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Pro-Lifers are, pretty much by definition, concerned about people whose lives are in danger because others have been given the legal right to kill them, or because there is a realistic possibility that this will happen. For the past few decades this has primarily meant two groups of people: the unborn, threatened with abortion; and the elderly and severely handicapped, threatened with involuntary euthanasia.
Any discussion about a major new government involvement in health care potentially affects both these groups, and may create new categories of the vulnerable.
Without discussing any particular legislation at the moment, let's just discuss the idea in general. For the last few decades, "health care reform" has been understood to mean some form of nationalized health insurance. Depending on the exact proposal, this may take several forms.
At one extreme is the "single payer option", where the government pays for all medical care. Under these proposals, the government provides all medical care, and it is made difficult or impractical for people to get medical care outside the system. If the government pays all the doctors, and the government owns all the hospitals, medical equipment, and drugs, then there would be no medical care available to buy without government approval. Perhaps you could get a doctor to give you an examination and some simple care in his free time for cash. (In the most extreme proposals, this would be illegal. At least one bill in Congress a few years back classified that as "graft and corruption in medical care" and would have made it a felony.)
More moderate proposals call for some measure of government regulation of health insurance and medical practice. The government might require all insurance plans to cover a specific set of treatments. Drugs or procedures might require government approval before being permitted. Et cetera.
Of course we already have a great deal of government involvement in medical care. The Food and Drug Administration must approve any new drug before it is available to patients. Doctors must be licensed by the government. There are numerous government regulations on insurance companies. The government pays for a sizable percentage of medical care through Medicare and Medicaid. It has been a long time since medical care in the United States was a pure free market business. The debate is about how much government involvement we should have. But that hardly makes the debate trivial. There is a huge difference between 50% and 100%.
So why is major new government involvement in health care a pro-life issue?
If the government is providing all health care, will it provide abortions? If it does not, then abortions may be almost impossible to obtain. Abortion will be effectively banned. If it does provide abortions, then abortions become free and easy to obtain and taxpayers are forced to pay for them. It is impossible to avoid the question. Abortion will either be banned or it will be made free and easy. Of course pro-choice people would strongly object to abortions being banned, and pro-life people would strongly object to being forced to pay for abortions.
It is difficult to imagine a compromise or a middle ground. Perhaps you could say that abortions will be available but the person getting the abortion must pay for it. It is unlikely this would satisfy either side. Pro-choice people would object to the idea that abortion is singled out as requiring separate payment. Pro-life people would object that as abortions are being performed with taxpayer-funded equipment at taxpayer-funded hospitals, they are still being forced to financially support something they find morally abhorrent.
Advocates of national health insurance routinely describe it as "free medical care". But of course it is not free: someone still has to pay for it. Doctors expect to receive a salary, medical equipment costs money, etc. If it's all going to be run by the government, then it must be paid for with taxes. (The government might call it "insurance premiums" or "user fees" or by some other name, but it's still taxes.) And no matter who is paying these taxes or how they are collected, they are not unlimited. There is no way the government could simply give any one who walks into a hospital or doctor's office any treatment they ask for. Obviously, if a perfectly healthy person for some reason decides that he wants an expensive operation, they are going to tell him no. Just a shade less obviously, it is unlikely that the government will be able to afford all possible beneficial care. Decisions will have to be made about allocating resources. Advocates of government-run health care claim it will save money. There are only two possible ways to save money: They can be more efficient, or they can give less care. No one has yet explained how the government will run hospitals more efficiently than private companies -- the government has never demonstrated that it was more efficent at running anything else. So the only practical way to save money is to reduce the amount of care available.
It's not hard to guess where they will cut. They have already given plenty of hints: They will cut medical care for the elderly and the handicapped. This is "passive euthanasia". It is surely a very short step from "we can't afford to give you the care to keep you alive" to "and being you are suffering so terrible we will help you by ending your suffering". This is "active euthanasia".
One might argue that this is not inevitable. Maybe not, but surely you must concede that it could happen.
A government take-over of all or a large part of American health care will inevitably raise questions about abortion and euthanasia. This is fundamentally an issue for pro-lifers -- and pro-choicers, of course.
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Sept 22, 2009.
Copyright 2009 by Pregnant Pause