Christian Action League
By L.A. Williams, Correspondent
Updated Text (September 25, 2009)
RALEIGH — High premiums, exclusions for pre-existing conditions and little to no coverage for preventive treatment — it’s no wonder that many Americans are unhappy with their health insurance. Add to those the estimated 15 percent of U.S. residents with no coverage at all (according to the U.S. Census 2008) and it’s clear the healthcare system needs help. But what that help should look like is another question altogether — one that, for Christians, should include concerns about publicly funded abortion, euthanasia and other ethical issues.
“With healthcare plans being bantered about, protests and so much rhetoric going on, not to mention that the Congressional bill is more than 1,000 pages long, it is tempting for citizens to simply tune out and bury their heads in the sand until the smoke clears,” said the Rev. Mark Creech, executive director of the Christian Action League. “But we urge folks not to do that. It’s important to look at exactly what these bills would do. That’s what we want to help sort through.”
In addition to H.R. 3200, the 1,018-page document passed by three committees of the House, there’s a bill that has been approved by the Senate Health, Education, Labor and Pensions (HELP) Committee and another introduced by Montana Sen. Max Baucus being eyed by the Finance Committee. The last two will likely be merged before being taken up by the full Senate.
Unfortunately, it appears that all three measures could increase federal funding for abortion, which is now limited by the Hyde Amendment (legislation that since the late 1970s has barred Medicaid from paying for abortions except in cases of rape, incest or to preserve the life of the mother.) Since the amendment, voted on annually, is a rider specifically to the Medicaid appropriations bill, it cannot be viewed as a protection against federally funded abortions offered via a separate health plan as some lawmakers have implied.
When the question of abortion arose during debate of H.R. 3200, Rep. Lois Capps (D-Calif.) offered an amendment that she argues will keep public funding out of abortion. She says that under the bill, even though the Secretary of Health and Human Services may allow the public portion of the healthcare plan to cover abortions not allowed by Hyde, those procedures would be paid for with “segregated private funds.” But the National Right to Life Committee has pointed out that a federally run healthcare system, by its nature, operates on “public” funds despite the fact that those funds were once in the pockets of private individuals. Simply renaming them “private” because they are not proceeds from taxes, but insurance premiums, doesn’t change that fact. NRLC points out that insurance premiums, once they leave Americans’ pockets are no more “private funds” than the money we pay to the IRS for income taxes.
As for the Senate bills, in its current form the Baucus measure would give federal subsidies to both private insurance plans and government-chartered cooperatives that pay for elective abortions; and the HELP bill, as a result of an amendment from Sen. Barbara Mikulski (D-Md.), would force insurance companies to contract with abortion groups like Planned Parenthood.
“The Baucus bill goes even farther by mandating that there be at least one health plan in each region across the country which covers elective abortions,” said Tony Perkins, president of the Family Research Council. He is calling on Christians across the nation to contact key senators and urge them to vote for changes introduced by Sen. Orrin Hatch (R-Utah) and expected to be discussed in the Finance Committee on Tuesday.
“Sen. Hatch has introduced several amendments that would prevent government funding for abortion and would protect current conscience laws for health workers,” Perkins wrote in an Action Alert. He named the following key senators who need to hear from pro-life supporters: Sen. Jeff Bingaman (D-N.M.), Sen. Thomas Carper (D-Del.), Sen. Kent Conrad (D-N.D.), Sen. Blanche Lincoln (D-Ark.), Sen. Bill Nelson (D-Fla.) and Sen. Olympia Snowe (R-Maine).
As the legislation now stands, Douglas Johnson, legislative director for the National Right to Life Committee said the pro-life movement should go to “Condition Red” on all three bills because of their “mortal threat to the unborn.”
Threats to those at the other end of the spectrum — America’s elderly — should also be a concern as Christians eye the healthcare plans. Fears have arisen, perhaps not so much because of the Congressional bills’ wording, but because of the culture that some say would be created by the “advance care planning consultations” that Medicare recipients would be offered at least every five years, when they have significant health changes or enter a nursing or long-term care center facility. Already, Medicare recipients can request a 40-minute session of advanced care planning counseling for which doctors can bill Medicare $92.33. But H.R. 3200 would include a more extensive session, which could be initiated by a doctor, physician’s assistant or nurse practitioner.
This consultation — which would inform the patient about the gamut of end-of-life care options available — could legally be refused. But the fear is that seniors — many who have always acquiesced to their white-coated physician — might feel pressured into signing an end-of-life plan to cut short their own care. In fact, rather than suggesting that the patient take their new knowledge of care options home and give them some thought before settling on an advanced care directive, the paperwork will be ready for them to sign on the spot.
Some lawmakers were so concerned about what seniors might be advised during the sessions, as pressures to cut cost mount, that they called for an amendment, introduced by Rep. Mike Ross (D-Ark.), to specifically prevent counselors from mentioning suicide or assisted suicide.
The concern over the counseling and how it might, purposefully or inadvertently, encourage euthanasia, led Baucus to keep the counseling out of his bill. However, under his legislation physicians in the top 10 percent of medical resource use by 2015 would face financial penalties — a move that could pressure doctors to limit health care for their older patients.
As for the so-called “death panel” rumors — the idea that the healthcare plans would set up boards to determine who is worthy of how much care, there are no such specific provisions in any of these three bills. However, President Obama’s appointees will determine what insurance plans and Medicare will cover, which is why the healthcare philosophy of one of his highest ranking officials has created so much controversy.
Dr. Ezekial Emanuel, health policy adviser at the Office of Management and Budget and a member of the Federal Council on Comparative Effectiveness Research, has said doctors should be trained to offer “socially sustainable, cost-effective care,” meaning that their medical decisions would not be based solely on the needs of the individual but also with an eye toward how limited resources would best benefit the society at large. In an article in the Jan. 31, 2009 Lancet, Emanuel and others laid out a “complete lives system” in which those ages 15 to 40 would have the most access to medical interventions, with those younger or older receiving less. He also suggests reducing health-insurance costs by paying for new treatments only when the evidence shows that the drug will work for a majority of patients. He would like to see a decision-making body set up to approve or deny new medicines and set limits on how much will be spent to extend a life.
“These ideas of choosing whose life is most valuable and whether or not the healthcare system should invest in someone who may not have many years left are troubling to say the least,” said the Rev. Creech. “Each life is God-given and precious and we should do all we can to preserve it.”
Creech urged Christians across North Carolina to not just follow the healthcare debate but to weigh in on ethical issues by contacting their North Carolina Congressmen and Senators and urging them to fight for a plan that doesn’t fund abortions and demands compassionate care for all.