Health Care reform, which is as much about insurance reform as health care reform, is facing the hard choice now, specifically, how to pay for it. This is also where scare tactics from those with vested interests in the status quo begin to work like acid, eating away at the moral imperative for reform. But, we should at least demand basic logic from all the participants.

Conservatives, mostly Republicans but some Blue Dog Democrats as well are opposed to or at least squeamish about having a federal option in the reform. The primary argument for the federal plan is not financial but specifically moral. Why should not citizens be entitled to the exact same coverage their elected representatives in Congress have? The person making the choice here is the consumer, not the government, so this is hardly an infringement of personal freedom.

Ah, but we are warned that the federal option, being free from the need to turn a profit, will undersell private insurance companies and drive them out of business. Well, would these conservatives rather have expensive private insurance or cheaper federal insurance? You can’t have it both ways. And, if they grant that the federal option is cheaper, they seem a bit hypocritical in complaining about the costs of reform.

The Senate is working on having cooperatives administer the federal option, with more local control. This is inherently appealing whether or not it saves money because it helps put the issue of health care spending in a proper moral context. It is difficult to get worked up about billions and trillions of dollars in D.C. but it is easier to grasp the local hospital’s needs, to see those needs not only as a financial burden but as a moral one, more akin to feeding your children than to paying more in taxes. In my hometown in Connecticut, the legislative and executive authority of the town is still vested in the town meeting. I do not remember a debate about the costs of a new ambulance or a new fire truck. Why? Because we all knew someone who had recently been helped by our magnificent ambulance corps or fire company. There was nothing abstract about it. If administering the federal option through local cooperatives, especially in rural areas where costs can run highest, can help people feel connected with their health care system, all the better. If it saves money, better still.

Later this morning, a group of religious leaders is having a prayer rally on the steps of the Capitol to push for reform. The rally will be followed up with prayer vigils in the home districts of key, swing congressmen during the August recess. This is a time to call your representatives and senators and urge them to vote for universal health insurance. And, if your congressman is a Blue Dog, tell them while we support compromises on any and all aspects of the funding mechanisms, we cannot compromise on vitiating the Hyde Amendment that restricts the use of federal funds for abortion. This is a time for citizens to be engaged, not just the lobbyists for the insurance companies. Make a call. Attend a prayer vigil. Get involved.

Comments

Anonymous | 8/6/2009 - 11:42am

Couldn't agree more with John Moore.  The profit motive doesn't fit in with health care.  Patients aren't customers who can shop around for the best product.  They are in need of service, often right now, and they may be in pain or losing blood. 
The profit motive can ruin business, if stockholders expect 20% profit every year.  Book publishing, for example, used to get by fine with 3-5% profit, and they employed excellent editors like Maxwell Perkins who helped shape the genius of Thomas Wolfe (if I have my names correct).  At 20% profit level, such editing goes.  But I digress.  If profit expectations can ruin business and our economy, it can certainly ruin health care.

Every since advertising came in, for meds and docs and hospitals and insurance plans, costs have soared.  Scrap private insurance and offer jobs for some of their people in Medicare-Medicaid, looking for waste and fraud but not for seeking ways to avoid covering people who need care.  Excise the profit motive.  Let medical personnel provide medical care to those in need.  And let public health measures flourish, reducing the incidence of illness and the need for care.    

Anonymous | 8/5/2009 - 4:16pm
Two questions.  First, I wonder how our sisers and brothers without Health-Care look upon this issue.  We who have Health-Care and we who are documented citizens always begin the discussion about Health-Care and Immigration Reform with one question, echoing the Priest and Levite of the Good Samaritan Story, - "How will this affect me?"  Secondly, I wish that we examined or questioned the decision to pre-emptively bomb Iraq with the same passion and detail that we do in examining Health-Care Reform.  Instead, we faced silent pulpits, silent Catholic Press, generally, and silent voices from the pews.  Most Catholics supported the President over the Pope.  Who benefits from both the silence and the of the satus-quo?  Who are hurt?  With whom would Jesus be in solidarity?  Our voices should articulate the vision of the prophet, not the blindness of the profit.  My God, how the poor can mess up our comfort!  How dare they?  See what you started, Jesus.  ''Preferential Option for the Poor'' and all that Cathoilc Social Teaching - how impractical, how naive, how counter-cultural!  What a silly God this Jesus!  Thank God for we who are wise!
Anonymous | 7/31/2009 - 6:21pm
We have to face the fact that it is time for a paradigm shift in this country. Continuing to permit health care to be treated like any other commodity in our economy means we will always be facing the irreconcilable conflict between the need to care for the sick and the desire to make a profit. When we open our eyes and recognize that health care is not a commodity to be allocated by price like gasoline or automobiles we will acknowledge our obligation to love our neighbor and care for our neighbor instead of trying to make a profit at our neighbor's expense. We are facing a titanic battle of greed and profits against our moral obligations to all of our people. I firmly believe that making health care a service available to all is a moral obligation we have failed to meet for far too long. Let's throw the insurance companies and drug companies out of the temple and start treating health care like the right that it is. We can afford good health care. What we can't afford is the continuation of the immoral greed and profiteering that has characterized our health care system for so long. Wouldn't Jesus expect us to extract profits and greed from health care and love our neighbor as we love ourselves?
Anonymous | 7/29/2009 - 12:08pm
Abortion will be covered in one way or another - indeed, it is now.  How, do you ask?  When private plans cover abortion, they are usually paid by employers who receive a tax cut on their corporate income taxes.  in other words, you are paying for it if you buy any product or if you pay any taxes.  The payment of abortion in national health care plans will not be very much different than this.  Even when there is no direct funding of abortion, usually most jurisdictions have a private medical charities fund among providers which funds uncompensated care provided by hospitals, which is usually paid by the locality.
 
