"How Obamacare is Destroying Accountable Care Organizations"

That's the title of an article from Forbes. Excerpt:

“Accountable care organizations” is the health wonk phrase du jour. Obamacare’s advocates point to its support for ACOs as one of the important cost-control initiatives in the law. Except that, like nearly everything about Obamacare, the truth isn’t so simple. It turns out that the government’s idea of an accountable care organization is completely unworkable, to the point where nearly all leading health providers have declared it dead on arrival.

It turns out these organizations are already being tried--under the Medicare Advantage system, which is a privatized system. But just to make the invisible hand a little more visible, the government insists on spending hundreds of millions of dollars to try out their own version. Only, the government model doesn't seem to be as popular; I wonder why?

On March 31, Donald Berwick’s Centers for Medicare and Medicaid Services issued 427 pages of proposed rules and regulations that will govern how ACOs will operate.

In May, ten groups that participated in an ACO pilot program called the Medicare Physician Group Practice Demonstration, including leading centers like Dartmouth-Hitchcock, Geisinger, and the University of Michigan, told CMS in a letter that it would be “difficult, if not impossible” to participate in Obamacare’s ACO program, due to its incessant federal micromanagement and high start-up costs.

Once again, ladies and gentlemen, your tax dollars hard at work.

Accidental Entitlements

From the Boston Globe:

President Obama’s health care law would let several million middle-class people get nearly free insurance meant for the poor, a twist government number crunchers say they discovered only after the complex bill was signed.

Well, wasn't that the idea all along? Hurry up and sign it, then figure out what it actually says!

Oh, the joys of "progressive" legislation.

HT: the Freeman online

More on health care and bureaucracy

Dr. Donald P. Condit writes in The Detroit News:

The sugar-coated rhetoric from HHS cannot disguise the bad medicine in this part of the Affordable Care Act, which intends to bureaucratically cut as much as $960 million in Medicare spending over three years. This Obamacare prescription threatens patients, the physicians who care for them, and the common good.

The only clear winners are the consultants and lawyers busy trying to decipher this 429-page tome.

Medicare beneficiaries will be "assigned" to 5,000 patient-minimum organizations to coordinate their care. While HHS Secretary Kathleen Sebelius talks about improvement in care, the politically poisonous truth is that Medicare is going broke and ACOs are designed to save money.

The words "rationing" or "treatment denial" or "withholding care" are not part of her press release, but reading the regulations reveals intentions to "share savings" with those who fulfill, or "penalize" others who fall short of, the administration's objectives. The administration's talking points include politically palatable words that emphasize quality improvement and care enhancement when the real objective is cost control by a utilitarian calculus.

Read the rest here.

Markets and Rationing

I just can't accept Andrew Sullivan's argument concerning rationing: "At some point, then, we have to ration." Rationing is something done by an arbitrator of some kind. This means the arbitrator himself apportions the resources; the amount you get depends finally on the arbitrator.

Markets simply don't ration. To speak that way is nothing other than a modern form of animism, attributing personality to something which is impersonal and abstract. Metaphors like "hidden death panels" are particularly insidious, since they to make equivalent two things which are decidedly opposite one another: markets governed by the rule of law and rationing governed by a bureaucracy. Perhaps Hayek was right when, particularly in The Fatal Conceit, he argued that the human tendency toward animism is an ever-present obstacle to perfecting the free society. This tendency, it seems, is as vibrant among the intelligentsia as it is among the average person.

As rationalists we tend to act as if the choice is between smart, benevolent people doing their best to give everyone a fair share and a cold, impersonal system which amounts to nothing more than "survival of the fittest." This dichotomy is built on the presumption that our reason is sufficient to solve the economic problem of scarcity. Completely ignored is the problem of information. We tend to think that all the knowledge needed to run things is theoretical. In the health care debate, people talk as if the only thing we need to do is more research in laboratories to try to make health care technology even better. This is not the case. The health care problem is the same as any other economic problem: trying to match the needs of consumers with the resources available. This problem is what I call a higher-order problem, in that no one human mind or even team of minds can solve it (not even in theory, I would argue). This is a consequence of the fact that there does not exist a complete list of values by which to match resources to individuals.

Thus we would like to have a mechanism by which to allow some spontaneous order, which tends to match consumers to their needs while overcoming the problem of information. This is what a free market does. It is a decentralized solution; no arbitrator need make any decisions about who gets what. The only need for government is to make sure everyone follows the rules of the game (which is certainly not always the case today!) and perhaps to provide a uniform base level of insurance to all participants (provided the resources exist). A base level insurance, in the case of health care, could be some sort of catastrophe insurance, or perhaps a certain dollar amount which may be spent on medical treatment. Nothing like the plan which exists today, which gives the government ever more increasing power over which kinds of health insurance options we have, could possibly be called a free market solution.

I don't know whether free markets are the best at solving problems the way we wish them to be solved. However, I also understand that the way we wish a certain problem to be solved now is necessarily based on the knowledge which we currently possess, and there is no reason to suppose that this knowledge is really sufficient to make long-term decisions about how the economic problem of health care will be solved. What we need, rather, is a solution which is itself dynamic, which can grow and adjust to coming changes, which will naturally adapt itself to changing and perhaps unknown needs. This is something only free markets can do.

It isn't a matter of "trusting" free markets, to return to my original theme. It is a matter of understanding them. Any talk about "market rationing" is simply a philosophical and/or scientific misunderstanding, and it obscures right thinking about economics. True, we may prefer to trust governments to ration rather than allowing markets to provide spontaneous order. And true, we may after all believe that governments have enough information to properly distribute health care to individuals. But that is a choice based on a remarkable amount of faith, of which I for one am skeptical.

