Busted Halo
feature: politics & culture
November 4th, 2009

Health Care Reform and Catholicism Revisited

A follow-up as the debate enters its final stage



Thousands of you read, responded to and shared my August piece about the health care debate and Catholicism. We are now in the final phase of the Congressional process and some things are clearer than they were then. Catholic Church leaders wanted undocumented immigrants included in the bill. They are not. Sadly, the Church stands almost alone among organizations in this country in its concern for the undocumented. They wanted universal coverage, and to the surprise of many, it looks like it will happen.

But, though the House bill does not fund or encourage abortion services, the bishops and most Catholics wanted specific language keeping abortion out of the bill entirely, and making it impossible for a future administrative action to change this, effectively bringing the Hyde Amendment into the bill and codifying it in a way that is stronger than its current status. This still could happen, as pro-life Democrats take up the cause. But what if it doesn’t?

The US bishops have a clear answer: Kill the bill. The US Conference of Catholic Bishops began a massive final push on health care this past weekend, hitting 17,000 parishes with a bulletin insert and email campaign to be distributed over the next few weeks. The bishops’ final stand on the absence of strong enough pro-life language: “If these serious concerns are not addressed, the final bill should be opposed.”

But what of universal coverage? What of help for the uninsured, some of whom die and suffer for lack of medical care?

In September, Cardinal Renato Martino, head of the Vatican’s Pontifical Council for Justice and Peace, expressed a very different view, equally grounded in Catholic teaching. Having lived for 16 years in the US, Cardinal Martino said he “could never explain” the fact that a large number of Americans lacked health care assistance, something every other developed nation provides for its citizens, concluding, about President Obama’s efforts for health care reform, “So I cannot but applaud this initiative.”

As I said in my earlier piece, if you oppose the bill on the basis that it should do more to exclude abortion, recognize that choice leads also to denying health care coverage to tens of millions of Americans — your neighbors — whose quality of life would be improved and some of whose lives would be saved.

The bishops’ press release accompanying this latest push reiterates that church teaching says “health care is essential for human life and dignity,” while also saying the bishops “recoil at any expansion of abortion.”

And that’s the point. Both issues are involved and there’s no way to separate them.

There is an imbalance here

But to me, there is an imbalance here. On one side is an incremental political victory — not even a change in current practices. On the other is a massive improvement in the social justice of this nation.

This is the first time in 60 years that a health care reform bill with universal coverage will be before the full Congress, rather than getting killed in committee. The insurance industry and others who profit off of the current system are scrambling to thwart yet another attempt to provide universal coverage to poor Americans.

Which side of this does it feel to you like the Catholic Church should be on?

Denver Archbishop Chaput’s column on Monday, November 2, explaining his frustration with the process, is moving and relatively balanced. The USCCB’s press release stresses that they have always stood for universal coverage. Unfortunately, this kind of nuance is lost in the fistfight of politics and in the headlines of a press that loves to make things look acrimonious.

But it’s one thing to recoil at the prospect of an expansion of abortion. It’s another to actively fight against something that is “essential for human life and dignity.”

I know from many conversations over the past year that many Catholics feel the nagging sense that our Church should have been a leading voice in the battle for universal coverage rather than a special interest speaking mostly about abortion.

Anthony Stevens-Arroyo says, in his latest Catholic America column in the Washington Post‘s On Faith section:

“Talking with ordinary Catholic lay persons in the pews… While some of us have higher levels of awareness or commitment to one side or the other of the partisan divide, most people in Catholic America want peace and justice as much as they want the right to life. Catholics look to our Church for unity in the things that matter and expect our clergy to help us think clearly about moral issues when deciding things politically — but not make those decisions for us.”

What the fuss is about

Without getting bogged down in the details, I think it’s important to give you a clear snapshot of what the actual Washington debate is about, free of the rhetoric of activists on both sides. As this goes to press, here’s the narrow issue with the House bill that is causing all the heat: Remember all the fighting over the “public” option? The compromise in the current bill is a government-coordinated, but not owned, “marketplace” where the uninsured can buy cheaper insurance, and those who can’t afford even those lower prices will get subsidies. The existing bill says that a private health care policy bought through this marketplace can include abortion services, but only if those services are funded from the private payments — no funds derived from government subsidies can be used for abortion.

