U.S. Catholic Bishops Try to Calm Right-Wing Anxieties Over Pope

By Rachel Zoll

Note: This article was first published November 10, 2014 by the Associated Press.

America's Catholic bishops came together Monday to project an image of unity, after a Vatican meeting on the family unleashed an uproar over the direction of the church.

Last month's gathering in Rome on more compassionately ministering to families featured open debate — alarming many traditional Catholics, who argued it would undermine public understanding of church teaching. Pope Francis encouraged a free exchange of ideas at the assembly, or synod, in contrast to previous years, when such events were tightly scripted.

At a meeting Monday in Baltimore, Archbishop Joseph Kurtz, president of the U.S. Conference of Catholic Bishops, signaled there was no conflict between a gentler approach and upholding church orthodoxy. Kurtz cited his home visits to parishioners, where he wouldn't give them "a list of rules to follow firsthand," but would instead "spend time with them trying to appreciate the good that I saw in their hearts," before inviting them to follow Christ.

"Such an approach isn't in opposition to church teachings. It's an affirmation of them," said Kurtz, who attended the Vatican gathering.

Cardinal Donald Wuerl of Washington, who also participated in the Vatican gathering, emphasized that last month's meeting was only the start of a discussion before a larger gathering on the family next year, where bishops will more concretely advise the pope on developing any new church practices. New York Cardinal Timothy Dolan said the divisiveness he read in media accounts did not reflect the collegial discussion inside the event.

"It was a synod of consensus," Dolan said. The pope, he said, has a God-given gift "for attentive listening."

The bishops made the remarks at their fourth national meeting since Francis was elected. While many Catholics have praised Francis' new emphasis on mercy over the culture wars, many theological conservatives have said Francis is failing to carry out his duty as defender of the faith. Some U.S. bishops have resisted turning their focus away from gay marriage, abortion and other contentious social issues to take up Francis' focus on the poor, immigrants and those who feel unwelcome in the church.

The papal ambassador to Washington, Archbishop Carlo Vigano, said in a wide-ranging speech bishops "must not be afraid to work with our Holy Father."

The public sessions at the U.S. bishops' meeting are focused on religious liberty, upholding marriage between a man and a woman, and moral issues in health care. In his speech, Kurtz said the bishops would continue to fight the Obama administration over the birth control coverage requirement in the Affordable Care Act. The administration has made several changes to accommodate the bishops' concerns, but church leaders say the White House hasn't gone far enough. Dozens of dioceses and Catholic nonprofits have sued over the mandate.

At the Rome gathering, tensions arose when Vatican officials released a mid-meeting report that contained language more welcoming to gays and people in civil heterosexual unions. The language was not included in the final report.

The Rev. Tom Rosica, a Vatican press office official for English-language media, attended the American bishops' assembly. He said an in interview that Catholic church leaders and lay people, as well as those outside the church, are reacting strongly to the Vatican meeting because they aren't accustomed to addressing issues the way Francis advocates.

"The pope made it clear doctrine would remain untouched," Rosica said.

He said Francis "is traveling at high altitude," above the backlash to his leadership, as he tries to revive discussion and move the church forward.


Related Off-site Links:
Cardinal: Pope Francis Doesn't Want a 'Self-pitying Church' – Cathy Lynn Grossman (Religion News Service via Crux, November 10, 2014).
The Church Needs the Commotion the Family Synod Caused – Editorial Staff (National Catholic Reporter, November 7, 2014).
What the Left and Right Get Wrong About Pope Francis – John Gehring (Crux, October 27, 2014).

See also the previous PCV posts:
• Tony Flannery in Minneapolis
• The "Francis Era" in America Starts Today in Chicago
• Creating a Liberating Church

Image: Bishop Kevin C. Rhoades of Fort Wayne-South Bend, Indiana, attends the U.S. Conference of Catholic Bishops general meeting in Baltimore Monday, November 10, 2014. (AP Photo/Steve Ruark)

Role of the U.S. Catholic Bishops in the Shutdown: Holding Government Funding Hostage in Battle Against Contraceptive Coverage

By William D. Lindsey


Note: This commentary was first published October 10, 2013 on William's blogsite, Bilgrimage.