In societies with money, free markets and taxes, every payment can be tied to almost every individual.  It is a fact of modern economics.  There are only a few degrees of separation from your wallet and the wallets of everyone else.
 
If you want to reduce or eliminate abortions, regardless of whether Health Care is passed, then make raising a child affordable by every family (which means a living wage, affordable housing, affordable college not paid by the parents, and health care reform).
Anonymous | 7/29/2009 - 1:09am
The structure of the health care system needs reform. As long as private health insurance companies are involved, they will ratchet up the costs and push to remove sick people from coverage. A single payer system will put the focus on health care for people. Medicare is a good example of a government run system that is more efficient than private health insurance.
I have called my Congresswoman, and I went to [url=http://www.thomas.gov]www.thomas.gov[/url] to read the work done by the Congress. The problem is that the text is very difficult to follow because it denotes deletions from the Medicare bill, and additions, etc. Is this the only copy available?
I did find the person in Linda Sanchez's office to be very helpful and open to my comments. I urge others to call and make your voice heard.
Anonymous | 7/28/2009 - 9:56pm

Here is my take without a lot of shouting;
The NYT has a story on medicare expences on Miami vs San Francisco . it's 8k a year for a per medicare patient in San Francisco vs 16k in Miami. Miami expences are going up twice the SF rate the last 8 years. I checked with a SF doc and nurse who said the salaries in SF might be twice what they are in Miami.so what’s up?? SF has a huge Kaiser Permanente HMO that has all electronic records and no fee for service therefore not ‘profiting’ on maybe useless procedures [also no fraud]. an excellent preventive med program..Also one of the highest approval ratings…A non-profit  national model ????
http://www.nytimes.com/2009/02/26/business/26health.html?_r=1&scp=1&sq=medicare%20San%20francisco&st=cse

http://www.nytimes.com/2009/02/26/business/26health.html?_r=1&scp=1&sq=medicare%20San%20francisco&st=cse

Anonymous | 7/28/2009 - 7:30pm

The problem with Congress and most so-called expert commentators is that few of them have read the proposed legislation and do not understand its ramifications.  I have been an health benefits expert for more than 30 years.  You don't have to be a rocket scientist to understand that if a Government Plan can demand best prices from providers, and cover as much as 20-100 additional people, many Private Insurance Companies will go out of business or experience dramatic reductions in size.

Today, only Medicare and Medicaid and some other federal organizations get best prices on prescription drugs.  Medicare and Medicaid also are the only health plans that can mandate providers to accept fixed prices for healthcare services as a requirement to participate in these Federal Plans.  The providers and pharmaceutical companies make up these large discounts to the Federal Govenment by charging higher prices to private plans.  This cost shift is significant but Medicare and Medicaid only covers a small percent of the US population.  The Government Option under the Obama Plan will cover millions more additional people.  The new Government Plan with its best prices will incentivize people to choose such an option.  As a result, Private Plans will lose millions of lives, layoff millions of workers, experience adverse selection increasing private plan costs further, and spell the demise of the private insurance industry.  Finally, there are few new cost containment features in the proposed legislataion that will significantly stem the 'increase' in future health plan costs.  As much as 30-50% of historic health plan costs have been attribuated to new technology and our aging US population will further increase utilization, naturally.

Its time to understand the ramifications of hasty decisions and misguided health reform initiatives beyond the political rectoric.  Everyone is for healthcare reform.  We can make our healthcare system better.  However, let's not make the cure worst than the disease.

