Catholic Online Forum

several features of H.R. 3200, as introduced on July 14, need to be addressed:

1. The legislation delegates to the Secretary of Health and Human Services the power to make abortion a basic or essential benefit in all health plans, or in the “public plan” created by the legislation. This would be a radical change: Federal law has long excluded most abortions from federal employees’ health benefits plans and places no requirement on private plans, most of which also decline to cover elective abortions.

2. Because some federal funds are authorized and appropriated by this legislation without passing through the Labor/HHS appropriations bill, they are not covered by the Hyde amendment and other provisions that have prevented direct federal funding of abortion for over three decades. The legislation needs its own provision against abortion funding to ensure consistency with the policy in all other federal health programs.

3. Provisions such as those requiring timely access to all benefits covered by qualified health plans could be used by courts to override and invalidate state laws regulating abortion, such as laws to ensure women’s safety and informed consent and to promote parental involvement when minors consider abortion. These laws are modest, widely supported, and constitutionally sound, but they could fall before a new federal mandate to maximize “access” to abortion. It should be made clear in the legislation that such laws will not be preempted.

1. The legislation delegates to the Secretary of Health and Human Services the power to make unlimited abortion a mandated benefit in the “public health insurance plan” the government will manage nationwide. This would be a radical change: Federal law has long excluded most abortions from federal employees’ health benefits packages, and no federal health program mandates coverage of elective abortions.

2. Because some federal funds are authorized and appropriated by this legislation without passing through the Labor/HHS appropriations bill, they are not covered by the Hyde amendment and other federal provisions that have long prevented federal funding of abortion and of health benefits packages that include abortion. The committee rejected an amendment to extend this longstanding policy to the use of federal subsidies for health care premiums under this Act. Instead the committee created a legal fiction, a paper separation between federal funding and abortion: Federal funds will subsidize the public plan, as well as private health plans that include abortion on demand; but anyone who purchases these plans is required to pay a premium out of his or her own pocket (specified in the Act to be at least $1.00 a month) to cover all abortions beyond those eligible for federal funds under the current Hyde amendment. Thus some will claim that federal taxpayer funds do not support abortion under the Act.

But this is an illusion. Funds paid into these plans are fungible, and federal taxpayer funds will subsidize the operating budget and provider networks that expand access to abortions. Furthermore, those constrained by economic necessity or other factors to purchase the “public plan” will be forced by the federal government to pay directly and specifically for abortion coverage. This is the opposite of the policy in every other federal health program. Government will force low-income Americans to subsidize abortions for others (and abortion coverage for themselves) even if they find abortion morally abhorrent.

Please consider the broader context. No federal program mandates coverage for elective abortions, or subsidizes health plans that include such abortions. Most Americans do not want abortion in their health coverage, and most consider themselves “pro-life,” with a stronger majority among low-income Americans. About 80 percent of all hospitals do not generally provide abortions, and 85 percent of U.S. counties have no abortion provider. By what right, then, and by what precedent, would Congress make abortion coverage into a nationwide norm, or force Americans to subsidize it as a condition for participating in a public health program?

BAKER, Oregon, August 17, 2009 (LifeSiteNews.com) - A genuine need for more comprehensive health insurance coverage should not lead Catholics to join the push to pass President Obama's health care legislation, which is "fatally flawed" with respect to pro-life and other major issues, said Bishop Robert Vasa of the Baker, Ore. diocese.

Bishop Vasa weighed in on the push for health care reform in an email response to LifeSiteNews.com's (LSN) inquiry today.

"I think the pertinent question is asked by you: Should we therefore be openly opposing the bills, even if that means a delay in health care reform?" wrote Vasa. "It is my belief that these 'changes' need to be made 'as a condition for support' and that there ought to be no support for the reform at all unless and until these very critical matters involving the care of pre-born human life, are satisfactorily resolved.

"Without these changes (and significant changes in other medical, moral and conscience issues) the health care bill is fatally flawed and as such cannot be supported," said the bishop.

First and most important, the Church will not accept any legislation that mandates coverage, public or private, for abortion, euthanasia, or embryonic stem-cell research. We refuse to be made complicit in these evils, which frankly contradict what “health care” should mean. We refuse to allow our own parish, school, and diocesan health insurance plans to be forced to include these evils. As a corollary of this, we insist equally on adequate protection of individual rights of conscience for patients and health care providers not to be made complicit in these evils. A so-called reform that imposes these evils on us would be far worse than keeping the health care system we now have.

Second, the Catholic Church does not teach that “health care” as such, without distinction, is a natural right. The “natural right” of health care is the divine bounty of food, water, and air without which all of us quickly die. This bounty comes from God directly. None of us own it, and none of us can morally withhold it from others. The remainder of health care is a political, not a natural, right, because it comes from our human efforts, creativity, and compassion. As a political right, health care should be apportioned according to need, not ability to pay or to benefit from the care. We reject the rationing of care. Those who are sickest should get the most care, regardless of age, status, or wealth. But how to do this is not self-evident. The decisions that we must collectively make about how to administer health care therefore fall under “prudential judgment.”

Third, in that category of prudential judgment, the Catholic Church does not teach that government should directly provide health care. Unlike a prudential concern like national defense, for which government monopolization is objectively good – it both limits violence overall and prevents the obvious abuses to which private armies are susceptible – health care should not be subject to federal monopolization. Preserving patient choice (through a flourishing private sector) is the only way to prevent a health care monopoly from denying care arbitrarily, as we learned from HMOs in the recent past. While a government monopoly would not be motivated by profit, it would be motivated by such bureaucratic standards as quotas and defined “best procedures,” which are equally beyond the influence of most citizens. The proper role of the government is to regulate the private sector, in order to foster healthy competition and to curtail abuses. Therefore any legislation that undermines the viability of the private sector is suspect. Private, religious hospitals and nursing homes, in particular, should be protected, because these are the ones most vigorously offering actual health care to the poorest of the poor.

