Australians have had a more or less universal medical coverage since 1975 with the introduction of Medibank and later in 1984, of Medicare. This system was modelled on the first true cradle-to-grave system of medical coverage developed in England in the 1940s under the Attlee Labour government. The British National Health system was a key component – perhaps the ‘jewel-in-the-crown’- of the so- called welfare state in Britain. Many other Western countries (usually under Labour or Social Democratic governments) gradually followed suit with systems of government- financed health coverage of their own.
America has been perceived by outsiders as being an anomaly to this sort of health coverage system. This is not quite correct. For many years the poorest citizens of the US have had coverage in the form of Medicaid and Medicare, and many employees have private health insurance cover included as part of their salary package. Non-residents though do often have to pay expensive bills should they require medical assistance while visiting or working in the US.
For several decades however there have been increasing calls from within Congress (mainly from Democrat representatives) and from elsewhere for a more comprehensive system guaranteeing health care for those in the US who still ‘fall through the cracks’ so to speak. The burgeoning number of illegal immigrants and unregistered workers is one such group.
Such a proposed system has received fierce opposition from mainly Republican members concerned about a lowering in standards of medical provision and against the probability of an effective rationing of healthcare. Fears of lengthening waiting lists for surgery, as happens in other countries where the government health schemes have been implemented, as well as inability to be treated by the doctor of one’s choice are also cause for concern in a country which has prided itself on being arguably the best, if one of the most expensive, place for medical treatment.
On March 21, 2010 President Obama signed into law the Patient Protection and Affordable Health Care Act (PPACA); a 2,400 page health care reform bill colloquially known as ‘Obamacare’. A minimum 4 year implementation timetable has been approved for what is perhaps the greatest government overhaul – some would say takeover – of health provision in US history.
It may seem odd to us here that there should have been such a long and deep opposition to a notion which to most of us surely seems a basic-need provision – even a right – in a modern, civilised society. Those of us who are pro-lifers, however, might pause to wonder if this new scheme is completely good, or as is the case in such schemes here and elsewhere, it may be used to further facilitate the advance of an anti-life agenda. Given Obama’s known views and voting record on life issues, which is as poor as one might expect from a liberal Democrat, there would be reason for concern. So, what exactly is there in this voluminous, era-changing bill?
Some of the measures include: mandatory federal funding of abortion; mandatory tax reporting (form 1099) of any transaction by small business or self-employed over $6001; so-called ‘death panels’(Independent Payment Advisory Board a.k.a. IPAB’s); gun ownership control measures (e.g. restrictions on weapons ownership for patients diagnosed with Post Traumatic Stress Disorder)2; greater centralised control of health provision throughout the country; provision for the introduction of implantable Radio Frequency Identification (RFID) microchip identification for US citizens; compulsory membership and coverage for every citizen.
The scheme has been widely criticised. It is perceived to foster waste of resources as the coverage may double-up on a citizen’s private health care coverage and calls for the creation of new large bureaucracies to administer the scheme. In addition, critics argue: the scheme still leaves millions uncovered3; has a projected cost of $940 billion at a time of high budget deficits; demands higher costs for consumers; mandates huge fines for non-compliant companies; means, as feared, patients are unable to keep the doctor of their choice; and creates a phenomena called “coverage but no care”, whereby a significant proportion of those newly-eligible for Medicaid will have trouble finding physicians who will see them.4
There is a mandated $695 annual fine for individuals who fail to purchase Obamacare insurance and President Obama has refused to rule out gaol time for the non-compliant individual.5 Grace-Marie Turner, writing for the National Review Online’s Health-care blog, in an attempt to capture the national mood at the time of Obamacare’s beginning last year put it thus: “doctors are fighting mad, patients are scared, and companies are starting to realise that the promises of health-care reform legislation could turn into a huge and costly burden.”6
The United States Bishop’s Conference issued a statement clarifying their opposition to Obamacare after President Obama, a few weeks before signing it into law, claimed incorrectly that they were not against it. The Conference then issued a statement detailing the hierarchy’s opposition to Obamacare with suggested follow-up action for those concerned about it. The Conference website statement reads: ‘All purchasers of … plans will be required to pay for other people’s abortions through a separate payment solely to pay for abortion.
