Catholic Medical Association evaluates health care reform proposals

Washington D.C., Sep 24, 2009 / 05:12 am

The Catholic Medical Association on Monday wrote an open letter to Catholic organizations and individuals to express its views on “key prudential aspects” of health care reform proposals. Some provisions risk violating the patient-doctor relationship and could threaten the dignity of human life, the association says.

The letter, signed by Catholic Medical Association (CMA) president Louis C. Breschi, M.D., expressed a desire to collaborate with others to shape legislation “in harmony with the Catholic faith.” The CMA said its views reflect years of experience in serving patients.

“We believe we are facing a crisis, not only in health-care financing and delivery, but in the health-care reform process itself,” the CMA wrote.

The country has the opportunity and obligation to craft “effective, ethical” responses to the crisis in health care financing and delivery, the organization continued, but it warned there is a danger that “misguided legislation” could worsen the problems.

According to the CMA, problems in health care include a lack of “consistent access” to affordable insurance and to appropriate health care. Services are also “expensive and fragmented.”

These problems, the association claimed, result largely from “misguided” tax, employment and government policy incentives. The organization criticized “increasing third-party payer intrusion” into the patient-physician relationship.

While Catholic ethical and social principles should be the subject of agreement, the CMA said these principles’ application is the main question.

In the association’s view, present reform proposals rely heavily on the federal government to “dictate” solutions and will empower “a small group of unelected government bureaucrats and committees” to determine the composition and cost of health insurance policies, the reimbursement of providers and the approval of treatments.

“We think this government-controlled approach is flawed in principle and ineffective, if not dangerous, in practice,” the CMA wrote, charging that the approach “clearly violates” the principle of subsidiarity and will be ineffective.

According to the CMA, Medicare will be insolvent by 2017. Further, Medicaid costs have run out of control to the point that 40 percent of physicians no longer accept it because of money-losing reimbursement rates.

The current health care reform proposals are also “dangerous” because of the presidential administration’s “repeated failures to accord proper respect for the dignity of human life.” The CMA cited the reversal of the Mexico City Policy and funding for human embryonic stem cell research, claiming that the Obama administration wants to make such policy decisions difficult or impossible to overturn.

Saying there have been some “misunderstandings” about health care provisions concerning end-of-life consultations, the CMA said “serious concerns” remain about funding the care of the seriously ill and the dying.

“Giving the federal government the power, and primary responsibility, to contain medical expenditures could threaten the provision of medical care to the most vulnerable, the elderly and chronically ill,” the organization said.

CMA's Solutions

The CMA proposed legislation that allows individuals and families to purchase health insurance that “meets their needs and also respects their values.” The association suggested this could be done by re-assigning the tax deduction for health insurance from employers to individuals and by bringing “appropriate incentives” from the market economy to health insurance companies to increase competition and correct regional insurance monopolies.

“Congress can also tailor programs to assist those most in need, the working poor, the unemployed, and those currently uninsurable due to preexisting conditions,” the open letter said.

The CMA endorsed “greater individual accountability” in health care spending, noting that 70 percent of spending is for conditions directly influenced by personal behavior.

Further, the CMA called upon Catholics and Catholic organizations to reaffirm the “foundational” teachings of the Church and to unite to defend the sanctity of life and conscience protections. The CMA also urged respect for subsidiarity, saying that medical decisions are best made within the context of the individual parent-physician relationship.

“We are convinced that if this important principle of Catholic social teaching is not correctly upheld, then short-term measures to defend the right to life and respect for conscience will ultimately fail and the patient-physician relationship will be irreparably compromised,” the organization said.

“It would be better to forgo long-needed changes in health-care financing and delivery in the short-term if these would lead to a long-term, systemic policy regime that is inimical to respect for life, religious freedom, and the goods served by the principle of subsidiarity,” the CMA said, calling for “principled and practical” reform measures.