For discussion: single-payer without abortion funding
MM’s most recent post led me to come up with an interesting thought experiment (some iterations of which I believe have been proposed before by some of our commentators). Let’s say the Democrats proposed a single-payer system that completely ended private insurance. Let’s say that Bart Stupak and Ben Nelson attached an amendment to this proposal that would ban the single payer from covering any form of abortion (including the morning-after pill) for any reason. This would, of course, put an end to both private and public coverage of abortion. Would pro-life Republican Senators and representatives be obligated to vote for the bill regardless of other qualms they might have about the merits of the single payer system? If not (i.e. if it would be legitimate for them to vote against the bill in order to avoid “socialism” despite the objective good that it would do in ending any public and corporate funding of abortion), then how do groups like Priests for Life and ALL justify the claim that a pro-life voter may not vote against a pro-life candidate for any reason? It gets more interesting if we point out that the average voter’s proximity to the evil of abortion (regardless of who they end up voting for) is far more remote than the average politician’s.
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The answer is no. The thought question pits principles against each other. The Right to Life vs. subsidiary and the virtue of prudence (i.e. not spending money you don’t have).
Until the law is rewritten to ban abortion altogether, we will still fund abortion through tax dollars. Either in the form of Federal contracts or subsidies outside the proposed single payer.
Doesn’t the right to life outweigh other principles? At least, that’s what we ordinary citizens are told when we’re voting. Shouldn’t the politicians who actually have a direct impact on these things be held to just as strict a standard?
Colin,
You mis-apply the principle of subsidiarity.
First, it can be argued that the proper level to do health insurance the widest level, as this supports solidarity and spreads costs over the widest group. And you can’t look at subsidiarity without solidarity.
Second, surely a large faceless profit-mamximizing private insurance company that makes money by denying claims and weeding out the sick is more detrimental to subsidiarity than a large bureacracy that grants universal coverage?
Third, doesn’t subsidiarity call for a parity relationship? An individual going it alone against the might of a private insurance company is not an exercise in subsidiarity.
Fourth, doesn’t subsidiarity call for a personal relationship between patient and doctor? This is a huge weak spot in the American system, and single-payer systems do far better here (in France, it covers house visits).
Fifth, don’t fall into the trap of the American right of equating subsidiarity with anti-government and pro-market! When Pius XI fleshed out his theories of subdidiarity, he condemned individualism as strongly as collectivism.
I don’t think that pro-life congressmen would be _required_ to support such an initiative, but it might be a good idea. I might myself support such a bill, despite the fact I think the evidence is pretty clear that going to a single payer system in the US would be a bad idea.
But then, I also don’t think it would be absolutely morally forbidden for pro-life congressmen who thought something like the House bill would actually help the country to vote for it even if it didn’t contain the Stupak ammendment. (Though I’d obviously rather see it with than without.)
Keep in mind: None of these things are utterly fixed either. If a bill such as you propose was passed, there would be nothing to keep pro-abortion legislators from turning around and expanding the program to cover abortion as soon as they had the votes. It’s not as if such a move would be a permanent and enduring victory — though it’s always possible it would turn out to be so.
I expect that, under the way Abp Burke has articulated this issue, they would indeed be obligated affirmatively to vote for this.
MM: individualism is not what American conservatives advocate. The absence of communities enforced by the government is not the absence of communities.
Good points, Darwin. Even if Stupak-like language stays in the bill (which is looking less and less likely, unfortunately), it’ll be like the Hyde Amendment in that someone will likely try to overturn it each time a budget bill comes around. Obviously that in and of itself isn’t a good enough reason to oppose the entire bill (assuming, as you say, that one thinks the bill would have a positive overall effect), but it’s something the pro-life movement will have to keep in mind.
Good question and discussion.
I’m strongly pro-market, pro-subsidiarity, pro-framers’-intent.
I’m the type of person who thinks single-payer would be disastrous.