On one level, of course, this is just moving money around. But it is consistent with the idea that no government funds be used. The alternative — forbidding such coverage in any plan that is part of this marketplace system — would mean that the poor, self-employed, and those employed by a company that doesn’t provide insurance could not purchase a plan through the marketplace that included abortion coverage even though their plan is entirely private. This would be an expansion from where we currently are. The Hyde Amendment forbidding federal funding of abortion services has been the law of the land from many years, though, so pro-choice lawmakers may accept its incorporation as a concession.

(There is also a current requirement in the House bill that this regulated marketplace must include at least one plan in any region that does offer abortion services. I can imagine no compromise that would make this palatable to pro-life advocates.)

It’s worth note, though, that abortion is unusual in how this funding argument is made. Do you hear many (any?) pro-life advocates making similar arguments to separate out the tax dollars that go to state executions, war or other anti-life acts? Refusing to pay their taxes unless no tax money at all is used at all for these things? When government gets involved in social problems, social debates get dragged into the political sphere, and not everyone shares the same social values. This is part of democracy.

Where do we go from here?

I understand the distrust at play. Clearly the reason some factions of the Democratic coalition vehemently oppose the amendment from pro-life Democratic Representative Bart Stupak, which would add the Hyde Amendment-type language, is that they hope some day to broaden the national health care plan to subsidize abortion coverage. Could a future administration try to do this? Yes. Could the current one go back on its word and do so? Highly unlikely but technically possible. But I know from my years in politics that things can always change. A victory today can be undone with the next election. All you can do is work towards your principles and preferences. No “battle” is ever “won.”

So pro-life advocates should fight to pass the Stupak Amendment, to codify the anti-federal-funding language. But if they fail to achieve that goal, that fight is for another day — one more step forward or back in the ongoing struggle. The choice then before us all will be whether to stand, as Catholics, as Christians, as people of faith and conscience, with one of the biggest social justice improvements of our lifetimes, or to obstruct and possibly even defeat it in the name of politics.

People complain about the absurd length of the House bill (around 2,000 pages). Like it or not, this is how law happens in America. A two-party parliamentary system generates complex compromises, not clear simple declarations. If you withhold support for any health care reform bill that isn’t perfect, you may maintain purity, but you will never see reform. That’s not amoral realpolitik; that’s reality.

Much as pro-life advocates may wish otherwise, abortion services are legal in this country. And, much as pro-choice advocates may wish otherwise, the ban on government aid paying for abortion services is also the law of the land. If neither side tries to use the current health care debate as an opportunity to change those two facts, then a compromise that will bring universal coverage to America is possible.

Not all choices in life are black and white (in fact almost none are) and we are called upon to use discernment and make difficult decisions about things that affect us, and sometimes others. This is one of those moments.

The Author : Phil Fox Rose
Phil Fox Rose is content manager of Busted Halo. He's a writer, editor and content lead based in New York and writes the On the Way blog at patheos.com. He is coordinator for the New York City chapter of Contemplative Outreach, helping promote centering prayer, which has been his contemplative practice for nearly 20 years. Phil has also been a political party leader, videographer, tech journalist, punk roadie, software designer, sheepherder, stockbroker and downtempo radio DJ. A common thread is the process of learning about stuff, figuring it out and then sharing that understanding with others. Follow Phil on Facebook here. Or on Twitter here. philfoxrose.com.
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Please note that the editorial staff reserves the right to not post comments it deems to be inappropriate and/or malicious in nature, as well as edit comments for length, clarity and fairness.
  • Matt

    Many people are indeed dying every day because they cannot get medical care. The care they need isn’t on the list of treatments that their governments will pay for, and so (unless they happen to be wealthy enough to come to the United States and live here for the duration of treatment) they die. I have relatives dead of diseases that are almost always survivable in this country, but they died either because government bureaucrats decided their lives weren’t worth saving, or because the shortage of doctors, nurses, and technology caused by government health monopolies led to long waiting lists for basic diagnostic procedures.

    Even if we manage to hold off abortion funding in PelosiCare, it will still result in more death. And I’m speaking now of the deaths of adults, as well as children.

