Should We Cover Some People, Some Parts of People, or All Parts of Everybody?
The United States is embroiled in a debate over healthcare. Ideological divides over morality and money are front and center, and threatening to derail any real progress on what has become a major crisis.
There is a curious divide in the national conversation we are having about what exactly healthcare is or what it should be. More often than not, it's about who or what should be left out of the final plan. Some say that it should only be about providing care to some people; others say it should be only about covering some parts of people. Proponents of these positions claim the moral high ground while seeking to leave out undocumented residents or restrict access to reproductive healthcare. What they are really doing is projecting their own vision of what is moral onto those who will be most affected by this distortion: the taxpayers who will fund and use whatever system emerges.
Coming on the heels of the economic crisis, it is no wonder that many focus on the questions, "What can we afford?" or more precisely, "What are we willing to pay for?" They are not unreasonable questions. But the answers that some people, who claim to speak for American Catholics, provide are not reflective of what Catholics in the United States believe. We know, because rather than simply relying on those who seem to have the best public relations, we asked nearly a thousand American Catholics what they believe about healthcare and healthcare insurance. If you've relied on the newspapers, bloggers and television news, the answers might surprise you.
Most American Catholics think providing healthcare to all people who need it is a matter of social justice. As Catholics, we understand that social justice means we are obliged to be concerned about and care for people who are poorer than we are, or marginalized, or those who don't have a voice in decisions that have an impact on their lives and the lives of their families. When we asked Catholics, they said that their understanding of social justice includes extending healthcare to the whole person, not just some parts of people. As a result, a majority of American Catholics think that reproductive healthcare services should be covered in any eventual reform of the US healthcare system -- including pre and postnatal care for women, contraception, condom provision as part of HIV/AIDS prevention and, yes, even abortion.
American Catholics don't want to be denied the healthcare services they need at hospitals and clinics that receive their tax dollars. Two-thirds (65 percent) of Catholics polled think that these hospitals and clinics should not be allowed to claim a religious exemption to providing procedures or medicines. Perhaps they understand better than many that the right to object to providing healthcare belongs to doctors, nurses and pharmacists, actual people who have a conscience. These people have the right to exercise their conscience to act -- or not act -- in a way their internal moral compass prescribes. They understand that it does not make sense to suggest that an insurance company, HMO, hospital system, pharmacy or clinic has a conscience or a religion.
American Catholics can picture themselves as patients, and want to be able to get birth control and condoms when they go to their doctor. They trust in patients to decide, in good conscience and with the advice of their doctors, on their best options. They don't want yet another obstacle placed in the way of receiving healthcare they're paying for -- especially one that's based on a false premise.
American Catholics also think they can speak for themselves. While most are not strongly opposed to the US Catholic bishops taking a stand on the issue of healthcare reform legislation, they certainly do not want the bishops telling Catholics that they should oppose healthcare reform if it includes coverage for abortion that they themselves, their wives, sisters or daughters might need. And despite his historic election with support from 52 percent of Catholic voters, the Catholics we polled don't think President Obama -- or the Democratic Party -- are well representing their interests.
Catholics for Choice is clear about what we believe. We believe that all people should have access to the healthcare they need. Nearly three-quarters (73 percent) of American Catholics polled agree. We believe contraception should be available and covered by insurance. More than 60 percent of American Catholics agree.
We believe that abortion should be covered by insurance -- whether private or government subsidized. Depending on the circumstances, as many as 84 percent agree with us, and when the question really comes down to respecting a woman's conscience in regard to her own health, a full half (50 percent) of Catholics polled agree that abortion should be covered whenever a woman and her doctor decide she needs it. Catholics are far more progressive than their bishops; our instinct tells us that, and our poll results prove it.
This conversation about healthcare and what Catholics think about it is, however, bigger than reforming healthcare and health insurance in the United States. US commitments to improve the health of people around the world, especially for women and girls, have been neglected for many years. Unfortunately, this neglect is compounded by the power of the Catholic hierarchy and other conservatives to do exactly what we are trying to avoid in the healthcare reform process. We cannot allow the voices of a small, well-funded and politically powerful group without much personal stake in the outcome to decide what parts of people are worthy of care, to decide from afar what women and men need to live healthy lives.
At Catholics for Choice, we believe in a world where women and men are trusted to make important, moral decisions about their lives. We believe no issue is more central to people's lives than their health. Using the status of a political or religious unity that does not subscribe does a disservice to that community. It is not a social justice agenda. Social justice does not mean telling people what would be best for them, and then seeing to it that those who disagree do not have the means to do otherwise. We believe it means making sure everyone has a chance to make the most of their lives, trusting people to make the decisions they need to make for themselves and their families. That means giving them a hand up when they need it -- whether we are of the same nation, political party, faith or family. We believe the conversations on healthcare should focus on social justice and doing the right thing.
Jon O'Brien is president and Sara Morello is vice president of Catholics for Choice.