Health Reform Update - Quite a Moment

May-June 2010


On Sunday evening, March 21, the U.S. House of Representatives was in the final moments of debate on a historic health care reform bill. In line with me to watch the vote from the House gallery was a family of three, the parents chatting with their son, who sat in a wheelchair. All of them brimmed with joy.

When the Capitol Hill guard came to announce that our group would be seated to witness the big vote, the parents smiled broadly as tears began streaming down their faces. Their son peered around the corner with pure excitement. Seeing this family was a powerful and emotional reminder of our goal. Health reform suddenly seemed more urgent than it ever had before.

So much was riding on the outcome of that vote: The health security of millions of people. The inability of insurance companies to discriminate or deny based on a pre-existing condition. The first steps toward paying for quality instead of quantity. A strong safety net for low-income and vulnerable people. Peace of mind for the family in line with me.

Long before I joined or even knew of CHA, its staff and member organizations were busy planning and pushing health reform. This call to create a more equitable and reliable health infrastructure for our country compelled many advocates before me to raise their voices on behalf of those without one.

We have been talking about this issue for a long time. The Catholic Church has always been a vocal proponent of a system that provides access to care for all, protecting the "sanctity of human life and the dignity that belongs to all human persons." In that same spirit, CHA and the hospitals we represent have for decades advocated, lobbied, pleaded for health care justice.

About 18 years ago, many thought the moment had arrived. Here is the text of an advertisement for the 1992 Catholic Health Assembly in this very publication:

"This presidential election year, healthcare issues are stirring more debate — among candidates and voters — than ever before. Reform of the U.S. healthcare system seems inevitable. But is it? What shape will reform take? What will be the future for healthcare in the United States?"

The same copy could have been written for our 2008 Assembly. Reform was indeed inevitable. It just wasn't clear in 1992 that it would take almost two more decades.

In the early '90s, CHA and the Catholic health ministry were as actively involved in moving reform forward as they have been in recent months. At the first public hearing of President Bill Clinton's Task Force on National Health Reform, CHA presented a vision of reform calling for universal access and a comprehensive benefits package.

Sr. Bernice Coreil, who at the time chaired CHA's Leadership Task Force on National Health Policy Reform and is now senior adviser to Anthony Tersigni, president and chief executive of Ascension Health, introduced President Clinton on March 23, 1994, at a White House meeting of health professionals. (President Obama, incidentally, signed health reform into law on March 23, 2010, exactly 16 years after Sr. Bernice walked the White House lawn with Bill and Hillary Clinton.)

"There is no excuse, moral or otherwise, for making millions of working families wait for coverage while attempts are made to lower costs for those who are lucky enough to have coverage now," Sr. Bernice said that day. "You know this, Mr. President, and the American people know it."

CHA's recommendations to Clinton's policy task force stemmed from a 1993 document, "Setting Relationships Right," which outlined a proposal for systemic health care reform. Many elements of that proposal found their way into the White House health care plan.

Due to a series of missteps and controversial management of the health care legislation, however, Clinton's proposal never saw the legislative light of day. The wait, and the fight, for universal coverage would continue.

The loss of public appetite for any further reform discussion did not deter CHA and Catholic-sponsored health care providers across the country. Committees of ministry professionals developed resources to understand the problems in our health care system and explain them in human terms. Advocacy continually focused on the need for a health system overhaul. Catholic hospitals led petition campaigns and worked to educate the American public and lawmakers alike.

This work never abated, even when the political winds were not blowing in the direction of health care reform. In 2007, CHA once again articulated its vision for reform, this time in a document developed with input from hospital and long-term care executives, doctors, nurses, administrators and others who work in or are touched by the health care system.

That document, the Vision for U.S. Health Care, became an important tool in ministry advocacy work. Anchored in values drawn from Catholic social teaching and embraced by many faith traditions — such as human dignity, justice, common good — the Vision statement offered a way to communicate our priorities to lawmakers and evaluate legislative proposals against our own principles for change.

After countless "Cover the Uninsured Week" events, grassroots advocacy efforts and relentless lobbying of Congress and the Administration, health reform, at long last, became law. The Catholic health ministry's contribution was clear and dramatic. Without the voice we brought to this debate — the faith-based, values-oriented vision for a system that serves everyone — our nation would not have reached this milestone.

That is no exaggeration. Having watched recent events from a front-row seat, I can say confidently that Catholic health care moved the dialogue forward in a profound and historic way. I am so proud to work with the bravest and brightest people in our ministry who helped make reform happen.

While many of the values and principles named in our Vision document are reflected in the bill that recently became law, some still are not. There is always work to do. Even when fully implemented, the law will leave some 15 million people without health coverage. We must speak for immigrants left out, and we must vigilantly monitor and comment on the regulations that will be written in coming months and years. Regulations put the law into practical effect, and our attention to the detail here will be a top priority so that patients and health care providers are always protected and the system is responsibly set up.

Huge tasks remain to make sure the law is implemented effectively and to persuade the public that health care reform is in our common, long-term human and financial interest. Still, I think it's OK to step back and look at the new landscape that Catholic health care helped shape — a landscape that now includes a path to universal coverage in the United States.

It was an amazing scene in the House gallery when the vote ticker reached the magic 216 and health reform moved from a heartfelt hope toward law of the land. The system will still not be perfect, and the law's effects are not all certain. What is certain is that Catholic health care organizations will continue to deliver effective, compassionate care to everyone in their communities — and to continually make the entire system better for all of us.

Accessible, affordable health care for everyone is now many steps closer to reality. We did it, not for us but for that family waiting in line at the Capitol and for millions upon millions of others. Congratulations and thanks to everyone involved. This is a big moment.

JEFF TIEMAN is senior director, health reform initiatives, Catholic Health Association, Washington, D.C.


Copyright © 2010 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Health Reform Update - Quite a Moment

Copyright © 2010 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.