Healthcare, Abortion, individual liberties, and going forward

Protesting against HCR and BHO. Photo: Astrid Riecken/Getty Images

It's been pretty quiet around these parts as I've been thinking about the recent Health care reform law that was signed by President Obama. After more than a year of debates that from the beginning were wildly uncivil and filled with smoke and mirrors the first step of reform has been completed - but the job is far from done.

In the end beyond death panels the two biggest concerns were the supposed loss of liberty with the notion that this is a healthcare take over (which persists in the postmortem of the bill passing) and that this law now somehow expands federal funding of abortion.

The first concern, which is the nebulous argument of the "loss of liberty" is even more nuanced than that about abortion. Many anti-reformist say that this is a Government Takeover of Healthcare, and say that the federal government can't mandate folks buy a private product.

This actually caused a flame war on the facebooks as I was arguing in favor of the mandate on a friend's mother's wall. (My friend's mother supports reform as well).

Current Jurisprudence actually lends to the credibility of the Federal Government not only mandating the purchase of insurance through the commerce clause but taxing individuals for not purchasing it vis - a -vis Congress' constitutional authority to levy a tax, fines, fees, what have you and this particular enumerated power is very broad. I'm not going to spell out all the specifics but through the magic of the internet provide you a link to a .pdf file from Congressional Research Service on the constitutionality of mandates. Enjoy. It's interesting to note that most folks hemming and hawing about loss of personal liberties in the healthcare debates were very quiet and supportive, and still are, of the Patriot act and all the personal liberties it abridged.

And to date I've yet to find anyone who can explain to me how a government telling you to purchase a private product is a takeover of that industry. Anyone care to explain that one?

Now for... abortion. I'm pro life -- any many ways probably more pro-life than my coreligionists, but that can be explained later. The Senate language for community health centers did not provide language which excludes abortion. In every other instance in the senate bill of funding for specific healthcare programs exclusionary language was used. Many on the far right of the pro - life movement pounced on this one line exclusion and the snow ball effect ensued.

In the end this caused a nasty divide pitting the USCCB against a bunch of Nuns and the CHA.

Who's right.

Well many would argue that it's the Bishops, not just because they're bishops, but because they're right. For many Catholics it's a simple matter of obedience, the Bishops' lawyers (who increasingly come from far right blindly ideological organizations) wouldn't advise the Bishops wrongly, and the Bishops wouldn't promulgate their decision based on false or misconstrued information so they must be right... right.

On the other hand you have the nuns who have been driving as far left as they can since the SVC and who are more likely to be seen escorting women to abortion clinics than praying for them or offering them the assistance they would need in prenatal care, while a foil to the Bishops and a P.R. boon for left leaning catholics, substantively because of such escort services don't have much credibility in this argument despite their best intentions and the great works they do helping the poor. And the Catholic Health Association ... well they're a hospital, and like other industries will suffer and benefit under reform, in this case hospitals and physicians will benefit more with federal subsidies so their support of the reform law has the appearance of impropriety.

Let's get one thing straight. All three groups, the Bishops, the Nuns, the hospitals -- wanted to see healthcare reform. All three don't want to see federal funding of abortion, and yet they devolved into a pissing match over the absence of one sentence regarding community healthcare, and then the fall out and recriminations over Bart Stupack getting an executive order reinforcing the language in the senate bill and reaffirming the Hyde amendment.

For my own part, while the E.O. was nice, the critics were right -- it was a piece of fluff. BUT it wasn't fluff because of the Obama is the most pro abortion meme - but because it's unnecessary, Hyde stands.

Simply put there was no abrogation of Hyde in the text of the bill. The mere absence of Hyde like language from the community health centers portion of the bill does not change the fact that funding for community health centers, while now being increased, still goes through HHS contra what Kathleen Parker argues today in the Post. From Mother Jones.

pro-life groups say the funding for the community health centers funding will be exempt from the Hyde Amendment because it's not being spent through the normal appropriations process. It’s true that these funds will reach the centers through a different legislative route, but it doesn’t matter. As Jost has explained in a detailed analysis (PDF), all of the community health clinic money is going to end up in the same "pot" at the Department of Health and Human Services. And, he writes, since all HHS funding “is subject to the Hyde Amendment, these funds cannot be used to pay for abortions."

Kathleen is right about one thing -- they Hyde Amendment is reupped annually on appropriations bills for HHS. But the Amendment applies to all funds at HHS, not just those appropriated at that one time in that one act, otherwise abortion access would already be possible with the subsequent bills that provide extend additional funding to HHS and it's programs.

The bill has passed, the only thing to do now is work on strengthening legislation to protect life and expand coverage while battling costs. Daivd Frum who has received more than his share of flak from the right of his party recognizes this and has come up with some common sense conservative steps going forward that will further reform the system. More and more conservatives are stepping up to bat against the Beck/Limbaugh Tea Party movement, and offering constructive critiques and ways forward. Personally I yearn for further enactments of the Wyden-Bennett proposals for reform, and yearn absolutely yearn for the day when the following four things happen: the employer based health care system is abolished, health insurance companies can sell plans across lines, health insurance companies exemption from anti-trust laws are ended, and when we end the abortion debate once and for all and some smart insurance types come up with an eye-med like company to cover all manner of 'reproductive health,' from birth control and IVF to elective abortions and gender reassignment surgeries.