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Beware religious meddling in the latest version of health care reform

Every so often, as the health care reform initiative spearheaded by the Obama Administration wends its way through Congress (or, more precisely, wend their ways through Congress, given that there are multiple bills coming from multiple committees in both Houses), I’ve warned about various chicanery from woo-friendly legislators trying to legitimize by legislation where they’ve failed by science various “alternative” medicine practices. This began much earlier this year, when I pointed out how Senator Tom Harkin (D-IA) invited the Four Horsemen of the Woo-pocalypse to the Senate to testify. These included Dr. Andy Weil, Director, Arizona Center for Integrative Medicine, University of Arizona, Vail, AZ; Dr. Dean Ornish, Founder and President, Preventive Medicine Research Institute, Sausalito, CA; Dr. Mark Hyman, Founder and Medical Director, The UltraWellness Center, Lenox, MA; Dr. Mehmet C. Oz, Director, Cardiovascular Institute and Complementary Medicine Program, New York-Presbyterian Hospital, New York, NY. This occurred after Harkin had famously complained about the National Center for Complementary and Alternative Medicine, the Center in the NIH that he, more than anyone else, had created, because it had not validated enough quackery. (Yes, I know he didn’t use those words, but that was what he had done.) Most recently, Harkin tried to insert language that would mandate that the government and health insurers pay for quackery, as long as it was from licensed practitioners. Given that some states license naturopaths and even “homeopathic physicians,” such an amendment, if it stayed in place, would open the way for paying for all manner of nonscientific quackery.

However, there is another bit of chicanery that legislators are pulling, this time with the Senate version of the bill, that I have been made aware of by Rita Swan of CHILD and fellow SBM blogger Kimball Atwood. This time, the threat is religious, with Senators trying to insert measures into the health care reform initiatives that will pay for “religious” treatments, such as Christian Science prayer. Indeed, one of these, S.1679, entitled Affordable Health Choices Act requires the government or private party insurers to pay for faith-based therapies:

SEC. 3103. PROGRAM DESIGN.

[...]

(D) The essential benefits provided for in subparagraph (A) shall include a requirement that there be non-discrimination in health care in a manner that, with respect to an individual who is eligible for medical or surgical care under a qualified health plan offered through a Gateway, prohibits the Administrator of the Gateway, or a qualified health plan offered through the Gateway, from denying such individual benefits for religious or spiritual health care, except that such religious or spiritual health care shall be an expense eligible for deduction as a medical care expense as determined by Internal Revenue Service Rulings interpreting section 213(d) of the Internal Revenue Code of 1986 as of January 1, 2009.

What this paragraph appears to mean is that under this bill, if it passes with this provision intact, health care insurers, be they private or government, would be required to pay for religion-based treatments, such as Christian Science “practitioners” for their health care “services.” More specifically, the bill emphasizes nondescrimination. I will be honest with you here. I’m not entirely sure if that means only that the bill requires that insurers do not discriminate against paying for religious woo, such as Christian Science prayer “treatments” or, as Kimball fears, that such language might reasonably be construed to mean that such fees paid to religious “healers” would have to be comparable to those paid to legitimate practitioners. One thing that’s truly ridiculous is that the IRS already allows “medical deductions” for Christian Science prayer charges and a bunch of other woo. Indeed, here is what the IRS has to say about the subject:

If you itemize your deductions on Form 1040, Schedule A (PDF), you may be able to deduct expenses you paid that year for medical care (including dental) for yourself, your spouse, and your dependents. A deduction is allowed only for expenses paid for the prevention or alleviation of a physical or mental defect or illness. Medical care expenses include payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, or treatment affecting any structure or function of the body. The cost of drugs is deductible only for drugs that require a prescription, except for insulin.

Medical expenses include fees paid to doctors, dentists, surgeons, chiropractors, psychiatrists, psychologists, and Christian Science practitioners. Also included are payments for hospital services, qualified long-term care services, nursing services, and laboratory fees. Payments for acupuncture treatments or inpatient treatment at a center for alcohol or drug addiction are also deductible medical expenses.

In other words, this passage, if allowed to stand, would mandate that insurers pay for faith healing by Christian Scientists. Indeed, as the Senate tries to merge Harkin’s bill with the bill that emerged from the Senate Finance Committee, chaired by Senator Max Baucus (D-MT), an amendment has been promoted by, of all people, the odd couple of Senators John Kerry (D-MA) and Orrin Hatch (R-UT), that says mandates in essence the very same “nondiscrimination” as the passage above using almost identical language (scroll down to Amendment C-14, also known as the Kerry/Hatch Amendment). At first glance, one might wonder why on earth Senator Kerry would support such nonsense, which seems more suited to conservative Christians. However, the Church of Christ, Scientist was founded in Boston and is based in Massachusetts; so maybe it’s not so strange after all. Indeed, maybe it’s stranger that Orrin Hatch, a Mormon, would be supporting such an Amendment.

