One piece of the House bill has caused a disproportionate amount of debate: a provision that "would block the use of federal subsidies for insurance that covers elective abortions" ("For Abortion Foes, a Victory in Health Care Vote"). The anti-abortion movement claims this as a major victory, and groups like Planned Parenthood and NARAL Pro-Choice America are understandably dismayed.
For the record, we would like to emphasize our staunch support of these latter organizations and our unshakable belief in a woman's right to choose. We believe that health care plans should cover all reproductive services, and we would love to see a health care bill that required insurers to cover such services. For that matter, we would love to see a health care bill that established single-payer health insurance (i.e., socialized medicine, or, if you prefer, commie-pinko-Nazi healthcare that will destroy America).
But we're not going to get that--at least, not anytime soon. Sometimes, to paraphrase Donald Rumsfeld, you go to war with the health care plan you've got, not the one you'd like to have. Something about half a loaf being better than none and the perfect being the enemy of the good.
Look, as important as reproductive rights are (and they ARE very important), the abortion debate sucks up a disproportionate share of executive, legislative, and judicial energy in this country. Right now, according to the National Coalition on Health Care, between 47 and 54 million Americans--between 20 and 27 percent of the population under age 65--have no health insurance. If foregoing federal funding for abortion means that most of those people have access to health care, that's an acceptable trade-off.
Because it's not even clear how much of an impact such a restriction will have. Some numbers from today's Times:
--According to a 2003 study, only 13% of abortions were billed to insurance companies.
--Only about 50% of employer-provided insurance packages cover abortion.
--Currently, the federal employees' health insurance plan and most state Medicaid programs ban coverage of abortion.
None of these statistics should be considered "good." But it does shed some light on the relative impact of the House's proposal. And if agreeing to restrict financing for abortions gets some conservatives--to say nothing of the American Catholic church, a powerful lobbying group in its own right--to back health care reform, so be it.
Down the road, as attitudes change, the law can be changed. It would seem easy enough--well, not "easy," but possible--to improve a national health care plan once it's been established. Once most Americans can get basic health care without going bankrupt, once health care becomes part of the background of American life (as Social Security and Medicare already are), then the pro-choice majority can fight for greater coverage of abortion services.
Right now, though, too many people starve, and that half a loaf looks mighty tasty.
Well. I think you said it best: 'between 47 and 54 million Americans--between 20 and 27 percent of the population under age 65--have no health insurance. If foregoing federal funding for abortion means that most of those people have access to health care, that's an acceptable trade-off.' If you agree that all 50-odd million of these people have a right to health insurance that the rest of us pay for, that's a killer argument. I'm on the line about health care for EVERYONE because I don't see how it adds up. I'm more of a keep costs down kind of person. Although I'd be up for a plan that focused on kids only because I believe all kids should have good health care. But everyone? I just don't see it. This ain't Star Trek.
ReplyDeleteWell, I suppose it also depends upon whether you consider health care a public good--positive externalities, and all that. What's the healthcare situation in Germany?
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