    The bishops’ opposition to abortion funding is commendable. Their single-minded focus on it, and willingness to encourage a disastrous course if only it doesn’t immediately and directly fund abortion is a serious mistake.

  • Joanna Somerville

    Many people are dying everyday because they cannot get medical care. Obortion is a decision for the future for some . Many Catholics would rather killa person and believe that it is alright but save the unborn so that they may be killedby this hate later.

  • Erin Aldrich

    This is the first well-articulated Catholic approach to the health care debate that I’ve heard. I’ve frankly been stunned that the Bishops have chosen to ignore the fact that the fight to defend human dignity goes beyond preventing abortion. It is an assault on human dignity when people do not have access to the health care they need.
    If we believe in a right to life, don’t we also believe in the right of someone who is ill to do whatever they can to get well or extend their life? What about sick peoples’ right to a dignified life?
    Thanks Phil – lovely article!

  • micaela swift

    “My point is and has been that those who‚Äôve been locked in the pro-life battle for years sometimes lose sight of the fact that anything else matters.”
    Anything else matters? What do you think abortion is? You cannot push it aside just because you are hoping to jump for joy on an issue such as universal healthcare. You’re completely missing the point that such an injustice and evil cannot be included in such a healthcare overhaul. So you cannot just dismiss the abortion issue “for now” like lib Catholics think. As a Catholic you do think for yourself, but you dont undermine the bishops who profess the Magesterium. If you do not know and understand the rtole of Bishops, the Pope, the Magesterium…you need desperately to re learn your Catholic Faith because you are completely astray in your logic on this issue of “universal healthcare with abortion” VS “universal healthcare without abortion”.

  • Fr. Mark A. McQuesten

    This conversation on the reform of health care is all well and good butis lacking in an appreciation that as a nation we simply cannot afford this type of program added onto Medicare and Medicaid. This is no right to universal health care. There is an imperative to help the poor and feed the hungry, but there is no imperative that requires the nation to go into debt and spend well beyond its means.

    The bishops are mostly concerned with keeping abortion from becoming federally funded and rightly so. But it is reckless to advocate that non-citizens and especially illegal aliens be incorporated into the health system. The bishops need to be interested in calling for balanced budgets, an end to wasteful spending and corruption as these too are good for the people and the nation.

    I would further add that the bishops would do well, if they are interested in limiting abortion, to start disciplining the “Catholic” legislators as they are the princpal source of our nations abortions woes.

  • David Spenard

    As a lifelong Catholic and an American who believes in the God-given right to life, liberty, and the pursuit of happiness, this article is rather disturbing. The ideas presented are based totally on the concept of thinking with your heart only, and leaving your head out of the process. There’s no argument that all life is precious and every human being deserves the dignity of being cared for in times of need. But to flat out suggest that Catholics are in support of illegal aliens is just downright absurd. These other countries need to fix their problems and then maybe people would stop coming here. But the irony is that the deeper this country falls into a hole, the worse the situation will be for everyone, including those that want to come here illegally.

    And for my second point, why does anybody in their right mind think that a government-run universal health care program will solve our health care ills? The government is a bloated, corrupt, inefficient bureaucracy that will grow to exorbitant proportions if this debacle is passed, and everyone will suffer because of it. What kind of social justice is that if everyone is knocked down a notch.

    The free market system works — period. If the government just got out of our way and let competition between providers open up across the country, then we would have over 1,700 providers to choose from, rather than just a handful in each state. Imagine when that choice is limited to one — the government. What do you think will happen then? There is no social justice in that.

    Wake up people. Our rights are being eroded little by little. The government wants to fully control health care, education, and energy. Once that happens, we no longer have our freedoms and we no longer have the United States. Use some common sense. The government is horrible at everything it does, except for the military. Health care run by the government will doom us all.

  • Zack Rowe

    There are many less expensive ways to reform heathcare in this country that haven’t even been tried This is a bad bill in so many ways that space doesn’t allow. Please lets get this done right.

  • Jan

    As a Catholic who has issues with the Bishops telling me how to think, I would ask them is not the health and well-being of millions a higher spiritual endeavor than anything that would stand in its way? MY Catholic religion is about love and good works and not about fear and greed. When did the Church become a single issue (abortion) religion?