In an editorial just uploaded to its website, America rightly deplores the effects of the shutdown of government on working people and people living on the margins of the American socioeconomic system. The editorial notes that many people are now forced to wonder when they'll receive the next paycheck, park facilities have been shuttered around the country, and hundreds of cancer patients, including 30 children per week, have been locked out of their last-resort treatment at NIH's Clinical Center. And it adds,

These are just a handful of the pernicious effects of the shutdown that resulted on Oct. 1 after the G.O.P’s latest effort to obstruct the Affordable Care Act. The closing of the federal government not only shuts down so-called nonessential services, like nutrition aid to women, infants and children, it also means that a federal flow of $3 billion a day into the already twitchy American economy has been cut off.

But then America goes on to maintain that the U.S. Catholic bishops "were aghast at the political breakdown" and wrote a letter to Congress on 1 October arguing that human needs must continue to be met, even if the government has shut down. Unfortunately, however, that 1 October letter, written as the shutdown began, comes on the heels of another letter that the USCCB sent (.pdf file) to Congress on 26 September. That letter is signed by Cardinal Sean O'Malley, chair of the Pro-Life Committee of USCCB (and a member of Pope Francis's "gang of eight"), and Archbishop William E. Lori, chair of the Ad Hoc Committee on Religious Liberty.

The 26 September letter states,

We have already urged you to enact the Health Care Conscience Rights Act (H.R. 940/S. 1204). As Congress considers a Continuing Resolution and debt ceiling bill in the days to come, we reaffirm the vital importance of incorporating the policy of this bill into such "must-pass" legislation. [Emphasis in original]

In other words, though on 1 October, as the shutdown began, the U.S. Catholic bishops wrote Congress to insist that human needs must continue to be met during a government shutdown, on 26 September they were encouraging members of Congress to hold the re-funding of government hostage to their insistence that even private, non-faith-based employers be allowed a "Taco Bell" exemption from the requirement of the Affordable Care Act that they provide contraceptive coverage for employees.

Permit us to discriminate--permit anyone, even a private employer in a company in no way affiliated with a religion to discriminate--or else. Or else we'll hold the nation hostage until our "conscientious" demands are met. As Adele Stan notes, it appears the USCCB wants to have it both ways: we're for the shutdown of government as a tool of holding the government hostage until our "conscientious" demands are met; but we're against it when it creates suffering for people.

Stan writes,

The bishops want to be on the record as champions of health care for the masses, food for the hungry, and shelter for the homeless—things the government, when operational, helps to provide. But they’re happy to block access to such services for those in need of them unless Congress agrees to block women of all faiths or none, on the whim of an employer, from receiving prescription birth control as part of the preventive care benefit in the Affordable Care Act (ACA).

If that doesn’t work, they wouldn’t mind seeing the global economy brought to its knees for the sake of making the most effective forms of contraception more difficult for women to obtain.

And she's correct. Via its 26 September letter to Congress, the USCCB gave a clear signal to Congress—and, in particular, to the radical Republican faction controlling the House of Representatives—that it approves of using the re-funding of the federal government as a weapon to try to roll back a provision of the Affordable Care Act to which the bishops object. So it's with astonishingly clumsy grace that the bishops, who have torn their moral credibility to shreds by their persistent shrill attacks on the Affordable Care Act, pretend now to give a hoot about the human effects of the shutdown they themselves helped to precipitate.

Pastoral leaders these men are clearly not, on the whole. Politicians, yes, and partisan ones, to boot. And they deserve to be held accountable, along with other religious and political extremists, for what has happened as they have harped about their right to a "religious freedom" that translates into their purported right to discriminate in the provision of healthcare, as the ACA is being implemented.


Related Off-site Links:
USCCB Takes on the Smell of the Elephants – Colleen Kochivar-Baker (Enlightened Catholicism, October 10, 2013).
Paralysis in Washington – The Editors (America, October 10, 2013).
Catholic Bishops to House: Shut Down the Government Unless We Get Our Way on Birth Control – Ian Millhiser (ThinkProgress.org, October 7, 2013).
At Any Cost: How Catholic Bishops Pushed for a Shutdown—and Even a Default—Over Birth Control – Adele M. Stan (RH Reality Check, October 6, 2013).
Catholic Bishops Want Entire Birth Control Rule Repealed, Not Just the Religious Exemption – Nick Baumann and Kate Sheppard (Mother Jones, February 9, 2012).
Doug Mataconis on the Bishops, Religious Freedom, and Living in a Civil Society – The Wild Reed (December 30, 2011).

