Health Care Reform – What Went Wrong?

Here we are just a couple days after the U.S. Congress passed Obamacare and we’re faced with the unpleasant task of asking the question, what went wrong?

Needless to say, many regrets will emerge in the weeks and months ahead, but one of the most difficult to swallow lies in the approach taken by the United States Conference of Catholic Bishops.

The Hyde Band-aid Leaves Much Uncovered

Despite the Catholic clarity with which some bishops separately approached this issue, from day one, the USCCB position was inadequate because it was based on the false premise that placing unprecedented control of the U.S. health care system in the hands of the federal government — in this case, under an Administration that clearly does not value human life — was a worthy effort.

“Our goal has been really for decades to have universal health care reform. We’re very much in favor of that; we were in favor of that many decades before it was fashionable,” said USCCB Associate Pro-Life Director, Richard Doerflinger.

“Unfortunately,” he continued, “the Senate health care reform bill is morally unacceptable.”

In a March 17th contribution to the Washington Post, Sr. Mary Ann Walsh, spokesperson for the USCCB, elaborated on what it would take for the legislation to become acceptable to the bishops.

“What the bishops have said is that for health care reform they would live with the status quo where the government does not pay for abortions or abortion-containing health plans [via the Hyde Amendment], but people who want abortion coverage can purchase it with other funds.”

Sr. Walsh went on to say that the Hyde Amendment “saves taxpayers from the ignominy of seeing their tax money used to end innocent lives.” If only that were entirely true!

Make no mistake, Hyde is better than nothing, but it is no pro-life panacea; it simply shifts the cost of abortion coverage away from the Federal government. The fact is, government funded abortion is taking place in the very shadow of USCCB headquarters in Washington, D.C. and seventeen other Hyde-complaint states with local tax payer money right now!

Remember who we’re dealing with here; this Administration considers abortion a “right” and a matter of “reproductive health.” To imagine that Obamacare — even with Hyde — would result in anything other that an explosion of locally funded abortion mills is a long-shot wager at best, and frankly, shockingly naïve.

So why would the Conference even dare to roll those dice? Well, in spite of its serious commitment to the pro-life cause, the USCCB was so overwhelmingly predisposed to embracing statist solutions to the nation’s health care challenges that it lost its perspective.

Catholic Social Teaching Went Missing

Imagine how well the Catholic faithful and our nation would have been served if the Conference had placed the debate where it truly belonged: squarely within the fullness of Catholic social teaching.

If the USCCB had done this, it would have been abundantly clear to all concerned that Catholic teaching is not a mandate for socialized medicine and government enforced universal health insurance. It is a call to morality, mercy and charity. It includes both solidarity and subsidiarity. It upholds man’s dignity through collective effort in order to meet the needs of the broader community, especially those of the poor, but it also defends individual freedoms, including freedom from excessive government control — in this case, control at the hands of the most radically pro-death Administration and Congress this nation has ever seen.

My comments are not intended to level criticism at the bishops per se, but rather to offer a sober assessment of that bureaucratic behemoth known as the USCCB. Individual bishops have indeed spoken well on the topic, but the clarity that some of them offered was largely drowned out by the incoherence of the Conference.

Archbishop Edwin F. O’Brien of Baltimore, for example, cited “the Catholic principle of subsidiarity” saying, “the Church believes that decisions should be made as close to those affected by them as possible, commensurate with the common good. This is especially true of the conscience-laden decisions often involved in health care.”

Of the numerous pages dedicated to “health care reform” on the USCCB website, not one mentions the incredibly important principle of subsidiarity even once. Had the Conference taken an approach similar to that of Archbishop O’Brien and other individual bishops, we might not be licking our wounds this very day.

From a thoroughly Catholic perspective, the health care reform debate wasn’t nearly as simple as the Conference made it out to be, as though preventing public funding of abortion and negotiating conscience clauses was enough to render Obamacare worthy of Catholic support. This, however, is exactly the stance taken by the USCCB from the very outset, and it only opened the door for those difference-making pro-life legislators to take comfort in the promise of an executive order restricting federal funding of abortion and justify voting “yes.”

The Conference did send a memo to legislative assistants Sunday morning warning that legal experts don’t believe that an executive order is sufficient to override the provisions enshrined in the current legislation, but it was too little too late. The USCCB had already taken on the posture of a one trick pony; it had relinquished a veritable arsenal of Catholic social doctrine in favor of one silver bullet, and once the Stupak block was convinced that abortion funding was going to be restricted, the Conference was out of ammunition.

