Your Health Care, Your Hospital, and Monica Goodling

From the Washington Post:

"The Department of Health and Human Services is reviewing a draft regulation that would deny federal funding to any hospital, clinic, health plan or other entity that does not accommodate employees who want to opt out of participating in care that runs counter to their personal convictions, including providing birth-control pills, IUDs and the Plan B emergency contraceptive."

Got that? Monica Goodling could be coming to a hospital near you.

Monica Goodling, you recall, is the bimbette that Bush Attorney General Gonzales elevated to hire or decline senior-level Department of Justice attorneys based on their religio-political views. (It's unconstitutional and illegal, but not to worry. This is the Bush administration.)

Under a draft regulation now being reviewed, if the Monica on your health care team doesn't approve of a prescribed course of care, she won't have to provide it. Unless your hospital wants to lose its federal funding, of course.

You might guess that this is about abortion. Well, not just abortion. It's also about contraception. If you doubt that, read that money quote again:

"The Department of Health and Human Services is reviewing a draft regulation that would deny federal funding to any hospital, clinic, health plan or other entity that does not accommodate employees who want to opt out of participating in care that runs counter to their personal convictions, including providing birth-control pills, IUDs and the Plan B emergency contraceptive."

It gets worse:

"There is also deep concern that the rule could have far-reaching, but less obvious, implications. Because of its wide scope and because it would-- apparently for the first time--define abortion in a federal regulation as anything that affects a fertilized egg, the regulation could raise questions about a broad spectrum of scientific research and care, critics say.

"'The breadth of this is potentially immense,' said Robyn S. Shapiro, a bioethicist and lawyer at the Medical College of Wisconsin. 'Is this going to result in a kind of blessed censorship of a whole host of areas of medical care and research?'"

Let's take a moment and think about this Big Brother's Watching You approach to health care.

In other words, if I'm your surgeon and I don't want you to have an abortion to save your life, you might die. Could this really happen? Theoretically, yes. Think about it. If you (a) live in a medically underserved rural area without the choice of surgeons, and/or (b) if your insurance plan reimburses only this surgeon and not that one, what would your alternatives be? Rent a plane and fly to the nearest enlightened medical center, hoping you make it in time?

Or, say an orderly doesn't want to change the sheets of a woman who's just had an abortion. What then? No clean sheets? Or what if your nurse doesn't feel like assisting at the insertion of an IUD. Say you’re hemorrhaging from a brutal rape and your doctor wants to prescribe a contraceptive that the nurse disapproves of?

Setting aside the question of rights, it's easy to see that such situational complexities, and especially questions posed by remote facilities that lack a choice of doctors, surgeons, or other qualified practitioners, mean that the proposed reg promises serious medical consequences for America's families, starting with our women.

From where I sit, the policy of elevating somebody’s opinion to the level of medical training is insane. As bad, it establishes a frightening tyranny of perspective, a state religion, as it were, that is reminiscent of the Middle Ages. I mean, it's one thing for my conscience to dictate my healthcare. It's quite another for my conscience to dictate your healthcare. What's next? Diagnosis by auto da fe?

Not only that. This regulation would give virtual extortionist power to any individual who objects to a prescribed course of care--not on medical reasons, mind, but on the basis of mere personal opinion. Unlike treatment advocates, such individuals would be empowered to threaten the facility with loss of federal funding.

Hospitals, clinics, health plans, and "other entities," in Arizona and every other state, will be plunged into financial, management, HR, legal, and, oh, patient care hell if this regulation hits the street.

It should go without saying that neither science nor health care should be politicized. Yet HHS is staffed at the highest levels by unaccountable political appointees, starting with the Secretary of HHS and the Surgeon General, and proceeding down the ranks of the Senior Executive Service, and, though their hiring decisions, to the mid-level managerial ranks. The latter will long outlast the former.

In the case of the Bush administration, these appointees have subordinated patient care and established science (Terri Schiavo, global warming, evolution, FDA, OSHA, and EPA regulations) to their personal notions of reasonable medical practice. That they are unaccountable ideological extremists is not a matter of opinion. It has been repeatedly documented. It's fact.

Now, using the mechanism of regulations governing federal funding for medical care, these extreme Rightwing Bush ideologues propose to redefine human viability from the moment of fertilization. The downside potential for women, for science, for hospital administration, and for modern healthcare is really too draconian to enumerate.

Well, here’s a thought: It's more than a little conceivable that if enacted, one effect of the regulation would be to open the ranks of professional healthcare to phalanxes of busy little gestation police ready, willing, and empowered to muck with everything from your menstrual cycle to the size and timing of your family. Happy thought. That could indeed occur, particularly especially if the far Right does not gain control of the US Supreme Court. In that case, unable to “win” the fertilization wars in the high Court, they would not hesitate to do using any available means.

Would rape or incest or the mother's health be taken into account? Gee. I don't know. Ask Monica.

Meanwhile, think hard about your vote in November.