But it’s not just the Senate, unfortunately. There is very similar language in House bill HR3200, sponsored by Representative John Dingell (D-MI):

Section 125. PROHIBITION OF DISCRIMINATION IN HEALTH CARE SERVICES BASED ON RELIGIOUS OR SPIRITUAL CONTENT.

Neither the Commissioner nor any health insurance issuer offering health insurance coverage through the Exchange shall discriminate in approving or covering a health care service on the basis of its religious or spiritual content if expenditures for such a health care service are allowable as a deduction under 213(d) of the Internal Revenue Code of 1986, as in effect on January 1, 2009.

My question upon reading this is: Why on earth is there a tax deduction for Christian Science “prayer” medical services in the first place? This is not medicine. It doesn’t even have use in a narrow area, such as back pain, as chiropractic might. It’s nothing more than wishful thinking, faith healing. Let me further ask a question. If Christian Science faith healing (which is all that it is, really) is considered a tax deductible “medical expense” by the federal government and, if these provisions remain in the health care reform bills, a service that the government will require health insurers to pay for? Why not reiki, which is basically faith healing that substitutes Eastern mysticism for Christian belief? Why not shamans? Heck, why not pay for Scientology E-meters? After all, if one form of religious woo is considered a tax deductible medical expense by the IRS and may well be considered a valid medical expense that the government and health insurers will have to pay for, why not Scientology? There’s no reason at all to distinguish one from the other. Both are considered legitimate religions under the law, aren’t they?

If I were in the hierarchy of the Church of Scientology, if these provisions favoring Christian Scientists remain in the final bill that passes, I’d be licking my chops to sue the government to force it to pay for E-meter treatments and” auditing.” Ditto if I were a reiki practitioner or any other faith healer. In fact, if this bill were to pass with some variety of this “nondescrimination” provision in it, I guess my only consolation would be the entertainment value of the government trying to justify not covering Scientology auditing treatments. (My guess is that the government would cave rapidly on reiki, given that it’s viewed by most as being “alternative” therapy rather than the faith healing modality that it is.) One would think that this sort of provision would be unconstitutional, but apparently it’s not (or it’s never been challenged) given that the IRS has apparently been allowing these deductions for Christian Science prayer “treatments” without difficulty for years now, even though, as far as I know, no other religion’s faith healing charges are given a similar tax deduction.

I warned before about the copious mischief being perpetrated upon health care reform efforts by proponents of ideology- and religion-based, rather than science-based, medicine. And make no mistake, those provisions are still there, requiring health insurers to pay for “integrative” practitioners, chiropractic, acupuncture, and “licensed” alternative practitioners. However, these new provisions, spearheaded by Christian Scientists and other religions through useful idiots like John Kerry, Orrin Hatch, and John Dingell, are every bit as worrisome, if not more so, than the provisions slipped in by Tom Harkin and his allies. The reason is that faith healing nonsense like this harms children, as the CHILD website documents. Remember Madeline Neuman, the 11-year-old child whose parents let her die of diabetic ketoacidosis? If her faith healing had been performed by a Christian Science “practitioner,” under this bill that practitioner could have billed for his or her “services.” For instance, if Neuman had been Ian Lundman, who was the same age when he died in 1989 of diabetic ketoacidosis because his parents relied on a Christian Science “practitioner” instead of doctors to treat his diabetes. This practitioner billed $446 for his “services.” Under this bill, the insurance company would have had to pay the bill. Ditto if Madeline had been instead Amy Hermanson or Andrew Wantland.

So the question remains:

Legal scholar Marci Hamilton has no problem with adults declining medical treatment for religious reasons, but she worries some of the proposed language could let parents to opt out of health coverage for their children.

“That’s another reason they may not take the children to the hospital when they become very ill,” said Hamilton, an expert in law and religion at Cardozo School of Law, a nondenominational affiliate of Yeshiva University. “The federal government should not be in the business of providing incentives for parents not to treat children.”

While enforcement could be difficult, no one knows how widely this loophole could be embraced.

From my perspective, one child suffering because of this loophole would be one child too many. I agree that competent adults should have the right to refuse treatment, even for life threatening conditions, for personal reasons, religious reasons; for in essence any reason they want or even no reason at all, as long as they understand the likely consequences. That is not my concern. What is my concern is that these loopholes will make it even easier than it already is for parents to choose prayer-based woo instead of science-based treatment for their children. Children should not be made to pay because their parents believe that prayer will save them from a life-threatening illness and thus eschew proper medical care. I’ve argued this time and time again, particularly in the case of Daniel Hauser. My worry about these provisions is that they would provide a custom-made defense for parents like those of Madeline Neuman or Ian Lundman, namely: How can you prosecute us for providing a service for our child for which the government not only allows a tax deduction as a medical expense but even mandates coverage by my health insurance company?