Confused and Confusing Communication Serves No One Well

The underlying problem with the Conference’s chosen approach is further evidenced by an analysis of claims made in the official “USCCB Position on Health Care Reform” as quoted in italics below:  [ ]

In our Catholic tradition, health care is a basic human right.

In repeatedly speaking of “health care” without any qualification or definition whatsoever, the USCCB had effectively allowed the political activists to define the issue according to their agenda. Remember; this Administration and the majority in Congress consider abortion a matter of health care.

As for what the Conference considered that “health care” which is a “basic human right” to include we were left to wonder; does this refer to interventional procedures, or annual check-ups? Are we talking about having moles removed, or prostate exams? The USCCB position doesn’t specify, but it does elaborate:

This teaching is rooted in the biblical call to heal the sick and to serve “the least of these,” our concern for human life and dignity, and the principle of the common good.

As with “health care,” leaving “the common good” without needed Catholic definition makes it a wax nose that activists can shape to their own liking. But at least the issue is being framed within the context of Sacred Scripture. So… the biblical call to heal the sick is the real issue, right? Healing the sick and serving the poor is indeed a true moral imperative, so that must be it… but just when it seemed that the crux of the matter was becoming clear, the Conference changed course:

Unfortunately, tens of millions of Americans do not have health insurance. According to the Catholic bishops of the United States, the current health care system is in need of fundamental reform.

This is a confusing turn. Is it about healing the sick or about “health insurance?” Does the USCCB really mean to say that health insurance is a basic human right?

We’re then informed that since a large group of people allegedly don’t have health insurance (never mind the actual health of these individuals, or their actual access to health care) the determination is that the entire health care system — the finest in the world — is in need of not just improvement, but fundamental reform.

This is a Pelosi-esque leap of logic, especially when we consider that the Conference — under the solitary condition of the Hyde Amendment’s flimsy guarantees — was fully willing to grant unprecedented control of the U.S. healthcare system to the same government that has nearly destroyed Medicare and Medicaid.

Commenting on the USCCB position, Richard Doerflinger stated that “health coverage is a matter of justice,” a position for which he claimed recourse to the social encyclical of Pope John XIII, Pacem in Terris.

The trouble is Pacem in Terris doesn’t mention the insipid term “health coverage” even once. In fact, it doesn’t even mention “health care,” but rather “medical care” and man’s “right to be looked after in the event of ill health.”

There’s a very big difference between an entitlement to “health coverage” and a right to “medical care.” In fact, it’s rather like the difference between triple bypass surgery and sleeping well at night knowing that your co-pay is low in the unlikely event you catch a nasty case of pink eye. So which is it?

What We Needed… and Still Need

What we, the faithful, needed was an approach to this matter that is more dogmatically Catholic than that of a political action committee.  What we needed was to see the debate framed within the fullness of Catholic social doctrine from day one. The USCCB never adequately explained its position, mainly because it approached the debate far more like a political action committee than a body of Apostles.

The lesson in all of this is clear: those bishops who are inclined individually to embrace and promote a fully Catholic approach to pressing national issues must wrest control of the USCCB from those bureaucrats who are unwilling to follow suit. In the interim, our faithful and intrepid shepherds must band together publically to clarify and counteract the Conference’s untenable positions when the good of the faithful and the state of the union truly demand it — as was the case in matter of national health care reform.

In the long run, what we most need for our bishops to do is to teach us, to sanctify us, and to govern us in the name of Christ.  If they can resist the temptation to wade into the heady “public policy” waters that surround the Washington beltway long enough to carry out this God-given mission with consistency and clarity, rest assured, there will be plenty of well-formed Catholics in both public and private life alike to serve the poor, the sick, and the suffering in a manner that is reflective of our innate human dignity for decades to come.

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  • GaryT

    Louie, thank you for writing with a clarity on the topic I rarely see. We cannot confuse health insurance with helping providing medical care. Medical care can be provided for free out of the goodness of people’s hearts – which is precisely what Jesus taught us to do.

    A good system must be based on justice and charity. Government run systems are neither. Pope Benedict wrote of the need to uphold justice and charity both in Dues Caritas Est. And he was merely following the precedent of Rerum Novarum more than a century prior.