Privatizing health care

I've been reading Tyler Cowen on Medicare, as well as some of the responses to him. Ezra Klein's recent response is especially effective:

Tyler Cowen and Matt Yglesias are going back and forth on the appeal of converting Medicare into a straight cash grant. This isn’t the Ryan plan they’re talking about. They mean handing seniors cash. As Matt writes, “If grandma wants to spend that money at the hospital, good for her. If she wants to spend it on heroin or a television, then that’s good for her, too.” Cowen concurs. “What would terrify the left,” he says, “is the likelihood that genuine privatized cash would actually win that competition.”

This has a lot of wonkish allure, particularly if you think, as I do and Matt does and Tyler does, that medical care is overvalued. But it misses the problem that leads to universal health-insurance systems: As a society, we are not willing to let people die painfully in the street, even if they have previously made decisions that would lead to that outcome. In reality, what terrifies all of us is what happens after someone takes the cash and then gets sick.

That's really it. And it's why I really waver on this issue. I believe in the absolute value of human life--one human life is not more valuable than another. But reality doesn't give us the option to put that into practice: preserving lives always comes at a cost, some lives more than others. Discerning the most life-affirming health care system (or economic system more generally) is tricky precisely because we don't know what it means to affirm the value of life in a world that generally isn't conducive to immortality.

But I still hesitate to accept Klein's conclusion, because I think there is a legitimate slippery slope argument to be made. If we're unwilling to hold individuals responsible for their decisions about health care, why are we willing to hold them responsible for other economic choices, like what food to buy or what career path to take? Since both of these choices really do affect long-run health, it seems only natural that a society determined to guarantee a certain quality of health care would eventually force its will in these common affairs, as well. After all, this may be the only way we know to lower health care costs while preserving health care entitlements.

To me the argument isn't solely about individual liberty, nor is it just about compassion. It's also about how we learn as a society. A society that respects free individual behavior doesn't necessarily do so because it thinks all people are entitled to be left alone, but rather because it favors experimentation and spontaneous innovation. Personal responsibility creates that sense of necessity which is the mother of invention. Who knows what kind of creative health care solutions people will come up with if they're free to use their money however they wish?

Such freedom comes at a cost, of course, but it is a cost we can measure. The problem with the alternative--individual mandates in health care--is that we can't measure the cost. We simply don't know what new ideas might have been discovered in a free system. In the long run, I would argue, what we don't know yet is more valuable than what we do know. This, to me, is the best argument for a free, privatized health care system.

On the other hand, I don't mind if we continue to waffle on the issue; being "too compassionate" is not such a heinous crime, after all.

Ken Cuccinelli's lawsuit against Obamacare

Ken Cuccinelli, the attorney general of Virginia, just won his case before a federal judge in Richmond on Monday. On Thursday he published an editorial insisting that the case go quickly to the Supreme Court. I think he makes an appropriate argument against the health care bill. Regardless of anything else Cuccinelli might say or do, I have to support him, at least in principle, in this argument:

The health-care law sacrifices the liberty of Americans and abandons the Constitution that protects that liberty. The power Congress claims it has to create the mandate and penalty has no principled limits: If the federal government can order a citizen to purchase a private product such as health insurance in the name of public policy, it can order us to buy anything.

Hayek on Social Insurance

From The Road to Serfdom, Chapter 9:

Nor is there any reason why the state should not assist the individuals in providing for those common hazards of life against which, because of their uncertainty, few individuals can make adequate provision. Where, as in the case of sickness and accident, neither the desire to avoid such calamities nor the efforts to overcome their consequences are as a rule weakened by the provision of assistance--where, in short, we deal with genuinely insurable risks--the case for the state's helping to organize a comprehensive system of social insurance is very strong. There are many points of detail where those wishing to preserve the competitive system and those wishing to supercede it by something different will disagree on the details of such schemes; and it is possible under the name of social insurance to introduce measures which tend to make competition more or less ineffective. But there is no incompatibility in principle between the state's providing greater security in this way and the preservation of individual freedom. To the same category belongs also the increase of security through the state's rendering assistance to the victims of such "acts of God" as earthquakes and floods. Wherever communal action can mitigate disasters against which the individual can neither attempt to guard himself nor make provision for the consequences, such communal action should undoubtedly be taken.

On traffic lights and economics

Suppose you are sitting behind a long line of cars at a traffic light, and the light turns green. Despite the light turning green, the car in front of you does not move for half a minute. Finally, you are free to drive, yet you are hardly able to move forward before the light is red once more. The light changes again, and you go through the same cycle. By now you'll be late for your appointment. You want to scream at all the cars who were in front of you and wouldn't move.

You think to yourself, "Why is it that when the light turns green, we don't move?" You decide that it would be much more logical if as soon as the light turned green, everyone at the light started moving simultaneously. This would make getting cars through the light much more efficient. Then you wouldn't be late. Driving would be so much better if everyone followed this simple rule that you are convinced they should pass a law requiring it. After all, it would help everyone, in the long run.

Someone explain this to me

From the New York Times:

The White House on Wednesday issued new rules requiring health insurance companies to provide free coverage for dozens of screenings, laboratory tests and other types of preventive care.

