Tuesday, November 17, 2009

Is it time to kill healthcare?

For decades feminists have supported universal healthcare, and for most of that time it just seemed to be a pipe dream. Now that healthcare legislation appears to be a real possibility, it may be time to kill it.

There are three main issues in the pending legislation that raise the question of whether we should oppose the Affordable Health Care for America Act. The first issue is the availability of the public option. A universal public option would give people a choice to obtain health insurance from either a private carrier or through the government. The House health reform legislation, HR 3962, would generally limit coverage to uninsured citizens who meet certain federal requirements. This provision fails to achieve the fundamental goal of universal healthcare: to provide coverage for everyone.

The second issue is insurance coverage for reproductive choices, including abortion. With the addition of the Stupak/Pitts amendment, HR 3962 prohibits the use of federal funds "to pay for any abortion or to cover any part of the costs of any health plan that includes coverage of abortion" except in cases of danger to the life of the pregnant woman, rape, or incest. The effect of the amendment essentially bans abortion coverage:

The Stupak/Pitts amendment would purportedly allow women who want comprehensive reproductive health care coverage to purchase a separate, single-service rider to cover abortion. But such abortion riders do not exist because women do not plan to have unintended pregnancies or medically complicated pregnancies that require ending the pregnancy.

The final issue, and perhaps most startling provision in HR 3962 provides for “nurse home visitation services” to assist low-income families with “behavioral and interpersonal guidance for self-improvement.” Gwendolyn Mink, a feminist activist and scholar, argues that this “provision is NOT about the delivery of medical services. As the bill states, one goal of home visits by nurses is to make the poor economically 'self-sufficient' and less 'dependent' on public assistance.” In addition, the home visits aim to increase “birth intervals between pregnancies” to essentially limit the number of poor children being born.

The very idea of destroying our chance at healthcare reform for another legislative session would seem antithetical to all of our progress on this front. Ultimately, whether a feminist chooses to support health care legislation with these provisions will depend upon whether she is committed to a bill that reflects real women’s lives. An SNL skit from this past Saturday illustrates the extent to which the Obama Administration may be willing to sign anything that is called healthcare. As feminists, we cannot be as compromising.

The decision whether or not to support the legislation could be reduced to utilitarianism. On the one hand, 34 million currently uninsured Americans will gain coverage. On the other hand, millions of people will be left uninsured or underinsured and those who gain coverage will be subject to governmental restrictions and intrusions. Is this a price we are willing to pay?

Even if President Obama signs legislation with these provisions, it is possible that one day the restrictions will be removed. True reform, however, cannot be achieved through piecemeal efforts that impose additional burdens upon low-income people and people of color. Legislators and HR 3962 supporters do not have the privilege to compromise their rights.


samina hitch said...

Very perceptive post, Eve. Your post points out the not-so-dreamy reality of what real reform requires. We should take note that this legislation is indeed a step towards realizing some cognizable right to healthcare, but any solution is particularly the best solution.

I think that we forget the governmental intrusions that accompany government presence, and healthcare is an area that historically necessitates privacy. Many populations who need access to universal healthcare the most are often already subjected to governmental intrusion via public benefits. It is not surprising, then, that the heavenly gift of universal healthcare comes with some seemingly minor imperfections – that disassociated legislators don’t understand and probably don’t care to change (unless they happen to come from a background that would be sensitive to the needs of disadvantaged populations).

I have been skeptical of the sweeping healthcare reforms of the Obama administration, and your analysis is a telling glimpse of how loopholes can be made (and ignored!) – and likely just to symbolically get the bill passed. Only time would tell if future reforms in the areas of home visits or abortion would happen at all, or if those provisions are in there (and safeguarded) as a means to make the bill more public-friendly.

It seems too risky, in my opinion, to support a bill that is egregiously imperfect. Sure, we might miss out on the dream of universal healthcare (right now) – but who wants universal healthcare that causes more harm than healing?

Erin S. said...

Yes, I'm afraid I'm becoming more and more skeptical of the health care reform, after being a fervent supporter in its early days. Seems to me like far too much is being sacrificed to make peace with conservatives and with the health insurance industry. It's extremely disappointing and troubling to me.

I have a friend who just moved to Wales, where free health care (and free reproductive health care!) is the status quo. She loves the system there, and says that while she didn't think she was moving for the health care, the more she reads about the situation in the U.S. the more grateful she is that she chose this time to move. And somehow it's getting easier for me to imagine following her. I'm beginning to think that things are just so screwed up here that they may not be fixable with party change.