The current House reform bill, HR 3200, does not meet the first or the fourth standard. As Cardinal Justin Rigali has written for the USCCB Secretariat of Pro-life Activities, this bill circumvents the Hyde amendment (which prohibits federal funds from being used to pay for abortions) by drawing funding from new sources not covered by the Hyde amendment, and by creatively manipulating how federal funds covered by the Hyde amendment are accounted. It also provides a “public insurance option” without adequate limits, so that smaller employers especially will have a financial incentive to push all their employees into this public insurance. This will effectively prevent those employees from choosing any private insurance plans. This will saddle the working classes with additional taxes for inefficient and immoral entitlements. The Senate bill, HELP, is better than the House bill, as I understand it. It subsidizes care for the poor, rather than tending to monopolize care. But, it designates the limit of four times federal poverty level for the public insurance option, which still includes more than half of all workers. This would impinge on the vitality of the private sector. It also does not meet the first standard of explicitly excluding mandatory abortion coverage.

[...]There are also perceived strengths of our current system:

1) Most Americans like the medical care services available to them. Our country, in some ways, is the envy of people from countries with socialized systems of medical care.

2) It is important to remember that 85% of citizens in the U.S. do have insurance. Forty percent of the uninsured are between 19-34 years old. (Source: Current Population Survey 2008 Annual Social and Economic Supplement) A 2007 study by the Kaiser Commission on Medicaid and Uninsured found that 11 million of those without insurance were eligible for Medicaid or SCHIP but were not enrolled. Those eligible but not enrolled include 74 percent of children who are uninsured. (Source: Characteristics of the Uninsured: Who Is Eligible for Public Coverage and Who Needs Help Affording Coverage?)

3) The competitive nature of our private sector system is an incentive to positive innovation and the development of advanced technology. Medical doctors and research scientists are esteemed. Doctors and other scientists immigrate to our country because of the better compensation given to those who provide quality medical care or produce successful research.

4) Medicare and Medicaid, while they have their limitations, provide an important safety net for many of the elderly, the poor and the disabled.

What Must We Do?
The justified reaction to the significant defects in our current health care policies is to say, “Something must be done.” Many believe: “We have to change health care in America.” Despite the many flaws with our current policies, change itself does not guarantee improvement. Many of the proposals which have been promoted would diminish the protection of human life and dignity and shift our health care costs and delivery to a centralized government bureaucracy. Centralization carries the risk of a loss of personal responsibility, reduction in personalized care for the sick and an expanded bureaucracy that in the end leads to higher costs.

A Renewal Built on Principles
We claim no expertise in economics or the complexities of modern medical science. However, effective health care policies must be built on a foundation of proper moral principles. The needed change in health care must therefore flow from certain principles that protect the fundamental life and dignity of the human person and the societal principles of justice, which are best safeguarded when such vital needs are provided for in a context of human love and reason, and when the delivery of care is determined at the lowest reasonable level. The rich tradition of Catholic social and moral teaching should guide our evaluation of the many and varied proposals for health care reform. It is our intention in this pastoral reflection to identify and explain the most important principles for evaluating health care reform proposals. No Catholic in good conscience can disregard these fundamental moral principles, although there can and likely will be vigorous debate about their proper application.

I. The Principle of Subsidiarity: Preamble to the Work of Reform

This notion that health care ought to be determined at the lowest level rather than at the higher strata of society, has been promoted by the Church as “subsidiarity.” Subsidiarity is that principle by which we respect the inherent dignity and freedom of the individual by never doing for others what they can do for themselves and thus enabling individuals to have the most possible discretion in the affairs of their lives. (See: Compendium of the Social Doctrine of the Church, ## 185ff.; Catechism of the Catholic Church, # 1883) The writings of recent Popes have warned that the neglect of subsidiarity can lead to an excessive centralization of human services, which in turn leads to excessive costs, and loss of personal responsibility and quality of care.

Pope John Paul II wrote:
“By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending.” (Pope John Paul II, Centesimus Annus #48)

And Pope Benedict writes:
“The State which would provide everything, absorbing everything into itself, would ultimately become a mere bureaucracy incapable of guaranteeing the very thing which the suffering person -every person -needs: namely, loving personal concern. We do not need a State which regulates and controls everything, but a State which, in accordance with the principle of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need. … In the end, the claim that just social structures would make works of charity superfluous masks a materialist conception of man: the mistaken notion that man can live ‘by bread alone’ (Mt 4:4; cf. Dt 8:3) - a conviction that demeans man and ultimately disregards all that is specifically human.” (Pope Benedict XVI, Deus Caritas Est #28)

While subsidiarity is vital to the structure of justice, we can see from what the Popes say that it rests on a more fundamental principal, the unchanging dignity of the person. The belief in the innate value of human life and the transcendent dignity of the human person must be the primordial driving force of reform efforts.

