U.S. Bishops Say Health Reform Skimps on the Poor

November 1, 2009

The U.S. Conference of Catholic Bishops inserted their opinion of Democratic plans for health care reform into many church bulletins today, mostly updating their October 8 letter to Congress.

Predictably, they oppose any provision that favors abortion and makes life more difficult for health care workers who want to distance themselves from abortions. And they assert that all the committee-passed bills have those provisions. But the bishops also repeated their concern that the plans “do not provide adequate access to health care for immigrants and the poor.”

Of course, the bills aren’t mainly designed for the poor; they’re designed to funnel health services to middle-income people as far up the income scale as possible. The early versions included subsidies for families earning up to $110,000 in annual income. And even though the two most prominent versions — the Baucus bill and the new Pelosi bill — have set $88,000 as the ceiling for federal subsidies, that is still well above the national average income.

For years the income ceiling for many federal entitlement programs has been about $44,000. Is it a bad idea to double that amount, granting federal health care subsidies to families with two good cars, four cell phones and an HD-TV in the air-conditioned living room of a house they own?

From the bishops’ perspective, although they favor a universal system, serving the poor should take priority. The bills could certainly be amended to help the poor more, but if they were as generous as the bishops would like, and still stay under the already stratospheric ceiling of $900 billion, those middle- and upper-middle-class subsidies would have to be jettisoned.

The long-term consequence of establishing middle-class health care entitlements is likely to be hard on the poor. The competition for federal health dollars is hard enough now, when the only other huge group staking a claim on them is the elderly, i.e. Medicare recipients. If anything like these bills passes, middle-income, working-age people will be the group getting the lion’s share of future health spending, because that’s where the votes are.


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