… Outside the abortion context, neither bill7 has adequate conscience protection for health care providers, plans or employers.8 Further, in a sample letter for Americans to send to their Senators, the Conference urges: “I am deeply disappointed that the current un-amended Senate health care bill fails to maintain the longstanding policy against federal funding of abortion and does not include adequate protection for conscience. I urge you to support essential provisions against abortion funding … I urge you to oppose any bill unless and until these criteria are met.”9 The senate version eventually had the no conscience exemption clauses struck down: America came close to having abortion laws as draconian as we now have in Victoria.
Obamacare puts a significant cost burden back on the states. Many will have an increase in Medicaid applicants as the eligibility threshold has doubled and as companies refuse coverage (and probably employment) under the new scheme. This new cost burden is being fought vociferously in some parts, as most states in the US are struggling to balance their books in the upcoming financial year.10’11Ohio currently spends 38% of its annual budget on Medicaid, while Massachusetts spends 27%.12 The US Congressional forecast predicted the States would need to find 37 billion extra dollars for Obamacare, to be funded by service cuts and increased taxes.13
What does healthcare have to do with tax record keeping, possible refusal of health provision and micro-chipping of the population? Admittedly the so-called ‘death panels’ were struck down under congressional pressure. However they are one of the measures President Obama is personally trying to reintroduce by executive order, effectively bypassing the new, more pro-life congress elected last November.
The gap between ‘rationing’ in the form of waiting lists and actual ‘death panels’, where decisions as to whether or not to continue basic health care are made, may seem wide. However should there be a good enough pretext, such as a fall in doctor and nurse numbers, funding cuts or a clear eugenics/population control agenda (being openly proclaimed now in some parts of the US and global media) the distance may not be really that far.
Regarding the little known provision for possible micro-chipping of recipients of Obamacare, it must be stressed in fairness that it is not a mandatory chipping at this stage, but the provisions will be possible from 2013 onwards.14 Nevertheless, the new law, when fully implemented, will make the United States the first country in the world with a framework in place to require each citizen to have implanted in them an RFID microchip for the purpose of controlling who is (or isn’t) to receive medical treatment in their country.
The welfare state of Britain is now in a very parlous condition as its government begins to implement highly unpopular service-provision cuts and tax increases in an attempt to rescue its economy from perilous debt, a situation arising from more than 60 years of government spending in all areas of British life. Economic strength is traditionally understood to be based on production and Keynesian deficit budgeting as in quantitative easing has to be paid for one day. It may now be something of a race to see which achieves population reduction first; abortion and contraception or taxing our children and grandchildren to such an extent that they can no longer provide for their own lives, let alone those of dependents. Sounds farfetched? Why are the youth of Europe turning to violent protest? Perhaps it is because they believe that if the current system is not repaired, by vote or perhaps by force, they will have no future. European youth, educated yet increasingly forced into idleness, are starting to fear that their parents and grandparents have spent (on credit) their futures away. European youth unemployment hits 25% in many countries (in troubled Spain it is nearly 50%) and austerity measures have so far included a 200% increase in tertiary fees in Britain. Austerity measures in Greece, Ireland, Portugal and elsewhere are further burdening struggling populaces now facing down additional tax increases and service cuts. Something’s got to give…
We might pray for the new American Congress, which does contain a few good men like Rep. Chris Smith and Rep. Ron Paul, to try and remit some of the more questionable measures of this mammoth act before it starts being fully implemented. The U.S. Senate, though still Democrat controlled, is only so by a slim margin: some Democrats voted to repeal Obamacare in a recent vote on a bill from the Republican- controlled House.15
The advantage for concerned pro-lifers now regarding Obamacare lies in timing: the bill is not due to be fully implemented before 2018. President Obama has lost much of his popularity since the heady days of his election. The impact of the legislation will be felt more and more on American lives over time.
