Deal W. Hudson
August 16, 2009
The newly launched USCCB Web site on health care tackles the question: “Are the bishops promoting socialized medicine by advocating for universal access?” That’s a good question since the prospect of a government takeover of health care has created a growing chorus of complaints about the present bills before the Congress.
The bishops’ answer to the question about socialized medicine makes it clear they do not consider a government-run program the only option for providing universal health coverage. “There may be different ways to accomplish this, but the Bishops’ Conference believes health care reform should be truly universal and genuinely affordable,” the bishops explain.
But thus far the bishops have not recommended alternatives to the type of government-run program contained in the bills before Congress. They have objected loudly to mandated abortion coverage but have not indicated any discomfort, in principle, with the federal government managing the medical care of every American citizen.
However, the bishops will welcome any reform resulting in a universal health policy that respects “human life and dignity” and includes “freedom of conscience,” while restraining costs and applying “costs equitably among payers.”
The media coverage of the health-care debate among Catholics has treated the Catholic Health Association’s (CHA) advocacy for the present legislation as if it were the official voice of the bishops. This is mistaken: CHA is a trade association of Catholic hospitals, and as such, it speaks with a voice of knowledge and experience but not ecclesial authority.
Another group, the Catholic Medical Association (CMA), has a different point of view on health care reform. The CMA was formed as a result of a 1965 debate with the Catholic Hospital Association over socialized medicine and widespread dissent regarding the teaching on contraception in Humanae Vitae.
CMA supports an approach to health-care reform “achieved by legislation that empowers people to own their health insurance policies (as contrasted with the government, or employer-controlled healthcare insurance) and using targeted measures to help people who cannot afford the entire cost of their insurance premium.”
CMA’s recommendation points the way toward an alternative solution – one based on the principle of subsidiarity – to reach the goals advocated by the bishops. Universal coverage can be achieved without handing healthcare entirely over to the federal government. Here are some specific recommendations of my own that would implement the general suggestions of the CMA.
Such a plan can begin with mandating health savings accounts (HSA) for everyone: These individual accounts become the vehicles to disperse payments to insurance providers. Everyone will be required to purchase his or her own insurance, and group insurance policies will end.
Insurance would be sold to individuals and not through employers or other parties. This solves the issue of portability, the ability of individuals to keep their own health insurance. This would also reduce costs: Consumers would seek to control their own consumption. The government would also take the lead in bringing about litigation (or tort) reform to curtail the amount of irrelevant and unnecessary testing and defensive procedures that doctors use to protect themselves from negligence claims.
At a minimum, individuals would be required to purchase hospitalization insurance so as to prevent people from using emergency rooms without paying. This would also lead to beneficial discriminatory pricing for those who choose to purchase primary care or preventative care as opposed to those who only purchase hospitalization. Verification of insurance would occur by including the policy number annually on one’s tax return.
The role of the federal government would be to spell out a minimum level of mandated services to be covered by insurance companies. Freedom of conscience provisions would be included, while abortion services and so-called end-of-life services would not. Insurance companies would not be allowed to deny coverage for preexisting conditions.
Health-care providers, in turn, would have to provide the same price to everyone for each service. Furthermore, the government would need to create incentives in order to increase the number of primary care providers and local clinics to help lower the baseline of medical care costs.
How are individual HSAs to be funded so that universal coverage is achieved? For the next three years, employers would contribute to each employee’s HSA the mean amount of dollars that they had previously paid into group insurance. For the millions of uninsured, Congress would contribute dollars to their HSA. Congress would have to determine at what level of income this assistance would cease.
There is more than one way to achieve the goal of universal access to health care – without turning over the reins to the government.