An Update on This Issue: Walking Like a Duck – Ken Briggs (National Catholic Reporter, October 11, 2013).

Quote of the Day

. . . In reaching its decision, the Supreme Court did nothing more than recognize what we all know: Of course, the government is involved in health care, that Congress has the right to regulate it, and of course the broken system needs to be fixed.

There is no doubt how the U.S. Catholic bishops should respond. Although they opposed the law initially, believing its anti-abortion provisions were insufficient, they have never once called for the law's repeal.

Court rulings since the Affordable Care Act was passed have said the law, on its face, does not provide for taxpayer-funded abortions. Yes, the U.S. bishops' conference should continue to press for a resolution on the federal mandate requiring coverage of contraceptives in health care plans that too narrowly outlines the definition of a religious employer.

But that issue cannot blind the bishops, or any Catholics, to the blessings the act will bring. The U.S. bishops have supported universal health care for decades. They should not – they cannot – back away now.

The U.S. bishops' own teaching document "Faithful Citizenship" rightfully points out: "A lack of health care [is] a serious moral issue that challenges our consciences and require[s] us to act."

. . . However complicated the intricate policy aspects of the Affordable Care Act, however confusing the actuarial tables, however conflicting the legal principles at stake, the moral issue is as clear as day: Every industrialized country in the world has found a better fix to the issue of health care than has the U.S.

Only the U.S. is so beholden to powerful, entrenched corporate interests that we have failed to achieve universal access to health care. It is time for the nation to find the political will to defend the principles that defined the Affordable Care Act.

Affordable care for all. Access for all. Lower costs for all. That is the recipe for a decent society and any continued obstruction is properly called indecent.

– The Editorial Board
"Upheld Health Care Law a Blessing for the U.S."
National Catholic Reporter
June 28, 2012

See also the previous PCV posts:
"A Great Day for the American People"
Three Moral Issues of Health Care
A Health Insurance Executive Recalls a Life Changing Experience
Universal Health Care: So That We Might Live
Recommendations for Health Care Reform by the Minnesota Universal Health Care Coalition

"A Great Day for the American People"

A statement by Steve Krueger, National Director of
Catholic Democratson the Supreme Court Decision on the
Patient Protection and Affordable Care Act

Today is a great day for the American people, particularly working class families and people living in poverty. It is a day when we have seen the conscience of our nation and the cause of social justice triumph over ideology, the timid, and the peddlers of fear.

Catholics Democrats applauds and thanks, first and foremost, President Barack Obama and all those who put our nation on a path to universal health care. They include Leader Nancy Pelosi and the Democratically-led 111th Congress, who had the vision and courage to use their political capital to pass the Patient Protection and Affordable Care Act (ACA) at a time when political divisions were reaching historic proportion.

We also applaud and thank the Justices of the Supreme Court who supported the constitutionality of the ACA and particularly Chief Justice John Roberts, a Catholic, for his vision, courage, and his break from his conservative colleagues on the high court. His support was the deciding swing vote that upheld the law. Although disagreeing with the so-called and misnamed "mandate" of the ACA, Chief Justice Roberts was able to recognize the constitutionality of the legislation on other grounds, thus enabling the extension of health care coverage to more 32 million Americans who otherwise would not have it.

As Catholics, we know that nothing animates the Catholic imagination more than helping the poor. We can only speculate about the role that Chief Justices Roberts' faith may have played in his decision. But surely it can be argued that his decision represents a Catholic sensibility.

While the media and others will primarily focus on the important political aspects of this decision, Catholic Democrats is mindful of the work before us in ensuring that all Americans have access to health care as a fundamental human right, a longstanding belief of the Catholic Social Justice Tradition. The high court struck down the requirement that states must comply with expanded Medicaid provisions. The discretion that states now have to limit the expansion of their Medicaid programs will put the health care coverage for millions of Americans at risk. Only time will tell what the impact of this will be on uninsured people. However, we expect that it will be important for social justice advocacy groups to fight for health insurance reform in those states that choose not to expand Medicaid coverage.

In addition to those living in states where Medicaid coverage may not be expanded, it is incumbent on our nation's leaders - and indeed all Americans - to be mindful that even as written, the ACA still would not have covered 26 million Americans according to Congressional Budget Office estimates. As one might expect, the burden of being uninsured today is borne predominantly by our African American and Latino sisters and brothers. The uninsured rates for African Americans and Latinos are 21% and 31% respectively, while the White Non-Hispanic uninsured rate is 12%.