A groundswell of opposition is mounting against Obamacare. One year on, the bill still faces many uphill battles and has taken some heavy hits. At the time of writing, 26 US states have initiated court challenges to the constitutionality of Obamacare, with others hoping to benefit should the case go against it.16 A news poll taken recently showed that 59% of those polled were against the legislation17 and a Rasmussen poll showed 58% wanted it repealed.18 In January a federal judge ruled Obamacare to be unconstitutional owing to its obligatory nature. The Supreme Court has until early May to respond.19 The burdensome Form 1099 provision has been repealed. Some pro-life state Governors are vetoing abortion funding from their Obamacare arrangements.20 Starting February 2nd, the House is beginning a policy of repealing Obamacare incrementally.21 Over a thousand companies have claimed waivers from implementing Obamacare22 – including Congress and the First Family themselves.23 This reminds the author of the joke about the cook who wouldn’t eat his own food!
What emerges in Obamacare is a scattergun bill with many measures typical of bureaucracy-loving and redistributive Democrats. Its grab-bag agenda seems to have more than a whiff of centralisation and control rather than hope and change.
In its move towards centralisation Obamacare is similar to the original schema for Australia’s own proposed health care reforms. Health reform was a favoured project of our previous Prime Minister,24 but owing to a change in the political landscape at state level25 its measures have been heavily compromised by the current incumbent.26
The health reform issue has been popping up in Australia, gopher like, for years. Former Prime Minister Rudd’s very centralising plan (similar to the heavily
centralising system he oversaw as chief health bureaucrat in Queensland prior to his federal career) has been fought down to a very vague set of do-good sounding principles by agreement between the Federal government and States’ Premiers in February this year.27 NSW Premier Barry O’Farrell has promised to include these proposed reforms as one of the issues with which he fights the Federal Labor government. Not that he has any interest in assisting the pro-life cause: quite the contrary, if his voting record is anything to go by. The Rudd plan had to be ditched after the defeat of the WA Carpenter Labor government as the states now vetoed the plan to cut their GST revenue in return for a federal takeover of hospitals – to end the ‘blame game’ over health provision, as then opposition leader Rudd put it in 2007. Tony 
Abbott, also a former health minister, recently suggested a platform for reform, which everyone agrees is needed, particularly in the area of mental health.
As in the US, we have resisted reform in the area of centralisation, which is a socialist notion, as one would expect coming from our Fabian P.M. As in America the states have played a key role in this.
It is difficult to see at this stage how the pro- life cause is directly affected for good or ill by the Australian proposals, given that they are thus far outline only, subject to further discussion in July. Certainly, however, any move towards centralism and away from the principle of subsidiarity is a move away from a personalist approach to healthcare, and indeed from the individual human person. The personalist understanding is surely the very foundation of the pro-life ideal and was emphasised over and over by Blessed John Paul II and now by Pope Benedict XVI. Away from subsidiarity and wherever there is an encroaching centralism, we are all in danger of becoming mere numbers in a system, a nameless subject, to be viewed dispassionately and disinterestedly, where doctor/ patient relationship is kept distant and oblique, where there is much less chance of a real long-term carer/patient relationship being built. Such a relationship would surely be very good for the working families the government purports to support, indeed surely in their best real interest. The very notion of the family doctor is fast giving way to medical centres. If the Australian government’s proposals are implemented, 64 new GP superclinics will be built28 and a greater reliance on large hospitals is to be promoted in moves likely to negatively impact GPs preferring to remain in a sole or private practice. Certainly a move towards a more anonymous medical provision could only increase the likelihood of teens gaining access to contraception and abortion without parents’ knowledge and/or consent. The provisions also allow for a total federal takeover of aged-care services.29 One hopes we never elect a Federal government with a pro-euthanasia platform or else the contagion of the Northern Territory may spread Australia wide.
The Australian reform proposals have so far stuck to the topic of health, unlike those of our US counterparts. Perhaps where the suggestion/threat/promise of the creation of a new bureaucracy is involved, the vaguer and more platitudinous they are the better – else someone in a position to do so might just get it into their heads to try and bring it about! Not to be encouraged!
The need for health care for the poorest of the poor cannot be questioned by any caring person, however the creation of new and expensive bureaucracies must be avoided except in the areas of real need and should aim to abide by the principle of subsidiarity which is best for the individual as well as the society. Certainly, any extra provision for abortion or the possible introduction of euthanasia-by-stealth is non-negotiable. US doctors (Rep. Ron Paul is one) used to be given ethics training in which they agreed to offer up to one third of their treatment gratis for those unable to pay fees, as were pre- Medibank doctors here in Australia. Might not a revival of the Christian principle of charity be a less controlled, cheaper and more human response to the on-going medical needs of the financially less blessed in America? The simple wisdom and common sense of the Church is again worth applying in a better practice of keeping to a system based on subsidiarity. Whereby we might ask who would better be able to understand the medical needs of a sick person in Sydney, Albury or Oodnadatta; or New York, Austin or Albuquerque: surely their local treatment teams who are empowered to have real input into the allocation of services rather than a commissar in an office somewhere in the Capital? Think locally, and act locally, too!
