Friday, August 28, 2009

Letting the Perfect be the Enemy of the Good

In a New York Times article today, a number of prominent Catholic Bishops came out against President Obama’s healthcare reform. The objections varied, from the seemingly Cold War minded Bishop R. Walker Nickless insisting, “The Catholic Church does not teach that government should directly provide health care. Any legislation that undermines the vitality of the private sector is suspect,” to the more conventional objections that in a federal plan, federal money would be used for abortions, ostensibly indicating a government endorsement of the procedure. Some bishops, like Bishop Nickless, believe “No health care reform is better than the wrong sort of health care reform.” My goal with this post is two fold. First, let’s take the abortion issue head on. I was raised Catholic and spend fourteen years in the Catholic education system, I’m going to tell you what I think and it’s a position, I believe, shared by many Americans. Second, let’s talk about the opposition of some bishops, but also the support from others.

I am opposed to people getting an abortion. I believe personal responsibility begins before conception and those unwilling or unable to handle the responsibility of having a child need to be mindful of the decisions that make prior to conception. That said, I consider myself pro-choice. I am pro-choice not because I am pro-abortion, but because we step on to treacherous ground when our government outlaws medical procedures primarily because of religious beliefs. I don’t think I’m in the minority of people when I say I don’t want people to have abortions, but I also don’t want to criminalize it. I don’t want to see federal money used on abortions, because I respect that a good portion of the society objects to it and there are ways to work around it. I would support legislation that makes this possible, but I won’t demand some bold-faced clause that says “Federal funds will never be used for an abortion.” It seems so simple, but that’s not how good laws get written. There are simply too many unanticipated scenarios in the real world that don’t allow for that kind of simplicity. So I'd rather people not have abortions, but I am not self-righteous enough to believe my beliefs are the only right beliefs, and I’m not so simple-minded to demand a simpleton clause that could expose thousands of well meaning doctors, nurses, and administrators to prosecution for doing their job and making the tough choices.

Of course the oft derided “Obamacare” would not be the first federally funded healthcare program. Currently for Medicaid, many states do not allow public funds to be used for abortions. This is not sufficient for the protesting bishops. They want a different model and some, like Bishop Nickless, would rather see the whole thing fail than to negotiate.

And that is the problem with so many of the current healthcare reform opponents. They simply oppose reform, but to disguise their intransigence on the issue they pick and choose every little thing they can and say they only oppose this part or that part. What you don’t hear from these protesting bishops or the conservative talking heads are viable alternatives. If this sounds like what I said in my last post on healthcare it’s only because it remains true. The opponents to reform are so intent on preventing reform and so disinterested in solving a tremendous issue, both as an issue of social justice and as an issue of spiraling entitlements, that they simply poo-poo any idea straying from the status quo. When I last posted on healthcare it led to a spirited and largely reasoned debate in the comments section between Colin, Ben, and I. I still disagree strongly with Colin and think he puts too much faith in capitalism. I also think his plan (a plan I have heard from some corners of conservatism recently) creates a wide gulf between the two sides, though perhaps not an insurmountable one. Despite our disagreements, in our discussion there was a point of agreement. Every American has a right to healthcare. I couldn’t wrest from Colin support that it is a moral imperative, but then again talking of moral imperative makes me sound a bit more like a priest…or a bishop….

And that is why I’m encouraged by what I hear from so many other Catholic bishops. They share the concerns of the protesting bishops that federal funds not be used for abortion, but they feel (which is in line with the broader themes of Catholic teaching) that healthcare is a right. They want to come to the table and participate in the shaping of this legislation. They know there will be compromises and they know what they’re sticking points and non-negotiables are. They have stated them plainly, but they still want to work with the president and Democratic lawmakers to find a solution. Access to healthcare is a right, and I don’t believe the quantity or quality of care should be conditional based largely on one’s socio-economic situation. We need change and we need to negotiate. What we don’t need is a cadre of protesting bishops so transfixed on one element of a much broader reform that they would let the perfect be the enemy of the good.

1 comment:

Colin said...

Three points:

1. Health care is not a right. Let me defer to someone smarter than myself for that argument:

A right cannot be rationed, while health care can.

2. I've already noted that alternatives to current health care proposals have, in fact, been offered by GOP members of Congress. John Mackey, CEO of Whole Foods recently offered some suggestions that he says have been proven to work at his company. For that he has been threatened with a boycott.

Rep. Tom Price alleges that Democrats have not even let Republicans provide input on current legislation:

From a more practical perspective conservatives do not possess the votes to get any legislation passed.

3. There is no system in existence where everyone gets all the health care they need or want. None. All face the problem of limited resources. The debate, therefore, should be over which system most efficiently allocates those resources. Time and time again this has proven to be the private sector, spurred on by competition. Government is synonymous with inefficiency and waste. Indeed, where government has involved itself in health care the results have been typically poor, both on the federal (Medicare trillion in the hole, something everyone agrees on) or state levels (attempts at universal or near universal care have run into extreme problems in TN, OR, MA and ME).

There is absolutely no reason to think that more government will prove to be a solution this time around. Indeed, for an administration that prides itself on bold and innovative thinking it's regrettable that it is simply recycling past approaches that have shown not to work.

What would be truly bold and innovative in health care would be choice and competition. Allow the purchase of insurance across state lines. Ease licensing requirements to increase the number of doctors and other medical professionals. Revise the tax code to eliminate the linkage between health care and employment. Stop mandating what has to be included in insurance coverage, which simply drives up costs.

None of these, however, are on the table or even being discussed. It's simply more rules and regulations, which is unfortunate.