Today is a great day for America but there is still much work to be done. As we look to the future, let us be mindful of the past and all those who helped forge this victory over the past century. In particular, we wish to remember Senator Edward M. Kennedy and his tireless efforts as a voice for the voiceless in advocating for health care coverage for all. His words from more than 30 years ago are as apt today as they were then: "For all those whose cares have been our concern, the work goes on, the cause endures, the hope still lives, and the dream shall never die."


According to its website, Catholic Democrats "represents a Catholic voice within the Democratic Party, and advances a public understanding of the rich tradition of Catholic Social Teaching and its potential to help solve the broad range of problems confronting all Americans."


See also the previous PCV posts:
Three Moral Issues of Health Care
A Health Insurance Executive Recalls a Life Changing Experience
Universal Health Care: So That We Might Live
Recommendations for Health Care Reform by the Minnesota Universal Health Care Coalition

Three Moral Issues of Health Care

By Jim Wallis


(Editor’s Note: The following is excerpted from Jim Wallis’ latest column in the September-October issue of Sojourners.)

There is not a religious mandate or God-ordained system of health care or insurance. No amount of biblical exegesis or study will lead you to a policy conclusion on health care savings accounts, personal versus employer provided insurance, single payer public systems, or private insurance plans. Luke might have been a physician, but he still never commented on whether or not computerizing medical records should be a national priority.

These policy questions are still of vital importance and will be debated and discussed in the coming months at the White House, in Congress, in the press, and I hope in our churches. With an issue like health, deeply personal but of great public concern, I believe that the faith community has a unique and important role to play. That is, to define and raise the moral issues that lay just beneath the policy debate. There will be a lot of heat, maybe even a few fires, over the weeds of the policy, and the faith community has the opportunity to remind our political and national leaders about why these issues are so important — why they speak to our values.

There are, I believe, three fundamental moral issues that the faith community can focus on and call our political leaders back to, lest they forget. They are: the truth, full access, and cost.


The Truth

For decades now, the physical health and well-being of our country has been a proxy battle for partisan politics. When Truman tried to pass a national health insurance plan, the American Medical Association spent $200 million (in today’s dollars) and was accused of violating ethics rules by having doctors lobby their patients to oppose the legislation. In the 1970’s when Nixon tried to pass a national health insurance plan, strikingly similar to what many democrats are proposing today, the plan was defeated by liberal democrats and unions who thought that they would be able to pass something themselves after the mid-term elections and claim political credit for the plan. In the 1990’s the “Harry and Louise” ads misrepresented the Clinton health care plan but was successful enough PR to shut down that movement for reform.

Already, industry interests and partisan fighting are threatening the opportunity for a public dialogue about what is best for our health care system. As a resource for congregations, small groups, and individuals, Sojourners has worked with its partners to publish a Health Care tool kit [click here to download] to help frame and guide this necessary debate. This guide gives an overview of the biblical foundations of this issue and frequently asked questions about it. What we need is an honest and fair debate with good information, not sabotage of reform with half-truths and misinformation.


Full Access

The second fundamental value question is that of quality and affordable full access to health care. About 46 million people in our country today are uninsured and many more find themselves without adequate coverage for their medical needs. Many of them are working families who live in fear of getting sick or injured. Some delay seeking medical attention at the risk of their own health and increasing cost later on, or use emergency room services instead of primary care physicians. An estimated 18,000 people a year die unnecessarily, many from low-income families, because they lack basic health insurance. As a father, I know how important the health, wholeness, and well-being of my family is to me and is to every parent. Seeing your child sick is a horrible feeling; seeing your child sick and not having the resources to do something about it is a societal sin.


Cost

The third issue is cost. An estimated 60 percent of bankruptcies this year will be due to medical bills. Seventy-five percentof those declaring bankruptcy as a result of medical bills have health insurance. The costs of medical care stem from varied sources. Some of these costs come from malpractice lawsuits, some from insurance companies with high overhead and entire divisions of employees hired to find ways to deny benefits. Someone who thought they were insured could find out that their benefits were terminated retroactively because the insurer decided that there was a pre-existing condition. In the end, some are paying too much for care and others are making too much from these present arrangements.

