The Moral Dilemmas of Obamacare

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In his novel Sybil, nineteenth-century British Prime Minster Benjamin Disraeli described a character as “distinguished for ignorance” because he “had only one idea and that idea was wrong.”  The idea – promoted for decades by high-minded social engineers – that a national healthcare law would benefit all Americans qualifies for the 2013 Disraeli Award.

The only Obamacare fan who called it right was former House Speaker Nancy Pelosi who said, “We have to pass the [health care] bill so that you can find out what’s in it.”  The American people have found out a lot since the October 1, 2013 rollout and little of it has been for the good, particularly the false claim that it would be “affordable.”

Over 5.8-million people have received notices that their individual policies have been canceled and there has been sticker shock over prices of replacement policies that have received the administration’s seal of approval.  Even the New York Times conceded in a front-page, above-the-fold story, “New Health Law Frustrates Many Middle-Class Americans.”  One insurance broker is quoted complaining: “Everybody was thinking that Obamacare was going to come in with more affordable rates.  Well, they’re not more affordable.” And we’re just getting started: wait until companies start seeing what the future looks like in 2014.

As Catholics, we have an obligation to apply moral principles to economic life.  Hence, heads of families, medical professionals, and employers have an obligation to provide a sense of stability, reasonable security, and honest services to those in their charge. Obamacare is challenging those moral principles.  Americans are finding them hard to uphold as they are being forced to make healthcare decisions that impact their lives.

A single working mother of two children told me that her family policy, which cost about $8,000 a year, had $20 doctor visit co-pays, and $200 per person deductibles, was canceled.  When she finally was able to log on to the government website, she learned that the cost of replacement coverage would remain the same but co-pays would double and deductibles would skyrocket to $3,500 per person.  The increased co-pay will mean less preventive care for her and her children.  And a catastrophic health issue could break her financially.

If a member of her family has an accident, she may have to choose between paying the deductible or making a mortgage payment, or paying utility, insurance and tuition bills or buying enough food to feed her family.  Obamacare is upsetting this mother’s moral compass.  She is losing sleep over this; praying the day never comes when she is forced to make such choices. 

Medical doctors are also facing ethical dilemmas.  With reimbursements being cut, many are opting out of various medical networks.  In California, for instance, approximately 70 percent of MDs are refusing to participate in the state exchanges.  The president of the California Medical Association, Dr. Richard Thorpe, said doctors can’t afford to work at a loss: “We need some recognition that we are doing a service to the community.  But we can’t do it for free.  And we can’t do it at a loss.  No other business would do that.”

A GP doctor I know is opting out because to break even under Obamacare he would have to increase his patient volume to a point where he would not be able to spend enough time with each of them to properly diagnose their ailments.  To maintain his ethical and medical standards he has reached out to long-time patients and offered his own plan.

The doctor has proposed limiting his practice to 300 people willing to pay an annual fee of $1,000.  In return for that payment he would be available to provide all their routine medical needs throughout the year.

My friend believes this is a fair plan because it would give him an adequate revenue stream to support his office and the time to provide adequate care.  While he has been troubled that he would have to turn away patients, he has concluded that Obamacare has given him no other alternative.

A small business I am familiar with that is severely impacted by Obamacare is being forced to make difficult choices. For years this company has provided Cadillac health care to employees at no cost to them.  Although the plan has been very expensive, the principals have believed it was the right thing to do.

Now these managers have been told that to maintain the present level of coverage, premiums will go up somewhere between 50 to 100 percent when their new cycle begins.  The projected costs, however, are unaffordable and over the next few months they will have to choose an alternate plan.

Because the company employs fewer than fifty people, one practical alternative that would save a small fortune is to direct their employees to go to the Obamacare exchanges to procure their own coverage and to pay for it themselves. 

Here’s the predicament:  Management believes it is immoral to throw their employees under the bus and let them fend for themselves at the exchanges.  This means their only option is to choose an affordable but less attractive plan that will cost their employees significantly higher out-of-pocket costs.

The Affordable Care Act has coerced fair-minded employers, dedicated doctors and struggling families into painful moral dilemmas. These are people, by the way, who care about others and aren’t opposed to a society taking care of the neediest. But there were and are other ways of solving problems than via the arrogant belief that the government can manage one-sixth of the U.S. economy. We’re only beginning to see the consequences of that fantasy.

I hope Pope Francis finds an opportunity to comment on the immorality of those who concoct government schemes that, however well intentioned, harm the common good, violate the principle of subsidiarity by curtailing the freedoms of individuals, families, and groups, and hurt the very people they intended to help.


George J. Marlin, Chairman of the Board of Aid to the Church in Need USA, is the author of The American Catholic Voter and Sons of St. Patrick, written with Brad Miner. His most recent book is Mario Cuomo: The Myth and the Man.