Busted Halo
feature: politics & culture
April 20th, 2010

Abortion and Health Care Reform

Pulling Together After a Missed Teachable Moment



Gratitude and gloom colored my view of the debate over health care reform.

On St. Patrick’s Day 2009, I learned that my chronic leukemia had morphed into a much more formidable lymphoma. It was not, statistically speaking, the cancer one would choose, especially as a husband and a father with two teenaged sons and a 20-year-old daughter. But I had sound health insurance, which allowed me the best treatment at one of the nation’s best hospitals. I was, therefore, especially grateful when reminded about the tens of millions of other Americans who lack medical insurance altogether.

The gloom descended when legislative dynamics seemed to pit the demands of Social Justice against the rights of the Unborn. The conflict was no surprise. Years ago, in sadness and frustration, I left the Democratic Party, unable to abide any longer its mindless pro-choice orthodoxy. At the same time, I had no illusions about the Republican Party’s building the “Culture of Life” which George W. Bush talked about (after electorally exploiting his Texas record of capital executions but before misleading us into Iraq). And politics is politics.

No, the conflict brought no surprise. But the Uninsured vs. the Unborn had the makings of especially stark tragedy.

My sense of tragedy, I confess, was heightened at times by a laughably self-centered fear as to what major political event I would last witness (earthside). Specifically, I feared departing while watching a major affront to the seamless garment — the commitment to a consistent pro-life philosophy.

I held and hold the seamless garment precious. It sustained me during my seventeen years defending death row inmates and capital defendants in Alabama and New York. It animated my writing. It accompanied me into any voting booth I entered. It has served as my tent, my flag and my sail.

Given the depth of voter opposition to publicly funded abortion, how difficult would it have been for a unified pro-life community to lock in, as part of a universal coverage agreement, the kind of steel-trap language the Stupak Amendment contained?

And what a symbolic, as well as substantive, victory it would have been. Protection of the less advantaged from illness, while safeguarding the unborn — what a rebuke to those pro-choice wags who caricature us as caring for life only from conception to birth.

Sadly, party allegiance trumped pro-life principle.

Now I envisioned mockery of the seamless garment by either the further indefinite postponement of universal health coverage or the enactment of reform that would increase the number of abortions in America. At my most pathetically maudlin, I fancied myself akin to members of the San Patricio Brigade, the Irish soldiers who switched sides in the Mexican-American War. Moments before hanging they had to witness the Mexican Army’s final capitulation.

But it wasn’t all in my morose imaginings. Objectively, at the intersection of health care reform and abortion there indeed awaited not just two potential tragedies but three. The first, the defeat of health care reform, has been averted. (Harvard Medical School researchers have estimated that lack of universal coverage has meant 45,000 unnecessary deaths annually.) The second, an increase in the number of abortions, could still unfold. (In contentious yet civil exchange last May on abortion and the Obama presidency, Douglas Kmiec and Robert George seemed to agree that federal funding could potentially increase abortions annually by the hundreds of thousands.) Whether that second tragedy does unfold, though, depends on whether we learn from the third tragedy, which has already occurred, the tragedy of the missed teachable moment.

A missed teachable moment

We need to look mainly ahead not back, but let’s be honest. Had the pro-life community pulled together across party, interchurch and intrachurch lines, it’s a certain bet that 100%-guaranteed-belts-and-suspenders “abortion neutral” reform (to use the United States Conference of Catholic Bishops’ term) would have been obtained.

Yes, Barack Obama campaigned on a hardcore pro-choice platform, but he has backed away from, for instance, the Freedom of Choice Act. More, both the White House and the Congressional leadership sorely wanted a bipartisan bill. Given the depth of voter opposition to publicly funded abortion, how difficult would it have been for a unified pro-life community to lock in, as part of a universal coverage agreement, the kind of steel-trap language the Stupak Amendment contained?

And what a symbolic, as well as substantive, victory it would have been. Protection of the less advantaged from illness, while safeguarding the unborn — what a rebuke to those pro-choice wags who caricature us as caring for life only from conception to birth.

Sadly, party allegiance trumped pro-life principle, pretty much throughout. Among Republicans, only one brave representative, Anh “Joseph” Cao (a former Jesuit from New Orleans), staked out a consistently pro-life stance by gaving support to the original House bill, which contained the Stupak Amendment. Senate Majority Leader Harry Reid, though long boasting pro-life convictions, vocally opposed the Nelson-Hatch-Casey Amendment, which the USCCB judged necessary to ensure abortion neutrality.

Sadder still was the mixed performance of Church leaders. The USCCB, to these ears at least, seemed pitch perfect most of the time. The question of whether the USCCB was wrong or right in opposing the House’s adoption of the Senate bill yields, for now, to good faith disagreement.