There is a lot of money, to say the least, wrapped up in health care. The faith community needs lift up the concerns of those who have no lobbyists on Capitol Hill or PR firms with slick advertising campaigns.

These are pressing issues for our country, lives are at stake, and it is a debate we must have and take seriously. For the month of July, we will be taking this discussion to our blog and having some of our regular writers and guests give their opinions and perspectives.

There are a myriad of special interests groups who will be promoting their own self-interests during this process. The faith community has the opportunity to step in and speak for the interests of the common good and those who would not otherwise have a voice. I am sure that every one of the 18,000 preventable deaths that will happen this year from a lack of basic health insurance breaks the heart of God. And, it should break ours too, because healing is at the very heart of the Christian vocation.

A Health Insurance Executive Recalls a Life Changing Experience

The following story is from Wendell Potter, a recently retired senior health insurance executive. Mr. Potter describes the single event that led to his deep questioning of the role of insurance companies in the U.S. health care system. These comments were made to Bill Moyers on The Journal, aired on PBS July 10, 2009.

_____________________________________

I just didn’t really get it all that much until toward the end of my tenure at CIGNA. . . . It really took a trip back home to Tennessee for me to see exactly what is happening to so many Americans. In July of 2007 I went home, to visit relatives. And I picked up a local newspaper and I saw that a health care fair was being held a few miles up the road in Wise, Virginia. I was intrigued and drove to the fair which was held at the Wise County Fairground. . . . It was raining that day, and I walked through the fairground gates. And I didn’t know what to expect. I just assumed that it would be, you know, like a health fair – booths set up and people just getting their blood pressure checked and things like that.

But what I saw were doctors who were set up to provide care in animal stalls. Or they’d erected tents, to care for people. I mean, there was no privacy. In some cases people were being treated on gurneys, on rain-soaked pavement.

And I saw people lined up, standing in line or sitting in these long, long lines, waiting to get care. People drove from South Carolina and Georgia, and Kentucky, Tennessee – all over the region, because they knew this was being done.

It was absolutely stunning. It was like being hit by lightning. It was almost – what country am I in? It just didn’t seem to be a possibility that I was in the United States.

Universal Health Care: So That We Might Live

By Lisa Nilles, M.D., M.A.T.


(Editor’s Note: The following transcript is of a talk presented by Lisa Nilles at St Joan of Arc Catholic Church on August 30, 2009.)


Today’s reading from Deuteronomy describes a scene some 3200 years ago, in which the Israelites, after many years of slavery and wandering in the desert, are finally poised to enter the promised land. Moses, unable to enter with them, uses this last chance to pass on all that God has revealed to him. Moses instructs the people, “Now Israel, give heed to the statutes and ordinances that I am teaching you to observe, so that you may live to enter and occupy the land that the Lord, the God of your ancestors, is giving you. You must neither add anything to what I command you nor take away anything from it, but keep the commandments of the Lord your God . . . for this will show your wisdom and discerning to the peoples.”

Now fast forward some 600 years, for this is when the book of Deuteronomy was actually written. Israel is in crisis. It is divided into two kingdoms, and partially occupied by the Assyrians. In order to survive, the nation needs to unite and pull together. The Moses story reminds people of their history and the principles upon which Israel was founded. Additional laws in the book form the basis for the reforms enacted by Josiah that once again unite Israel. These additional laws address such things as social relationships, and care of the poor and needy. For example, “If there is among you anyone in need . . . do not be hardhearted or tightfisted toward your needy neighbor. You should rather open your hand, willingly lending enough to meet the need, whatever it may be.” Israel’s secular rules are infused with a conscience and guiding set of principles.

Now, fast forward again – this time to the United States in 2007. We are a nation at war, a nation divided by the ideologies of the “right” and the “left,” a nation on the brink of an economic recession. It is at this time that Wendell Potter, the head of corporate communications for CIGNA health insurance company, visits the Wise County Health Fair. He is astounded. He cannot believe that in this land of milk and honey, this land with a huge and successful health industry, thousands of people seek care in makeshift shelters, hundreds of miles from their homes. Indeed, there is a disturbing irony in the fact that the organization that coordinated this fair, Remote Access Medical, was founded in 1985 to airlift medical supplies to remote areas of the world such as the Amazon rain forest. Now, Remote Access Medical devotes 60% of its resources to free care in the United States. We have become the land of remote medical access. That this has happened is tragic. That it has happened in a setting where enormous profit is made from health care is a disgrace. When the health of our economy is measured by the profits of health insurance companies rather than the health of our citizens, we have become a nation that has lost its way.

