US Bishops' Biggest Hope: Life-Affirming Care for All

Interview with Richard Doerflinger on Health Care Reform

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By Kirsten Evans

WASHINGTON, D.C., DEC. 18, 2009 ( With only one week left before Christmas, and as ordinary Americans flood shopping malls and prepare for the holidays, the U.S. Senate is working overtime to pass a massive health care reform bill before the end of the year.

President Barack Obama has made health care reform a hallmark issue of his first year in office, calling it the most significant legislation of its kind since Franklin D. Roosevelt’s Social Security Act of 1935.

The U.S. episcopal conference has taken an active interest in articulating guidelines for health care reform, and gained national recognition for their influence in advising lawmakers in crafting the “Affordable Health Care for America Act” that passed in the House of Representatives last month, and is awaiting approval in the Senate.

ZENIT caught up this week with Richard Doerflinger, associate director of the bishops’ Secretariat of Pro-Life Activities, to ask him about the bishops’ interest and involvement in the shaping of health care reform legislation.

ZENIT: Since the presidential election and the inception of the new administration, health care reform has been catapulted to the forefront of American political debate. Was health care reform a concern of the U.S. bishops before 2009?

Doerflinger: Yes, we have been calling for reform to guarantee universal access to health care for over half a century. In recent years, the bishops have been very involved in efforts to expand health care coverage, especially for children and pregnant women, through the Children’s Health Insurance Program established 11 years ago.

ZENIT: Cardinal DiNardo of Galveston-Houston, a relative newcomer to the bishops’ conference and chair of the Committee on Pro-Life Activities, has described health care reform as being “urgently needed.” Why do the bishops see health care reform as an urgent need?

Doerflinger: We see the right to basic health care as a corollary of the right to life, as Pope John XXIII said in his encyclical “Pacem in Terris.” It is a scandal that the wealthiest nation in the world still has tens of millions of people with no health coverage at all.

ZENIT: The bishops have targeted three non-negotiable principles for a just and ethical healthcare reform: respect for life and conscience, affordability, and fair access for immigrants. Could you briefly summarize for us what each of these three issues embodies?

Doerflinger: Respecting life and conscience means that reform must respect everyone’s need for health care, from conception to natural death, and never promote abortion or other procedures for taking life. Employers, insurers, insurance purchasers and health care providers must also be free to live according to their conscientious convictions on respect for life.

The criterion of affordability is based on our preferential option for the poor and vulnerable: The first priority in financing the system should be that health care is made affordable for the poor who are most in need of help.

Fairness to immigrants is essential because the right to health care is based on simple membership in humanity, not in political status or place of origin.

ZENIT: There has been a lot of talk recently about the famed Hyde Amendment language and the Menendez Amendment. Could briefly explain to us why these two amendments are so important?

Doerflinger: The Hyde Amendment has prevented federal funding of abortion in most major federal health programs for 30 years, and many parallel provisions have applied this same principle to the remaining programs. Our goal on abortion in the health care reform legislation is very simple: The policy of the Hyde Amendment must be maintained so that this legislation is not used as a vehicle for promoting the destruction of unborn human life.

The Menendez Amendment is part of our effort to maintain fairness to immigrants — it would allow states to opt out of the current punitive federal policy that prevents legal immigrants from accessing government health care for the first five years they live in our country.

The current policy is both unfair ethically and counterproductive pragmatically — people deprived of regular access to health care wait until they are very sick and then resort to hospital emergency rooms, where health care is at its most expensive and the cost is passed on to everyone.

ZENIT: The U.S. bishops received a great deal of press and recognition for their impact on crafting the bill that passed in the House last month. This bill contained the Hyde Amendment language we spoke of above. The presence of the bishops was described as decisive in achieving bi-partisan support for this language. To what would you contribute the success of the bishops?

Doerflinger: We are seen by many as an honest broker on issues such as health care and abortion. We strongly support reform, and strongly defend the rights of the unborn; we are not tied to any party, but argue these positions on their merits as moral issues, and we are happy to work with members of both parties to achieve a better policy.

But the decisive factor in the House debate was the active involvement of several dozen pro-life Democrats who shared our twofold commitment to life and health care reform. They made their support for the legislation conditional on the bill’s abortion funding problem being fixed. We only lent support and advice — they put their reputations and careers on the line.

ZENIT: Did you find you made any unsuspected alliances with other organizations in the effort to craft a just health care reform bill?

Doerflinger: I wouldn’t say it was unsuspected because it has become a common occurrence. Because we will work with members of Congress on all our issues related to human dignity, we end up being seen as part of the “liberal” coalition on immigration and affordability, and part of the “conservative” coalition on abortion.

We simply see these as complementary aspects of our single message on human dignity. In the effort to address the abortion problem itself, we worked with committed groups ranging from Family Research Council (seen as politically very conservative) to Democrats for Life and Sojourners, seen as being on the liberal side of the spectrum.

ZENIT: Now that the bill has passed to the Senate, we know that the provisions the bishops fought for in the House bill remain at high risk. What is the biggest challenge the bishops are facing as the bill they fought for is now debated on the floor of the Senate?

Doerflinger: Currently the Senate bill falls short of the House version on all three of our criteria. Perhaps the most contentious issue has been abortion, as a majority of the Senate seems committed to using this bill as a way to vastly expand federal subsidies for health plans covering elective abortion.

And the Senate does not have the large number of pro-life Democrats that proved so decisive in the House, though some pro-life members such as [Nebraska’s Democratic Senator] Ben Nelson have become especially well-known for their courage in insisting that this issue be addressed. At this point we do not know what the Senate will finally pass, or if it will pass a bill this year.

ZENIT: In concrete terms, what could be some of the conscience issues that ordinary American Catholics could face in the future if a health care reform bill which the bishops do not approve of were to pass?

Doerflinger: Catholic employers could find themselves penalized for trying to purchase health coverage consistent with their core convictions, as they cannot comply with a “basic benefits package” that mandates inclusion of procedures such as contraception and sterilization. Catholic health care providers could also find themselves marginalized in a health system that is required by the government to ensure rea
dy access to procedures that Catholic facilities do not provide. Individual Catholics may no longer be able to find a Catholic health plan in line with their own moral convictions, because Catholic ethical standards do not live up to the government’s idea of an essential benefit. These issues need to be addressed in the legislation.

ZENIT: What is the bishops’ biggest hope for health care reform? And what is their biggest fear?

Doerflinger: Our biggest hope is for a renewed health care system focused on basic life-affirming care for all, reflecting our human solidarity and our dependency on each other to live and flourish. Our twofold fear is a continued ailing system that leaves tens of millions without coverage, or a system “reformed” in all the wrong directions to promote the taking of life at its beginning and its end. Neither of those results is acceptable to us.

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