  • amiehartnett

    Breaking news – House just passed the bill AND it includes the addition of the Stupak amendment: (fromHuffington Post):
    Stupak’s…amendment…would ban the public health insurance option from funding abortion and also ban any private plan operating within the exchange from funding abortions. Under Stupak’s plan, a woman buying private insurance from within the exchange with her own money would not have a choice of a plan that covered abortion.
    I wonder if the Bishops might be pleased about this latest development?

  • Margaret Wolford

    I am a life-long Catholic (62 years) who will support the bill without futher protection against abortion and for illegal immigrants. In my estimation, the US Bishops need to back up from the “all or nothing mentality’ that they have adopted and think about the positives rather than their “absolute’ negatives. Couldn’t the possibility exist that extending affordable coverage to more Americans might be the reason why someone decides not to have a future abortion? As well, couldn’t the possibility exist that the reduction in overall healthcare costs would allow us to more easily bear those associated with taking care of those who will still not be covered?

  • Niall McShane

    “I know from many conversations over the past year that many Catholics feel the nagging sense that our Church should have been a leading voice in the battle for universal coverage rather than a special interest speaking mostly about abortion.” I completely agree. This article makes a great point about comparing the possibility of a minor shift in abortion funding with a seismic change in how the richest nation on earth provides affordable health care for its citizens as all other developed nations do. Another poster commented about the inadequacy of health care in the middle ages. I fail to see the relevance of that point. The fact is that through God’s grace, we have learned more about disease and the human body, we are better able to cure illnesses today and we have a moral obligation to ensure that these advances are not restricted to those who have the means to afford them and denied to those who do not. The actual situation is even worse than that. Not only do the rich have access to life saving procedures that the poor cannot afford – they also have access, through medical insurance to procedures that can best be described as optional while others are denied essential live saving treatments. Even the pets of the wealthy have better health outlooks than the 30-45 million people who do not have health insurance in America today. This is a moral outrage and one that the USCCB and many Catholic leaders and lay organizations have fought long and hard to address. To have the possibility of finally achieving this goal snatched away because of a technicality that might, possible, conceivably, lead to some amount of money going to fund a service that is already legal would be a travesty of massive proportions. President Obama has indicated a desire to work to reduce the incidence of abortion through improvements in education, social policies and other means. We should engage with him on this and find ways to encourage more young people to refrain from sexual activity, support those who do find themselves with an unplanned pregnancy, and promote adoption and other services to reduce the incidence of abortion. A recent study showed a significant correlation between socio-economic conditions and abortion rates. This link was much stronger than the impact of restrictive laws and prohibitions. We need to embrace all means to reduce and eliminate abortion but not in an unrealistic absolutist sense that would deny another generation of americans the right to affordable health care.

  • Laura Weirich

    Bravo! I’m very impressed by your perceptions of the bill. I think many pro-lifers lose sight over other important social justice issues. We all need to compromise a little in order to accomplish much for the greater good. I’m a pro-lifer, but I also believe that every life is sacred. I don’t think an unborn baby who is dying from an abortion is any more important than a cancer patient who is dying at home because they can’t receive or afford health care coverage. Both are lives lost. If we can at least prevent one life from being lost, than the bill is worth it.

  • Matt from St. Iggy’s

    Awesome column Phil. Very well thought out.

  • Phil Fox Rose

    “GK Thursday”, I don’t claim to be a professional moral theologian, but I certainly try to be a thoughtful one. I’m aware of the concept that some moral values are more important than others. Your point would make sense if I was advocating support of a health care bill which added universal coverage and also unfettered state-funded abortions. But my main point, which I made clearly but you chose to ignore, was that in fact the abortion issue at play here is a technical political fight, while the social justice issue is a huge change.

    Your remark that I am putting the people above the bishops is also off the mark. Actually, I pointed out that differing views have been expressed by a Vatican official as well. My point is and has been that those who’ve been locked in the pro-life battle for years sometimes lose sight of the fact that anything else matters. I am not in any way undermining or challenging the authority of the bishops. Bringing up past heresies and anti-religious revolutions is hilarious. And offensive. I believe I have the right and responsibility as a lay Catholic to think for myself and ask questions and express how I might struggle with something my church leaders are saying.