The “Right to Health Care” as taught by the Church is a companion to the fundamental right to life, and rights to other necessities, among them food, clothing, and shelter. It may be best understood as a “Right to Acquire the Means of Procuring for One’s Self and One’s Family these goods, and concomitantly, a duty to exercise virtue (diligence, thrift, charity) in every aspect of their acquisition and discharge. This language of rights, coupled with duties toward those who ‘through no fault of their own’ are unable to work, is present throughout papal teaching, and only reinforces the idea that, in its proper perspective, the goal is to live and to work and ‘to be looked after’ only in the event of real necessity.” (Source: Catholic Medical Association, 2004 document, Health Care in America. – bold and italics our own)

The right of every individual to access health care does not necessarily suppose an obligation on the part of the government to provide it. Yet in our American culture, Catholic teaching about the “right” to healthcare is sometimes confused with the structures of “entitlement.” The teaching of the Universal Church has never been to suggest a government socialization of medical services. Rather, the Church has asserted the rights of every individual to have access to those things most necessary for sustaining and caring for human life, while at the same time insisting on the personal responsibility of each individual to care properly for his or her own health.

Indeed part of the crisis in today’s system stems from various misappropriations within health care insurance systems of exorbitant elective treatments, or the tendencies to regard health care services paid for by insurance as “free,” and to take advantage of services that happen to be available under the insurance plan. Such practices may arguably cripple the ability of small companies to provide necessary opportunities to their employees and significantly increase the cost of health care for everyone

As Catholic people [...] we are not allowed to wash our hands of it and to let things shake out as the federal government would have it. Our more than bicentennial experience with our federal government leads many to the conclusion that our government really does only one thing well: waging war. In every other area of life, when someone says, “I am from the government and I am here to help you,” our survival instinct tells us to run and hide. [...]

I would suggest, after many who have approached the problem from a Catholic’s perspective, that there are certain Catholic social principles that any countrywide health care provision must satisfy.

1. The first is the dignity of every human person. Whatever we do we must respect all human life from conception to natural death. We do have a collective duty to provide access, affordability and quality of care for all citizens because they are human beings. This of course includes personal responsibility for our own health care.

2. The second principle is that any such plan must manifest a commitment to the common good. This demands prudent use of resources and ethically and economically sound market-oriented reforms. Pope Benedict has stressed the common good as one of the “motors” of all just human society and it is no less true in health care than in any other area.

3. The third principle is solidarity. This social justice principle requires us to hold that health care reform proposals will address the needs of the poor and vulnerable, which include those suffering from chronic disease. The Scriptural warrant for this is found in St. Matthew’s Gospel in the 25th Chapter in the terrifying scene of the last judgment, when the king will ask each of us: “What did you do for the least of these?”

4. The fourth principle is subsidiarity which commands us to seek the most effective approach to solving the problem. Our federal bureaucracy is a vast wasteland strewn with the carcasses of absurd federal programs which proved infinitely worse than the problems they were established to correct. It perhaps is too extreme to say that competent government is an oxymoron, but sometimes it seems that way. The moral principal of subsidiarity implies decreasing the role of government and employers in health care when lower order groups can better serve individuals and families. We need to think of health care as more of a market than a system.
The Catholic Medical Association has warned that: “The clear historical experience in the United States assures that a unitary, or a single payer, system of health care financing and administration would profoundly subvert the sanctity of human life” (from the Association’s publication, “Health Care in America: A Catholic Proposal for Renewal” in Linacre Quarterly, 2004, available at http://www.cathmed.org/publications/health%20CARE.pdf).

It was observed by the ancients that usually the problem with totalitarian governments is not that they do not love their people; the problem seems to be that they love them too much — they just do not trust them. To establish control, these governments have always tried to control food. Remember why Jacob’s sons went down to Egypt in the Book of Exodus. But since homo sapiens is an omnivore, this proves increasingly difficult. Modern socialist governments like to control not food but the means to protect and extend life. Some have called the current efforts of our federal government “senioricide” or “infanticide.” That perhaps is too severe, but we as Catholics should take care that health care does not morph into life control.

In principle, the Church ought to always promote wider and more complete access to health care; however, that does not mean that in practice the Church ought to support each and every plan which is proposed by civil leaders. At this time, I want to offer you some key principles that should always be used when evaluating the moral value and justice of a given plan to provide health care. The following is a brief summary of these principles

The Dignity of Human Life
[...]Any attempt to provide greater access to health care without safeguarding human life from the moment of conception is inherently inconsistent. Pope Benedict XVI shares this great wisdom of the Church in his latest encyclical letter, Caritas in Veritate, when he recalls the words of John Paul II, “A society lacks solid foundations when, on the one hand, it asserts values such as the dignity of the person, justice and peace, but then, on the other hand, radically acts to the contrary by allowing or tolerating a variety of ways in which human life is devalued and violated, especially where it is weak or marginalized” (Caritas in Veritate, 15; Evangelium Vitae, 101). True health care begins with the unborn child in the womb. When a given plan to provide care fails to protect that life, it is no longer animated by a source of truth and justice, thus it will not, and cannot, flourish.

Conscience Rights
[...]The doctors, nurses and health care professionals who possess such medical expertise are prime candidates for coercion from those who would destroy the most vulnerable human lives. The right to follow one’s conscience, as informed by God, must be guaranteed. It is imperative that health professionals and institutions have the freedom to refuse to perform unethical procedures and even to refuse to refer a patient to another professional or institution for treatments they believe, according to the natural law, are immoral.

Access to All
In our day, when many times utilitarian values overlook the most vulnerable, we must ensure that the poor, the elderly, the handicapped, legal immigrants and the unborn, together with all citizens of our nation, have access to health care.