    Yet somehow we keep on thinking socialism is the same as charity when it is quite contrary to it.

    I can’t help but notice that the good samaritan acted with CHARITY. Our modern version would go something like this: “Then a samaritan passed by. Moved with compassion, he whipped out his cell phone and dialed 911. Knowing that the government-paid ambulance was on their way, he then moved on, being careful to never having come in contact with the victim. He felt good about himself for inconveniencing himself with the trouble of dialing 3 keys on his phone.”

    Jesus never once clamored for a government-run health-insurance system. And health insurance is most definitely not an inalienable right available to all people throughout all time. If so then God sure gave Adam and Eve the short stick when he did not provide them with health insurance.

  • terrygeorge

    thank you for this article. we need many more like it.
    so much to say and i’ve got to go to work, but some basic ideas:

    first of all, to many in catholic authority are observably pubically biased in favor of democratic party. oh they may talk a decent pro life talk, but when it comes down to action they do not walk the walk. instead they justify pro choice politics for other reasons. consider the wide and in many cases unjustified chastisement of pro life politicians who may not align with the USCCB or other church authorities on other issues. would that the public chastisement of pro choicers was as loud and vociferous as that against some of Bush’s policies recently. So many examples i don’t have time to list many, such as Casey vs Santorum and Our Sunday Visitor. thankfully CE is more resistant to this bias.

    along these lines there needs to be greater public unity between pro life politics and church authority. every ill mentioned criticism of a pro life individual or policy by someone who could be seen secularly as a church authority (remember in secular eyes this is not limited to bishops or clergy or religious) gets 1000 times more press than a supportive statement, and vice versa for comments in support of a pro choice person or policy. bishops need to be aware of this and take control of usccb in this respect! next voters guide needs to be 1000 times more insistent on need to vote pro life than on exceptions which get all the press

    also no where near enough consideration of biblical priorities such as living debt free. perhaps we need more emphasis on wisdom books in cycle of readings

  • steve p

    The best and most clear eyed article on this whole debacle that I have seen.

  • Joe DeVet

    A fine article placing a portion of the blame where it truly deserves to be placed.

    Fr. Richard John Neuhaus pointed out some years back that a monsignor who was an apparatchik in the then-USCC bureaucracy, commented in an unguarded moment that the USCC is “the religious arm of the Democratic Party.” It would appear to be largely still true of the USCCB. I’m guessing a large number, maybe a majority, of them voted for Obama. Just as many in the local diocesan curia where I work did.

    I have a lot of respect for Richard Doerflinger for his past performance in the area of respecting life. He’s a sensible man, and probably knew better than the things that he was forced to say. He probably was forced to take the positions on health care that he did, in order to stay employed. Shame on him.

    There’s more, of course. Any form of socialized medicine, whether or not the abortion and conscience and “immigrant” issues had been “fixed”, will involve direct and indirect euthanasia. The USCCB and most commentators seem oblivious to this reality. The economics of the case are far too compelling for this huge life issue to be avoided.

    By my reckoning, the USCCB bishops are ill-prepared to try to deal with this issue. When it finally becomes visible on their radar screen, chances are they will never see their own complicity in causing the problem in the first place. And by then it will be too late for them to have much influence. Their Catholic flocks, who will not have been properly catechized by their shepherds, will be supporting direct and indirect euthanasia at the same rate as the general populace do, as is the case today with abortion and other evils.

    Then there’s the awful principle expressed early on by USCCB spokesmen, that any health care legislation needs to be “abortion-neutral.” One can understand what they were trying to do, but this is a terrible descriptor when the status quo is a totally-unacceptable government-mandated “right” to kill children in the womb.

    Blind guides!

  • momof11

    If there is a government program in place that supposedly takes care of things people will become calloused and no longer live charity towards their neighbor. Is that not the reasoning behind the principle of subsidiarity? Instead of the bishops pushing for government programs they should have been spending their time and advertising to urge people toward charity. If they were more outspoken against contraception and for chastity within and outside of marriage there would assuredly be less single mother households, which make up a large amount of those un/under insured or cared for.

  • kirbys

    I agree, momof11–and there would be more children to care for elderly parents and relatives!!

  • goral

    There was no hierarchical opposition to this bill to speak of. Sure there were token statements and the usual boring, pro-life, polite requests.

    I think the bishops got battle fatigue from their assault on last season’s swine flu. I’m weary of handshakes to this day.