The USCCB was terrific, yet individual bishops disappointed. More than a couple seemed MIA. Worse, some appeared more intent on advancing Fox News talking points than explicating moral premises or unpacking prudential judgments. Visit some of the diocesan and archdiocesan web sites that still carry the past year’s statements by various shepherds. Sample the messages of let’s-not-rush-reform, the overemphasis of subsidiarity at the expense of solidarity, and the heavy-handed insinuations as to (government not insurance company) rationing and (government never insurance company) bureaucracy. Don’t miss, too, the subtle crediting of the “death panel” nonsense. You will wonder whether in some church circles the RNC playbook and Rush Limbaugh had edged out Benedict’s Caritas in Veritate and the Catechism.

But what is done is done; opportunities lost are lost. Work awaits.

Work awaits

But what is done is done; opportunities lost are lost. Work awaits.

Whether health care reform will result in an increase in abortions, on account of purported loopholes, or decrease, on account of better health services (including prenatal care), will likely turn on the vigilance of the whole pro-life community.

Whether health care reform will result in an increase in abortions, on account of purported loopholes, or decrease, on account of better health services (including prenatal care), will likely turn on the vigilance of the whole pro-life community.

In a better world, final heath care reform would have contained the Stupak Amendment. Pro-life Democrats would not even have had to consider compromising and accepting in trade Obama’s executive order forbidding federal funds going toward abortion. Those who dismiss that order as empty, however, overlook, among other things, its recognition that “it is necessary to establish an adequate enforcement mechanism to ensure that Federal funds are not used for abortion services.” The pro-life community should be on this like white on rice.

Billions of dollars will go for community health centers. The USCCB fears that, statutorily, these funds could pay for elective abortions, notwithstanding contrary representations. While pledges remain fresh, pro-lifers need to ensure the prompt adoption of the promised “enforcement mechanism” that will guard against such spending. More, we need to make plain that our collective attention will never drift from the danger of such spending. Never.

Perhaps more subtle is the problem of federally subsidized insurance plans that allow for abortion coverage. All purchasers of such policies must pay a separate fee to cover abortion. Whether this actually keeps tax money from making abortion more available will depend on how closely insurance companies are monitored. Will they be kept from reaching outside this separate fee pool to reimburse for abortion services?

This still leaves the problem of the pro-life family for whom the abortion-covering plan offers necessary coverage, coverage not encompassed by available plans excluding abortion. These families should not have to choose between contributing to a discrete abortion-services pool and ensuring that husbands and wives, daughters and sons, have access to the range of services required by their particular circumstances. It would be a sad reform indeed that extends first-time coverage to millions of families while putting in a vice the consciences of other families.

The number of pro-life families who will face this dilemma defies prediction. Still, we can say confidently that these situations will be fixable through unified pro-life pressure. Again, overwhelmingly, Americans, independent of opinions on abortion itself, condemn making people pay for abortion in violation of their personal beliefs. Armed with real-life instances of such injustice, the pro-life community can mobilize such sentiment and ensure whatever reforms the Reform may require.

Of course, this will require the pro-life solidarity so lamentably absent on the last go-round.

The Author : Kevin Doyle
Kevin Doyle founded New York's Capital Defender Office in 1995 and headed it until twelve years later when it brought an end to the death penalty in New York State. He gives daily thanks for his so-far-successful umbilical cord stem cell transplant.
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  • Lisa

    For those lamenting the “secularization” of our culture: There are countries that continue to have state-mandated religion. Perhaps you could move? I prefer to be able to chose my beliefs and not have something I don’t believe in forced upon my children.

  • kitchen opened,

    Uptight exposition. Beggars should not be choosers.

    what about the opposite take on that

    The Senate planned to begin debate as early as Monday on a bill that would increase spending on the State Childrens Health Insurance Program by $31.5 billion over the next 4 1/2 years. Congress approved a similar bill in late 2007 that former President George W.

  • Kevin Doyle

    April 27, 2010
    I appreciate the last week’s feedback, on line and off, concurring and dissenting. Allow me just two comments.

    First, for several years, I taught a course on the Death Penalty and this required me to delve into national polling data. I found only one poll that tried to match attitudes on the Death Penalty and attitudes on the Unborn. To my pleasant surprise, in that poll, nearly 30% were consistently Pro-Life. The most popular position was Pro-Unborn/Pro-Execution (the Bush-Reagan stance); then Pro-Unborn/Anti-Execution (the Dorothy Day-John Paul II stance); then Pro-Choice/Pro-Execution (the Obama-Clinton-earlier-Romney stance); then Pro-Choice/Anti-Execution (the Kerry-Kennedy stance). This made me realize that we, the Seamless Garment crowd, had an uphill battle but were a far more formidable group than reflected by the media or in electoral politics. Of course, the responses of Carol Crossed, David Allen, Wm. Doino, and Fr. Peter reinforce that fact. (Carol Crossed, by the way, is on the Board of Feminists Choosing Life in New York; this decidedly non-timid group presses a Consistent Life Ethic as creatively as any I know).

    Second, Wm. Doino makes an important point to which I would like to add. Our Faith provides many things. It provides First Truths. And, almost as important today, it provides a place where we can tune-out the din of our consumer culture and hear ourselves think about those First Truths and everything else. Mindfulness is in short-supply. Sometimes it seems like we suffer National ADD. Our Faith provides a refuge, some quiet and perspective, Eternal (one hopes) but temporal too.

