Amid the political bombast, it’s easy to forget why we needed health-care reform in the first place.
Affordable Care Act
Conception. Pregnancy. Abortion. Abortifacient.
Those words today are in a rhetorical swamp where contesting religious, medical, and political views muddy understanding. And soon the U.S. Supreme Court will wade in.
On March 25, it will hear challenges to the Affordable Care Act’s provision that employers must provide insurance coverage with no co-pays for contraception.
Every time he goes to the doctor’s office, Daniel Eddinger takes a leap of faith.
Eddinger, a 28-year-old father of two from Lexington, N.C., doesn’t have health insurance.
But he’s not worried about the cost of getting sick.
Instead of insurance, he says, he relies on God — and the help of other believers — to pay his medical bills.
This morning at breakfast, I was reading an article in the newspaper about how the Affordable Care Act is negatively affecting some individuals — especially those who buy their own insurance, rather than receiving it through an employer. The article was interesting, but what struck me the most was the way the problem was framed. Rather than approaching the story from a public policy angle, the article mainly focused on the reaction of consumers of health-care goods and services. The crux of the article was whether some individuals should be required to buy a product they might not want or need so that other individuals could have affordable access to health-care products they need desperately but might not be able to afford under the old regime.
The dilemma was presented as a story of tension between healthier consumers and less healthy consumers fighting to get the best deal for their health-care dollars. But could there be another way of thinking about health care, and about our society as a whole? Is there a framework that would allow us to consider these questions in a way that assumed connection, caring, and community between individuals, rather than the zero-sum competition of the market?
Yes, President Obama said that if we like our health insurance, we can keep it.
Yes, that turned out to be false for a few million people.
Yes, the president chose his words poorly. Whether or not health reform became the law of the land, there’s no way any president could have known if we’d be able to keep our health insurance from one year to the next.
The theatrics around the Affordable Care Act seem only to be matched by the public’s ignorance about what it actually is. Case in point: when late-night talk show host Jimmy Kimmel sent a reporter out on the street to ask people their opinions, they felt markedly better about the nuts and bolts of the Affordable Care Act than they did about Obamacare.
Never mind they’re the same thing (sigh).
It seems that a handful of lawmakers have seen to it that our ignorance is sown into full-blown fear, obfuscating the fact that the shutdown – which was largely a fight over the ACA – cost our economy about $25 billion. For those who have been following even on a cursory level, the arguments against the ACA are becoming quite familiar:
· The individual mandate infringes on my freedom not to have insurance.
- The whole thing costs too much.
- It’s a slippery slope to a single-payer system.
On this last point, we can only hope the critics are right, particularly since a single-payer health care system is the only model that has offered hard evidence of both covering everyone and reducing total costs. But since we’re not there yet, let’s consider what we do have with this new law.
It was a strange, but telling, spectacle when those who billed the government millions for working on its Affordable Health Care registration system denied any accountability for the portal’s astounding failure.
“The other guy did it,” as they say in court. The client kept changing specs, no one did any whole-system testing, other vendors are to blame — blah, blah, blah.
Whatever shred of truth lay in their blame-shifting ran up against another wall of non-accountability. The Republicans did it with their insane sequestration, said Democrats. The Democrats did it, said the GOP. Health and Human Services did it. The Oval Office did it.
In the end, of course, no one will accept accountability, for we live in an age when the “buck” never stops on one’s own desk, if it stops at all.
Time was when a determined minority vowed to change the nation’s collective mind about racial integration and the Vietnam War.
I was in that minority. We considered our cause just. We called our tactics “civil disobedience,” “grass-roots organizing,” “protest,” “civil rights,” “saving America.”
It’s a bit disingenuous now for us to lambaste a conservative minority for wanting the same leverage and for using the same tactics. “Civil disobedience” can’t be relabeled “obstructionism” just because the other side is using it.
This morning a Canadian woman wrote such an interesting comment on an old post of mine, "Rationing is not a four-letter word," that I want to share it with you. I don't know the author, her full name (though she tells me her first name is LaVonne, so she's obviously a great person), or her contact information, so I can't give her full credit. But thanks, LaVonne-in-Canada: I learned a lot from you.
Here's what she wrote about how Canadian health care works for her. I've added a few comments in italics, in case you want to compare the situation of LaVonne-in-Canada with that of LaVonne-in-the-United-States.
As people of faith, we sometimes don’t take time to prepare ourselves for what is ahead. With so many things vying for our time and attention, it is difficult to educate ourselves about all facets of critical matters. Even in our relationship with God, we gloss over important details that will guide us into a closer walk and become content with a distant half-hearted relationship. However, a casual walk with God is not one we should settle for. By delving into God’s Word, we are able to draw upon God’s wisdom for guidance and find a deeper relationship with God as we travel through this journey of life.
In a similar fashion, we cannot settle for casual knowledge of the Affordable Care Act, which is now upon us and “gives Americans unprecedented information about the health plan choices in their own communities.” The Kaiser Family Foundation reports in a recent poll that 51 percent of all Americans are still unsure about how the ACA will affect them. 42 percent of Americans thought that Congress had overturned the act or that the Supreme Court had ruled it unconstitutional. And, many Americans worry that they will have to shell out more money due to the new health reform law. This uneasiness and misinformation certainly warrants a closer look as we journey through the multiple avenues of the Affordable Care Act.