The White House issued new rules? When did the president gain the power to legislate? And how is this not a slow but steady government take-over of health care? The whole argument for this legislation (which mysteriously has come from the executive branch, according to the NY Times) appears to be, "We're the government, we have the experts on our side, so do what we tell you." As illustrated in the Times article:

In general, the government said, Americans use preventive services at about half the rate recommended by doctors and public health experts.

...

The rules stipulate that no co-payments can be charged for tests and screenings recommended by the United States Preventive Services Task Force, an independent panel of scientific experts. The rules apply to new health plans that begin coverage after Sept. 23 and to existing health plans that make significant changes after that date.

At least the experts who are so benevolently dictating what happens in our economy are willing to admit that you can't get something for nothing.

The administration said the requirements could increase premiums by 1.5 percent, on average.

There is, after all, no free lunch.

I am troubled by the fact that people are willing to grant the President more and more power over the private sector all for the sake of "fairness" and this "fundamental right" to health care. Motivated by a sense of resentment toward businesses we like to demonize, we willingly create a monster in the White House, who promises to ensure that everyone gets what they need. That is not the system of economics that has led to American prosperity. We did not achieve prosperity by handing such authority over to a single team of "experts," and we will not sustain prosperity that way. In the long run, we will all be worse off--even the poor, who supposedly benefit from such paternalism.

Dealing with betrayal

Steven Ertelt, editor of LifeNews.com, has written an article on his site which appears to argue that in light of Sunday's vote on health care, pro-life Democrats can't be trusted to come through on the pro-life debate.

The fact that Bart Stupak and other Democrats flaked out at the very last minute is disturbing. And the fact that Democrats for Life is virtually the only pro-life organization right now that is praising the passage of the recent health care bill is at least somewhat disturbing.

It's easy to feel betrayed by pro-life Democrats. The article describes this feeling very well:

Chris Smith, the long-time leader of pro-life lawmakers in the House, told WSJ that Democrats face enormous pressure to yield because the party is so beholden to pro-abortion interests.

"The peer pressure to be part of the team can be overwhelming," he said. "But sometimes it's absolutely necessary, regardless of the cost, to bend into the wind, unmovable, committed to what your heart, mind and conscience know to be right."

"For so long, Bart did that. Then he was like a runner who stopped a hundred feet before the finish line. It's a sad day for the unborn, a sad day for their mothers, and a serious setback for the culture of life," he said.

So the question is, can pro-lifers trust Democrats at all?

Ertelt and others appear to be saying "no" in light of a perceived betrayal on the part of Stupak and other Democrats. But I would argue that this is a dangerous way to deal with betrayal. If pro-lifers let high emotions get to them at this juncture, they will be making huge long-term sacrifices that they cannot afford to make.

One interesting question is how the abortion issue got so partisan at all. This issue was not so partisan in the beginning. I think we have a bit of a chicken and egg problem here.

As this Gallup poll shows, the two parties have become more polarized on abortion over the past few decades. I have to wonder why this is. Did pro-lifers join the Republican party because the party supported their views? Did pro-choicers join the Democratic party because the party supported their views? Or did people within their parties change their views?

Clearly some have changed their views over the years, probably due to political pressure from within their party, as Ertelt's article demonstrates:

Former president Bill Clinton, former vice-president Al Gore, Ted Kennedy, Jesse Jackson, current number two Senate Democrat Dick Durbin, presidential candidate Dennis Kucinich -- the list goes on and on of Democrats who, at one time, articulated the pro-life position only to compromise down the road.

And as another example, Ronald Reagan went from signing a liberal abortion law as governor of California to becoming a champion of the pro-life movement.

All this shifting around has caused a bit of a feedback loop. As more pro-lifers flock to the Republican party, the Republican party responds to its constituents by becoming more pro-life (but perhaps only on paper!) which in turn attracts more pro-lifers. The same idea holds for Democrats and pro-choicers.

But we cannot let this cycle continue indefinitely. That would be sacrificing the long-term victory for perhaps a few pathetic short-term political gains. Are we so short-sighted? Can we not see past these political skirmishes we fight, which have very little if anything to do with changing America into a culture of life?

In the long run, we should want nothing less than for abortion to be unthinkable, just as slavery is today. How do you propose that will ever happen if we demonize Democrats for their beliefs on how to make health care accessible?

Whatever your views on abortion, whether or not this health care bill will actually fund abortions is apparently not very clear, with intelligent people on all sides of the issue saying very different things. This is not a fair line to draw on the sand on the abortion issue, although I admit it ties knots in my stomach to think that there's even the possibility of taxes funding abortions.

If Democrats for Life are praising this health care bill, it is probably not a matter of sheer party loyalty; rather, it is probably a matter of commitment to a certain view of how economics (of health care in particular) should work. I happen to disagree with that view of economics, but not on strictly moral grounds (although I might be able to make some moral arguments against it).

Bart Stupak, as I blogged earlier, admitted his feeling of internal conflict over this whole matter. He wanted this health care bill to pass, with abortion being the only thing holding him back. I imagine that those who are unwilling to sympathize with him at this point are simply those who (like me, admittedly) were never big fans of this health care plan to begin with.

The principle of charity demands that we accept these explanations for what happened on Sunday, rather than the explanation that pro-life Democrats are just "spineless Obama-drones," as I blogged the other day out of frustration. I'm willing to admit that my attitude was wrong, but apparently pro-life leaders out there are willing to turn that attitude into a coordinated political movement. This will not work.

The pro-life movement has long been known for its religious influences. Now, at this juncture, we need to take those religious influences seriously, and remember that faith in God requires a desire for reconciliation. If we let our differences turn into political hatred, we will be destroyed from within.

