A Catholic perspective on the McCain and Obama healthcare plans
With the 2008 presidential election just a month away, Americans will soon choose between two candidates who have proposed significant and very different changes in the way healthcare is administered in this country.
What exactly would Democrat Barack Obama and Republican John McCain do with a system that many people agree needs genuine reform? Would the poor and uninsured be better served by one plan than the other? What about employers and their employees? And most importantly for Catholics, does either plan line up with Church teaching?
Legatus member David Wilson, founder and CEO of Wilson Partners, an independent employee benefits consulting firm based in Troy, Mich., sees the respective candidates’ plans as a clear choice between greater government control (Obama) and free-market reform (McCain).
He favors the McCain plan because he believes it empowers people to take control of their own health and healthcare, something he says will improve both.
“Government can take control of all the healthcare payments,” Wilson said, “but if it doesn’t engage the individual in taking responsibility, you will not have improved health, only more costs. Any system that fosters a retarding of responsibility is going to have greater costs and less health.”
Wilson’s view mirrors that of other free-market advocates, including Michael Tanner of the Cato Institute, who pronounced the McCain plan superior to Obama’s “Plan for a Healthy America,” which claims it will lower costs and ensure affordable, high-quality healthcare for all. According to Tanner’s analysis, Obama’s plan relies on what is known as “managed competition,” a concept that keeps healthcare private, but with strict government controls and regulations.
The Obama plan would require employers to provide “meaningful” coverage for their employees, contribute to its cost or pay a percentage of their payroll toward a new national plan, which would be created for those not covered by an employer or other government program. Additionally, Obama is proposing expanding eligibility for Medicaid and SCHIP (State Children’s Health Insurance Plan) and requiring parents to buy health insurance for their children.
“Obama’s plan, with its heavy reliance on government,” Tanner writes, “leads to the same problems that bedevil universal healthcare systems all over the world: limited patient choices and rationed care. McCain’s proposal is much more consumer centered and taps into the best aspects of the free market.”
Access and choices
Like the Obama plan, McCain’s health proposal promises improved access to healthcare, but by providing patients with choices beyond the employer-based health insurance system. McCain’s plan would retain employer-based coverage as an option, but would give directly refundable tax credits of $2,500 to individuals and $5,000 to families so they could select their own insurance provider. The money would go directly to the provider and any unused portion could be deposited into expanded health savings accounts.
In addition, the McCain plan would allow for the purchase of health insurance across state lines, meaning families and individuals could shop for lower prices in states with fewer coverage mandates.
Grace-Marie Turner, an adviser to the McCain campaign and president of the Galen Institute, an organization that promotes free market healthcare reform, said the state-line provision alone could decrease the number of uninsured by 12 million.
Turner said the Obama plan calls for “private insurance in name only.” Under it, she added, “insurance companies would be so highly regulated that they would be little more than governmentregulated utilities. They would have to offer governmentprescribed plans with government-prescribed premiums, profit margins, loss ratios and administrative costs. They would basically be functionaries of the government because the consumer would not have a choice.”
But those who like the Obama plan claim it does more than McCain’s to meet the needs of the poor and the estimated 47 million people who are uninsured. Clarke E. Cochran, coauthor of The Catholic Vote: A Guide for the Perplexed, recently told Catholic News Service that Obama’s proposal is more in keeping with the U.S. bishops’ call to help the poor and uninsured and to fortify Medicare and Medicaid. However, Cochran also said Obama’s plan is not likely to provide protection for the unborn, a key issue for Catholics.
Although abortion and other life issues are not mentioned specifically in either candidate’s plan, the starkly different positions of Obama (who supports abortion) and McCain (who has a largely pro-life voting record), are likely to be reflected in their health policies.
Dr. Steve White, a Daytona Beach, Fla., pulmonary medicine specialist and former president of the Catholic Medical Association, which produced a 2004 report on healthcare in America, said because Obama wants more government regulation and control, there is reason to believe he would insist on including reproductive procedures opposed by the Church in basic health-coverage standards.
White said he fears that if Catholic hospitals support the Obama plan in hopes of getting funds to pay for care of the poor, they may find that down the road they will no longer be able to decline participation in activities that conflict with Church teaching.
Michael O’Dea, president of Christus Medicus, a healthcare reform group aimed at giving Christians “conscientious choice” in health insurance, agreed. “The only way Catholic health providers will be able to practice their faith is to break the law, to close down their organizations or to go underground. That’s where we’re headed under an Obama plan.”
O’Dea said he also sees the Obama plan as contrary to the Catholic teaching of subsidiarity, which says the state is not to “substitute itself for the initiative and responsibility of individuals” (Catechism of the Catholic Church, 1894).
According to this principle, he said, “responsibility is supposed to begin first with the individual and the family. Government is supposed to assist the family but not to come in and take over the family.”
However Tracy Williams, president and CEO of Verus Health, an Indianapolis firm that provides administration services to selfinsured health insurance plans that are consistent with Catholic teaching, said whichever candidate is elected probably would make little difference to his company in the long run because “there has never been a federal regulation around which intelligent people cannot do what is right, do what they want and/or profit.”
Although his firm obviously would take issue with any regulation requiring health insurance plans to provide abortion coverage, for example, Williams said, “Such a blatant trampling of religious freedom would not deserve to stand.
“In the end, business owners in this country — and whether that business owner is a Catholic diocese, Catholic hospital, or an individual who believes abortion is wrong — that business owner should not be required to fund something which is diametrically opposed to his faith.”
Judy Roberts is a freelance journalist based in Graytown, Ohio.