Conservatives in Congress are trying to derail the health reform bill by arguing that it allows people to purchase private insurance that covers abortion. Conservatives are demanding that the bill include language prohibiting even private insurers from paying for an abortion. Many of these conservatives are the same people who have denounced the public option as creeping socialism. Republican House minority leader John Boehner has called the health insurance reform bill, “the greatest threat to freedom that I have seen in the 19 years I’ve been in Washington.”
Why do conservatives who fear the heavy hand of the state interfering with the freedom of insurance companies nevertheless support government restrictions on women who want to use their own money to purchase insurance that covers abortion? There are really two issues raised by that question: First, how “free” is our health care market now? And second, are restrictions on women the fairest and most effective way to reduce the number of abortions?
As to the first issue it is already too late to argue for a free market in health care. We have had socialized medicine in the United States for generations; we just have it done badly.
Forty years ago Republicans were denouncing Medicare as socialism. Most people over 65 are pretty happy with socialized Medicare. We spare no expense taking care of the elderly, but we leave their grandchildren unprotected. That seems irrational.
People who are lucky enough to work for employers that provide health insurance are also the beneficiaries of socialized medicine. In fact, private insurance is a form of socializing risk. The young and healthy workers pay premiums that subsidize older and sicker workers.
But our insurance system is hugely inefficient. It generates windfall profits for insurers and creates perverse incentives for doctors to order unnecessary procedures. That’s why we have the most expensive health care in the world, but the World Health Organization ranks the quality of our health care 37th – lower than any other western industrialized country and just behind Costa Rica. And the soaring cost of employer-based insurance hurts the competitiveness of our exports. For example, on average the sticker price of an automobile produced by a U.S. manufacturer is inflated by about $1500 to pay health insurance for workers. That burden on U.S. manufacturers is one more reason for our trade deficit, sinking dollar, and the loss of manufacturing jobs.
Everyone who doesn’t get socialized Medicare or socialized health care from their employers relies on community health clinics and emergency rooms for socialized medicine. And the rest of us pay for this through our taxes. The lack of universal health care also reduces the quality of our health care system for everyone. Anyone who has gone to an emergency room knows just how long you may wait while ER doctors are treating uninsured people with bellyaches and colds because they can’t afford their own doctor. When people with infectious diseases don’t get treated, all of us are exposed. And when people wait until they are very sick to see a doctor, it is far more expensive to treat them. All these costs are passed on in the form of higher hospital costs for everyone.
So pretending that we have a free market to defend against the threat of socialism is nonsense. We have the worst form of medical socialism already – bloated, inefficient, and unfair. Right now decisions about our health care are dictated by the vagaries of our employment status, the terms of our insurance, or the dictates of an HMO bureaucrat. Doesn’t it make more sense to allow the government to establish policies to reduce paperwork, guarantee access, and treat all Americans the same regardless of pre-existing illnesses?
The second issue is whether restricting a woman’s right to buy insurance that covers abortion is the fairest and most effective way to reduce the number of abortions? It doesn’t matter whether you oppose abortion or not. It’s hypocritical for conservatives who are concerned with “freedom” in the health care market to argue that women should not be free to purchase private insurance that provides a medical treatment that is constitutionally protected.
Let’s be clear that the proposed law is not providing any subsidies for abortions. The Supreme Court has said that government has a right to discourage women from seeking an abortion by subsidizing childbirth without providing equivalent benefits for abortion. Federal law has long denied women any federal funds for abortion, and there’s no doubt that Congress will continue to ban federal funds for abortion.
The freedom to choose to bring a child into this world is only meaningful if one can afford it. One way to encourage women to carry their fetuses to term would be to provide women with the necessities of life for themselves and their children. Health care is one of the necessities that young mothers require. That’s why abortion opponents should be marching in the street demanding health reform with a government option and loads of subsidies that would reduce the cost of health care.
The critics are right about one thing. The health reform bill is about freedom: freedom from the fear that in America being sick can be a financial catastrophe. The health reform plan will give more American families the freedom to choose a plan that works for them.
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