Which brings us to today. We are now in the midst of a swirling health care debate, much of which has been reduced to a shouting match of staged events rather than a true dialogue. We are besieged with information and misinformation, overwhelmed with sound bites, disheartened by revelations of insider deals, and dismayed at the power of the voices of industry over the voices of the people.

Like Israel so many years before us, we need to return to, and be guided by, our unifying values. In the realm of health care reform, what is our unifying value?

The answer is clear: universal care. No more, no less. Everybody in, nobody out. The word “universal” does not allow exclusions of the sick, the poor, the unemployed, and the visitors to our nation. The word “care” does not allow allow exclusions of essential components of care such as mental health care, dental care, or medications.

Universal care is a value handed down to us over the millennia. Beginning with the admonition in Deuteronomy to care for the needy, to the words of Jesus to love our neighbor as ourself, to the United Nations Declaration of Human Rights which named medical care a basic human right, to the papal encyclical Pacem in Terris which did the same.

In the din of the current debate, who is calling for universal care? How might we get there? Let me highlight worthy efforts at the national and state level in the march toward universal health care.

At the national level, pay attention to efforts to enact a form of national health insurance. National health insurance, as encapsulated in Rep. John Conyer’s “Improved and Expanded Medicare for All” bill, HR676, would open the doors of Medicare to every American. As a model for reform, we know that conversion from our overly complex and woefully inefficient multiple-payer system, consisting of upwards of 1300 private payers in addition to our public payers, to a single payer system, would save enough money in administrative costs that we could pay for universal health care without any increase in total health spending. It is a tragedy that “Medicare for All” was excluded from this year’s initial health care hearings. Nonetheless, due to persistent pressure from citizens, and with courageous congressional leadership from Rep. Weiner of New York, the “Improved and Expanded Medicare for All” bill has been promised a full House floor debate and vote this fall. This is the first time that a national health insurance bill will receive a vote on the floor of the House.

What about the “public option?” A strong public option could be a stepping stone to universal health care. A weak public option won’t add much of anything to our current health care system. This “public option” concept means that Americans would have the choice of buying insurance from a publicly administered plan, along with choices of privately administered plans. This sets up the debate – who can administer health care more efficiently – the government or the private sector? While this is an intriguing concept, for this test to succeed, there must be a guarantee that the public and private plans compete on a level playing field. To date, the bills written that include a public option are inadequate. They include a public option that is a far cry, and deadly weakened, from that imagined at the outset. Minnesota progressives, including ISAIAH and the Minnesota Universal Health Care Coalition, have outlined criteria necessary for a strong public option. We have sent letters to the Minnesota delegation with these details.

If we tragically fail to enact meaningful national health care reform this time around, we must move ahead at the state level. We have a strong universal health care bill in the Minnesota Legislature, called the Minnesota Health Act. This bill, co-authored by Senator John Marty and Rep. David Bly, and supported by over 1/3 of Minnesota legislators, is based on the value of universal care. The bill begins with the following language, “In order to keep Minnesotans healthy and provide the best quality of health care, the Minnesota Health Plan must ensure all Minnesotans receive high quality health care, regardless of their income.”

We must persist until we have universal health care so that, in the words of Deuteronomy, “you may have life.” For indeed we know that those without access to health care are sicker and die younger than those with access. Dr. Michael Belzer, chief medical officer of Hennepin County Medical Center describes uninsurance as “a fatal disease.” Unless we reverse our current trend of steadily worsening access to health care, uninsurance will be the third leading cause of death in the 50-64 year old age group by the year 2015. Dr. Martin Luther King, Jr. insists, “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” We must act.

I leave you with two ideas for becoming informed and involved in this historic march toward universal care.

First, watch the episodes of Bill Moyers’ Journal over the past months devoted to health care reform. These are available on the PBS website, and, as well, are catalogued on the Minnesota Universal Health Care Coalition’s website. Moyers offers a compelling look at the institutional forces behind the debate, and a poignant look at the devastating consequences to individuals denied access to care – in America.

