First, a little background: Back in the Old Days, the Feds wanted the speed limit to be 55 mph on all highways across the country. Now, the Feds couldn’t make a law to do that directly, because states have some rights in these matters, but they could do something just as good: Withhold Federal funding unless and until the state itself made the statewide highway speed limit 55 mph. This, of course, worked quite well, albeit with spotty enforcement in some states. (In Montana, the fine was $5 payable in cash on the spot for “Wasting natural resources” or similar.)
So, if the GOPpers get in after the Democrats push a federally-funded socialized medicine plan through, what’s to stop them from withholding Federal medicine money from all states that allow abortions?
(Oh, and I won’t have Internet access for the next few days. I’ll catch up with the thread ASAP.)
Well, I guess that’s my question. I get the feeling this would go to SCOTUS, but I’d like to know a bit more about it. Hence my thread here.
My question is of two parts, then, I suppose:
[ul]
[li]Could the Feds cut funding to hospitals that provide abortions?[/li][li]Could the Feds cut funding to a state that contains hospitals that provide abortions which might or might not receive Federal funding? (That is, those hospitals which provide abortions might not receive Federal funding.)[/li][/ul]
I don’t see what this has to do with socialized medicine in particular - surely if the goverment could get away with this, elements opposed to abortion would be able to find some way to backdoor-ban it.
First, understand your hypothetical is completely unrealistic in the current environment. Socialized medicine is like the VA – the government owns the hospitals, pays the doctors, and runs the show. That’s not what anybody is talking about. The current progressive push is for health reform with a public option. So for people who want to keep their old insurance, they can. But people who can’t afford private insurance, or don’t have a job that offers it, or have health conditions which mean the private insurers refuse to give them a policy at any price, they can get health care from a government insurer. But that public plan, like Medicare and like Aetna, likely isn’t going to own hospitals or pay doctors, it’s just going to be a government-run (and therefore not profit-maximizing) insurance “company.”
I suppose it’s not y’all’s fault that you don’t understand this, given how poor the media coverage has been and how obfuscatory the right-wing noise machine has been on this. But come on, this is serious shit.
But let’s pretend that the thing that folks are working on is some socialized medicine, where the government is completely in control of health care in this country. (I understand the Canadian system is like this and, unlike in the UK or most of Europe, Canadians who want to pay for other health care aren’t allowed. Although they just go to the U.S. for it – that’s the only reason the system is politically viable, even there. AFAIK, Canada is the only country in the world that has such restrictions.) The GOP, assuming they’re ever in power again, would quite possibly try to limit or cease the provision of abortions. This would be unconstitutional. Roe v. Wade says that people have a constitutional right to abortion in some circumstances. The government – through any of its instrumentalities – has no right to deny that. So, either the government hospitals would be required to provide abortions same as they would be required to set broken legs. Or, the government would be required to allow private health clinics offering abortion services to operate.
The Government is permitted to deny public funding of abortions, as in the case of Meidicaid, which I believe only funds abortions in cases of rape, incest, or threat to the mother’s life. I also think VA hospitals typically refuse to perform elective (as opposed to health-related) abortions. I think you’re right about your latter option: if a single-provider (or even single-payer, perhaps) system refused to cover elective abortion, separate, private clinics would have to be permitted to operate.
No. Canada is more like your first example in that the governments of the provinces are the insurers. In fact, this sentence of yours would be correct for Canada:
The provincial government does not hire physicians or pay them a salary, though it does pay them through insurance claims. Hospitals are neither run nor staffed by public servants, and (you guessed it) file insurance claims from their patients with the provincial insurer. You are correct that there is only one insurer–it really is a single-payer system–but the provincial governments are definitely not “in complete control of health care.” The independent, self-employed physician, not a government bureaucrat, makes the decisions for the patient. Including the abortion decision–and the provincial insurer pays without any argument.
That being said, however, you are correct that Canadians have no choice in the matter. If they don’t like what they get from their provincial plan, they are prevented by law from seeking alternate coverage. I do know that Canada is not the only country that does this, although I believe that the only others that deny their citizens a choice in health insurance are not the kind that demonstrate great examples of a democratic government. (Cuba? North Korea?)
And, as a political animal, the rates and policies of the insurer will be politically driven, much as is going on now with politicized lending from the Fed. If you let politicians and interest groups, left or right, get their claws in the health insurance industry, you can’t expect impartiality.