Catholic principles for healthcare reform
Bp. William F. Murphy, Chairman, Committee Domestic Justice and Human Development testifying before Congress on behalf of U.S. Catholic Bishops.
"As Congress begins debate on health care reform the Catholic bishops of the United States offer the following criteria for fair and just health care reform. Health care reform needs to reflect basic ethical principles. We offer these as a guide:
a truly universal health policy with respect for human life and dignity;
access for all with a special concern for the poor and inclusion of legal immigrants;
pursuing the common good and preserving pluralism including freedom of conscience and variety of options; and
restraining costs and applying them equitably across the spectrum of payers."
How does the proposed legislation H.R. 3200, America's Affordable Health Choices Act measure up to the above principles?
1. "a truly universal health policy with respect for human life and dignity"
This first principle raises the fundamental question of what is the philosophy or perspective from which we are approaching this whole issue of health care reform. One can approach it from a highly individualistic view asking questions like: What's in it for me? Or, How will it's provisions affect my insurance? Or one can approach it from a more communitarian understanding of the human person. What is my responsibility to my fellow human beings? What kind of society do we want to create? The Bishops take the approach that we are social beings responsible for one another. Respecting human life and dignity makes it a moral and ethical responsibility for individuals and community to care for what happens to others — to create a society which provides for the basic needs of all. Health care is surely a basic human need!
From this basic principle the Bishops draw several more practical and concrete guidelines that take into consideration the current composition and characteristics of American society, namely:
a) access for all with special concern for the poor and inclusion of legal immigrants
b) pursuing the common good and preserving pluralism including freedom of conscience and variety of options, and
c) restraining costs and applying them equitably across the spectrum of payers;
These secondary principles flow logically and necessarily from the premise that "we are our brother’s keeper". And so let us examine how H.R. 3200 measures up from this fundamental Christian perspective.
2. "Access for all with special concern for the poor and inclusion of legal immigrants"
Positive: Every American will be required to have health coverage. Medicare recipients will continue to receive Medicare benefits, as will those receiving Tricare and VA benefits. The lowest income Americans will continue to receive Medicaid benefits. Those Americans who earn up to 400% of the federal poverty level ($88,200 for a family of four) will receive affordability credits to help them purchase insurance on a sliding scale. Those closest to the poverty level will receive the most assistance while those closest to 400% will receive the least.
Furthermore: The plan will protect you and your loved ones from losing your health care insurance for loss or change of jobs. Insurance companies will not be able to bar those who have pre-existing conditions or arbitrarily drop people when they are most in need.
Negative: The legislation makes no provision for illegal immigrants; This omission raises the question whether this bill is a truly universal health policy with respect for human life and dignity.
3. "Pursuing the common good and preserving pluralism including freedom of conscience and variety of options"
Positive: In a number of ways the bill safeguards freedom of conscience, preserves pluralism and provides a variety of options:
allows health care plans to provide for abortion but no public money can be used to fund abortions.
mandates that health care decisions are to be made between a patient and their doctor. The legislation specifically forbids any study or research from being used to either mandate or deny care to a patient. The legislation significantly increases research funding to gather data about what procedures are most effective in order to give doctors the best possible information when treating their patients
4. "Restraining costs and applying them equitably across the spectrum of payers"
Positive:
The CBO (Congressional Budget Office) estimates the cost to be $1.042 trillion over ten years. To pay for this, the bill addresses inefficiencies in Medicare and Medicaid and cracks down on fraud, waste and abuse in these programs to save $465 billion over the next ten years. An additional $583 billion will have to be raised to cover the rest of the cost. A proposed 1.2 percent tax on the wealthiest income earners would help pay this cost. The Senate is considering other ways to raise funds. Implementation of health information technology for electronic records could save billions of dollars and moving to generic forms of biologics is projected to save an additional $10 billion over 10 years.
Spiraling health care costs will be held in check by more coverage for preventive health care measures; treating the working poor early so that they are not forced to wait until their condition deteriorates to the point that they need to go to emergency rooms. The "public option" if adopted will also keep costs down by forcing insurance companies to compete with a lower cost option.
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