Tag Archives: Catholic Medical Association

Navigating murky waters

John F. Brehany: Catholic business owners and the challenge of ObamaCare  . . . .

John F. Brehany

John F. Brehany

The looming implementation of the Patient Protection and Affordable Care Act (aka ObamaCare) is posing critical short-term and long-term challenges to Catholic business owners. How they respond will go a long way toward determining whether the Catholic faith will remain a viable and vibrant presence in American society.

Since ObamaCare’s passage in 2010, employers have waited to learn how the new law would affect their employees and their bottom lines. After missing multiple deadlines, the Obama administration was forced to delay the employer mandate until 2015. In the meantime, however, businesses have experienced significant uncertainty and rising costs, which have negatively impacted employers and employees alike.

A recent U.S. Chamber of Commerce survey showed that only 3 in 10 small business owners say they are ready to comply with ObamaCare, and 25% of business owners are still not sure of what the new law means for them. The average cost of health insurance for families increased by almost $2,500 during President Obama’s first term — almost the exact amount he promised that premiums would decrease as a result of his signature legislation — and a growing number of employers expect costs to rise even higher when ObamaCare is fully implemented. Businesses are responding in a variety of ways — like dropping “extra” benefits such as coverage of spouses, passing on more costs to employees, buying cut-rate health insurance, and by cutting employee hours.

Under ObamaCare, a person who works 30 hours per week is considered a “full-time employee” qualifying for health insurance. Many businesses have reduced employees’ hours below this threshold, causing labor leaders to publicly complain that ObamaCare is undermining the 40-hour work week and the economic benefits provided by full-time employment. Catholic business owners must exercise creativity and prudence in order to protect their businesses and their employees. But these choices pale in complexity to the ethical challenge posed by the HHS mandate.

The most radical change for Catholic business owners under ObamaCare in the short-term is the imposition of the HHS mandate, which requires all health insurance plans (not only those of businesses with more than 50 employees) to provide FDA approved contraceptives (including abortifacients), sterilization, and reproductive counseling to all girls and women without copays or deductibles. While faith-based institutions fought the Obama administration’s radically new definition of “religious employer,” the HHS mandate took effect months ago (in new health insurance plan years starting after Aug. 1, 2012) for practically all businesses in the United States.

Catholic business owners now face a significant ethical dilemma — to either comply with the HHS mandate and cooperate with the evils it entails or to refuse and accept the consequences. To comply with the mandate means to directly subsidize drugs, devices and operations which are objectively evil. Moreover, these “reproductive benefits” will be available not only to employees, but to their daughters, who will be able to access these “services” without the knowledge of their parents. Such a direct and confidential subsidy has long been a goal of Planned Parenthood.

However, refusing to comply with the HHS mandate can entail, at a minimum, either crippling fines of at least $100 per employee per day or dropping all health insurance coverage. Given the manifest evils being subsidized and the direct attack on religious freedom, Catholic businesses can justify providing health insurance in compliance with the HHS mandate (as remote mediate material cooperation) only on a temporary basis while seeking a long-term change in the law or an adequate exemption.

In the long term, it’s possible that the Obama administration and its supporters are hoping to eliminate employer-sponsored health  insurance and impose a single-payer system, in which the federal government is the ultimate arbiter of health-care services, pricing and payments. Sen. Tom Coburn (R-Okla.) and Jeffrey Flier, M.D., dean of Harvard Medical School, both argued in the past that ObamaCare, by intent or by its very nature, is practically guaranteed to fail in a few years. Sen. Harry Reid (D-Nev.) admitted as much in an interview in August. What does this mean for Catholic business owners?

Radical changes in health-care financing may be unavoidable. Employer-provided health insurance is not mandated by Church teaching; a just wage and workplace are. In these challenging times, Catholic businesses can play a key role in promoting a whole range of goods identified by Catholic moral and social teachings, including religious freedom, human dignity, responsibility in the workplace, and subsidiarity, to name only a few. We are now facing a powerful federal government that is increasingly hostile to religious freedom and promoting a culture of death. Only if Catholics work together in new ways and establish new networks of support, can the Church sustain an authentic public witness to the faith.

In the coming months and years, Catholic business owners should view the challenges posed by ObamaCare as an opportunity to renew their Catholic faith and witness to it more explicitly — in their businesses and in the public square.

