Sunday, June 27, 2010

Dishonest Attacks on Medical Care Reform

Letters to the editor pages are still getting submissions that denounce the health care reform law as socialistic and making it possible to pay for abortions with federal money. The first false claim can be easily answered. The second involves an exploration of some rather extraordinary reasoning to even understand how that false argument was developed.

Only Those Are Not Open to Reason or Evidence Can Think it is Socialistic

It is neither ultra-liberal nor socialistic. If it provided for a single-payer plan, there would be reason to consider these charges. Not only is there no single payer plan, its advocates were not permitted to testify and were carted off in cuffs. There is not even a public option. The individual mandate in the PPACA legislation comes from Mitt Romney’s plan. The national plan is only socialistic if the Republican governor’s plan in Massachusetts is also socialistic. Much of the rest of the current law was borrowed from Republican proposals, offered when the GOP successfully killed HillaryCare.

No doubt there are many Americans who will simply ignore this clear evidence.

Hyperbole, exaggerations, and distortions are to be expected in politics. We have come to tolerate this, but the problem is that outright misinformation and worse is becoming common. An example is the false claim that the health care legislation opens the floodgates to publicly financed abortions. No one has been able to point to any language in the law that permits federally funded abortions because it does not exist. There are many prohibitions, which critics conveniently overlook.

Rules Governing the Exchanges

The health care law permits state insurance exchanges to offer health care plans that include elective abortion coverage, but no federal tax dollars or credits can be used purchase the additional abortion coverage. People who want nothing to do with abortion will also have the option of buying a plan for which no abortion add-on is available. Each state exchange must, in the language of the law, have “at least one” such plan. Some have falsely claimed that the states are limited to one no-abortion plan. The fact is that the states are also authorized to exclude all health plans that have abortion add-ons.

Separate billing for the additional abortion coverage is required. The private premiums must be segregated into separate accounts which must be audited by the states. The administrative costs of offering separate abortion options are likely to be significant enough to discourage insurers from bothering with them.

The Stupak amendment to the House bill, which was supported by pro-life people, did something similar. It permitted enrollees to use their own funds to buy supplemental policies to cover abortions. The Senate Bill provided for a separate premium for additional abortion coverage in the form of add-ons.

It is possible hat there could be situations in which people who oppose abortions might find it necessary to purchase a plan that includes abortion and has no provision for eliminating that coverage. That is theoretically possible, and in that case some people might be in the undesirable position of funding other people’s abortions. In that odd case, the insurance company would be giving coverage of abortions for which it receives no compensation from the government or customers. How likely is that an insurance company, in business to generate profits, would offer this free coverage? There were so many strained arguments and distortions that one cannot help but wonder how much political partisanship was involved. In the event that this situation should occur, the law forbids insurers to advertise that such a policy might exist, thus making it hard for someone looking for that coverage without paying for it.

The Community Health Centers Theory

More important is the shaky theory that community health centers (CHCs) could offer abortions with money from PPACA . Abortions are not performed in CHCs, No one has shown that an abortion has ever taken place in one of the community health centers.

Health and Human Services (HHS) regulations forbid CHCs to carry out abortions except in the case of incest of saving the health of the mother.

Those who insist that the CHCs might find a way to provide abortions say that the CHCs could claim they are not bound by HHS regulations or the prohibitions in the PPACA, because they are using PPACA money that comes through HSS.

One would think that PPACA prohibitions would apply to PPACA money and that HSS rules would apply if HSS distributes the funds.

Funding abortions still would be forbidden by other parts of the health care reform legislation, except in cases of incest and saving the life of a mother. Section 1303(b)(2) has unmistakable language prohibiting the use of federal funds, tax credits, or cost-sharing reductions under the act to pay for abortions.

Nevertheless, the fear remained that a court might claim that abortions can be provided by these agencies because (PPACA) money did not come to them directly through an HHS appropriation act. So far, no one has produced a single case in which a judge ordered abortions funded when they were prohibited by a regulation or law.

