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With more than 620 Catholic hospitals serving the public around the United States, hundreds of Catholic medical clinics and shelters, and even a few Catholic-affiliated medical schools, Catholics have a keen interest in healthcare reform. That interest isn’t new. It’s rooted in experience, including the experience of trying to help people with little or no health insurance at all. For decades, the U.S. bishops have pushed for an overhaul of our nation’s healthcare industry and the way it delivers its services. Why? Because the Church sees access to basic health care as a right and a social responsibility, not a privilege.

But Catholic support for the general principle of reform does not bind anyone to endorse a specific piece of legislation. God gave us brains for a reason, to think ; and we need to use them, because the practical and moral problems we face on the way to good healthcare reform are as formidable as the goal is admirable. This is why the U.S. bishops’ conference has tried so diligently for the past three months to work with Congress and the White House in seeking sound compromise legislation. As of November 5, all those efforts have failed.

The bishops have a few simple but important priorities.

First, everyone should have access to basic health care, including immigrants. The Church would hope to see that access broadened as widely as possible. But at a minimum, it should include those immigrants who live and work in the United States legally. Second, reform should respect the dignity of every person, from conception to natural death. This means that the elderly and persons with disabilities must be treated with special care and sensitivity. It also means that abortion and abortion funding should be excluded from any reform plan, no matter how adroitly the abortion funding is masked. Whatever one thinks about its legality, abortion has nothing to do with advancing human “health,” and a large number of Americans regard it as a gravely wrong act of violence, not only against unborn children but also against women.

Third, real healthcare reform needs to include explicit, ironclad conscience protections for medical professionals and institutions so that they cannot be forced to violate their moral convictions. Fourth”and this is so obvious it sometimes goes unstated”any reform must be economically realistic and financially sustainable. We can’t help anyone, including ourselves, if we’re insolvent. If we commit ourselves to health services, then we need to have the will and the ability to really pay for them. That’s a moral issue, not simply a practical one.

Note that these priorities do not attack the constitutional status of abortion. That’s a different battle. Nor do they take anything away from people who regard themselves as pro-choice. But they do protect the rights of the many, many citizens who see abortion as tragic and evil, and refuse to be implicated in supporting it.

Given the broad Catholic support for some kind of comprehensive healthcare reform, the historic links of the Democratic Party to the Catholic community, and the party’s total control of the White House and both chambers of Congress, the reform legislation actually moving through Congress as I write these comments on November 5 is not only inadequate and baffling, but insulting and dangerous.

With the exception of a few leaders, like Democratic Congressman Bart Stupak, Congress has ignored or rejected every attempt at resolving the serious concerns voiced by the bishops”or alternately, has pushed solutions like the Capps Amendment that do not solve the problems, and even create new ones. The White House has done nothing to intervene. “Common ground” thinking in Washington apparently has more reality as public relations than as public policy. And as a result, all of the main healthcare reform proposals in Congress, including the huge, 2,000-page merged House bill, are fatally flawed. Unless they are immediately and adequately amended, they need to be opposed and defeated.

For all of Congress’ public talk about “consensus building” and “consensus health care,” Washington has proved once again that hearing loss can be job-related. Most American Catholics, from people in the pews to pastors and bishops, want healthcare reform to work. But too many people in Washington don’t know how to listen, or don’t want to listen, or just don’t care.

James D. Conley, S.T.L., is the auxiliary bishop of Denver.

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