It can be hard to overcome these strong feelings caused by this past weekend, but we must. Otherwise, we risk throwing away the long term for the sake of the short term. We risk throwing away the future of the unborn for the sake of our own self-righteousness.

I believe we pro-lifers risk also deluding ourselves into thinking we have more political sway than we really do. Polls that I've seen have all shown that abortion is pretty low on the list of voting priorities for both Republicans and Democrats. If that's the case, then what are we doing throwing our lot with one party or another?

Polls show at least half of Americans consider themselves pro-life. That would appear to be more than enough to make an enormous influence on abortion law. But apparently it isn't, and I suspect the reason is that the abortion issue isn't a high enough priority for those who already consider themselves pro-life. And how do we expect to change that if we're busy demonizing people like Bart Stupak and Democrats for Life?

Pro-life leaders need to examine themselves carefully before they sell out our future for the sake of their pride. As I've said time and time again, the pro-life movement is not a conservative movement. Nor is it a religious one. It is a human rights movement with a message that is perfectly consistent with any number of political, social, and economic systems.

It's time to put aside our feelings of betrayal and work as quickly as possible toward reconciliation. As long as there are both Republicans and Democrats in this country, we will need support from both of them. Unless you imagine that freedom lies in a one-party system!

Calming Down...

The past few days have been stressful for me as I've watched this whole health care debate unfold and reach its climax. I feel like I'm sort of reliving the days when Obama won the election back in 2008. That was what got me blogging in the first place; I guess it's fitting that I've been driven to blog so much lately.

I blog because I'd like to think that at the very least, I can put my ideas out there, rather than just keep them in my head all the time. Sure, it's fun to just talk politics over lunch with friends, but we live in an age where getting ideas out into the public arena is not nearly as difficult as it used to be. I feel a responsibility as a thinking individual to be part of a much bigger conversation.

Ideas matter. They determine our relationship with the world around us. They shape our government policies, which in turn shape all of our lives. The fate of our democracy depends on us being able to critically evaluate those ideas that affect all of our lives. We cast the votes that endorse one idea over another; we need to take responsibility for understanding those ideas.

Ideals, as opposed to ideas, just don't cut it. Ideally, we could simply wish everyone to have health care coverage, and it would happen. But the problem is, that can't happen. Intentions are not enough. The world does not run on our good intentions. It runs on our ideas, not our ideals.

In my opinion, that's where health care reform falls short. It's full of good ideals, but not good ideas. What is needed is a clearer picture of what's actually causing inefficiencies in the current health care system. It doesn't do any good to repeatedly point out that there is a problem, which is one of the most frustrating tendency I've found in liberals on this issue. As if conservatives don't know there's a problem! But unfortunately, it is possible to do worse than nothing. I fear the bill we just passed is in fact worse than if we had just done nothing.

Which leads me to blame conservatives for not tackling this issue when they had the chance. What we need in the government are smart conservatives. Not "compassionate conservatives" the way George W. Bush thought. Compassion is a good thing; but compassion is useless if you don't know what you're doing. Far more important is for conservatism to be smart.

But smart conservatives also need to be pro-active. I'm tired of seeming to have only two choices: one choice is to have Democrats in power taking the country further left, the other choice is to have Republicans in power focusing on the war on terror and not implementing any conservative solutions to domestic issues. Where was the health care reform back during the Bush era, when Republicans could have at least passed significant tort reform? What were the Republicans thinking when they passed No Child Left Behind, another inefficient big government program that fails to see the fundamental problems with education?

Since I've been truly alert to politics, I can't think of one thing that Republicans have successfully argued for on the domestic front other than lower taxes. As if lowering taxes solves all economic problems! And it makes me so sad, because I read all the incredibly bright conservative thinkers out there with great ideas about how to bring real reform on huge issues like education and health care. Who's going to put those ideas in place? We need a smart conservative, one who can make the case to the public convincingly, and then actually get it done, the way Obama and Pelosi hammered their agenda through.

Whatever else I have to say about Obama, he's a pretty impressive politician. If I agreed with his ideas, I'd probably be ecstatic. Unfortunately, it never feels good when the star player is on the other team.

And with that, I think I can wind down, count my blessings, and remember that frustration will not accomplish anything. I'm thankful that in this country I have the freedom to express my criticisms, my doubts, and even my frustrations. But with that privilege, I think, comes a responsibility to figure out the best way to use it. I can certainly do better than just complain.

Ideas matter, and I'll continue to defend ideas that are counter to Obama's. But they don't really matter as much as love. And no matter what this health care bill does, I can still choose to love my neighbor. Will it cause me to have to pay more to the government? I can still be generous with what I have left. Will it actually, as Obama says, end up saving us money? Well, then I'll have the blessing of being proved wrong.

Will it end up promoting abortions? That is still a tricky issue. But even then, the way we show love does not change. We go and we stand and pray and show that we love all people, no matter what. We give our own money to pregnancy centers, and show that there is an alternative to abortion. We change hearts and minds. There really is no shortcut past this. Our political stances are only as good as the love we show to other people.

It's good for my soul to have written this out for myself, and also for all of you who happen to think I have anything to say worth reading. In the land of political commentary on the Internet you don't get a lot of calming influences. If nothing else, at least I'll sleep better at night.

Did you know you voted for socialism?