JOHN F. BREHANY, PH.D., STL, is the executive director and ethicist of the Catholic Medical Association.

Health care: a right or privilege?

A ‘right’ to health care completely skirts the issue of individual responsibility . . .

Deal W. Hudson

Deal W. Hudson

Our bishops want health care reform. They are advocating reform resulting in universal health coverage that respects “human life and dignity” and includes “freedom of conscience,” while restraining costs and applying “costs equitably among payers.”

The bills now before Congress give the federal government the commanding role in providing universal coverage; however, they also leave the door open to funding abortion and end-of-life care, which the bishops have loudly rejected.

The bishops do not consider a government-run program the only option for providing universal health coverage. “There may be different ways to accomplish this, but the bishops’ conference believes health care reform should be truly universal and genuinely affordable,” the bishops explain on their website.

“The Church does not teach that government should directly provide health care,” wrote Bishop R. Walter Nickless of Sioux City, Iowa. “The proper role of the government is to regulate the private sector in order to foster healthy competition and to curtail abuses. Therefore, any legislation that undermines the viability of the private sector is suspect. Private, religious hospitals and nursing homes, in particular, should be protected because these are the ones most vigorously offering actual health care to the poorest of the poor.”

Many Catholics are moved by the argument that health care is a “moral issue.” That claim, however, has to be rightly understood. Health care is not a moral issue per se. No one is obliged to pay for the sum total of all medical care either needed or desired by his “neighbor.” This is not the intent of Catholic social teaching regarding the “right” to health care.

As Bishop Robert W. Finn and Archbishop Joseph F. Naumann wrote recently: “The right of every individual to access health care does not necessarily suppose an obligation on the part of the government to provide it. Yet in our American culture, Catholic teaching about the ‘right’ to healthcare is sometimes confused with the structures of ‘entitlement.’ The teaching of the Universal Church has never been to suggest a government socialization of medical services.”

The problem with talking about “rights” to things like health care is that it completely skirts the issue of individual responsibility. Why am I responsible for paying for another person’s medical care when that person has squandered their resources, abused their physical well being, or simply chosen not to make a contribution to work-based health care coverage? The latter is why well over 10 million Americans are uninsured.

There’s also the issue of making distinctions within the category of health care itself. No Catholic wants to pay for another person’s abortion, contraception, in-vitro fertilization, euthanasia or embryonic stem-cell treatment. To give the federal government control over medical care in this country will eventually result in all of these services, including abortion, being paid for by Catholics. Even if abortion funding is stripped from the current legislation, it will undoubtedly be added later on. All it takes is one vote of the House and the Senate and one signature in the Oval Office.

Clearly, any sort of national or state health care program is not going to delve into issues of a person’s use of their financial resources which could have been spent on health coverage, or their employment history which could have provided health coverage, or even the treatment of their own well-being. That’s why a citizen’s moral obligation should be limited to essential services. This “safety net” approach to health care means that those without insurance, and in real need of medical care to treat serious health issues, should receive assistance. In point of fact, our nation’s hospital emergency rooms already provide this assistance. It is federal law that no hospital emergency room can fail to find treatment for someone presenting him or herself for medical care. The number of children being born in U.S. hospitals to illegal immigrants attests to this.

There are many moral issues, but none of us is morally — in a financial way — responsible for assisting people in obtaining the goods associated with that moral issue. After all, the goods associated with our moral choices most often cannot be possessed without our serious commitment to them. The best example is with regard to education. No one is educated by virtue of sitting in a classroom or, as St. Thomas Aquinas put it: “The student is the primary cause of his education.” The same dictum should be kept in mind with health care.

The Catholic Medical Association (CMA) understands that individuals must be held responsible for their own health. CMA supports an approach to health-care reform “achieved by legislation that empowers people to own their health insurance policies (as contrasted with government- or employer-controlled health care insurance) and using targeted measures to help people who cannot afford the entire cost of their insurance premium.”

CMA’s recommendation points the way to an alternative solution — one based on the principle of subsidiarity — to reach the goals advocated by the bishops. Universal coverage can be achieved without handing health care entirely over to the federal government. This alternative vision of reaching the bishops’ goals for health-care reform should be put before the Congress as soon as possible.

Deal Hudson is the president of the Morley Institute & the former publisher of CRISIS Magazine. The director of InsideCatholic.com, Hudson has published articles in The Wall Street Journal, New York Times, National Review and others.