October 3, 2017

Medicaid, opioid addiction and transgender issues explored at health care symposium

Health care reform, transgender theory and the opioid epidemic were featured topics at a Sept. 20 gathering of Minnesota’s Catholic bishops and lay leaders.

Co-sponsored by the Minnesota Catholic Conference and the Catholic Health Association of Minnesota, “Healthcare in Minnesota: A Symposium Considering Contemporary Challenges” brought together local and national experts to speak about the emergent health care topics. It was held at the University of St. Thomas in St. Paul.

In opening remarks, Jason Adkins, MCC executive director, said that the three seemingly unrelated topics of health care coverage, addiction and the nature of the human person were actually linked through an understanding of a healthy human ecology.

The morning event began with a three-person panel on federal health care reform, with a focus on its potential effects on the poor and vulnerable. Meghan Goodwin, a policy advisor for the U.S. Conference of Catholic Bishops, outlined Republicans’ efforts in Congress to repeal and replace the Affordable Care Act and the bishops’ advocacy on the proposed changes.

“The Catholic bishops of the United States have consistently advocated for access to decent health care that safeguards and affirms human life and dignity from conception until natural death,” she said.

Goodwin said that the bishops have viewed the series of proposed health care legislation, including the “Graham-Cassidy” bill, as “morally problematic” because the bills would fail to serve the poor and vulnerable. That particularly applies to the bills’ proposed cuts to Medicaid, she said. The Senate has a Sept. 30 deadline to pass a health care bill.

“This is more about spending on health care than it is about developing a robust health care policy,” Goodwin said about the proposed health care bills.

Patrick Ness, public policy director for the Amherst H. Wilder Foundation in St. Paul, said that Medicaid has been important to people’s access to health care in Minnesota. The Amherst H. Wilder Foundation is among several organizations, including Catholic Charities of St. Paul and Minneapolis, that have formed This is Medicaid, a campaign to protect the federal-state insurance program for people in need.

As a safety net, Medicaid serves 690,000 families with children, 200,000 single adults and 180,000 people with disabilities and seniors over the age of 65.

“Medicaid has been working for 52 years, and we need to continue that partnership,” Ness said. “This is our decision. This is a choice we’re going to make as a country in the next 11 days around how we care for one another through health care.”

Medicaid reflects Catholic social teaching in principles such as a preferential option for the poor, human dignity and the common good, he said.

State Sen. Michelle Benson, a Republican from Ham Lake and chair of the state Health and Human Services Finance and Policy Committee, offered a contrasting view of government’s role and spending priorities.

When it comes to health care, she said, states should have more control than the federal government. The Affordable Care Act has caused some businesses to close because providing health insurance was unaffordable, she said, and it has granted government too much control in individuals’ health care decisions.

“The Affordable Care Act has destroyed the individual insurance market and left no private path, which is why public programs become so much more important,” Benson said.

She said that efforts have to be taken to address the $20.1 trillion national debt, and that the government “cannot promise everything to everyone forever without ever paying the piper.”

She added: “Let’s make sure that we have a safety net, but let’s not pretend it’s a panacea, let’s not pretend that it all has to be solved in Washington, and let’s not pretend that doing big things with other people’s money is charity.”

She said that Catholics have a responsibility to use their own money “to do good things” and treat the sick and dying as “a child of God.” “Those words will never come out of a government program,” she added.

Transgender theory

Franciscan Sister Renee Mirkes of the Pope Paul VI Institute in Omaha, Nebraska, utilized research on gender dysphoria to explain a Catholic response to secular trends in the area of gender.

She emphasized that gender dysphoria, an inconsistency between a person’s biological sex and his or her subjective experience of his or her gender, is a psychological issue and one that should be treated with therapy, not hormone replacement therapy and surgeries.

A theological ethicist, Sister Renee outlined the research of Dr. Paul McHugh, under whose direction Johns Hopkins University in Baltimore stopped performing sex reassignment surgeries in the 1980s, and Dr. William Reiner, a child and adolescent psychiatrist at the University of Oklahoma, whose research supports the view that biology, not cultural influence, determines gender identity.

Sister Renee also explored transgender theory as an increasing religious liberty and conscience rights issue, and said that more robust conscience and religious protections are needed for medical professionals who object to “transition therapies,” such as prescribing hormone-blocking drugs to a child who wants to live as the opposite sex, as well as for school administrators that don’t want to accommodate transgender bathroom and locker room situations.

“By propping up health care rights of conscience, we are in no way limiting rights of transgender patients,” Sister Renee said. “In fact, when a transgender patient is refused by an objecting physician, that patient has one last chance to reconsider a second opinion about what they’re doing and the medical wisdom about pursuing these hormonal and surgical interventions, that in many cases would be irreversible.”

Heart of the opioid epidemic

The final topic the symposium explored was the Church’s response to opioid abuse, which has killed hundreds of thousands of Americans. Panelist Dr. Sally Satel, a psychiatrist and resident scholar at the American Enterprise Institute in Washington D.C., said law enforcement has limitations in regulating the crisis, and the medical field feeds the situation by leaning toward prescribing opioids rather than other means of pain treatment. She also said psychiatric issues and other underlying causes can lead to opioid addiction.

“There’s a deeper impetus for use; it is an inner need,” she said.

Father John Stabeno of Catholic Charities in the Diocese of Camden, New Jersey, touched on that need. It stems from a “spiritual bankruptcy” created by an abandonment of responsibilities, he said, calling it a “deep-seated idolatry” where a person chooses something over God.

Father Stabeno, who has worked in the area of addiction for more than 30 years, said it behooves the Church to serve as a “triage” for addicts, often mired in isolation.

State Rep. Dave Baker, whose son died of an opioid overdose in 2016, gave a local and personal perspective on the opioid crisis. He sees legislation as crucial for improving things, but he also sees the need for the Church to be ready to help someone with an addiction.

“If not, we’re going to miss the opportunity,” said Baker, a Republican from Wilmar.

He added that people should not treat the addiction as a “moral failing” or the person as a problem to solve.

Adkins told The Catholic Spirit that the symposium was “an opportunity for a start to the conversation.”

“We know how some of these things have been discussed on the national level; it’s important to bring them down to Minnesota and what do they mean here and how can we as a Church respond,” he said. “Pope Francis is calling us to be a field hospital, and there’s a lot of hurting people on a number of issues.”

Sister Candace Fier of the Schoenstatt Sisters of Mary, who attended the symposium, observed that the three issues presented uniquely impact the dignity of the person.

“They feed off one another,” said Sister Candace, director of the Office of Family Life for the Diocese of New Ulm.

St. Cloud Diocese Catholic schools superintendent Kevin Powers believes the leaders attending the symposium are called to engage in dialogue with the people of their respective dioceses.

“We need to start talking more openly with our churches and our families about the health care crisis,” Powers said.

Adkins recognizes the challenges facing health care in Minnesota are large and said the symposium wouldn’t extract all the answers in a morning.

“I think everyone should agree that access to basic health care is a right, and the question is how do we best ensure that the most people have access to health care,” Adkins said.