The Executive Order

A handful of courageous pro-life Democrats addressed this concern by prevailing upon President Barack Obama to write an executive order prohibiting the use of funds under this law from being used for abortions in CHCs and elsewhere. . Critics quickly responded that executive orders have no legal force, which is simply wrong. Others said, Obama could later change his mind. He could, but he would be making a terrible political mistake.

A final concern was that conscience protection provisions in PPACA were inadequate. However, the act explicitly references existing federal law on this subject. As late as 2005, the pro-life people were saying there was no conflict between existing conscience protection and the Emergency Medical Treatment and Active Labor Act because elective abortion is not an emergency procedure.

Was the Misinformation Deliberate?

The pro-life groups and other institutions who raised these concerns have an important role to play in our democracy, where all positions should be argued with civility, honesty, and factual information.

By presenting misinformation, they have made themselves less believable and have injured their causes. One wonders how they acquired so much misinformation. There were so many strained arguments and distortions that one cannot help but wonder why people in pro-life groups and other institutions did not exercise caution in raising their concerns and in making sweeping condemnations of the health care reform legislation.

It seems that over time, some pro-life organizations have lost their political independence and have become appendages of a political party. The vitriol heaped on Bart Stupak by the Susan B. Anthony List appeared to be rooted in partisan passion.

The Catholic bishops had long supported public health care, but their recent position on PPACA was puzzling. The case for claiming that the legislation opened the door to publicly funded abortions was thin and not based on clearly demonstrable factual information. Some of the bishops’ talking points were wrong, and their web site for a time linked to someone else’s false claim that the measure would fund abortions in clinics run by Planned Parenthood.

Possibly the bishops relied too much upon their Republican allies for information on the law and were thus misled and used. As much as one might try, it is hard to avoid political partisanship when one has been allied with the same people in the abortion struggle for so long.

Two bishops, Joseph F. Naumann and Robert W. Finn issued an attack on the health care measure that was couched in the language of Catholic discourse but seemed to be a political rather than religious argument, and it left the reader wondering if they were uncomfortable with the Catholic belief that health care is a right, not a privilege. Another bishop, in Sioux City, felt it necessary to address the question of a public option.

The bishops have the right and duty to speak for Catholics on moral matters. The intra-Catholic debate about the health care bill was not about the morality of abortion, it was over what the law stated and how it was likely to be interpreted. The episcopal criticisms of Catholic hospital administrators and the sisters seems to be a way of claiming that the bishops also have primacy when it comes to interpreting what legislation means and should say. How else can we see the ban on a congregation of sisters advertising for new vocations because they had “taken a stand against the United States bishops….”

Some of the recent letters that have appeared here also indicate that some laymen believe that to be a good Catholic one has to be a good Republican. There is even the odd belief that a Catholic bishop should insist that gays do not have the right to earn their livings as members of the Armed Forces. What seems to be occurring is that more than a few people have decided that little separates religion and politics, and some add their personal prejudices to this unholy and toxic mix.

People who subscribe to this confusion see politicians being denied communion because they have an inappropriate answer for the highly theoretical question, would use the power of the state to force non-Catholics to obey catholic teachings on abortion. Roe v. Wade is not going to be repealed anytime soon, yet this theoretical question is given precedence over matters that deal with all sorts of injustices, all sorts of everyday suffering, and warfare that is hard to justify using the just war test or the teachings of the Vatican.

Why did they Spread Misniformation?

In the end, we do not know why the bishops and pro-life groups spread misinformation. Maybe they were duped by Republican operatives. Some people were probably carried away with partisanship. Another possibility is that many of these people shared a sort of bunker complex in which they imagined that their opponents were very clever and somehow framed legislation so that, without explicit enabling language, opened the door to abortions funded by federal money.

Any action that promotes the idea that religion and policies are the same or justifies spreading misinformation damages out political process. This is especially true in times of crisis like today, where there is altogether too many appeals to hot button, emotional issues, and far too few appeals to reason. Perhaps some will remember that these groups spread misinformation about health care and be less inclined to listen to them in the future.


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