Despite polls showing that Americans did not approve of this health care bill, Rev. Al Sharpton insists that the American people wanted this all along. Obama ran on a socialist platform, he says (apparently not troubled by that idea). The people overwhelmingly voted for Obama. Therefore, the people overwhelmingly voted for socialism.

Sadly, he's right. Whether or not people knew that's what they were voting for, that's what they voted for. This is why mere words like "change" and "hope" as well as phrases like "yes we can" serve no purpose but to hypnotize people into voting for a disaster.

Next time, America, remember that policies matter, and they're the only thing that matters when it comes to elections. It doesn't matter how inspiring or how charismatic a politician is. All that matters is what he will do.

And what Obama has done is apparently not going to go through without a fight from several states. (See also this article.)

A victory for the American people? It sounds more like a civil war.

Well, never mind

Never mind about Stupak. Never mind about integrity. All we have in Congress is a bunch of spineless Obama-drones. And then some Republicans, I guess.

Good job, Pelosi. Today is your day.

God Bless Bart Stupak

The more I've been following this health care debate, the more I've gotten confused, discouraged, and at times angry. Being invested in the pro-life issue, I was of course primarily concerned with abortion funding. I've long known that Obama is 100% committed to the pro-abortion cause, so I knew right from the introduction of a health care reform bill that abortion funding would be something to watch.

I was encouraged back when Congressman Bart Stupak originally introduced his amendment to ban abortion funding in health care, and 64 Democrats joined with the Republicans to vote in favor of the amendment. If this passes, I thought, at least it'll be something I can live with (although some pro-lifers were concerned even by that amendment).

Then the Senate bill came out, and apparently it did not live up to the language of the Stupak amendment. Trying to figure out exactly what it does say, and trying to figure out what's really going on, has been a sobering experience.

Every pro-life e-mail list has been frantically telling its members to contact their representatives in Congress to try to get opposition to this bill until it's changed to exclude abortion funding. But the sad realization I've come to is that all this energy devoted to this one bill should have been channeled a long, long time ago.

Part of what made me realize this is the way some people have had the gall to argue that we shouldn't oppose this bill now, because the government already funds abortions, anyway. I guess trying to do something about it now is considered infringing on women's personal liberties. Never mind my personal liberty in keeping my money from supporting abortion.

The more I've learned, the more I've come to realize just how much abortion is ingrained in our culture and in our economy. Decisions made by federal courts a long time ago have firmly established abortion is something politically unopposable, except in pitifully small ways. Honestly, if pro-lifers gain any victory on this health care bill, it too will be pitifully small.

This is why I simply can't vote for anyone who isn't pro-life. Although it seems rather futile in the short run, the fact is absolutely nothing of any long-term consequence can ever be done politically on this issue unless politicians have a price to pay for being pro-choice.

A big part of me would love to say I still respect pro-lifers who voted for Obama, based on many other important issues of conscience. But in many ways, I just can't. I have a really hard time respecting people who claim to believe abortion is wrong but won't do anything about it politically. The currency of politics is votes; give people your vote, and you give them incentive to stick to their current beliefs. Being pro-abortion is one of the worst beliefs I can think to endorse.

Change can only happen on this issue if people stick to their principles. Of course, it's true that many people will simply have to be convinced to change their minds. But much of the time, it's simply a matter of pro-lifers not having any backbone, being willing to sell out when the debate gets tough.

That's why Bart Stupak is just the man. This Democrat from Michigan has become the focal point for more political ire than I can imagine. But he isn't backing down.

Stupak is a long-time supporter of health care reform. In his own words, "I believe everyone should have healthcare. In all my correspondence — I’ve been saying for years — it’s a right, not a privilege."

But there's a price that Stupak isn't willing to pay: he isn't willing to see federal subsidies supporting abortion. And oh, the criticism he's taken from the Left; just Google his name and search for a few seconds.

For instance, Michael Moore has decided to chime in with a letter, brilliantly titled, "My Congressman, Bart Stupak, Has Neither a Uterus Nor a Brain." Besides Moore's characteristically inflated rhetoric and poor reasoning, the letter also contains unproven accusations against Stupak all for the sake of demonizing the guy, just because of his principled stance on this difficult issue.

Another article accuses Stupak of being willing to "kill the living to save the unborn." It also takes a stab at Stupak's conservative constituency:

Coming from a state that has been so touched by this recession, you'd think that voting against health care reform would be political suicide, but apparently, if Rep. Stupak is reading his constituents correctly, they are people who are willing for other people to die from lack of health care insurance, more than they are able to see beyond the perceived threat within their own "conspiracy theory" minds that health care reform is nothing more than a liberal, socialist plot to provide free, federally funded abortions. Next they'll be saying that President Obama is not a U.S. citizen and has no right to be president. Yeah right.

No one thinks any of this. But people bent on passing this health care bill without regard for its potential side effects will go to great lengths to make Stupak and his supporters out to be idiots.

And I just wonder, why? Why don't the Democrats just throw Stupak a bone, here? In the end, maybe it won't matter; maybe the Democrats will be able to ram it through without his support. But is it really so much to ask that federally subsidized health insurance plans don't cover abortions? I guess it is for most Democrats in Congress.

The Republicans we can count on to oppose anything that the Democrats try to pass in terms of health care reform. Part of that is a matter of principle, and part of it is just partisan politics; we all know that. What's amazing about Stupak is that he's withstanding enormous pressure from his own party, the party in power, to give in.

You just don't see that kind of courage every day. The news media and the bloggers can say whatever they want about his motives. But I say, God bless him. It's nice to see politics based on principle once in a while.