Subsidiarity
Subsidiarity is the principle that states “a community of a higher order should not interfere in the internal life of a community of a lower order, depriving the latter of its functions, but rather should support it in case of need” (Catechism of the Catholic Church, 1883). As a society seeks to bring about any good such as health care, there are many organic and intermediate groups which cooperate together to reach the desired goal. There is a danger in being persuaded to think that the national government is the sole instrument of the common good . Rather, according to the classic principle of subsidiarity in Catholic social thought, many different communities within society share this responsibility. These various strands of community life within society build up a strong and cohesive social fabric that is the hallmark of true communion of persons. States, towns, fraternal organizations, businesses, cooperatives, parishes and especially the family have not only legitimate freedom to provide the goods they are rightly capable of supplying, but often times do so with far greater efficiency, less bureaucracy and, most importantly, with personalized care and love. This is especially the case in the tremendous work that the Church has done in successfully bringing health care, from early hospitals to modern research centers, to more and more people. [...]Honoring the principle of subsidiarity will enable all men and women to be true participants in contributing to the goal of providing greater access to health care.

[...]

Human dignity

To begin, one must recognize that the provision of health care is rooted in our recognition of the basic dignity of every human person, made in God’s image. [...] Each person should have access to basic, affordable, adequate health care. This is a goal that should be supported by our nation. However, the goal becomes more complex because there is a variety of opinion as to what “basic, affordable, and adequate” means.

Safeguarding human life

[...] Inclusion of any procedure which attacks innocent human life would be inconsistent with any truly legitimate health care reform measure. As Pope John Paul II noted in his encyclical, "The Gospel of Life” (“Evangelium Vitae”): “It is impossible to further the common good without acknowledging and defending the right to life, upon which all the other inalienable rights of individuals are founded and from which they develop.”

Expounding on this basic truth, the US bishops noted in their statement, “Living the Gospel of Life: A Challenge to American Catholics”: “[...]Indeed, the failure to protect and defend life in its most vulnerable stages renders suspect any claims to the ‘rightness’ of positions in other matters affecting the poorest and least powerful of the human community.”

Beyond this, there are other procedures/treatments, such as in-vitro fertilization, voluntary sterilization, sex-change operations, and the provision of contraceptives, that some would consider basic health care. There is no right to these, as they too are in violation of the moral law and human dignity; as such, they should not be included in any proposal.

Conscience protection

[...] Earlier this month the Equal Employment Opportunity Commission (EEOC) took action against Belmont Abbey College, a small Catholic college in North Carolina, for removing coverage for abortion, contraception, and voluntary sterilization from their employee insurance plan after they were inadvetently included. The EEOC ruled that Belmont Abbey was guilty of discrimination. This action sets a dangerous precedent and highlights the dangers that await if very clear conscience protections are not included in health care reform proposals.

Other concerns

[...]One might legitimately ask if giving a large, inefficient, but powerful bureaucracy like the federal government control of health care is a wise move. For one, this runs counter to the well-known principle of subsidiarity, so prominent in Catholic social teaching: “a community of a higher order should not interfere in the internal life of a community of a lower order, depriving the latter of its functions, but rather should support it in case of need and help to coordinate its activity with the activities of the rest of society, always with a view to the common good." "The principle of subsidiarity is opposed to all forms of collectivism. It sets limits for state intervention.” (cf. Catechism of the Catholic Church, nos. 1883,1885). [...]The government can act to remove abuses, and to regulate the health care industry so that the markets efficiently serve all the people. Government may also be needed to see that no one, especially the working poor and the most destitute and forgotten, falls through the cracks. But, the essential element of the principle of subsidiarity is the protection of individual freedoms from unjust micromanagement and manipulation by the state.

Though, as your bishop, I would like to support the provision of adequate health care for everyone, I cannot support the bills/proposals that are currently before Congress, for they do not adequately incorporate the essential principles listed above. I offer this brief summary in hope that it will assist you in exercising your role as a citizen. Communicate your concerns and pray for those who must make these decisions, our elected officials.[...]We must never forget as then-Card. Ratzinger stated, “There is only one morality …, the morality of God’s commandments, which cannot be temporarily suspended in order to bring about a change in the status quo more quickly.”

Finally, a picture of you with your name directly underneath.

Authentic health care reform must, at a minimum, ensure the following:

— Access to health care coverage for all people, including legal immigrants, from conception until natural death (access does not necessarily demand government-operated health care. Catholic health care facilities have been providing access to health care for all who come to them throughout the history of the church);

— No federal funding for abortions and no support for euthanasia;

— Protection for freedom of conscience for healthcare workers and institutions;

— Lower health care costs and equitable cost sharing;

In his encyclical Deus Caritas Est (DCE), Pope Benedict XVI recognized that it was the responsibility of the lay faithful to work for a just ordering of society. Catholics cannot relinquish their participation "in the many different economic, social, legislative, administrative and cultural areas, which are intended to promote organically and institutionally the common good." (DCE 29)

Some will ask why the Catholic Church and other faith-based organizations are involved in the health care debate at all. Secular purists erroneously argue that a separation of church and state means religious organizations should not be part of any discussion of health care reform. Nothing could be farther from the truth. For nearly 2,000 years, health care has been an integral part of the charitable work of the church. In fact, the Catholic Church "invented" hospitals as part of our charity toward the poor and the sick.

the Catholic doctrine of subsidiarity states that "a community of a higher order should not interfere in the internal life of a community of a lower order, depriving the latter of its function, but rather should support it in the case of need and help to coordinate its activity with the activities of the rest of society, always with a view to the common good" (Pius XI, Quadrigesimo Anno I). In other words, care of the sick should be provided at the local level, not from the top down.

Church and state meet at the intersection of justice and charity. "Justice is both the aim and the intrinsic criterion of all politics . . . . The State must inevitably face the question of how justice can be achieved here and now. But this presupposes an even more radical question: what is justice? The problem is one of practical reason; but if reason is to be exercised properly, it must undergo constant purification, since it can never be completely free of the danger of a certain ethical blindness caused by the dazzling effect of power and special interests." (DCE 28).