    We’re going to have to look to plumbers and electricians and moms and all the rank and file to battle the Kennedy style darlings of the catholic left.

  • Xaviertrth312

    Thank you for this article. As Catholics we stand first and foremost for the dignitiy of the human person – any sort of wishy washy confused message is detremental.

  • ilovecatholics

    I have decided to drop my e-mail account with catholicexchange. This article disgusts me. I don’t have to be a Republican just because I am Catholic.

    I can want health care for poor people–and yes even to be as extreme to suggest that the poor should even have HEALTH INSURANCE and I can be Catholic, too. It is mean to say that poor people should just beg people and count on the charity of some doctors in some cities to provide free health care. By the way, in my state, there is no free hospital for people who are uninsured.

    Unless someone comes knocking on my door and says they cannot afford health care, I don’t need to worry about it. I have health insurance, but I do not think poor people have that right. I don’t care if they lie awake at night and worry about getting sick or some disease. I don’t care if a working father cannot afford to buy coverage for his family. (Wake up; it happens every day.) That doesn’t sound like Jesus. I don’t think Jesus is Republican or Democratic.

    Now you are bashing the voice of the Catholic church–the USCCB. I am tired of radical right-wingers using the voice of the Catholic church to say that it is someone’s responsiblity to come up with a plan to locally provide for the poor.

    Are you helping to pay for the insurance premiums on just one person or just one family in your church? How are you helping just one poor person in your community to receive health care? If you are not aware, the need is tremendous!!! Just because they are not knocking on your door and directly asking you to help them does not mean that they are not there.

    Also, just because Obama comes up with a plan does not automatically mean it is useless like this article implies. Why not just ask for donations for the Republican party?

  • ilovecatholics

    By the way, like the USCCB, I am against federal money being used for abortion funds. I think the USCCB was right on target. I pray for an end to abortion. I have prayed outside of abortion mills. I did not vote for Obama.

  • skkurtis

    ilovecatholics asks how many are paying for a neighbors health insurance. Are you directing that to the conservatives among us? If so, I ask, what percentage of income does a typical liberal contribute? What was Biden’s total charitable giving in 2007? It was $995 out of $320K which is 0.3% ( Obamaa has been more charitable at 6.4%, or $172K out of $2.7 million income ( Does Obama need more than $300K to live on? If caring for the poor is so important, I would expect the leader of the progressives, currently Obama, to give us a better charitable example, say $2.4million, or 89%. This tells me that the liberal push for universal health insurance is just liberal with other people’s money.

    ilovecatholics is free to be digusted, or not, by this article or anything else. That is the beauty of the personal freedoms that this country provides. That is what Obama’s and the progressive health care concepts destroy in the long term. This health care mandate only looks good on the surface. The struggle to care for the poor has been a problems for ages. The liberal/progressive solution is a government forced program which erodes our personal freedoms and the rights of the taxpayer. That becomes government forced “morality” which is not at all consistent with catholic teachings.

    The ends do not justify the means.

  • ilovecatholics,

    Your post has too many wayward thoughts for me to address them all but here’s a few:

    “I can want health care for poor people–and yes even to be as extreme to suggest that the poor should even have HEALTH INSURANCE and I can be Catholic, too.”

    To be Catholic is to have active concern for the sick and suffering. And sure, you may suggest that health insurance administered by a government entity is a good idea, but what you cannot do is promote it as a basic human right and as a matter of Catholic doctrine. You would be on especially shaky ground if you had to ignore other components of Catholic social doctrine, like subsidiarity, to make your point.

    “It is mean to say that poor people should just beg people and count on the charity of some doctors in some cities to provide free health care.”

    No one is promoting this, but since you bring it up, charity freely given is always preferred to government redistribution. This isn’t just my opinion, it’s what the Church teaches. Paying your taxes isn’t an act of love equal to giving of oneself to the needy; be that of time, talent or treasure.

    “By the way, in my state, there is no free hospital for people who are uninsured.”

    Hospitals in the U.S. are required to treat the uninsured. Does that make it a free hospital? Everyone sees a need to improve our health care system, but happens to be the finest in the world and NOT in need of fundamental reform.

    “Now you are bashing the voice of the Catholic church–the USCCB.”