That’s why we all need to contact our Senators and Representatives now, this week, to voice our concerns. Some key talking points have been provided by Rita Swan to use, along with the contact information for Max Baucus. When a bill reaches several hundred, or even a thousand, pages, it becomes easy for woo-meisters and religious “healers” like Christian Science “practitioners” to insert all sorts of little provisions into the bill that not only appear to be unconstitutional but give faith healers legitimacy through law that they can never obtain through science or medicine.

Who cares if it makes a mockery of medical science? Who cares if it shreds the First Amendment prohibition against the establishment or favoring of one religion over another by giving not only a tax break to one Christian sect that is not given to any other religion but providing a mandate that insurers pay for the prayers for the sick of that one Christian sect and no other? Who cares if it means letting children die of preventable diseases when parents choose prayer instead of medicine? Who cares if it means that insurers have to pay for the “services” of the “faith healers” who let children die?

Does anyone care?

Posted in: Faith Healing & Spirituality, Politics and Regulation, Religion

Leave a Comment (11) ↓

11 thoughts on “Beware religious meddling in the latest version of health care reform

  1. DoctorSeth says:

    Thanks for this thoughtful column and mostly about making your conclusion about the kids who will be the victims of perpetuating this insidious nonsense.

    Unfortunately, the IRS already allows much of this, including Scientology audits. The regulations (IRS pub 502) require only that the taxpayer considers that the expense is primarily for the treatment of disease or enhancing the function of the body or part (with specific exceptions for general health such as vitamin supplements or gym memberships).

    Many states license naturopaths and homeopaths and I would expect that payments to these would thus have to be acceptable expenses to the IRS.

    We need a Flexner report for the 21st century.
    SA

  2. Kausik Datta says:

    This country appears to be slowly, but surely, sliding towards becoming a Christian theocracy. One theocracy to rule them all…?

    If these provisions, under-handedly slipped into the main body of the bill, indeed get passed, will that mark the beginning of the final phase of that descent?

    Is there no one of any substance who can stand up to this insanity and say, ‘No’? What about the medical community at large? What about the various societies and bodies made of eminent physicians, that guide health-related policies?

    Religious faith breeds irrationality – my long-held view. And in an environment of irrationality, no realm of human life is sacrosanct, medical science included. If the insurers are forced to pay for the bogus therapies and quackery, that would ultimately impinge negatively upon individuals like you and me, with genuine and valid medical needs. How far is the day when an insurer would be able to strongly recommend a few faith healing sessions for appendicitis instead of surgery?

  3. pmoran says:

    Yes, go for the throat on this. Nevertheless, I think the *political* weak point of spiritual healing and quackery is not that they probably don’t do a lot. It is that they represent *optional* health care consumption.

    Insurance and tax-based health systems MUST first concentrate upon ensuring access to basic health care for all and especially to necessary big-ticket items that are otherwise beyond the reach of the average person. It has proved difficult enough to do that in other countries at politically acceptable costs and without oppressive forms of rationing, usually arbitrary caps on expenditure.

    It is thus ridiculous to be thinking of bloating any comprehensive new system with potentially open-ended consumption of CAM/spiritual healing.

    Those who want these “extras” should finance them themselves, through extra insurance if wished.

  4. RichF says:

    This is just another example of why government and healthcare should be completely separate. Politicization of healthcare is the inevitable result.

  5. weing says:

    I think quackery and spiritual healing should be considered as cadillac plan benefits and should be taxed like hell to provide the basic SBM package. For some reason, I have this nagging fear that the opposite may end up being the case.

  6. tarran says:

    I think anyone who cares about science based medicine would be fighting Obama’s “reforms” tooth and nail rather than supporting them.

    If you give government greater control over some institution or service, it is going to be politicised. Period.

    You can no more depoliticize government action than you can rape someone lovingly.

    If one wants to expand the use of reason, one should be removing institutions that gain their legitimacy trough force or appeals to authority and encouraging the development of institutions whose legitimacy comes from their performance and ability. That means dismantling state institutions that are funded through taxes and face little or no accountibility for their poor performance and transferring their functions to institutions who must perform to earn their keep.

    Let the Christian Scientists and the Scientologists waste their money on their ineffective treatments. You can then reserve your hard earned savings for the stuff that works.

    The current “reform” which is more a bailout and cartelization of insurance companies than any actual consumer friendly reform, will inevitably allow the Crysal Worhippers/Cultists/Quacks etc to have some measure of control over the quality of medical care you and your family receive.

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