But even I can’t believe it would cause a million-plus deaths per year, like abortion does. It’d cause a lot, and it would cause other evils which would be bad enough to be comparable, as a general measurement of evil, to the deaths of thousands or tens of thousands. But it wouldn’t be as bad as abortion.
Therefore, if single-payer was coupled with the outlawing of abortion, I would certainly vote for the combination. The good (outlawing abortion) would outweigh the bad (single-payer).
But if single-payer were coupled with merely making abortion expensive or inconvenient? (Which, it seems, is the combination you’re proposing.)
Nah. That’s not good enough.
I’m not sure how monstrous single-payer would be, over time, but let’s put the evils of it at roughly equivalent to the evils of, say, a couple of hundred thousand deaths a year. If your changes to the affordability of abortion can’t prevent at least that many abortions, the trade-off doesn’t work.
“I’m not sure how monstrous single-payer would be, over time, but let’s put the evils of it at roughly equivalent to the evils of, say, a couple of hundred thousand deaths a year.”
And your evidence for this supposition comes from…
but let’s put the evils of it at roughly equivalent to the evils of, say, a couple of hundred thousand deaths a year
Excelsior,
What would cause these deaths? Can you point to evidence of unnecessary deaths in countries that do have single-payer plans? The United States comes out poorly in a great many measures (life expectancy, infant mortality). Somewhere around 90,000 to 100,000 people die every year from preventable infections they catch in hospitals.
I’m strongly pro-market, pro-subsidiarity, pro-framers’-intent.
Why should your political position determine how well or how poorly a single-payer plan would delivery health care? I can imagine a totalitarian government forcing people to lose weight, exercise, stay on a carefully controlled diet, and so on, and it would be totally unacceptable on to me on ideological grounds, but it might result in a healthier population.
Is this like global warming, where conservatives and liberals look at the same scientific evidence and arrive at different conclusions? That truly baffles me.
“First, it can be argued that the proper level to do health insurance the widest level, as this supports solidarity and spreads costs over the widest group. And you can’t look at subsidiarity without solidarity.”
I’m not. I simply disagree with the implementation and I believe the current package violates the principle of subsidiary. Universal coverage != gov solution. There are other ways. As I’ve stated before we don’t have a free market system or a socialized system. We have a wierd hybrid of both.
“Second, surely a large faceless profit-mamximizing private insurance company that makes money by denying claims and weeding out the sick is more detrimental to subsidiarity than a large bureacracy that grants universal coverage?
Third, doesn’t subsidiarity call for a parity relationship? An individual going it alone against the might of a private insurance company is not an exercise in subsidiarity.”
And a huge government bureaucracy fixes this how? Ever deal with the Post Office? At least with private insurers you can sue them. Who do you appeal to when the government turns you down?
“Fourth, doesn’t subsidiarity call for a personal relationship between patient and doctor? This is a huge weak spot in the American system, and single-payer systems do far better here (in France, it covers house visits). ”
France is a mess ecnomically. There is a huge youth base that is unemployed and it is going bankrupt. Not to mention the occasional riots.
“Fifth, don’t fall into the trap of the American right of equating subsidiarity with anti-government and pro-market! When Pius XI fleshed out his theories of subdidiarity, he condemned individualism as strongly as collectivism.”
You’re the one making that assumption about my views. The solidarity = gov solution is the same equating that you are accusing me of.
Finally, I find it interesting that no one replied to my abortion point. I was curious if anyone had a comment about that.