Health Care Bill -- Another Update

The United States Conference of Catholic Bishops (USCCB) argues in this report that the current health care reform bill isn't covered by the Hyde Amendment and would indeed provide federal funding of abortions.

Fact #3: The new funding appropriated for community health centers by the Senate health care bill is not covered by the Hyde Amendment.

This should be clear from the wording of the Hyde Amendment itself: "None of the funds appropriate in this Act" may be used for most abortions (referring to the annual Labor/HHS appropriations act). The Senate bill's new funds are not appropriate in the Labor/HHS appropriations act, so Hyde does not cover them.

The report traces the legal precedents set by federal courts on the issue of abortion funding. The astonishing fact is that federal funds are required to pay for abortions as necessary health care for women, except if the legislation that appropriates funds specifically excludes abortion.

If it weren't for the Hyde Amendment, even state legislatures would actually be required to fund abortions. For instance:

When the Hyde amendment ceased to prohibit use of federal Medicaid funds for abortions in cases of rape and incest in 1993, federal courts throughout the country ruled that states participating in the program were now required by the underlying Medicaid statute to provide and help pay for rape/incest abortions--even if that meant overriding state constitutions that allow state funding of abortion only in cases of danger to the life of the mother.

I guess the reality is, most of us, even pro-lifers, don't really know how bad things already are. The courts are basically ready to pounce on our freedom of conscience. They are restrained only when health care legislation specifically says abortion will not be covered. If that wording isn't there, the courts have set a precedent of going to the opposite extreme: abortion must be covered.

For example:

A similar situation came to light in 1979, when members of Congress asked why the Indian Health Service (IHS) was continuing to provide abortions despite enactment of the Hyde amendment. The agency replied that it had no choice but to do so: The authorizing legislation for the IHS created a broad mandate for services to conserve the "health" of Indians, and the Interior appropriations bill funding these services contained no abortion limitation like the Hyde amendment to the Labor/HHS bill. Therefore "we would have no basis for refusing to pay for abortions" (Letter from Director of the Indian Health Service to Cong. Henry Hyde, July 30, 1979). Not until 1988 did Congress finally revise the authorizing legislation for the IHS to require that program to conform to the annual Hyde amendment.

The USCCB argues that the current Senate health care bill has exactly the same flaw: it's not covered by the Hyde amendment, because the Hyde amendment amended a particular appropriations bill.

Clearly the Hyde amendment is not a law in its own right. Therefore every health care bill that would be passed by Congress must contain its own language that specifically prevents abortion funding--its own Hyde amendment. The current Senate bill apparently does not.

It's hard to know who to believe, but frankly I'm more inclined to trust the USCCB than all the liberals in Congress who want to take my money for their political purposes, far more than organizations like Planned Parenthood who profit from the promotion of abortion.

So I'm going to try to call Congressman Perriello again and tell him I'm against this bill. Congress has no right to take our money without guaranteeing that it won't be funneled toward abortion.

Abortion and Health Care - An Update

Last week I blogged about why the National Right to Life Committee is opposing the current Senate Health Care bill on the grounds that it could allow federal dollars to fund abortions.

I read a few articles last night that gave me pause. First, several Catholics and Evangelicals advocating for health care have written a letter to Congress defending the current bill and its treatment of abortion.

I don't know how "pro-life" these Christians really are. I have no doubt that they are "personally against" abortion, but from the names I saw on that letter, I'm not inspired to think that these guys are in the pro-life movement for the long-haul. They seem to be too enamored with progressive politics to put up a genuine fight for pro-life legislation.

Nevertheless, their letter makes clear that in a way, the current Senate bill really will keep federal dollars from funding abortions. That said, there is something Americans need to understand in general about abortion in this country.

The fact is, we already endorse abortion with our federal tax dollars. I say "endorse" rather than "pay for" because, according to the Hyde Amendment, no federal money is allowed to be used to pay for abortions. However, organizations such as Planned Parenthood, which is the number 1 abortion provider in the nation, do get federal money for the other things they do.

While my taxes aren't specifically paying for abortions, they are helping an organization that actively promotes abortion. In other words, I am being forced to endorse abortion, even if I'm not paying for it.

The same thing will occur with this new Senate bill. Insurance plans that provide abortions will technically have to take a separate fee for the "abortion part" of their plans, thus being forced to use only private money to pay for abortions.

However, the fact is, these plans will still be subsidized by the government. It's just like the current state of affairs with Planned Parenthood. I am not being forced to pay for abortions, but I am being forced to endorse abortions.

Morally speaking, this is rather grating to me. I wish I could live in a country where no company that performed or paid for abortions could get federal funding. But I suppose fighting for that would be very much an uphill battle, since precedents have already been set against this.

So I guess in the end I wonder how wise it is for the NRLC to fight so hard against this bill on the grounds that it could fund abortions. It doesn't seem like it really will, directly, at least. And if we're going to ask that insurance companies that provide abortion coverage not be subsidized at all, well, we might as well push to de-fund Planned Parenthood, while we're at it.

Not that this is a bad idea. I just think it's an uphill battle, and there might be something morally twisted about using the health care issue as a platform for getting our opinion heard on this issue.

The second article I read last night indicates that Tom Perriello, my representative, just made a statement in which he expressed his belief that the current health care bill will not fund abortions. I have to say that I respect Perriello on this issue. Even if he isn't pro-life, he seems to have a genuine commitment to respecting pro-life convictions, and wants to make sure tax dollars don't fund abortions. He voted for the Stupak amendment, and I'm not sure I'm totally willing to doubt him on this Senate bill.