Catholic lay faithful must recognize and accept their responsibility to refine and sanctify the government’s search for just systems. Affordable health care for all individuals is certainly a just, noble and worthy goal. But Catholic politicians must ask themselves and their colleagues difficult questions. Is it just to achieve a noble goal by sacrificing the lives of our most vulnerable citizens? Must the unborn and the elderly be killed in order to achieve health care reform? Can we, as a nation, ever justify reaching a good end by evil means? Catholics, and all men and women of good will, know the answers to these questions in their hearts.

How will this health care reform define us as a nation and as a people?

The answer must include:

1.) A statement disallowing taxpayer dollars to fund abortions and, necessarily connected to this prohibition, embryonic stem-cell destruction.

2.) A statement forbidding the practice of euthanasia.

3.) Allowing the federal conscience laws to stand.

[...]There are, at least, three versions of House and Senate bills being worked on, and none are in their final form. This means that Catholics must continue to monitor the process as it goes forward and contact their representatives in Washington, D.C., with their thoughts.

It is obvious that doing so is having an effect. (For the Senate, call (202) 224-3121 and ask to speak with your senator; call (202) 225-3121 to speak with your representative. If you do not know the name of either, give the operator your zip code and you will be connected to the correct office.)

Reading the commentaries of my brother bishops, I realized that I did not mention another essential Catholic principle that should have been included in my last column: subsidiarity, which posits that health care ought to be determined, administered and coordinated at the lowest level of society whenever possible.

In other words, those intermediary communities and associations that exist between the federal government and the individual must be strengthened and given greater control over policies and practices rather than being given less and less control.

To usurp this “hierarchy of communities” is terribly damaging in the long run, both to society as a whole and the individual citizen (See Catechism of the Catholic Church, No. 1883, Compen­dium of the Social Doctrine of the Church, No. 185 ff).

Papal insights

Two quotes from Pope John Paul II and Pope Benedict XVI are instructive in this regard:

Pope John Paul II has written:

“By intervening directly and depriving society of its responsibility, the Social Assistance State leads to a loss of human energies and an inordinate increase of public agencies, which are dominated more by bureaucratic ways of thinking than by concern for serving their clients, and which are accompanied by an enormous increase in spending” (Pope John Paul II, “Centesimus Annus,” No. 48).

Pope Benedict writes:

“The State which would provide everything, absorbing everything into itself, would ultimately become a mere bureaucracy incapable of guaranteeing the very thing which the suffering person — every person — needs: namely, loving personal concern. We do not need a State which regulates and controls everything, but a State which, in accordance with the principle of subsidiarity, generously acknowledges and supports initiatives arising from the different social forces and combines spontaneity with closeness to those in need . . . . In the end, the claim that just social structures would make works of charity superfluous masks a materialist conception of man: the mistaken notion that man can live ‘by bread alone’ (Mt 4:4; cf. Dt 8:3) — a conviction that demeans man and ultimately disregards all that is specifically human” (Pope Benedict XVI, “Deus Caritas Est,” No. 28).

To neglect the principle of subsidiarity inevitably leads to the excessive centralization of human services, which leads to higher costs, less personal responsibility for the individual and a lower quality of care.

“I can’t understand for the life of me how the Catholic Church could be against the biggest social justice issue of our time, where the very dignity of the human person is being respected by the fact that we’re caring and giving health care to the human person — that right now we have 50 million people who are uninsured,” Kennedy told CNSNews.com. “You mean to tell me the Catholic Church is going to be denying those people life-saving health care? I thought they were pro-life,” said Kennedy. “If the Church is pro-life, then they ought to be for health-care reform, because it’s going to provide health care that are going to keep people alive. So this is an absolute red herring, and I don’t think that it does anything but to fan the flames of dissent and discord; and I don’t think it’s productive at all.”

Statement of Bishop Tobin in Response to Congressman Kennedy’s Attack on Catholic Church

[...]“Congressman Patrick Kennedy’s statement about the Catholic Church’s position on health care reform is irresponsible and ignorant of the facts. But the Congressman is correct in stating that “he can’t understand.” He got that part right.

As I wrote to Congressman Kennedy and other members of the Rhode Island Congressional Delegation recently, the Bishops of the United States are indeed in favor of comprehensive health care reform and have been for many years. But we are adamantly opposed to health care legislation that threatens the life of unborn children, requires taxpayers to pay for abortion, rations health care, or compromises the conscience of individuals.

Congressman Kennedy continues to be a disappointment to the Catholic Church and to the citizens of the State of Rhode Island. I believe the Congressman owes us an apology for his irresponsible comments. It is my fervent hope and prayer that he will find a way to provide more effective and morally responsible leadership for our state.”

Our Catholic moral tradition teaches that every human being, from the moment of conception to natural death, has an innate dignity that entitles him or her to certain rights and protections, including the fundamental right to life and the right to affordable healthcare, which flows from the right to life.

As the Catholic Bishops of Texas, we are hopeful that such reform legislation will someday be enacted into law. However, we must also express our concerns that the current healthcare reform proposals being considered by the U.S. House of Representatives and the U.S. Senate do not yet rise to the level of guaranteeing these fundamental rights and protections.

True health care reform must maintain longstanding public policies that restrict funding for abortion and respect the consciences of health care providers. The language in the Capps amendment, which is part of several proposed bills, does not adequately ensure the protection of all human life. In addition, the cost structures of any health care reform plan must not impose excessive financial burdens on low and moderate income individuals and families. Measures must also be in place to safeguard the health of all of society, including the poor, the elderly, and immigrants. Legal immigrants and their families must be allowed timely access to comprehensive and affordable health care coverage and an adequate safety net must be maintained for those who remain uncovered.