Footnotes.
1 http://www.thenewamerican.com/index.php/ usnews/politics/4002-obamacare-gotcha-even- coin-dealers-and-coin-collectors-are-adversely- affected/
2 http://www.themoralliberal.com/2010/12/07has- republicans-given-up-on-repealing-anti-gun- obamacare?/
3 http://www.nationalreview.com/blogs/print/47296
4 ibid
5 See Obama Refuses To Rule Out Jail Time For People Who Don’t Buy Health Insurance http://www. youtube.com/watch?v=_u6Kd3WCIU&feature=related
6 ibid
7 The bill existed in two different forms as presented to the House of Reps and the Senate
8 http://hotair.com/archives/2010/03/14catholic- bishops-send-message-to-faithful-we-oppose- obamacare/
9 ibid
10 See Medicaid Expansion Will Bankrupt States http://www.youtube.com/watch?v=DR4Nyx9Banw
11 http://watchingamerica.com/News/31795/ american-states-going-bankrupt/
12 http://findarticles.com/p/articles/mi_qa3827/ is_20100104/ai_n48635169/
13 ibid
14 On page 1001 of the PPACA Bill we read: “Subtitle C-11 Sec 2521, National Medical Device Registry. “The Secretary shall establish a national medical device registry (in this subsection referred to as the ‘registry’, to facilitate analysis of post market safety and outcomes data on each device that; (A) is or has been used in a patient; (B) is a class III device; or a class II device that is implantable.”(Emphasis added) At (g) (1) it defines a class II device (as previously defined in a FDA document of June 2004 as including the possibility of an RFID chip – see Class II Special Guidance Document: Implantable Radiofrequency Transponder System for Patient Identification and Health Information, available at: http://www.fda.gov/ downloads/MedicalDevices/DevicsRegulation and Guidance/Guidance, as an object ‘that is implantable, (emphasis added) life-supporting, or life sustaining.’ Page 1004 states: in relation to the data to be stored on the implantable device “(B) in this paragraph the term ‘data’ refers to … patient survey data … electronic health records, and any other data deemed appropriate by the Secretary.” (Emphasis added: the ‘Secretary’ being the Health Secretary. See also: http://www.jimbonews.blogspot.com/2010/04/ microchipping-to-begin-in-36-months.html
15 http://www.thenewamerican.com/index.php/ usnews/congree/5966-house-passes-healthcare- repeal/
16 http://blog.heritage.org/2011/01/21/how-the- states-can-carry-the-torch-to-repeal-obamacare
17 http://blog.heritage.org/2010/03/22/new-cnn-poll- 59-oppose-obamacare
18 http://thehiexchange/Blog/?p=49
19 http://www.washingtontimes.com/news/2011/ jan/31/obamacre-unconstitutional/
20 http://www.lifenews.com/2011/01/06florida- bill-excludes-abortion-from-obamacare-crist-veto- reponse/
21 http://online.wsj.com/article/SB10000142405274 8703652104576122520508633078.html
22 http://hotair.com/archives/2011/03/07/ obamacare-waivers-soar-past-1000/
23 http://healthblog.ncpa.org/surprise-the-people- who-wrote-obamacare-have-exempted-themselves- from-its-provisions/
24 http://www.news.com.au/national/kevin-rudd- outlines-radical-health-care-reform/story
25 http://www.news.com.au/politics/rifts-opem-in- kevin-rudds-health-plan/story-e…
26 http://www.news.com.au/national-affairs/kevin- rudd-can-still-be-proud-of-ditched-health-plan-roxon- argues/story…
27 http://www.coag.gov.au/coag_meeting_ outcomes/2011-02-13/docs/communique_ attachment_20110213.pdf
28 ibid
29 http://www.ncoss.org.au/content/view/4773/111/