One of the most depressing things I heard on the first day of the government shutdown was that it was a record fundraising day for both parties. Washington, D.C., is no longer about governing; it is just about winning and losing. But the people who will lose the most during a government shutdown — and then an impending United States government default on paying its debts — are those who live day to day on their wages, those at the lower end of the nation’s economy, and the poorest and most vulnerable who are always hurt the most in a crisis like this. And what happens to those people is the focus of the faith community; that is our job in politics — to talk about what happens to them. Faith leaders have been meeting to discuss what we must do in response to this political crisis brought on by absolute political dysfunction
The government shutdown seems to have gotten the attention of the nation. And if this ends in a default on our debt, the potentially catastrophic crashing of the economy will certainly wake us up. The only positive I see in this crisis is that the right issues — the moral issues — might finally get our attention.
The federal government began shutting down overnight, for the first time since 1996, after Congress failed to compromise on how to fund federal agencies — battling instead over implementation of the Affordable Care Act.
From The Washington Post:
The impasse means 800,000 federal workers will be furloughed Tuesday. National parks, monuments and museums, as well as most federal offices, will close. Tens of thousands of air-traffic controllers, prison guards and Border Patrol agents will be required to serve without pay. And many congressional hearings — including one scheduled for Tuesday on last month’s Washington Navy Yard shootings — will be postponed.
Faith leaders on Monday called on Congress to end partisan brinkmanship and consider the real damage their actions have on the American people.
Old News: U.S. spends more on healthcare, gets worse results
We Americans are first in the world when it comes to per capita healthcare spending, and yet we don't live as long (we're in 51st place), more of our mothers die in childbirth (we're in 47th place), more of our babies die in their first year of life (we're in 50th place) ... well, you've seen the statistics, and they aren't pretty.
Interesting Spin on Old News: Medical and social spending should be seen as a whole
"The truth is that we may not be spending more," wrote Elizabeth H. Bradley and Lauren Taylor in a 2011 New York Times article — "it all depends on what you count." If you count "the combined investment in health care and social services," such as "rent subsidies, employment-training programs, unemployment benefits, old-age pensions, family support and other services that can extend and improve life," we're in 10th place among developed nations.
In an attempt to attract conservative voters, undecided senators, and Republicans, talks of doubling border patrol security is in the works. Increasing border patrol security from 21,000 agents, to 42,000 agents, members of the Gang of Eight and Republicans, Bob Corker of Tennessee and John Hoeven of North Dakota have come together and created a package plan to entice conservative’s support for the passing of the immigration bill. Politico reports:
Strengthening border security had long been the major impediment to attracting conservative votes, and a compromise that resolves the issue would significantly improve chances for passage of the overall bill.
Read more here.
California is the facing a new challenge: getting young adults to enroll in the Affordable Care Act. More than 2 million Californians, ages 19 to 34, are uninsured. Getting these individuals enrolled is crucial to balancing the cost of older, sicker patients. The state is developing media strategies to specifically target young adults and encourage to them buy insurance. The Los Angeles Times reports:
The success of the healthcare law "depends on reaching everyone who is uninsured, but particularly young people who may feel like they don't need insurance," said Larry Levitt, a senior vice president at the Kaiser Family Foundation.
Read more here.
The first draft of form was confusing and complex so the Obama administration has created a simplified application for healthcare. The Associated Press reports:
Details to be released Tuesday include a three-page short form that single people can fill out, administration officials said. Medicare chief Marilyn Tavenner, also overseeing the rollout of the health care law, called it "significantly shorter than industry standards."
Read more here.
I have to admire Melinda Gates' chutzpah.
In her recent TED talk and on her blog, Impatient Optimist, Gates insists that "contraception is not controversial" — when, in the last year, it has been explosively controversial, with many Christians (not just Catholic Christians) seeing the "contraceptive mandate" as a real threat to religious freedom.
Yesterday, the new Affordable Care Act laws took effect, meaning that most employers must now provide free birth control coverage in their health insurance policies. Whether it constitutes a threat to religious liberty and whether remains to be seen — faith-based groups with religious objections to the law have a "safe harbor" until Aug. 1, 2013. Whether HHS will create an extension of this harbor is as yet unknown.
Regular readers of my blog know where I stand on health insurance. As to the contraceptive mandate specifically, I'd prefer not to wade in those particular waters — David Gibson had a good piece if you're interested in the question of whether the mandate kills religious freedom. However, I do want to consider two small points about contraception that lean me toward the (self-identified Catholic!) Melinda Gates point of view:
1. Contraception doesn't take life;
2. Women want contraception.
Today Wheaton College, a leading evangelical Christian school and the alma mater of the Rev. Billy Graham in Illinois, sought an injunction for "emergency relief," as it seeks to remain exempt from the Health and Human Services (HHS) insurance mandate which comes into effect today.
Filed on Wheaton's behalf by The Becket Fund for Religious Liberty, the preliminary injunction would, the college hopes, temporarily keep at bay the fines which would be levied on them under the mandate, should they fail to comply with the provisions.
The provisions, which are part of the Affordable Care Act, would require “most employer health insurance plans to provide birthday control coverage,” as was reported on God’s Politics last month. Many Catholic institutions and groups have already filed lawsuits again the mandate, and Wheaton is one of a growing number of evangelical institutions joining in the legal challenge.