Health care reform is a vital concern to us in Texas, as our state has one of the highest numbers of uninsured persons in the nation. Health care is a fundamental component of the Catholic Church’s ministry. In Texas there are 43 Catholic acute care hospitals, 8 nursing homes and 17 other Catholic-sponsored service organizations including hospice, home health, assisted living, and senior housing facilities that provide quality health care to millions. The Church itself is a major purchaser of health insurance for the thousands of employees in our many agencies and institutions. The Catholic Church in Texas brings both everyday experience and strong convictions to the issue of health care reform.

The Catholic Bishops of Texas will continue to support reform of our nation's health care system in ways that respect the lives of all human persons while providing affordable access to health care for all. We will be a committed partner in advancing reform on this life-and-death issue; but if the final form of the legislation does not include acceptable language in these areas then we will have to oppose it vigorously.

Daniel Cardinal DiNardo
ARCHBISHOP OF GALVESTON‐HOUSTON
José H. Gomez
ARCHBISHOP OF SAN ANTONIO
Michael Mulvey
ADMINISTRATOR OF AUSTIN
Edmond Carmody
BISHOP OF CORPUS CHRISTI
Álvaro Corrada del Rio, S.J.
BISHOP OF TYLER
Kevin J. Farrell
BISHOP OF DALLAS
David E. Felhauer
BISHOP OF VICTORIA
Curtis. J. Guillory, S.V.D.
BISHOP OF BEAUMONT
Armando X. Ochoa
BISHOP OF EL PASO
Raymundo. J. Peña
BISHOP OF BROWNSVILLE
Michael D. Pfeifer, O.M.I.
BISHOP OF SAN ANGELO
Plácido Rodríguez, C.M.F.
BISHOP OF LUBBOCK
James A. Tamayo
BISHOP OF LAREDO
Kevin W. Vann
BISHOP OF FORT WORTH
Patrick J. Zurek
BISHOP OF AMARILLO

Date: October 28, 2009
From: Department of Justice, Peace and Human Development, Secretariat of Pro-Life
Activities, Office of Migration and Refugee Policy, Office of the Secretary of Communications
To: Pastors, Diocesan Pro-Life Directors, Diocesan Social Development Directors, Diocesan Communications Directors, State Catholic Conference Directors
Re: URGENT: Nationwide USCCB Bulletin Insert on Health Care Reform

For many years, the U.S. bishops have supported decent health care for all based on our teaching that health care is essential for human life and dignity and on the Church’s experience in providing health care and assisting those without coverage. Specifically, the bishops have clearly required that longstanding federal protections that restrict abortion funding and mandates and that protect conscience rights must be reflected in health reform legislation. In addition, the bishops have focused on efforts to insure that coverage is affordable to families and that immigrants have better health care as a result of reform. We seek reform that protects the life, dignity and health care of all.

The President of the Conference and the Chairmen of the three major USCCB committees engaged in health care reform have written all the bishops and asked that the attached USCCB Nationwide Bulletin Insert on health care reform be printed or hand-stuffed in every parish bulletin and/or distributed in pews or at church entrances as soon as possible. Congressional votes may take place as soon as early November. If your Arch/bishop is not in agreement with disseminating the bulletin insert, you will be hearing from your Arch/diocese immediately.

Also included are suggested Pulpit Announcements and a Prayer Petition. Please encourage parishioners to pray for this effort as well. More information can be found at http://www.usccb.org/healthcare.

Thank you for your urgent actions and prayers on behalf of this nationwide effort!

To be announced at all Masses on the weekend following the Bulletin Insert distribution:

Congress is preparing to debate health care reform legislation. The Catholic bishops of the United States strongly support genuine health care reform that protects the life and dignity of all, from the moment of conception until natural death. However, all current bills are seriously deficient on abortion and conscience rights, and do not yet provide adequate access to health care for immigrants and the poor.

Last weekend you received a special flier/bulletin insert from the US Bishops Conference asking you to please contact your Representative and Senators immediately and urge them to fix these bills with pro-life amendments. The flier/bulletin insert included a web address that allows you to send an email message to Congress with a click of a button. Additional fliers/bulletin inserts can be found at___________ (back of church, etc.). The bishops have asked for our swift action and the commitment of our prayers for this critical effort. Thank you for your help. We can help make sure that health care reform will be about saving lives, not destroying them.

Suggested Prayer of the Faithful:

That Congress will act to ensure that needed health care reform will truly protect the life, dignity and health care of all and that we will raise our voices to protect the unborn and the most vulnerable and to preserve our freedom of conscience. We pray to the Lord.

USCCB NATIONWIDE BULLETIN INSERT

Tell Congress: Remove Abortion Funding & Mandates from Needed Health Care Reform

The bills will have to change or the bishops have pledged to oppose them. Our nation is at a crossroads. Policies adopted in health care reform will have an impact for good or ill for years to come. None of the bills retains longstanding current policies against abortion funding or abortion coverage mandates, and none fully protects conscience rights in health care.

[...]Health care reformshould be about saving lives, not destroying them.
ACTION: Contact Members through e-mail, phone calls or FAX letters.
 To send a pre-written, instant e-mail to Congress go to http://www.usccb.org/action.
 Call the U.S. Capitol switchboard at: 202-224-3121, or call your Members’ local offices.
 Full contact info can be found on Members’ web sites at http://www.house.gov & http://www.senate.gov.