    This is perhaps the source of your confusion. The USCCB is NOT synonymous with the “voice of the Church.” It is a bureaucracy that often falls short, as in the present case, to teach the fullness of Catholic teaching. If you want to hear the voice of the Church, read your Catechism, listen to your bishop when he teaches in union with the Holy Father, study the councils and papal documents, etc… and you will learn a whole lot more about what this health care situation demands than the Conference ever gave you.

  • ilovefaithfulcatholicism

    It is a sad time in the U.S. when a small minority can manipulate our system of government to bring about the complete re-structuring of such an important area for all citizens as our health care. Please consider the following:

    — The plan was contrived in secrecy by left wing Democrats without compromise or public input.

    — It sets exremely damaging precedents by the forceful and subversive way in which this plan went through the legislative process without going through normal committee hearings and conference committees.

    — It includes many anti-life, anti-family, anti-freedom, and anti-democratic provisions that will negatively most of the U.S. population, the stability of the U.S. budget, and the financial well-being of other social programs,such as the Medicaid and Medicare Systems, which are approaching financial collapse.

    — The remaining credibility of all public and religious leaders and organizations who support the health plan is in grave danger. Most Americans support fixing the health care problems and they could have been fixed in far simpler and less costly ways, without undermining our health care system and the foundations of our democratic republic.

    — It will drive many health professionals to quit and impose huge reductions in health services for all and many reductions in coverages for those on Medicaid and Medicare.

    — It includes rationing of health services affecting people of all ages, especially the old and infirmed, as well as controlling all “health” related activities.

    — It was adopted without the openness and other protections promised many times by President Obama.

    — It will NOT lower health care costs and it will NOT improve our health care system.

    — Most Americans will be taxed heavily for next 3-4 years before the system even starts coverage. However, we can expect a MAJOR CHANGE IN THE FIRST YEAR that would allow health coverage to start immediately, causing the borrowing to sky-rocket soon after the plan is adopted. (If anyone denies this, how can they be believed since there is so much deceit coming from Pelosi-Reid-Obama?)

    — Future generations will pay heavily for these costs and for a huge expansion of federal employees at wages far above the average wages in the private sector.

    — It could be used a model for other measures to strictly control or eliminate our other freedoms, including the freedom of religion and speech. (Such a precedent could be used by the extreme left or extreme right, and this whole process should be strongly rejected by all public and religious organizations.)

    — First caution to all: Be very careful as the government amasses huge new powers and funding.

    — Second caution to all — including religious organizations: Think carefully before supporting this new health care plan — If even part of the above comes true, you will be blamed for contributing to the destruction of the U.S. health care system and the U.S. economy.

    — All Catholics and others should hope this health plan will be discarded and Congress starts over to do it right this time.

    “By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending.” (Pope John Paul II, Centesimus Annus #48)

    These are not normal times. Please pray and fast for everyone involved.

  • GaryT

    “The state which would provide everything, absorbing everything into itself, would ultimately become a mere bureaucracy incapable of guaranteeing the very thing which the suffering person—every person—needs: namely, loving personal concern.” Love is the domain of the church, according to the two great commandments. “Love—caritas—will always prove necessary, even in the most just society. There is no ordering of the State so just that it can eliminate the need for a service of love. Whoever wants to eliminate love is preparing to eliminate man as such. There will always be suffering which cries out for consolation and help. There will always be loneliness. There will always be situations of material need where help in the form of concrete love of neighbor is indispensable.”

    charity “does not simply offer people material help, but refreshment and care for their souls, something which often is even more necessary than material support. In the end, the claim that just social structures would make works of charity superfluous masks a materialist conception of man: the mistaken notion that man can live “by bread alone”

    – Pope Bendict XVI, God is Love

    I think these are very important points for us all to consider on and meditate on.
    And yes, I do contribute to charities (a lot more than Joe Biden) that help people with their physical health and more importantly to help with their spiritual health.

    On a more practical note, every social program to date has succeeded in running massive deficits. Did you know that unfunded US government obligations amount to about $60 trillion??? This works out to about $200,000 per person. If you don’t think you have that kind of money to pay your share of the debt, then you should look more closely at how that money is being spent. By the way, running massive debts now and sticking the debt on our kids is theft (which is a violoation of a commandment) and is also taxation without representation, since our children have to pay taxes that they never had the opportunity to agree upon.
    Further, many social programs have encouraged immoral behavior that is damaging to society as a whole.

    Providing healthcare for people who cannot afford it is a good and noble thing. We need to honor the principles of justice and charity when we do.