Second, join the Minnesota Universal Health Care Coalition in the Campaign for the Minnesota Health Plan. It may be that the march to universal health care begins right here at home, not in Washington. Please join us. We need you.

Thank you.

Recommendations for Health Care Reform by the Minnesota Universal Health Care Coalition

As members of organizations representing physicians, nurses, labor, faith groups, and advocates across Minnesota, we are deeply concerned about improving the health and health care coverage of our communities. We feel strongly that a single-payer system is the most efficient and equitable way to guarantee affordable health care for all. Affordable access to health care is a fundamental prerequisite for promoting health. Consistent research supports our belief that a single-payer system will offer tremendous cost-savings over our current fragmented multi-payer system.

Absent a single-payer system, we believe a robust public option is an essential outcome of the current national health care reform discussion, and the design of that public option is critical to its ultimate success or failure. A well-designed public plan will protect consumers against discrimination in the health care marketplace, give enrollees a real choice of providers and help to ensure that all Americans have an affordable and accessible option for health care. In contrast, a poorly designed public option could quickly become unsustainable, fail to control costs or expand coverage, and make true reform even more difficult in the future.

As the federal health care reform discussion moves forward, we urge Congress to design a public option that will be viable and sustainable. We believe that Medicare is unusually efficient, and a public plan that possessed Medicare’s low overhead, reasonable provider payment rates and large size would have the ability to compete fairly with the insurance industry and lower overall health care costs. The Lewin Group* has stated in two reports that a public plan that meets the first six criteria below would be able to compete fairly with the insurance industry.

1. The public plan has a large pool of enrollees on the day it begins operations. This pool could be created in part by the automatic enrollment of Medicaid and SCHIP enrollees and a large portion of the uninsured.

2. The public plan is open immediately to all Americans (including large employers).

3. The public plan is authorized to negotiate on behalf of its entire enrollee population to achieve reasonable reimbursement rates for providers and fair prices from drug manufacturers.

4. The public plan is required – along with the private insurance industry – to cover a comprehensive set of benefits.

5. Enrollees in the public plan should receive subsidies that make the purchase of insurance from the public program affordable for all Americans.

6. Premium payments to all insurers should be adjusted to reflect differences in the health status of their enrollees to protect all insurers against adverse selection (higher costs caused by enrolling a disproportionate share of the sick).


There are numerous other criteria that would strengthen the public program. We believe the three criteria listed below should also be considered essential as well:

1. Require providers to accept enrollees of the public program.

2. Prohibit the public program from limiting enrollees’ choice of provider and giving providers incentives to deny care.

3. Ensure that states retain the right to establish their own single-payer systems.


As members of a broad spectrum of the public, concerned about the present state of our health care system, convinced that meaningful reform is possible and vital, we urge Congress to insist that any legislation creating a public program meet these criteria. If the public program does not meet these criteria, it will be unable to lower health care costs. If we do not lower costs, we will not achieve universal health insurance. If we do not achieve universal health insurance this year, we will have squandered a rare opportunity to improve the health and economic security of all Americans.


Charlotte Fisher, RN/NP
President, Greater Minnestoa Health Care Coalition

Reverend Dan Garnaas
Leader, ISAIAH

Chris McCoy, MD
Policy Committee Chair,
Minnesota Local Action Network of the National Physicians Alliance

Susan Hasti, MD
Chair, Minnesota Universal Health Care Coalition

Ann Settgast, MD & Elizabeth Frost, MD
Co-chairs, Physicians for a National Health Program – Minnesota chapter

Dan McGrath
Executive Director, TakeAction Minnesota

Joel Albers PharmD, PhD
Coordinator, Universal Health Care Action Network – Minnesota


* To develop criteria for an efficient, Medicare-like public option, we relied on the papers published by Jacob Hacker in 2001 and 2007 in which he presented a detailed version of a public program. Mr. Hacker is the most prominent advocate of the public option approach. We also relied on evaluations of Mr. Hacker’s papers by the Lewin Group, a subsidiary of United Health Group. Mr. Hacker’s 2007 paper is entitled, “Healthcare for America: A proposal for guaranteed, affordable health care for all Americans building on Medicare and employment-based insurance,” and is available here. The Lewin Group analysis of Mr. Hacker’s 2007 paper, published in 2008, is entitled, “Cost impact analysis for the ‘Health Care for America’ proposal: Final Report,” and is available here.