MESSAGE to SENATE:
“During floor debate on the health care reform bill, please support an amendment to incorporate longstanding policies against abortion funding and in favor of conscience rights. If these serious concerns are not addressed, the final bill should be opposed.”

MESSAGE to HOUSE:
“Please support the Stupak Amendment that addresses essential pro-life concerns on abortion
funding and conscience rights in the health care reform bill. Help ensure that the Rule for the
bill allows a vote on this amendment. If these serious concerns are not addressed, the final bill
should be opposed.”

WHEN: Both House and Senate are preparing for floor votes now. Act today! Thank you!

(CNSNews.com) – The U.S. Conference of Catholic Bishops dismissed the House Democrats’ plan to try to isolate funding for abortion in the health care bill as a “money-laundering system” that would do nothing to stop federal funding of abortion, an issue that could potentially derail health care reform.

“While all funds in the public plan begin as private funds, in the pockets of taxpayers and purchasers, they all become federal funds once they are paid to the government (whether paid as taxes or as premiums) – and all abortions in the plan are paid for by the federal government,” the USCCB memo reads.

“So this money-laundering system, aside from making the operation of the public plan more unwieldy, does nothing to address pro-life concerns,” the bishops said.

For private health insurance plans, which can also be purchased with federal subsidies, the Ellsworth amendment would have the federal government segregate federal funds from individual premiums based on an estimate of the average cost of abortion procedures.

This arrangement apparently would enable the government to claim it is not paying for abortion by saying it never paid the abortion surcharge, which would be delineated on every American’s health insurance statement.

The bishops, however, state: “[T]he government’s approach of ‘segregating’ the supposed cost of abortion into a distinct ‘abortion surcharge’ charged to all purchasers only makes the mandatory payment of abortion in these plans even more specific and direct than if the purchaser had to pay it as part of an overall premium.”

The Catholic support for the Stupak Amendment, which brought the Hyde Amendment’s prohibition of the use of federal funds for abortion into the legislation, should not be interpreted as a complete support by the Church of everything else in the health care reform legislation. For instance, the proposed health bill continues to provide abortion payments in cases of rape and incest and when the life of the mother is threatened. This is contrary to Church teachings about the inviolability and dignity of every pre-born human being regardless of the circumstances of their origin.

The legislation aims at further developing school-based clinics that provide, as well as appropriate medical interventions, contraceptives and referrals for abortion. This is a completely unacceptable use of Catholic tax dollars. It is surmised that the states with assisted suicide, presently our own Oregon and Washington, will be provided with some federal funds for “counseling” for patients who might be candidates for this “medical service.” This too is unacceptable. There has been a program of federally funded abstinence education and the present proposal abolishes this while funding sex education. These sex education programs generally provide information on “how to” while avoiding pregnancy rather than “why not.” Whether this component is linked to abortion or not, and it probably is, the Church certainly opposes this approach to sex education. There may be some conscience protections in the bill particularly with regard to direct and intentional as well as elective abortion but this is grossly inadequate. Catholic and Christian physicians and nurses, well as all men and women of good will, as well as private or religious health care institutions, need to be free from coercion relative to the so-called “medically necessary” abortions, contraception, sterilization, and other “services” that do not respect the value, sanctity or integrity of human life. Such adequate conscience protections are not currently included.

There are other more global issues that make the health care reform legislation problematic. The provision of health care is done in the context of a sacrosanct relationship — that between the patient and the physician. This is both a personal and a professional relationship and the physician has the right and the need to be free to diagnose and prescribe for the patient a mode of treatment that is morally and medically sound. There is already a degree of interference in this relationship by way of a variety of mechanisms, but the reform legislation seems to heighten that interference. Further, the reform legislation moves in the direction of a monolithic system with many coverage mandates and little option for families to change the coverage provisions of their personal health care plan or to form pools that reward healthy behaviors. Many plans, for instance, are mandated to provide contraceptive coverage and any Catholic family who would wish to have this coverage excluded from their plan would be prohibited from doing so. They are thus forced to pay for a provision they oppose for religious reasons and that would, in this plan, be available to their minor children without parental consent. This intrusion into the heart of the family is likewise offensive.

Needless to say, the legislation is seriously flawed and though there might have been some small sense of victory with the Stupak Amendment there are still very serious concerns about the impact that this legislation could have on the provision of health care in America. It is not expected that we will be able to configure the plan in such a way that it would be entirely consistent with Catholic moral and social principles but we must work to assure, at very least, that we are free to live our faith in a way consistent with our faith tradition. The inclusion of a comprehensive conscience protection clause would go a long way in assuring that freedom.

The central argument against the Nelson amendment, voiced during floor debate by many Senators, was that this amendment goes too far by barring federal subsidies to entire health plans that include abortion coverage. The three-decades-long precedent of the Hyde amendment and similar provisions governing all other federal health programs, it was claimed, is this: Federal funds may not be used “directly” for an elective abortion, but non-Federal funds such as private premium dollars may be used in the same health plan for such abortions.1 The underlying health care reform bill was said to respect this tradition by “segregating” funds with plans to allow “private” funding of abortion. It was chiefly on the basis of this argument that the Nelson amendment was tabled (see attached sheet of quotes from Senate floor debate).

However, yesterday’s overwhelming vote to approve the Consolidated Appropriations Act creates a new situation. In that vote, almost all Democrats, including almost every Senator who claimed the Nelson amendment’s policy goes too far, voted in favor of that exact policy. For these Senators voted to retain the actual current language of the Hyde amendment, and of the parallel provision governing abortion in the Federal Employees Health Benefits Program – and that language clearly requires a policy in all other federal health programs that is identical to that of the Nelson amendment.