Finally, I happened to glance at a thought-provoking blog post which asks the question, "Does universal coverage reduce abortions?" A little bit of evidence is given that it does, although the post doesn't go into great detail. That also got me thinking: are we pro-lifers right to oppose this bill if it could actually have the net effect of reducing the number of abortions in this country?

Fundamentally, of course, that's an empirical question about the future, and such questions don't have sure answers. And it's hard, if not impossible, to know who to trust more to answer accurately.

Of course, fewer abortions would not end the abortion issue for me or for anyone who is pro-life. But it would be a step in the right direction.

I pray for this country, I really do. There are plenty of other issues to be dealt with on the health care issue, and the only issue I've really invested myself in is the abortion issue. I pray that we have the wisdom to balance them all.

Media Discrepancies

Compare these two headlines:

1. Poll: 67 Percent of Americans Oppose Funding Abortion in Health Care Bill
2. Americans evenly split on abortion health coverage

Pretty amazing, huh? It makes perfect sense when you consider the ideological bent of each publication. The first headline is from LifeNews.com, a news source dedicated to pro-life issues. The second is from the Seattle Post-Intelligencer.

The discrepancy may not be all media bias, though. It's interesting to compare the different questions that were asked in these polls.

The Seattle PI cites an Angus Reid Public Opinion national survey:

The poll found that 44 percent of Americans support banning abortion coverage through insurance plans subsidized by the government: 42 percent disagree, and 14 percent told Reid they are not sure.

Got that? The question was, would you support banning abortion coverage.

Now let's look at the Quinnipiac University poll cited by LifeNews.com:

The new survey asked: "Do you support or oppose allowing abortions to be paid for by public funds under a health care reform bill?"

Whereas the previous question asked whether you support banning abortion coverage, this one asked whether you support allowing abortions to be paid for.

It's hard to say what the outcomes of these two polls really mean. Why would Americans be evenly split on banning abortion coverage, but overwhelming opposed to allowing abortions to be paid for?

One hypothesis might be that the Quinnipiac question was more explicit in stating that the government would actually be paying for abortions. Perhaps a respondent who doesn't quite understand what's going on would think that banning coverage for abortions would somehow put a restriction on abortion, rather than simply prevent public funds from paying for abortions.

Or perhaps it never occurred to some people that public insurance coverage for abortions means the government pays for abortions, i.e. our taxes pay for abortions.

Or maybe people just find it hard to support a ban on paying for abortions, because supporting a ban makes it sound like you're against the status quo. "Just leave it alone" might just sum up the majority opinion on this issue.

The most frustrating possibility, of course, is that it's all a matter of media bias. I take small comfort in knowing that the best a left-leaning newspaper like the Seattle PI can do is find a poll suggesting Americans are "divided" on this issue.

That saddest thing of all is to see how "liberals" continue to hamper discussion on this issue, quoting opinions like "There is no point in reopening a debate about abortion in the U.S. right now." It seems the Left wants more than anything to protect the status quo on abortion and silence opposition. That's not very liberal, in the truest sense of the word.

Public Funding and Freedom of Conscience

Well, the pro-life movement has been banging on recently about how this new health care bill that is about to be voted on in the Senate tomorrow (merry Christmas, America) still contains a way for public funding to be used for abortions.

Despite polling data that shows heavy opposition to the health care bill in general and abortion funding in particular, Democrats are using their political power to politely ignore the opinions of us insects.

A lot of it just comes down to misinformation and a fundamentally flawed approach to all of this legislation. Virginia Senator Mark Warner wrote the following in an e-mail:

I have also been contacted by some Virginians about the vote last week on Amendment 2962. This amendment would have prohibited any health plan participating in the insurance exchange that covers an individual who receives a federal subsidy from covering abortion. I voted to table the amendment because the current health care bill already upholds federal law, which states that no federal funds may be used for abortion unless the pregnancy is the result of an act of rape or incest, or where the life of the mother is in danger.

This kind of reasoning is a little offensive. It suggests that pro-lifers are suggesting amendments just to waste time, as if we haven't actually looked at the possible implications of current legislation.

Any amendment that clarifies existing law is fine by me, especially on a subject as serious as abortion, but apparently Senate Democrats are against this. By tabling that amendment, Democrats are once again choosing to appease the radical pro-abortion groups, rather than rigorously protect the consciences of the majority of Americans.

What frustrates me is that it's impossible to make it clear just what will happen with all $800 billion that will go into this health care bill. While Democrats argue that existing law forbids it to be used for abortion, pro-lifers bring a legitimate case against this.

Just because money isn't earmarked for abortion, doesn't mean it can't be used for abortion. This health care bill, as I understand it, will subsidize many different insurance plans. If some of those plans cover abortion, even if they're not "government-owned" plans, this still constitutes public funding of abortion.

That is, if the government is going to give handouts for people to buy whatever insurance plan they want from a range of options, and some of those options cover abortion, then this constitutes public funding for abortion. When it comes down to it, I, a tax-payer, will be forced to pay into a system that does things that violate my conscience.

This is why I find the conservative argument against big government spending to be generally pretty compelling. If you let other people spend your money for you, you'd better be given an accounting of what they do with it. But that just isn't possible when it comes to the government. Their fingers are just in too many pies.

