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Bioethicists Weigh In On the Healthcare Reform Vote

I have posted about universal health care coverage many, many times as an ethical and moral imperative. In the last year, my hopes (along with many other bioethicists, I’m sure) of attaining universal coverage have gone up, down and sideways, like a roller-coaster ride, exhilarating and frightening, with emotions ranging from inspiration to resignation.    Now that the US House of Representative has finally passed a health reform bill, I’ve requested several bioethicists (and friends of the WBP) to share their thoughts on the ethical implications of the passage of this bill.

Art Caplan of UPenn:

“The passage of this bill, flaws and all, represents the elimination of the single greatest failure in American health care—a lack of universal insurance coverage.  With this legislation in place America can finally say after decades of failure that it has honored its responsibility to create equal opportunity for every citizen.”

Tom Murray, President and CEO of the Hastings Center:

I liked Nancy Pelosi’s comment that being female will no longer be considered a preexisting condition. As I tried to say in my essay in the Connecting American Values to Health Reform collection, and reiterated in my Perspective in the New England Journal of Medicine, any serious and responsible health reform had to include universal participation along with means for insuring that we could be good stewards of our finite health care resources.

The “universal participation” piece was not fully accomplished, but very significant progress was made. Already today, however, news reports say that it will be under attack in several states. We will have to see whether it survives.

Perhaps the least appreciated aspect of the legislation is the set of strategies to make stewardship a reality (most commentators lump it under “cost containment”).

Ezra Klein offers a very useful, brief summary here

Hilde Lindemann, Professor of Philosophy and Immediate Past President of the ASBH says:

Can one be happy and angry at the same time? The passage of the health care reform package is cause for rejoicing: it helps the poor and dispossessed—a disproportionate number of whom are women and children—gain access to health care. But it was achieved at the cost of both parties’ affirming in very loud tones that if a woman is pregnant unwillingly, she has recourse to abortion only if she can pay for it privately. That so much of the rhetoric surrounding reform was given over to underscoring what has been the case since the Hyde Amendment was passed many years ago, leaves me furiously frustrated.”

Nancy Giles of CBS Sunday Morning said it best:

So I’m a progressive, and I don’t consider this bill, or Dennis Kucinich (D-Ohio), or anyone who supports this legislation to be “selling out”  because it doesn’t go far enough. The bottom line is 30 million more people will get health care coverage, and that will save lives now.  Voting “yes” gets a foot in the door.

Change takes serious effort, but progress happens. The fight for women’s rights didn’t end when we got the right to vote in 1920; the Lily Ledbetter Fair Pay Act signed just last year was another move toward true gender equality. Civil rights didn’t end with the Emancipation Proclamation or the Voting Rights Act of 1964. 

HR 4872 is a crucial first step, and can be amended and improved,  but doing nothing is not an option. Health care should be a basic human right. And no one should be uninsured, or underinsured, or go broke paying their medical bills in the richest country in the world.

Amen to that.

Linda MacDonald Glenn is fellow of the IEET, and a bioethicist, healthcare educator, lecturer, consultant and attorney. Linda also serves as a Scholar of the Women’s Bioethics Project.


Obama’s major point is irrefutable: the status quo is no longer tenable. Medicare is even more unnaccountable than Social Security—healthcare spending is a monument to unaccountability. But healthcare has to be holistic in the full sense of the preventive factor. The far Right in America looks down on preventive as, apparently—reading between the lines—a threat to junk food industries; and commerce IS delicate, the sum total of all transactions. To make it worse there are many careerists in government, and far-leftist activists who are unempathetic. The #1 reason I became a post-futurist was a realization of the vast timeframes involved in changing patterns having existed for eons; traditions having existed for thousands of years and, not at all as a digression, such includes bad eating habits. Sometimes v. bad habits; bad habits in seeking professional care, including utilizing marginal care. For instance chiropractic may be beneficial, but overrated; not cost-effective.

I support this vision myself and I think this health care bill is a breakthrough step that needed to be done. I hope more people will realize that this change is for the better and stop opposing to every step Obama is making to get this country out of chaos.

Obama’s opponents, by their overreactions, reveal the intense anger. Take Palin’s truly bizarre notion that Rahm Emanuel’s use of the ‘R’ word was remotely aimed at her developmentally disabled son Trigve. For someone who has obtained such wealth as Palin has (meaning Trig will never want for medical care) to feel so angrily insecure indicates she thinks it is a complete zero sum game and her child Trig is somehow threatened by government health care “Death Committees” who will supposedly tax her family to the extent that Trig will suffer; even though she has reached a position, including not only wealth but also connections, where Trig will never lack for any health care, ever.

Sam, do you think it’s possible that many people oppose the bill, not merely because Obama’s behind it, but because they see worse trouble (than the admittedly poor status quo) coming out of it?

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