    Faith can also lend us the energy necessary to ensure sound prudential judgments. Prudential judgments among people of good will may, as Wm. Doino observes, differ. (The contrasting final votes of Rep. Cao and Rep. Stupak, whose departure from Congress Sean rightly laments, evidence this.)

    But people of good will are bound to come together in prudential judgments more often if we all demand that prudential judgments reflect not only a clean heart but a clear head.

    This means charitably challenging the reasoning of those who would deny protection to the Unborn or the Uninsured. It means, for instance, asking our Pro-Choice friend how passage through the birth canal or viability mark the sudden personhood of a creature that has had measurable brainwaves for months. It means asking the Anti-Health-Reform friend who objects to cost just how it is America can annually spend billions of dollars on pornography and tens of billions on beer but not afford universal coverage. (Yes, our country must, like a family, live within its means, but what family withholds medical care from certain members?) It means asking the Pro-Choice friend who says we need legalized abortion for rape victims, just what percentage of abortions arise from rape. (Thankfully, it is a minute fraction.) It means asking those who bear frightful anecdotes about universal coverage elsewhere just where the repeal movements are in those countries. (Even at the height of Thatcher’s Market-enthusiasm the abolition of England’s National Health Service was not a possibility.)

    Fostering sound prudential judgments takes honesty but at least as much demands homework and a stomach for rigorous engagement. A Faith-anchored life helps on all fronts.

  • Fr. Peter

    Hello Kevin!
    Well done! We can have both: good heath care for all, and a society that protects and defends human life from conception until natural death. Thanks!
    Fr. Peter

  • William Doino Jr.

    Bravo to Busted Halo for publishing a serious, conscientious and thought-provoking piece.

    I think one of of the problems Kevin points to, in promoting a well-rounded pro-life culture, is the profound secularization that has overtaken our culture, and the ways it has affected the Church. All too may Catholics learn their views about abortion, healthcare and social justice, not from the Catechism and the great papal encyclicals, but from listening to what our culture tells them; and what our culture tells them is often un-Catholic, if not anti-Catholic. Hence, we need to rescue ourselves from these negative influences, and study what the Church itself actually teaches. Granted, applying Catholic principles in a successful legislative way, in the American republic, often involves difficult prudential judgments that people of good will can, and do, disagree about; but in order to even begin that debate, we need to understand those principles in the first place.

    With regards to abortion, which has been at the center of this debate, I would hope, going forward, that the pro-life community will be able to strengthen and solidify legal protections for the unborn, and where they are missing, re-insert and pass them. (Ditto pro-life conscience clauses and protections). This can be done even as we continue to debate how best to implement effective health-care reform, reduce poverty and advance social justice. One of the encouraging signs of recent times is the increasing amount of pro-life sentiment in the general population, especialy the young.

    Despite our society’s pervasive secularization and all the things to lament, there are more positive signs now developing, and we should build upon them, putting our faith into action, and thus elevate our Church.

  • Sean

    I regret that Rep. Stupak felt compelled to retire, rather than seek re-election. This very decent man, who waged a principled fight virtually alone, deserved better from both sides of the debate.

  • Matt

    The death panels aren’t gone.

    My relatives neglected to death by “universal” health care in Canada are still dead, while my friends here in the US who survived the same cancers are (praise God and the American medical system) still alive (one has been asymptomatic for five years, which makes her statistically no more likely to die of cancer than any random person off the street, the other hasn’t gone five years yet but nevertheless shows all signs of complete and permanent remission, thanks to the prompt diagnosis and treatment she’d never be able to get from the government).

    Dogs and cats in “universal care” countries can still get MRIs with no waiting while human women must stand in line for months waiting for a mammogram, while the cancer many of them have in their breast grows beyond the point where it can be treated effectively.

    We still face a future where any medical treatment some government bureaucrat decides is less cost-effective is banned, even for those who will die without it.

    We still face a future where every American must either pay for the murder of innocent children or go to prison. And we still face a future where euthanasia becomes more widespread and more encouraged (and almost certainly eventually mandatory).

    And we still face a future where health care institutions funded by the largest charitable society in the history of mankind, our Church, are faced with a choice of either rejecting the moral teachings of that Church or else shutting down.

    We are not permitted to do evil in the hope that good might come out of it. The health care bill is evil. Whatever good one might imagine will result from it, formal and material cooperation with evil nevertheless renders the act evil, regardless of motive.

  • David Allen

    Excellent article, we will pray for you… We live in the UK which has had universal health care for many decades. You are spot on with your point on where we will be going forward. It is up to all of us to intercede and work on behalf of the unborn… The job now has begun, God bless you

  • Carol Crossed

    Kevin seems to hold both the value of the unborn and the value of health care in tandem. A very brave and Truthfilled place to stand. Can I stand there too? I am really really really going to try to stand four-square on the side of both/and rather than either/or.

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