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CAMPAIGN-HEALTH Jun-17-2004 (1,090 words) Backgrounder. With logos posted March 10 and photos posted today. xxxn

Campaign '04: Candidates back church call for health care reform

By Nancy Frazier O'Brien
Catholic News Service

WASHINGTON (CNS) -- It's been more than a decade since the U.S. Catholic bishops declared in their 1993 document "A Framework for Comprehensive Health Care Reform" that the U.S. health care system "serves too few and costs too much."

With more than 43 million Americans now uninsured, the trend in the past 11 years has gone in the direction of serving fewer and costing more.

Both President Bush and Sen. John F. Kerry of Massachusetts, the expected Republican and Democratic nominees for president, have outlined detailed plans for expanding access to affordable health care, protecting and strengthening Medicare, reforming medical liability law and reducing health care costs.

Bush's plan focuses on expansion of a network of community health centers to serve low-income Americans; establishment of tax-free health savings accounts to pay out-of-pocket health costs; refundable tax credits to help workers buy health insurance; introduction of a prescription drug benefit for seniors through Medicare; formation of association health plans that would allow small businesses to band together for lowered insurance rates; and "common-sense reform to medical liability law" that would reduce "frivolous and time-consuming legal proceedings against doctors and health care providers."

The centerpiece of Kerry's health care reform proposal is a federal guarantee to pay the full cost of more than 20 million children enrolled in Medicaid if states agree to expand coverage to children living at 300 percent of the federal poverty level and to the family members of children living at up to 200 percent of the poverty level. The plan would provide insurance to more than 18 million children and adults currently uninsured, according to the Kerry campaign.

Kerry also has proposed the creation of a "premium rebate" pool that would reimburse employee health plans a portion of the cost of care in certain high-risk health cases as long as companies use the savings to reduce the cost of workers' premiums. He would give all Americans access to the same health care plan that covers Congress and the president, offer small business owners refundable tax credits for up to 50 percent of the cost of insuring their workers, and reduce prescription drug costs by closing loopholes in patent laws.

Kenneth Thorpe, chairman of the department of health policy and management at Emory University in Atlanta, recently estimated that Bush's proposal would cost about $90 billion over 10 years and would provide coverage for 2.5 million people currently uninsured. Kerry's plan would cost an estimated $690 billion over 10 years and would add 27 million people to the ranks of the insured, Thorpe said.

At a recent campaign appearance in Youngstown, Ohio, Bush said community health centers were the centerpiece of his health plan; he has promised to build or expand 1,200 such centers by 2006, and said he is halfway toward that goal.

"It's a common-sense approach to making sure the system meets the needs without centralizing the decision-making process in Washington, D.C.," he said.

Kerry's campaign Web site says the Democrat's proposal to reform health care would "save Americans, purchasers and the federal government billions in health care costs every year." Kerry "believes that all parts of the health care system -- insurers, providers, lawyers, employers and patients -- have a responsibility to help make the health care system more affordable," it adds.

But the Kerry health plan, as outlined on his Web site, also includes among its priorities protecting women's "right to choose" -- a stand clearly at odds with the Catholic Church's strong opposition to abortion.

"(Kerry) believes that the Constitution protects their right to choose and to make their own decisions in consultation with their doctor, their conscience and their God," the Web site says. "He will defend this right as president (and) ... support only pro-choice judges to the Supreme Court."

The U.S. bishops do not comment on candidates' specific proposals, but they outlined their hopes for health care reform in the 2003 document, "Faithful Citizenship: A Catholic Call to Political Responsibility."

"This reform must be rooted in values that respect human dignity, protect human life, and meet the needs of the poor and uninsured," they said. "With tens of millions of Americans lacking basic health insurance, we support measures to ensure that decent health care is available to all as a moral imperative. We also support measures to strengthen Medicare and Medicaid as well as measures that extend health care coverage to children, pregnant women, workers, immigrants, and other vulnerable populations."

Father Michael D. Place, president and CEO of the Catholic Health Association, hopes that whoever is inaugurated president in January 2005 will move the health care reform discussion forward by convening "a summit of all those people who fought each other last time (in 1993-94) and killed health care reform."

Quoting Ron Pollack, executive director of Families USA, a national health care consumer organization, Father Place said, "Health care reform failed because everyone thought that their perfect solution was the only solution."

The role of a president should be to bring together all the parties in health care reform -- providers, insurers, consumers and special-interest groups -- and ask them, "What's your second-best solution?" the priest added.

But health care reform must be systemic, Father Place said in a column for the May-June issue of Health Progress, the Catholic Health Association's bimonthly journal.

"The gap between how things ought to be and how they are cannot be overcome by patchwork efforts," he wrote. "Instead, there must be a real transformation of how persons maintain access to health care and how health care is delivered in our country."

Speaking June 8 at the CHA's annual assembly in Chicago, pollster Celinda Lake, president of Lake Snell Perry & Associates in Washington, said health care still lags behind the economy and the war in Iraq as issues of primary importance to voters.

But she said health care issues will be "more powerful" in the elections if "viewed through an economic lens" by voters. Most Americans are "flabbergasted" when they discover the number of children and working adults who lack insurance, and even those with insurance are worried about job loss or higher health care costs, Lake added.

The place of health care in the 2004 elections "is going to depend on how Iraq plays out, and the war on terrorism," said Father Place. "If, God willing, the transitional government in Iraq is successful, and the focus does get back to domestic policy," he added, then health care reform might get the attention it deserves.


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