Moral Guidance on Health Care Reform

The United States Senate is currently struggling to draft a health care bill to replace the Affordable Care Act. The House previously passed a bill, but the Senate has essentially gone back to the drawing board and is trying to develop their own unique bill. Both in its politics and policy details, the process of doing so is mind-numbingly complex and difficult, and the results will have a tremendous effect on the lives of all Americans.

But the moral aspects of this kind of legislation are equally momentous in their importance. All legislation involves moral decisions about what to permit or prohibit, what to promote or discourage, what to spend money on and what to defund. Legislation like a health care bill is particularly fraught with moral dimensions that no “scoring” from the Congressional Budget Office can measure.

This is where our legislators need to listen to the advice of our Bishops, who have been examining this health care reform process for decades, and who have essential moral guidance to offer. In a letter sent to the Senate on June 1, the bishops who chair four major USCCB committees (including Cardinal Dolan, the Pro-Life chair) offered a clear moral template for any health care bill. As always, the bishops expressed their concern for how legislation would affect the most vulnerable people, including low-income people, immigrants, and the unborn.  But the principles they laid out are even broader:

  • No Affordable Care Act repeal effort should be undertaken without the concurrent passage of a replacement plan that ensures access to adequate health care for all.
  • Respect for life: No health care reform plan should compel us or others to pay for the destruction of human life, whether through government funding or mandatory coverage of abortion. Long-standing “Hyde Amendment” protections must extend to any relevant health care plan in order to prevent federal funding of abortion and not as a temporary fix or future promise. Federal resources must not be used to assist consumers in the purchase of health care plans that cover abortion.
  • Access for all: Reform efforts must begin with the principle that health care is not a privilege, but a right in keeping with the life and dignity of every person. All people need and should have access to comprehensive, quality health care…  
  • Truly affordable: Many lower-income families simply lack the resources to meet their health care expenses. The Bishops have serious concerns about structural changes to Medicaid that would leave large numbers of people without the coverage they now rely upon, including those who gained access to care as part of the Medicaid expansion that came with the ACA. Reform also ought to address barriers to affordability for those living above the poverty level but who are still working hard to make ends meet.
  • Comprehensive and high-quality: Health care is much more than mere insurance. Other aspects of health care policy require the attention of policy-makers: … focus on the maintenance and promotion of good health as well as treat disease and disability for all people, regardless of means; Incentives for preventative care, early intervention and maintaining a reasonable choice of providers… encourage individuals to develop a sense of ownership over decisions that affect their health and well-being; encourage people to enter medical professions, and which foster more humane and responsive relationships between doctors and patients…
  • Honoring conscience rights: Congress should expressly provide conscience protections for those who participate in any way in health care. Such protections should extend to all stakeholders, including patients, insurers, purchasers, sponsors, and providers.

Crafting complex legislation is not a pretty process, and inevitably involves many political compromises and imperfect solutions. But health care is too important a human right to be left entirely to amoral market forces, or to the often-immoral intrusiveness of government regulations. Either approach values ideology over people, and endangers lives of vulnerable people. One need only think of the massive funding and support provided to the abortion industry, regulations that violate religious freedom and seek to coerce cooperation in immorality, or the heartless attitude of insurance companies that will pay for suicide drugs but not for chemotherapy.

Congress has a difficult task in front of it. But our bishops have given much-needed guidance, and we should urge our legislators to heed it. The common good of our society, and social justice for all, is too important to leave to a debate that focuses only on political and economic concerns, and not on morality.

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