Guest Opinion: Health Reform. End Times For Seniors?

What about the pending health care reform is causing so much consternation among America's senior citizens?

PHOENIX, Az. (Catholic Online) - Washington D.C. is poised to enact comprehensive legislation that will radically change America's health care system, moving it closer to a system of health care rationing such as what is already prevalent in Europe. In fact, the Senate began debate on the reform package at 3:00 p.m. on Monday, November 30, 2009. The final language of the new health care reform legislation is subject to legislative conference committee changes and amendments. However, it does appear that ex-Senator Tom Daschle, thought by many to be the "architect" of these health care reforms, was correct when he said that seniors will bear the brunt of these changes. Let's consider some of the issues.

What about the pending health care changes is causing so much consternation among America's senior citizens?

Let's begin with the bill passed out of the House of Representatives, H.R. 3962. At the top of the list of provisions objectionable to seniors are the proposed cuts to Medicare funding. The house bill eviscerates Medicare, cutting $500 billion from this important senior health care program. Similarly, H.R. 3962 slashes $150 billion from the popular Medicare Advantage Plan which one out of every five senior citizens relies on to supplement Medicare benefits. In addition, the House health bill creates a Medicare reimbursement framework that many, this writer included, believe will promote euthanasia. These new rules will effectively coerce physicians to subject the elderly to end-of-life consultations and encourage elderly patients to use "living wills", a catch all term which refers to many different kinds of legal instruments. "Living Wills" are absolutely objectionable to many people when they counsel withdrawing nutrition and hydration, as they often do, by calling such ordinary care and compassion "extraordinary" medical procedures.

These provisions will also enable government bureaucrats to dictate to physicians what they are required to tell their elderly or ill patients about important - and deeply personal - life and death matters. The health care bill also mandates that physicians follow what are called "competitive effectiveness standards" in making health care treatment decisions. Since some have stated their acceptance of an approach to what is often called "end of life care" which, in effect, promotes rationing by placing efficiency over the dignity of human life, these competitive effectiveness guidelines will likely be used as one of the primary instruments to deny real end-of-life care to seniors. They will actually end up promoting euthanasia.

While the House bill does the heavy lifting on euthanasia, the Senate bill pushes goes one step further, containing provisions which actually promote assisted suicide consideration. Section 1323 of the Senate bill prevents community health insurance plans from limiting access to what is called "end-of-life care". What does the term mean? Interestingly enough, Sec. 1553 of the Senate bill contains a de facto conscience clause which protects physicians from charges stemming from a failure to provide services which facilitate assisted suicide or euthanasia. With the overall statutory scheme of the House bill and Senate bill being so one-sided in favor of an approach to "cost effectiveness" which could promote euthanasia and assisted suicide, I guess the authors of the Senate bill decided that a token concession should be given to physicians who would adhere to the Hippocratic Oath and shirk from offering these "end-of-life services".

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Given the health care bills comprehensive framework supporting this kind of morally questionable approach to what are called "end-of-life" procedures, is it any wonder that increasing numbers of Americans, especially seniors, have grave doubts about claims that health care reform will improve their access to medical care? Only 38% of Americans favor the current health care reform proposals with 56% opposing, according to a recent Rasmussen poll. As the prospect of health care reform looms ever closer, seniors are feeling more and more uncomfortable with both Medicare cut induced restrictions in basic health care services and the prospect of having to endure a kind of compelled persuasion of the end-of-life health care variety.

What about claims that health care costs will be reduced by these proposed health care reforms?

Is the cutting of $500 billion in Medicare a true cost reduction or is it, as many claim, a denial of service to seniors? Nomenclature is important here. After all, reducing the cost of something, either a product or a service, tends to be done to improve the efficiency of getting that product or service to the consumer. This type of authentic, person centered cost cutting is generally a good thing. As a result of this increased efficiency the consumer ultimately benefits because the service is provided in a more cost effective manner. Legitimate examples of beneficial cost cutting in the health care arena would be reducing frivolous medical liability suits and cutting Medicare fraud and waste.

On the other hand, when a service is not delivered more cost effectively, instead, the service is not provided at all - that goes way beyond cost reduction and is in reality a denial of service. Viewed in this light, the proposed Medicare cuts are not actually cost savings which benefit the patient; they are instead withdrawals of essential medical services. This becomes a gravely serious matter when the denial of service concerns life-sustaining care. For seniors, health care reform is about to get extremely personal. When the deep cuts to Medicare are considered in the context of what I have already called the pro-euthanasia framework of the health care reform bills, it is a foregone conclusion that there will be across the board denials of life-sustaining care to seniors. When necessary life-sustaining care is not provided to seniors, it naturally follows that increasing numbers of them will die prematurely. To describe Medicare cuts that will result in denial of life-sustaining care as "savings" is verbal engineering of the lowest order by political elites whose values are diametrically opposed to those of the majority of voters.

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What about the long-term consequences of the federal government's takeover of the health care sector, coming on the heels of the government's recent take over of the automobile and banking sectors?