I think Mickey’s thought experiment has an interesting flip side as well. The fact is that Democratic health reform has a tragectory, short or long term, of more and more government involvement. Therefore the arguments that abortion groups are throwing around, that it’s really private abortion insurance coverage that is the issue to be protected, is not the central issue at all. Because if Mickey’s plan was proposed, it would eliminate the private insurance issue as they are stating it, and they would still oppose the bill. Even if Mickey’s plan said, single payer only EXCEPT we’ll allow private abortion insurance, the abortion politicians wouldn’t accept it, any more than they accept it in Stupak now. In fact, there is no solution that will appease the abortion people except if the PUBLIC plan covers abortion. Think about it–if there was some compromise guaranteeing that there are private plans in the exchange to cover abortions for women who pay 100%, who would end up being covered and who wouldn’t? Women who pay 100% would get abortion coverage, and women who need a subsidy would not. But that’s not acceptable to the abortion lobby–they have argued since before Roe that the abortion “right” is meaningless if only well-to-do women have total access. The worst scenario for them is no government funding for abortion plans–a very close second is no government funding to make abortion free for poor women. Because they have ALWAYS targeted poor women to get abortions, on demand, for free, precisely to increase abortions. It is the women who aren’t getting abortions today because they aren’t covered because they’re poor, that the abortion lobby cares about getting abortion coverage.
So while Mickey’s hypothetical would be a tough pill to swallow for Republicans, it is almost the last thing pro-abortion Democrats like Obama would accept. This whole thing is about free abortions for poor women. That’s why the Capps amendment was acceptable to them–the public option provided free abortions to poor women. The idea that a compromise on private coverage would be acceptable is not plausible. Mark my words, the Senate compromise of Stupak will NOT settle for abortion coverage for women who pay their own way. There WILL be coverage for the poor, and necessarily there will be money laundering or government mandates to make it happen.
Matt,
Do you consider it the acceptance of money laundering by the Supreme Court that they decided (5-4, I believe) that although taxpayers’ dollars given to religious schools would be in violation of the constitution, vouchers given to parents who then give them to religious schools are acceptable, because it is the parents, not the government who made the choice to give money to a religious school?
As I understand the Capps Amendment, which keeps government and private money separate and uses not government money for abortion, it is a lot less of a contribution by the government to abortion than vouchers are contributions to religious schools.
If you give a woman a subsidy to buy insurance coverage, and she chooses an a policy that covers abortion, like the parents who use the voucher, isn’t she the one making the choice about abortion, and not the government?
Because they have ALWAYS targeted poor women to get abortions, on demand, for free, precisely to increase abortions.
I don’t understand why Planned Parenthood is such a major provider of contraceptive advice and contraceptives. It is such a poor way to maximize the number of abortions. Perhaps they give out fake pills and poke holes in condoms to maximize unwanted pregnancies.
It is a terrible indictment of all the pro-choice organizations that the number of abortions has been steadily declining for so long. Hopefully health care reform can get us back to pre-1975 levels and keep the abortion mills humming.
DN, no need to launder that voucher money because it ain’t “dirty,” either constitutionally or morally. But if abortion is your religion, then I can see why you would treat them the same.
And the spread of promiscuity and contraception spreads abortion very successfully for PP as well as decimating non-white populations, if you care to look at the facts.
DN, no need to launder that voucher money because it ain’t “dirty,” either constitutionally or morally.
Matt,
You are dodging the question, as I suspected you would. In the case of vouchers, the government money needs to be turned into nongovernment money, otherwise government is directly contributing to a religious enterprise, which would be unconstitutional. Why is giving the money to parents and having them give it to a religious school not government contributing to religion, yet giving money to a woman to help her buy insurance that includes abortion coverage is government funding of abortion?
Why don’t you take a shot at answering the question?
Hey everyone, I have some shocking news for you. You’d better sit down. Senator Reid unveiled his health care bill tonight, and well, remember when pro-aborts claimed to be worked up about women who couldn’t get abortion coverage when they pay their own way? Ssurprise! Abortion is covered in his PUBLIC OPTION. That’s free abortions for poor women, for those of you keeping score.
Matt: I know. I just posted on it.
http://vox-nova.com/2009/11/18/harry-reid-kills-health-care-reform/
Matt & Mickey –
More news. The entire Senate Republican Caucus intends to vote against a health care bill with the full Stupak language first chance they get.