D., of the Catholic University of America. Due to the reality of budget constraints, this funding would come at the cost of offering bona fide healthcare services. This is a deeper problem, as we shall see.

Socialism has been intimately tied up with the expansion of abortion-on-demand. The first nation in the world to legalize abortion was the Soviet Union, in 1920. (Margaret Sanger called the USSR “the country of the liberated woman,” and today’s Left still calls the Bolsheviks’ stance an “idealistic pursuit of civic empowerment.”) As Reggie Littlejohn has pointed out, China has performed six-times more forced abortions (336 million) than all the abortions performed in the United States since Roe v. Wade (61 million).

Support for abortion defines “softer” forms of socialism, as well. The DSA boasts that it is “visible in the reproductive freedom movement,” and its chapters raised raised more than $127,000 for the National Network of Abortion Funds.

The problem goes far deeper than the anti-Christian orientation of socialism. Pro-life Christians must understand that socialized medicine is intrinsically anti-life, because its blinkered economic model denies care to those who most desperately need it.

Nationalized, single-payer healthcare demands rationing that costs lives at every stage of development. A single-payer healthcare system that is “free at the point of access” removes all barriers to demand; however, it does not increase the supply of doctors or hospital beds, triggering shortages of basic medical items. As my friend Peter Kapsner recently told me, when a family member had an emergency during a trip to Scotland, the NHS hospital did not even have a band-aid to stop the bleeding.

At its worst, single-payer rationing means vital surgeries are postponed until they cause needless deaths. “In the UK there may be up to 15,000 avoidable deaths from cancer every year in people over the age of 75 years,” The Lancet reported last July. “[B]etween 2003 and 2005, cancer mortality rates in the UK were … 31% higher than in the USA among people over the age of 85 years.”

Rationing takes place based on the likelihood of success, but also based on factors such as age and strength. Doctors regularly denied lifesaving treatment to the elderly because of their age, the Royal College of Surgeons found in 2012. When the government passed a law to prevent doctors from denying the seniors cataract surgeries, it was ignored, and thousands of elderly people went blind.

Some may argue that the U.S. insurance system “rations” care by refusing to pay for treatments. It’s true that the U.S. system is far from ideal. Too many layers of bureaucrats stand between doctors and patients, in part because insurance has expanded to non-emergency services. But when a health insurance company denies treatment, the patient can pay out of pocket, or seek a charity that will provide the care without cost.

When a national healthcare service denies treatment, it often means a death sentence. Consider:

  • Last June, a British judge ordered a young Catholic woman of Nigerian heritage with “moderately severe” learning disabilities to have a forced second-trimester abortion against her will, in a case filed by the publicly funded National Health Service. A higher court overturned the order – but the court later ordered her to be fitted with a contraceptive device;
  • In April 2018, the NHS sued to stop the parents of 23-month-old Alfie Evans from transferring their child out of an NHS hospital to another facility, where he would receive free medical treatment; and
  • In July 2017, 11-month-old Charlie Gard died under similar circumstances.

These are not episodes from a dystopian novel, nor rulings from a totalitarian backwater. They are but a handful of the most egregious recent decisions of the United States’ closest ally, Great Britain. Sadly, they are not confined there.

Throughout Europe, the most common form of bribery involves national healthcare. The watchdog Transparency International warned of “petty bribery that blocks access to basic public services, including health care and education.” In 2016, one out of 10 EU citizens surveyed said they had to offer a bribe to get healthcare for themselves or a loved one. National healthcare systems favor the strong and well-connected at the expense of the poor, weak, and vulnerable. (Imagine a healthcare service crossed with the Harvard admissions scandal, and you begin to get the picture.)

The situation is dire, and everyone knows it. Two-thirds of NHS doctors admitted their patients would be forced to go to a private-sector doctor to receive necessary care. Yet a high-ranking NHS official recently wrote an op-ed instructing British citizens to stop “prioritising themselves,” because visiting private doctors took money out of the coffers of the NHS. This shows the prescience of Pope John Paul II’s warning that “the Social Assistance State” creates “public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients.”

National healthcare systems can never be pro-life, because no amount of money can fund infinite demand. Rationing must follow. And that rationing costs lives.

Those who value life should support a free-market system that promotes innovation, experimentation, and technological progress to find cures for more diseases. They should honor its results – and heed the failures of its competitors. And they must oppose any system that allows the state to deny treatment to babies, the elderly, or those with physical or mental challenges.

The pro-life movement must connect its good intentions to sound economics. Innocent lives depend on it.

(Photo credit: Elvert Barnes. This photo has been cropped. CC BY-SA 2.0.)

Rev. Ben Johnson

Rev. Ben Johnson is Executive Editor of the Acton Institute's flagship journal Religion & Liberty and edits its transatlantic website.