Ugh, this whole thing just makes me sick. Someone has to bang on about it. If the government is really going to take my money and then potentially let it end up in the hands of an abortionist, then that brings up serious questions about paying taxes. I've never thought about civil disobedience before, but I do occasionally wonder how bad things will get.

Maybe I'll just start eating more Domino's Pizza.

A Bloody Sacrament

In the midst of all the recent debate on health care, I've realized that conceptually in our culture we have started to lean toward creating a new state religion. This religion has hospitals instead of churches, and doctors instead of priests.

The goal is not to inherit eternal life, but simply long, hopefully comfortable life; faithful obedience certainly has its rewards. Instead of a church treasury, we have insurance companies, and all are required to tithe regularly.

Doctors are entrusted with the salvation of our people. This is clear from the fact that no one asks for the price of health care before going to get it. If you thought you were going to the doctor just to receive goods and services, you'd want to know the price ahead of time.

No, it's not goods and services you go to your doctor to receive. You are not a customer. You are a sinner in need of baptism--you need to be made whole again. Your life is incomplete without it.

(I'm convinced this is why natural market mechanisms have failed to keep health care costs low. It is why every transaction between you and your doctor has to go through your insurance company, and for that reason costs are uncontrollable.)

(Ironically, actual religion has become more market-based, as evidenced by those obnoxious church billboards I see advertising such perks as "great worship, great fellowship." For some reason I see these mostly when I'm in Texas.)

Every Sunday I go forward to receive the Lord's supper at my church. It is "an awesome and unbloody sacrifice," a sacrament to make me whole again, to feed me with the life of Christ.

Someone once referred to abortion as a "bloody sacrament" of our culture. I can see why. Who is in greater need of being made whole than a woman who finds herself in the position of carrying in her womb a human being she cannot care for?

What I hadn't thought about was how the priests themselves, the administrators of this bloody sacrament, actually see what they're doing. A remarkable article on LifeSiteNews.com gave me a lot to contemplate.

The article reports on an abortionist who wants to take seriously the moral dilemmas that come with actually performing abortions, yet does not want to conclude that there should be any legal limits on abortion. In the end, both her stance on the issue and her tone become quite religious.

This excerpt caught me as particularly striking:

To answer the questions, Harris notes that the "violence" of abortion must be acknowledged, and relates a "bizarre" experience she once had of observing a premature baby struggling to survive immediately after dismembering an unborn child the same age:

The last patient I saw one day was 23 weeks pregnant. I performed an uncomplicated D&E procedure. Dutifully, I went through the task of reassembling the fetal parts in the metal tray. It is an odd ritual that abortion providers perform - required as a clinical safety measure to ensure that nothing is left behind in the uterus to cause a complication - but it also permits us in an odd way to pay respect to the fetus (feelings of awe are not uncommon when looking at miniature fingers and fingernails, heart, intestines, kidneys, adrenal glands), even as we simultaneously have complete disregard for it. Then I rushed upstairs to take overnight call on labour and delivery. The first patient that came in was prematurely delivering at 23-24 weeks. As her exact gestational age was in question, the neonatal intensive care unit (NICU) team resuscitated the premature newborn and brought it to the NICU. Later, along with the distraught parents, I watched the neonate on the ventilator. I thought to myself how bizarre it was that I could have legally dismembered this fetus-now-newborn if it were inside its mother's uterus - but that the same kind of violence against it now would be illegal, and unspeakable.

Harris then goes on to explain that she rationalizes the bizarreness of the situation by the "location" of the baby, whether it is "inside or outside of the woman's body," and "most importantly, her [the mother's] hopes and wishes for that fetus/baby." However, she says, "this knowledge does not change the reality that there is always violence involved in a second trimester abortion, which becomes acutely apparent at certain moments, like this one. I must add, however, that I consider declining a woman's request for abortion also to be an act of unspeakable violence."

See with what reverence the abortionist treats the life she is destroying! It is like a priest handling the very body and blood of Our Lord, carefully consecrating it and feeding it to his congregation, who eat gratefully (sometimes ungratefully).

Does the priest ever wonder how he could possibly perform this act on the body of Christ? Jesus had to die on a cross for this. How can such unspeakable violence be justified for the sake of you who want eternal life? Do you sinners actually think your gratitude is enough to justify this?

But the priest knows that nevertheless his flock needs to be made whole again. He cannot withhold the body of Christ, for it is offered even to sinners.

In the same way, the abortionist reveres the aborted fetus--the awesome and bloody sacrifice--as a little Christ, one who has graciously lost his life to make his mother whole.

And this priest of this holy religion continues to preach the good news to all the nation: that enshrined in our Constitution is a bloody sacrament that can never be taken away. Once we were under the law, but now we are under "choice."

The Son of Man goes as it is written of him, but woe to that one by whom the Son of Man is betrayed! It would have been better for that one not to have been born.

It is no small thing that an abortionist would be honest about what abortion is. But on the other hand, should Judas take the credit for the salvation of the world?

Hat tip: Thanks to Sarah and Krissy for this article.

Two can play that game...

So MoveOn.org did a video with a bunch of celebrities attempting to make fun of conservative critiques of the public health insurance option.

Protect Insurance Companies PSA from Will Ferrell

But conservatives can play that game, too, it seems. Here's a video from Catholic Vote Action:



I don't know where this one is from, but I might as well throw it in the mix:



A lot of times I wince when conservatives try to outwit liberal satire, but in this case, the liberal video was so bad it made the conservative videos hilarious. Thanks, Alexa.

I'm most disappointed in Will Ferrell's performances. At least when he impersonates Bush, it's funny.