Mike Barberi

Anonymous | 7/28/2009 - 6:15pm
 
MSW-
 
You have seen me write here about the need to improve our health care insurance system yet this process has become an overreach by the Administration and in particular from a Democratic Congress. The overreach is an attempt to fix / rearrange everything and not bother to pause to gain bi-partisan support and walk away with an historic victory.
The president had the upper hand here a few months ago and he could have delivered a sizable and measurable improvement in our health care system. He would have thrown a few bones to the republicans who really are working towards similar goals but come at this with a different attitude (less central control/ more flexibility in various plans vs. straight jacket benefit requirements etc)
 
No matter what one thinks of Ronald Regan, this was the political vision and genus of his administration— he was able to bring along Democratic majorities in the congress to pass his legislation.
 
But the bi-partisan approach would not have met the cries of a petty and far more reactionary congressional leadership – especially in the House. So instead we get diverted by suggestions that health care reform can become “free” by passing a  tax on “those rich people” a method for income redistribution that played to a certain liberal base ( Et tu Sean?)  but in my mind not only scared the Republicans and the Blue Dogs but also raised questions on who was driving the ship. Do I really trust Rep.  Waxman with national health care decisions?
 
So now the entire process is facing a groundswell the other way.  It sadly reminds one of the Clinton health care reform debacle of 1993.  If we lose this opportunity it will not be the fault of Republicans or big business or Sean Hannity but instead of  BHO and the Congressional Democrats who lost sight of the real goal.

Joe
Anonymous | 7/28/2009 - 5:14pm

More local control over both Medicare and that portion of Medicaid that goes to the elderly is likely desireable, as well as any cooperative purchasing arrangement as part of national health care reform.
The key feature of such reform, and the reason it is necessary, is to fund those who either can't afford insurance given their wage level (or the dominant wage level of their industry) or because of pre-existing conditions.  I am not sure one can be Roman Catholic and not believe that reform in both of these areas is necessary.

Covering those at low wage levels is an apt area for government action, since individual employers could not otherwise afford to do the right thing - both due to the perceived productivity of their workers (in other words, wage inequality - as someone in the firm is usually raking it in hand over fist) and because if they were to do the right thing, their price point would not be competitive.

This will likely lead to some kind of payroll tax on employers only, possibly with an offset for employer provided insurance.  This is currently deductible as part of the corporate profits and individual income taxes on sole proprietors.  The corporate profits and individual income tax rates could then be lowered to make them revenue neutral.  Increased personal income taxes on high income individuals and individual business owners who make a profit in the high income range (not those who gross there) are necessary not for health care reform itself, but to deal with the deficits created by the Bush Administration.  Without some deficit progress, health care reform is less likely.

Requiring insurance companies to cover pre-existing conditions is likely the impetus for much of the funding to resist the public option, since without it insurance companies will jack up the fees on most current policy holders in order to pay for those they would rather not insure at a community rate.  Regardless of whether a public option is passed (and it may not be), the insurance companies will likely seek some form of bail-out when the financial impact of covering the currently uninsureable at a reasonable price is realized. 

This bailout will likely include some kind of public funding for either the companies themselves or a public insurance fund to cover their most costly patients.  With time, the definition of a costly patient will be anyone who is sick, which likely makes single payer insurance inevitable - even if it can't be passed in the current political environment.