  • Lynne Shine

    Not sure that illegal aliens will be denied health care if there is a government option – regardless of legislative option. See equal protection clause of the constitution. However, if there isn’t a government option – and I hope there isn’t (the government doesn’t have a very good track record with Medicare) – I don’t see why the United States should be providing all kinds of government benefits to illegal aliens. How about following the law and do what it takes to be here legally? That is not unreasonable. The United States can not take care of the world. Other countries need to be responsible for their citizens, and people need to start taking responsibility for themselves and their families – instead of expecting someone else to do it for them!

  • Bill McGarvey

    In the spirit of having an open and constructive dialogue on this complex issue, we’d appreciate it if readers would use their actual names when they comment instead of anonymous screen names.
    Thank you.
    Bill McGarvey

  • G.K. Thursday

    Phil FoxRose, while a passable journalist, is not a very knowledgeable or even thoughtful moral theologian. The possibility of a conflict between what is known as “the slaughter of the innocents” versus any other human good cannot be contemplated in a just society. So in a just society a bill which has a genuine possibility of creating government funded abortion cannot be approved. Those truly seeking justice cannot escape the logic of this argument. Of course not all activists are truly seeking justice.

    Health care, although a basic human right, is a historically conditioned right (i.e., health care in the middle ages was still a human right, despite its primitivity). The right to life is not so historically conditioned. Hence FoxRose’s depiction of a conflict between universal health care and the right to life is unfounded in Catholic moral theology (which includes Catholic social teaching, not vice versa). In the Catholic moral tradition, there has always been recognition of a hierarchy of values, and at the apex has always been the right to life.

    FoxRose of course avails himself of the journalist’s standard argument: “lay Catholics disagree with their bishops therefore the bishops must be wrong.” This argument is a commonplace of the journalist covering Catholic affairs, but reveals a complete ignorance of Church history. There have been many occasions when a large and vocal group of laity sought to undermine the orthodoxy of the Church, most notably during the 4th century under the Arian princes of Italy and their crowds of followers. The fact that there were strong clerics (bishops, secular clergy and monks) who stood against this lay-driven power-grab, is one of the chief reasons the Church survives today. Seen through the eyes of faith, this was the work of the Holy Spirit. Other historical examples would be the French Revolution, the times of the martyrs in Uganda and many, many others. A large vocal group of laity calling for the abandonment of orthodoxy to fit its political ends/vision should not cause the bishops to pause in the slightest in their duty to teach the fullness of the Gospel “in season and out of season”.

  • amiehartnett

    While I respect the collective viewpoint of the USCCB, when I got an email containing the mandate for pastors to run the bulletin item and announce the issue and even SPECIFICALLY dictate the intercessory prayer for mass last week…it really gave me the creeps. I am in no way a fan of pulpit parenting. I always feel that although guidance from Church leaders is necessary and welcome by some, swinging the hammer in the manner they have for the past 18 months or so is getting ridiculous. I also find it self-defeating and bizarrely naive for these educated men to think that many American Catholics have the political identity to be both anti-abortion activists AND pro-undocumented worker activists.

    I am not criticizing their motives; but the methods stink.

  • Pat

    You seem to be saying that Catholics should be in support of the government taking over their healthcare. I have wide experience in working for the Federal government as well as in the healthcare sector, public and private. Why are you saying all Americans will be covered under this bill when even the writers concede they will not. Why do you support this when it does nothing to help the uninsured working poor or those who are losing coverage because of unemployment until 2013? They need help now and there are many ways to do that. Do you agree with all of the debt that will be incurred under the bill to pay for union deficiencies? Are you good with having the government come into your workplace to tell you as an employer or employee what you can eat, and what activities you should be doing before, during and after work? Yes, I have the exact sections that I read – I have written government documents, I can read them. There are alternatives to helping people with insurance costs and doing it now rather than giving a former VP billions to build an electric car overseas that most of us will never afford at $100,000. You won’t need to worry about charity in the church, we won’t be able to give anymore, the government will be deciding who gets our money. I was not raised to believe that the government should be involved in my church nor should my church be involved in dictating how much involvement the government should have in my life.

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