Neither of these longstanding provisions says anything about “segregating” private and federal funds within a health plan or benefits package. Attempts to achieve such segregation are irrelevant to current policy, which bars federal funds from being used for any part of a package that covers elective abortions.

Literally the only substantive difference between these noncontroversial and widely supported provisions and the Nelson amendment is that the latter explains at length that (a) it does not prevent purchasers who do not receive federal subsidies from buying a health plan including elective abortions, even on the Exchange created by the health care reform bill, and (b) it does not prevent purchasers receiving federal subsidies from buying separate supplemental abortion coverage with their own funds.

The Consolidated Appropriations Act also maintains important current laws protecting conscience rights: The Hyde/Weldon amendment (Sec. 508 (d) of Division D), to prevent governmental bodies from discriminating against health care providers that decline involvement in abortion; and two provisions to respect moral and religious objections to mandated contraceptive coverage (in the federal employees’ health program and in the District of Columbia). The first of these is included in the House-passed health care reform bill (Sec. 259 of H.R. 3962); the Senate bill does not yet include any of them.

[...] While its abortion language has been called a “compromise,” it is only a compromise between current law and a broader policy on abortion funding, as it explicitly authorizes the use of federal funds to subsidize health plans covering elective abortions for the first time in history.

III. Conclusion

In sum, the Executive Order cannot and does not fix the statutory problems of direct funding of abortion at CHCs, and of funding insurance plans that cover abortions; it cannot and does not make up for the absence of conscience protections that are missing from the statute; and it does not strengthen the conscience protections that are there, though it could have in certain limited ways. Where the Order purports to fix a shortcoming of the Act in these areas, it is highly likely to be legally invalid; and where the Order is highly likely to be legally valid, it does nothing to fix those shortcomings.

Thus, the shortcomings of the Act remain, and correspondingly, the need for fixes remains. Only Congress, with the consent of the President, has the legal authority to make those fixes. Congress and the President should act promptly to do so; they should not await courts’ likely invalidation of the few provisions of the Executive Order that even purport to be fixes.

USCCB News Release

10-213
November 16, 2010
FOR IMMEDIATE RELEASE

Pro-Life Spokesperson Urges Institute of Medicine Committee to Focus on Life-Saving Preventive Health Services for Women, Exclude Contraception, Sterilization

Contraception is not authentic preventive health care because pregnancy is not a disease
Birth control poses serious health risks to women and adolescents
Mandating coverage would pose unprecedented threat to conscience rights

WASHINGTON (November 16, 2010) — Deirdre McQuade, spokesperson for the Secretariat of Pro-Life Activities of the United States Conference of Catholic Bishops, addressed the Institute of Medicine’s Committee on Preventive Services for Women as they convened for the first time on November 16th. She urged them not to recommend contraception or sterilization among mandated “preventive services” to be announced next August by the Department of Health and Human Services (HHS) as the Department implements the new health care act.

“As you study the vital question of preventive services for women under the Patient Protection and Affordable Care Act (PPACA), I urge you to focus on services that will offer authentic care and save lives,” she said.

Echoing the letter sent by the Office of the General Counsel (http://www.usccb.org/ogc/preventive.pdf) to HHS on September 17, McQuade said, “The Conference has a particular concern that contraceptives and sterilization not be mandated as ‘preventive’ services. To prevent pregnancy is not to prevent a disease—indeed, contraception and sterilization pose their own unique and serious health risks to women and adolescents. In addition, contraceptives and sterilization are morally problematic for many stakeholders, including religiously-affiliated health care providers and insurers.”

According to McQuade, the preventive services recommended under the Interim Final Rules share a basic medical profile. “They pose little or no medical risk themselves, and they help prevent or ameliorate identifiable conditions that would pose known risks to life and health in the future,” McQuade said, but contraception “presents the opposite profile.”

She continued, “Use of prescription contraception actually increases a woman’s risk of developing some of the very conditions that the ‘preventive services’ listed in the Interim Final Rules are designed to prevent, such as stroke, heart attacks and blood clots (especially for women who also smoke), so a policy mandating contraceptive services as ‘preventive services’ would be in contradiction with itself.”
McQuade added, “At various times women may have serious personal reasons for wanting to avoid or delay a pregnancy. However, these personal reasons do not transform a temporary or permanent condition of infertility into a prerequisite for health, or turn a healthy pregnancy into a disease condition.”

She also highlighted the potential impact on conscience rights. “Currently, such employers and insurance issuers [who object to contraception and sterilization] are completely free under federal law to purchase and offer health coverage that excludes these procedures. They would lose this freedom of conscience under a mandate for all plans to offer contraception and sterilization coverage,” McQuade said. “Thus the Administration’s promise that Americans who like their current coverage will be able to keep it under health care reform would become a hollow pledge.”

St Petersberg Times Editorial on the subject in today's paper

But that exemption doesn't go far enough for the Catholic Church, which has mounted a full-court press to try to expand the clause to include more affiliated organizations — be they parochial schools, charities or the vast network of religious-affiliated hospitals. This potentially affects untold thousands of female employees and their families who do not share the religious beliefs of their employer.

Lynch warned that if the administration didn't heed the Catholic Church's demands, the diocese would drop its health care plans altogether and have employees shop for policies on their own. ... The White House must not cave in to the church's demands.

The strongest opposition to the bishops' push comes from Catholics for Choice...

And religious groups have every right to encourage members to abstain from using contraception or any other procedure. But seeking help toward that goal from government shouldn't be an option in a country founded on individual freedoms.

Since healthcare reform is federal legislation, the Venice diocese is waiting to see what stance the United States Conference of Catholic Bishops takes, said Billy Atwell, the diocese's spokesman.