Monday, August 24, 2009

Health Care Reform II: An Abortive Effort?

After spending weeks attempting to fabricate issues that would sink not only President Obama's health care legislation but also Mr. Obama's presidency, the Republican party has been handed a real issue this week that could get them their first wish, anyway.

The Democratic bill before the House apparently mandates that the bill's public (government-run) insurance option will collect from the people who elect it, funds that would be kept separate from "public" funds and used to pay for abortion services beyond those currently allowed through Medicaid (only in cases of rape, incest, and threat to the health of the mother). Moreover, private insurance companies that under the reform bill would be subsidized with public funds could elect to do the same.

Needless to say, I'm deeply disappointed. Mr. Obama excuses this before groups like Planned Parenthood by insisting that "reproductive" health care should be covered by the pubic plan. I couldn't agree more. But ... in what way is an abortion "reproductive"? A woman who has an abortion is choosing not to reproduce. Euphemisms, anyone? It's a bit like calling pornography "mature entertainment."

Worse, the provision provides abortion advocates a sleight-of-hand way around the Hyde Amendment, which in 1976, ended Medicaid funding for elective abortions. Since then, the U.S. government has not funded "elective" abortions and all but 17 states have followed suit, enacting similar restrictions for the use of state funds. The Hyde Amendment has been law almost as long as Roe v. Wade (yes, the Republicans are right here: Roe v. Wade was a textbook study in judicial activism and legislation from the bench). Pro-abortion Democrats ought to feel obligated to accord Hyde at least as much respect as they insist that others give to Roe v. Wade as "the law of the land." The fact-checkers have called this one out: It's a big change. Huge.

More disappointing is that it's a big change that has clearly been engineered not to look like one. Mr. Obama set himself up for well-deserved criticism when he responded this week that the health care reform package did not provide government funding for elective abortions. Technically, of course, he's correct. Instead, it requires anyone who elects the public option to pay into a "private" pool of funds that will be used by the government-administered plan to pay for elective abortions. Not exactly "pro-choice." Although Mr. Obama said, during his campaign, that he desired to find a way to reduce the incidence of abortion, the plan he's defending will make them easier to get and imply government encouragement of abortion. Inconsistent, at best. Defenders of the provision say, of course, that folks can opt for a subsidized private plan that doesn't fund abortions. That hardly changes the fact that the public plan will pay for abortions. A bit of bookkeeping chicanery doesn't change that.

These facts prompted serious schism in the reform ranks: Joining the alarm this week were anti-abortion Democrats — enough of them to sink the health care reform, if the provision is not removed. As many as 19 Democrats will refuse to support the bill if it doesn't clearly exclude funding for abortions.

There's no way the reform bill gets out of the House as it stands.

And that would be a travesty. I'd like to stand by my comments in my preceding post on health care reform. I take nothing back. Health care reform is something that needs to happen. If it doesn't get reformed now, it will demand a much more draconian reform in the future. And it will be even more expensive then than now. And if we don't get it, we'll dearly wish someday that we had.

(It's important to note that the provision for voluntary access to subsidized "end-of-life" counseling — advance planning, as in living wills, hospice care, etc. — was introduced and championed by a Republican, not a Democrat. And that Republican, pro-life U.S. senator Johnny Isakson of Georgia says the "death panel" nonsense was just that.)

Unfortunately, the very pubic squabble (one can hardly dignify what's been going on by calling it a debate) about health care reform is sure, now, to take an ugly and terribly unnecessary turn for the worse. No doubt the same crew that has been trying to tar-and-feather the President and run him out of Washington from the beginning will gleefully capitalize on this week's health care events.

Meanwhile, word is that Democrat Nancy Pelosi is in conference with the unhappy anti-abortion Democrats to try to come up with a "compromise." Here's a compromise: Take out the abortion coverage, and you can get your bill passed. If Ms. Pelosi and Mr. Obama are so married to funding abortions that they will permit a "must" health care reform effort to go down to total defeat, they will not have Rush Limbaugh and Newt Gingrich to blame for it. They will have only to look in the mirror.

Those who support the provision, of course, protest that if abortions aren't funded by the public plan, then some low-income women would lose abortion funding they now have under private insurance policies. That is true. If Ms. Pelosi and her compatriots on the far left would like to see abortions funded, there is no law against organizing a private insurance group that offers abortion coverage as supplemental insurance. Those who care to take advantage of it can, and those who believe as Ms. Pelosi does are free to make that plan as affordable as they can make it. Those who want "choice," then, can choose to pay for it. (That would, in some small, oblique way, justify the "pro-choice" label.) More importantly, that would keep the government out of the abortion business, as the law clearly demands. And those among America's 45 million uninsured who rightly maintain that abortion is the taking of human life wouldn't be forced to choose between their conscience and the health of the children they chose to keep.

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