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About The


September 9, 2009
Column #1,463
Reforming Health Care
By Mike McManus

First, you might ask, "Why should a column called `Ethics & Religion" take a stand on a political question such as Health Reform?"

Jesus said, "I have come that you might have life, and have it abundantly."  In today's context, it means that every American deserves access to health care that he/she can afford.  As Ted Kennedy wrote the President: "What we face is above all a moral issue; at stake are…fundamental principles of social justice and the character of our country."

Five elements of President Obama's Health Care Reform merit support:

1.  Insurance companies should be prohibited from denying coverage to those with pre-existing conditions, prohibited from either dropping coverage after a patient submits a big claim or be allowed to set a ceiling on benefits.  The President spoke of Illinois man who "lost coverage in the middle of chemotherapy because his insurer found that he hadn't reported gallstones that he didn't even know about. That delayed his treatment and he died."

2.  Obama rightly said, "Individuals will be required to carry basic health insurance - just as most states require you to carry auto insurance." Most of those without health insurance are younger, gambling that they won't get sick. Their inclusion will help bring down the cost for others.

3. The cost should be subsidized for lower income people, but not for those with incomes up to $88,000 for a family of four as House bills require.  Such a price tag is a major reason why the total cost is a staggering $1 trillion over 10 years. 

4.  Most employers should offer health care for employees, though "95% of all small businesses…would be exempt from these requirements," the President said.

5.   Insurance companies should be allowed to sell policies across state lines. It is wrong in Alabama that one company has 90% of the business. 

On the other hand, this column has opposed "free lunch" politics of both parties - endless tax breaks by Republicans and trillion dollar health plans by Democrats. Even those earning $30,000 can afford to pay part of the cost of health care. 

Obama said "Under our plan no federal dollars will be used to fund abortions."  Sadly, that is simply not correct. House committees defeated 11 attempts to prohibit using public funds for abortion. 

Reasonable people will disagree on whether abortion is morally right or wrong, but there has been a consensus in America since passage of the Hyde Amendment in 1976 that public funds should not subsidize it. Polls reveal opposition to public funding by 2-1 to 3-1.

During the campaign, President Obama championed passage of a "Freedom of Choice Act" to "provide all essential services, including reproductive services."  His campaign confirmed that "reproductive services" included abortions.  Won't he fulfill his campaign promise?

Most important, Obama acknowledged that "reforming medical malpractice laws can help bring down the cost of health care," a position Republicans have urged, and Democrats have opposed.  He only proposed "demonstration projects," however. The CEO of a southern hospital told me, "Defensive medicine due to fear of being sued costs between $50 - $100 billion annually."  A more serious commitment by Obama might win Republican votes.

Encouragingly, Obama proposed a $900 billion program, $100 billion less than the least expensive House bill. However, he claimed the bill "will not add a dime to our deficits." How will it be paid for? He said, "Reducing waste and inefficiency in Medicare and Medicaid will pay for most of this plan."  That simply is not credible.

More fundamentally, the President claims his bill will slow the growth of health care costs.  How is that possible when he is substantially expanding health care entitlements to 30 million people?  Increased demand for a fixed number of doctors and hospitals will drive up costs.

Finally, with the long-term bankruptcy of Medicare in the near future, plus this $900 billion bill, it is essential to end "fee for service" medicine, in which doctors and hospitals are paid for each service rendered. 

A better answer is move all Americans into prepaid group practice.  My family has been part of Kaiser-Permanente for 25 years.  We have paid a flat fee, which did rise over time, but have had full health care from physicians who are paid a salary. My life has twice been saved by Kaiser's timely care.  Pre-paid group practice offers quality care at a reasonable price.

On balance, however, a Health Care Reform bill should be passed, especially if its costs are trimmed, malpractice reform is added, and the President decides to live up to his new pledge to explicitly prohibit public funding of  abortion.

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