Anonymous | 7/28/2009 - 4:21pm
Here, here - to Jim Collins.  There is nothing but truth to what you have written.  The problem lies in the complacency of the American people.  Healthcare access is the cry of the people, but the particulars most people don't involve themselves to be informed!  Laziness?  Perhaps, but the status quo has been for the last 30 years to cry about a problem and let someone else solve it!  If the American public wants healthcare reform, then the American people should present plans and alternatives to what is being brewed in Washington!  True!  How dare the President & Congress continue with their luxurious medical options while trying to pawn off antiquated medical practices as the new standards for the American people.   As with most legislation as of late, the tactic is to manipulate the ignorant minds of the American people through fear, panic and a sense of severe loss if the vote is not taken immediately!  People need to realize that the President is elected by the people, FOR THE PEOPLE, and we need to keep reminding him of this - This plan is not FOR THE PEOPLE, but against the decency of the right to quality medical care!  There is no bandaid or ''fix-all'' for the healthcare problem, and the LIBERAL DEMOCRATS that have moved the meter from far left to moderate by their mainstream presence would have you believe that it's all or nothing, their plan or no plan, black and white!!  There must always be present in the minds of the voting public this question: WHO BENEFITS THE MOST FINANCIALLY or otherwise from the way the reform bill is written?  This greed is what has motivated such tactics in the past.  Recall the panic for the bailout, and now some of these CEO's are receiveing millions in bonuses, while 12% of the country is unemployed!  Is this justice?  NO!  If we look at models, such as in Sweden, we can attempt to implement such a ''socialized medical system'' without compromising private healthcare.  The concern must be realized that if medical care should become federal, like medicare in it's current state, the public must realize that their access to the best treatment is nearly always measured in cost and not in quality of life!  It will also measure the value of one's life based on statistics, and cost-benefit and not life-benefit or health-benefit!!!   Therefore, we must urge our representatives and congress to vote NO on the current reform bill put forth and DEMAND extensive revision and study to provide a healthcare policy that even the President and Congress would prefer over their current healthcare options.  If they can't agree to take it for themselves, then it is immoral and unethical for them to pass it on to the rest of us!!!  That would be Equality in Healthcare.  Stop the fascism!  Stop the corruption!  Stop the propaganda!!  Vote No on this and urge your representatives and congressmen to vote NO as well. And ''MAY GOD BLESS AMERICA!''
Anonymous | 7/28/2009 - 11:10pm
I am willing to listen and urge my representative to vote for health care reform but
1. Did anyone have chance to read through that thick binder and tell us what it entails? Just like I wouldn't sign my name on a piece of paper without reading it, I don't think I should tell my representative to vote for something he/she hasn't read
2. Will abortion be covered in this "universal health care"? Will my tax money be used to provide abortion to anyone who requests it,  including teenagers w/o parental consent ?
Anonymous | 7/28/2009 - 2:54pm
all my statements are documented primarily from officiai usa govrenment reports.the usa health medical industry et al needed no preperation time for the fllod of abortion requests in the first week after the legalizing abortion in 1973,i was a successful catholic health professional at the time and was totaly unaware of this for many years to follow,i was a staff pharmacist in a large teaching hospital in Boston for 5years at that time.this is then other trends since 1973 of the usa health medical industry et al to the presenrt  time,the annual infation rate every year after was always twice the inflation of food,energy and housing,the nation vital health statisitic of longevity,longevity without disability,infant mortlaity rate has declined relative to the growing industrialized world.the usa health medicial industry et al was 8per cent of gross national product in 1974,it has risen every year to its present 17per cent of the usa gross domestic product(the gnp to gdp changeover may indicate an even more negative effect on usa economic competivenss by the usa health medica industry et al,the usa health medical industry et al because of my need to prove my professiona blacklisting in 1978 started to have large declines of catholic doctors,nurses,pharmacists and other health professions starting in the mid 1970s anc continuing to the present,the decline could hardly not have been noticed by medical health indusutry insiders by the mdi 1980s.the usa govt did nothing to chastise the health medical business et al for its poor caretaking of the nations public health,its huge inflation rates and its unwarranted growth.therefore with large govt direct subsiides of medicare,medicaid and tax susbidy for private health iinsurance the usa health medical indsutry et al is and has been socialized medicine since 1990,i forgot the carte blanche usa givt has allowe don annual medical fraud,waste,abuse. dont expect Christian and real democratic values to inlfuence any health medical indsutry et all in America today and for the foreseable future
Anonymous | 8/11/2009 - 5:29pm
While not advocating throwing insurance and drug companies "out of the Temple" I think we as Catholics have to acknowledge that the dignity of the human person must include reasonable access to reasonable health care for everyone.  A capitalist system will always err on the side of profit - that is its job.  It's disingenuous to predict government making life-or-death decisions based on economics when that is what our insurance and drug companies already do every day. It becomes necessary for society (government?) to try to construct a not-for-profit model whose ultimate and final goal is decent health care for every citizen, period.  If private companies can compete, perhaps by offering premium services or boutique health-care packages, more power to them.  If they can't, they will die out gradually, because they have been unable to follow their mission or adapt to the marketplace, or perhaps killed the goose that laid their golden egg.  The advertising scare tactics and goon squads trying to disrupt public debate should tell us something about their motives. It is time for the administration to get on message (and rein in the more radical leftist mouthpieces in Congress, if possible) and get something put in place now. 
Anonymous | 7/28/2009 - 3:21pm
I am getting involved all right. I am urging my representatives to oppose this legislation which most members of Congress haven't even read. Some people are reading it and when they report what is in the bill it is such a massive takeover of our health system by GOVERNMENT that we will all regret it. There is a need to provide a better and more comprehensive system but this is just a government takeover which they are trying to ram through before everyone wakes up to what is in it.
It is fundamentally flawed. When Congress and the administration are authorizing the payments there will be conflicts. When it comes down to the choice between paying for our health care or cutting it so that the President and the Congress can pay off their special interests, guess who will win.How dsare the President and Congress impose on us a system that they will not ake for themselves but exempt themselves from it.