Congress, and its Catholics, should say yes to health care reform.
We do not reach this conclusion as easily as one might think, given the fact that we have supported universal health care for decades, as have the United States Conference of Catholic Bishops, the Catholic Health Association and other official and non-official organs of the Catholic church. There are, to be sure, grave problems with the bill the House will consider in the next few days. It maintains the squirrelly system of employer-based health care coverage that impedes cost reduction. Its treatment of undocumented workers is shameful. It is unnecessarily complicated, even Byzantine, in some of its provisions. It falls short of providing true universal coverage.
Nonetheless, the choice Congress faces is between the status quo and change -- and the current bill is a profoundly preferable step in the direction of positive change. The legislation will lower costs, not only for individuals and small businesses currently burdened by rising premiums, but for the Medicare and Medicaid programs, which threaten to strangle the federal budget. It will extend health care coverage to 30 million Americans who currently lack it. Finally, a society that covers most of its citizens will be a society more likely to eventually cover everyone -- our immigrant brothers and sisters included.
Much of the focus on the bill in these last days, and not only in the Catholic world, has been on its provisions regarding abortion. All sides agreed to abide by the spirit of the Hyde Amendment, which for more than 30 years has banned federal funding of abortion. But the Hyde Amendment applies to government programs only, and trying to fit its stipulations to a private insurance marketplace is a bit like putting a potato skin on an apple. Pro-choice advocates could not understand why a government that currently subsidizes abortion coverage through the tax code should balk at subsidizing private plans that cover abortion in the insurance exchanges the bill establishes. They have a point. Pro-life groups understandably worry that opening the door to federal funding of abortion, even indirectly, risks further encroachments on Hyde. They have a point, too.
This being a political debate, it was bound to get nasty. And nasty it has gotten. The Catholic Health Association and its leadership is taking heat for their courageous stance in favor of the bill; the nearly 60,000 women religious who endorsed the measure yesterday , even as their congregations face scrutiny from Rome on other matters, should be applauded.
While we acknowledge the thoughtful tone of the statement by Cardinal Francis George  of Chicago, the president of the U.S. bishops' conference, some of his confreres have taken it upon themselves to impugn CHA's motives , the competence of its leadership, or both.
Part of the difference between the positions taken by the Catholic Health Association as well as by the leaders of the women's religious communities, and that taken by the USCCB has to do with their different roles. CHA actually knows how health care is provided at the ground level. The USCCB's inside-the-beltway analysis is focused on possible scenarios, many of them worst-case scenarios. The U.S. bishops' conference is right to worry about such things and the sisters are right to put those worries in perspective.
In any event, what is being debated is not the morality of abortion but the politics of abortion, and there is plenty of room for honest and respectful disagreement among Catholics about politics.
That said, the bishops have to be clear that some of their talking points might lead honest observers to question their competence -- or worse. In the past week or so, much has been made of the bill's provision of $7 billion dollars to community health centers. The National Right to Life Committee chimed in that this money could go to pay for abortions at clinics run by Planned Parenthood. Back to Logic 101: All Planned Parenthood clinics may be clinics, but not all health care clinics are Planned Parenthood clinics. The community health centers in question do not, never have, and have no intention of performing abortions, and they are prohibited by statute from doing so. This is a red herring and it was profoundly disappointing to see the USCCB Web site  give credence to it.
Bottom line: The current legislation is not "pro-abortion," and there is no, repeat no, federal funding of abortion in the bill.
Meanwhile, writing in The Washington Post last Sunday, T.R. Reid, a first-rate journalist, a Catholic, and author of "The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care." argues persuasively  that industrialized countries that achieve universal or near-universal insurance coverage have a demonstrably lower abortion rate than we have in the United States. It should matter to those who believe in the sacredness of all human life that this legislation will not only provide health care to those who don't currently possess it, but will encourage women facing crisis pregnancies to choose life. Given the intractable nature of the abortion debate in the United States, this amounts to a pro-life victory of historic proportions.
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The current health care bill, for all of its problems and all of its controversies, will further turn our society in the direction of solidarity and away from the Social Darwinism its opponents prefer.
Congress, and its Catholic members who seek to promote the common good, should vote yes.