Thursday, January 28, 2010

The Complexity of Health Care Reform

The United States can handle complexity. However, this health care crisis offers a challenge on many levels. When, for example, in the land of the free, can government make someone purchase health insurance? When is it safer to provide preventive care to all to avoid the spread of communicable diseases to some?

Politics adds to the complexity, if some seek to treat the health care debate as a tool to strengthen their political party and weaken another’s.
Size shuts us down if we fear the problem is so big as to overwhelm us. We need to get tens of millions more people into the health care system, but where are the doctors to treat them and the medical schools to produce these doctors?
Yet not complex is the fact that for the common good we need health care for all. It is a matter of morality.

That Americans can look beyond themselves has shown dramatically in recent days, as citizens donated tens of millions of dollars to an earthquake-ravaged Haiti. People reach out when they see others in need. Americans watching the news are proud as they view the floating hospital USNS Comfort treat the wounded and deliver babies off the coast of Haiti.

That same spirit of caring can surely be tapped within our borders, where the moral problem of tens of millions of uninsured people faces us. Time and again people respond to others in need, even if it involves personal sacrifice.
Leaders need to inspire the rest of us to take the long view, beyond the next election, to what is good for the nation overall.

The U.S. bishops point out that health care reform must be guided by a basic principle: to protect and enhance life for as many people as possible. The bishops list four criteria toward this end: Provide quality, affordable health care for all; respect life from conception to natural death; guarantee protection of conscience; and promote fair treatment for immigrants.
Current health care proposals in Congress have taken some good and some not so good steps in this regard.

It is not good to leave between 18 and 23 million people uninsured, as current bills do. If only five percent of them get seriously sick and/or have communicable diseases, we’re talking about 900,000 to 1.15 million people exposed to serious illness or death by their inability to access basic health care when they need it. Given that we’re our neighbors’ keepers, assuring that everyone has access to health care is a moral necessity.

What’s not good is using health care to expand abortion and undermine rights of conscience. The Hyde Amendment and similar provisions, governing all current federal health programs including the federal employees’ health benefits program, bans putting federal dollars into elective abortions or health plans that cover them. Only the House version of the health reform legislation continues this ban. Under the Senate plan, someone opposed to abortion could be forced to write a check to support abortions for others, even in a federally subsidized health plan. Neither the House nor Senate bill would protect a religious institution from being forced to provide or fund services anathema to its beliefs or being penalized for its moral stand.

What’s not good is telling taxpaying residents on the way to U.S. citizenship that they have to be in the country five years before they can benefit from the programs which they help support, while they await their swearing-in as citizens.
What is good is the proposal to help pregnant women have healthy babies.
What’s good is a ban on policies that keep people with pre-existing conditions out of the insurance pool.

What’s good is getting everyone into the insurance pool, including the young professionals who think they can’t ever have a medical emergency, such as a broken bone or cancer. They can be educated to see they need health insurance, just as they need auto insurance.

Americans have handled complexity before, be it the invasion of Normandy in the 40s, the virtual wiping out of polio in the 50s, the landing of a man on the moon in the 60s. Surely the same American ingenuity, self-sacrifice, and good will make it possible to work through the current health care crisis.

originally published on

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