Cutting through the Fog

by Keith Cooper

From Broader View Weekly, August 14, 2009

Since members of Congress began their August break recently, there have been efforts on both sides of the debate to present their cases. Democrats have held town hall meetings to allow for discussion of the legislation. Cable news and talk radio have launched campaigns to color public opinion and oppose the reform measures.

Unfortunately, other forces are also at work. Special interest groups and political action committees are organizing folks to disrupt meetings, shout down speakers, and give the impression that a “huge” mob of grass-roots individuals are rising up against the government. Some protests have turned nasty and even violent.

Lost in the fray are the real details of the bill and issues of concern.

The objective of this week’s column is to attempt to cut through the fog and fury of the heated rhetoric and help decode some of the actual bill that is beginning to emerge from Congress.

Unfortunately, it is unrealistic to represent the thousand-plus page document accurately within our limited space. Also, I will admit that I have not read the entire House bill, and that I have read none of the document that the Senate will resume work on when the session returns in September. In fact, wading through the tangle of legalese gave me a greater appreciation for our representatives charged with crafting, amending and even reading the legislative materials that cross their desks. I am not excusing members of Congress who vote on bills without reading them fully, but I found myself wishing for a staff of interns to parse the bill for me.

In the interest of brevity, I will take a look at a few of the criticisms leveled against the bill and discuss them with reference to its actual provisions.

One claim of the opposition (whatever form that opposition takes – be it GOP leadership or conservative media) is that individuals will be forced into a public government-funded health insurance system even if they have existing health insurance with which they are satisfied. There is a provision wherein an employer’s offered health insurance plan is evaluated against certain criteria to ensure that such plan provides sufficient coverage. Any insurance plan that fails to meet these criteria would hardly be worth enrolling in. Employers not currently offering insurance that measures up, have the option to enroll in an appropriate plan or choose the public option. The hope is that employers will be able to provide more inclusive health insurance coverage to their employees by having greater choice of options available.

Opponents also claim that the House plan specifically provides for tax-payer funding for abortions. The Right to Life movement has been loud in its opposition to the bill because it accuses lawmakers of providing funding for abortions in sections of the bill addressing outpatient clinic services and family planning services. In fact, there is no specific reference to abortions at all within the bill from the House of Representatives. There is a portion of the bill that allocates funding to clinic services, but only as a means of defining the breadth of medical coverage under the plan to include entities outside of physician’s office and hospital services.
Some in the movement are pushing for a specific prohibition of public funding for abortions but one of the sections of which they are critical comes close to just that. The section on family planning services denies coverage of those services for women who are already pregnant. While I disagree with this limitation, it should placate abortion opponents. Apparently, though, any public funding of women’s health services is equated with promoting abortion in the minds of some.

The most interesting claim opponents of the bill are making is that it promotes physician-assisted suicide or euthanasia. To be fair, there is a provision that discusses end of life decision and promotes physician-patient consultation that weighs the concerns versus the benefits of certain treatments. This provision does encourage consultation on living wills and sustaining treatments of patients in end-of-life situations. Some conservative talking heads have said that the bills deference to existing state laws regarding these matters implicitly promotes euthanasia since two states (Oregon and Washington) permit physician-assisted suicide. While it is true that the bill suggests physicians discuss a state’s legal requirements regarding the patient’s care, it neither implicitly nor explicitly warrants the practice of euthanasia. The fact is that many ethical doctors already institute a policy of consulting with patients, especially those who are aging, about realistic treatments. Surgeries or treatments that are invasive are often risky and may yield little relief to certain patients, regardless of age. The tendency may be for doctors to recommend treatments to prolong life or minimize symptoms whenever possible, but I believe a realistic approach is morally superior to playing God at the expense and potential peril of the patient.

I am not endorsing the current bill. I had hoped for a real reform of the broken health care system in our country that would provide the neediest among us with the security that vital health services are within reach of us all. I think this bill falls well short of that. However, I feel that the bill should be disputed on its merits and not amid a smokescreen of misinformation.

It is unreasonable for me to claim that this column comes close to educating Broader View Weekly readers on the various components of the health care reform bill. I can only offer this advice: educate yourself. HR 3200: The Affordable Health Care Choices Act of 2009 is available for download at www.house.gov. Also, check the rhetoric you hear against the list of fact checking resources provided weekly on page 2 of the Broader View Weekly. Most importantly, don’t rely on any one source for news or information.