Health care represents 15% of America's GNP and if the federal government assumes control of this industry, such an expansion of government power would be unprecedented. The federal governments pending intrusion into health care flies into the teeth of the fundamental principle of Catholic social doctrine, the principle of subsidiarity. This important social ordering principle states that decisions are best made at a smaller, more local level, rather than issuing forth from a more distant centralized source. Subsidiarity is wholly consistent with principles of limited government and supports a proper understanding of personal freedom and personal responsibility. On the other hand, it stands squarely in opposition to the statist welfare state's core tenets of top down, centralized bureaucratic planning.

Who will control the decisions over your health care?

While the American public may not be as concerned over the nuances of competing socio-political doctrines, they care very much about who calls the shots in health care decisions. The recent erosion of popular support for what is being called health care reform is being fueled by the serious concerns people have about the federal government making their health care treatment decisions, rather than having those decisions be made by them in consultation with their personally chosen local physician. In this regard at least, the majority of Americans would tend towards agreeing with an application of the principle of subsidiarity which would oppose the kind of federal government controlled health care approach which may be just around the bend.

Who will bear the true cost of this health care "reform"

Another concern is that these health care reform bills will usher in a system that unquestionably places the burden of health care reform squarely on the weakest and most defenseless; the seniors and unborn. These problematic policies are based on principles of utilitarianism which many Catholics properly find objectionable. Essentially, utilitarianism has a diminished view of personhood that judges a person based on how "useful" they are to society. Younger people are viewed as useful and productive whereas the old and terminally ill are marginalized and not valued. Viewed together, the House bill and Senate bill envision a health care system that clearly favors the young and healthy over the old and less healthy. Reduced to its most fundamental element, the health care reforms proposed by the Democratic majority are quite utilitarian.

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The Real Moral Issues

The morally bereft approach reflected in these current legislative bills poses a serious dilemma for Catholics who seek to follow the tenets of Catholic teachings. Pope John Paul II's landmark encyclical letter The Gospel of Life affirmed what the Natural Law has long revealed to all of us, all human life has inherent dignity and value. In his Letter to Families", John Paul II warned us against utilitarianism and its impoverished view of human life. In Worthiness To Receive Communion, General Principles, Pope Benedict XVI (then Joseph Cardinal Ratzinger) stated that while Catholics could disagree on many issues, abortion and euthanasia are grave sins and intrinsic evils and Catholics are obligated to adhere to the Church's teachings on these issues. Recent directives from the United States Conference of Catholic Bishops mandating that Catholic hospitals provide life-sustaining care including nutrition and hydration to patients who are comatose or in a what is often called a "persistent vegetative state" (PVS) continues the consistent line of Catholic teachings which insist that we respect and protect all human life, at all stages, as the highest good. Given the stark contrast between Catholic teaching and the utilitarian nature of these current health care reform bills, it is clear that winning the hearts and minds of the Catholic faithful was not a priority of the drafters of these bills.

What then are the objectives of those pushing these health care reforms?

Once you look behind the false cloak of "reducing costs and improving access" you find a number of plausible objectives being presented by those who opine over such things, even among proponents. John Cassidy, a well-known politically "left of center" author at New Yorker Magazine, gave us a peak at what he claims are the real goals of Democrat led health care reform efforts. Cassidy's November 24, 2009 commentary in New Yorker Magazine (online) stated that the purpose of these reform efforts was to create a new entitlement program that, once implemented, will be virtually impossible to get rid of. This will achieve the twin goals of redistributing income by putting health care under centralized government control while also making the middle class more dependent on government.

If true, then this so-called health care reform has everything to do with increasing the influence, power and control of political elites currently in charge and very little to do with improving health care. The response of Democratic leaders to John Cassidy's claims concerning the purpose underlying health care reform efforts has been a deafening silence. Why, is anyone's guess - but I am sure that some do not want to draw any more attention to this eye-opening claim. Mr. Cassidy's contentions only add to concerns over a number of stark realities about this round of health care reform.

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First, this attempt at health care reform is not American politics in its finest hour. Instead, what we are seeing is a political modus operandi which is quite Machiavellian, employed to advance an agenda which is steeped in utilitarianism. Neither of these speaks very highly of the motives of some of the current proponents of health care reform. Clearly, in their present form, these health care reform bills are a full frontal attack on the Catholic Church's foundational teachings in defense of all human life, from cradle to grave. During the next four weeks, Congress will push forward and attempt to reconcile the Senate and House health care reform bills and come up with a bill to send to the President for signature. With heightened public scrutiny of the controversial sections of these bills, public support for health care reform may continue to erode. Like never before, the Catholic community needs to unite and speak out in defense of life. The United States Conference of Catholic Bishops is to be commended for its support of the Stupak amendment which, if enacted in the final legislation, will significantly restrict abortion funding.

However, our Bishops need to be encouraged to also continue to oppose health care reforms that will place the elderly and handicapped at risk with the same courageous insistence. We all need to do the same. The Bishop's recent directive that Catholic hospitals be required to provide life sustaining care such as nutrition and hydration to comatose patients is an important first step in protecting the lives of the lives of seniors and of the handicapped. However, the faithful need to encourage their Bishops to speak up against alleged health care reforms that will end up promoting euthanasia and actually hurting the elderly and handicapped. While we are at it, there has never been a more important time for everyone reading this article to call our elected leaders in Washington and let them know how we feel as well.

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Mark Henry is a Catholic attorney, speaker and author of "Finish Faithful", a how to guide on a Catholic approach to estate planning

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