http://www.foxnews.com/politics/first100days/2009/03/03/obama-repeal-bush-aborti on-regulation/

OK. This thread is NOT to debate whether a woman has the right to an abortion or not.

We've beat that horse thousands of times and no one has or is going to change their position on it.

What is up for debate here is whether a Doctor or health care provider has the right to tell their patient that they will not perform an abortion on them if it violates their conscience and moral beliefs.

I say they do. As in "We reserve the right to refuse service to anyone"

The feds say that they will withhold federal funding if they don't. How do you spell Blackmail?

How about a Catholic or Lutheran or Christian run hospital? Should they be forced to provide abortions?

What about the Doctor or health care provider’s rights?

There are plenty of places that are more than willing to do abortions, Planned Parenthood and a multitude of other clinics that a Doctor that doesn't want to perform an abortion should not be blackmailed by the feds into doing it.

Now a question (Because I don't know the answer). Are Doctors in Oregon required to provide lethal drugs to a patient for assisted suicide that requests them or can they refuse?

I think doctors ought to have a choice on treating patients -- they should be able to decide to let God handle the ones they don't feeling like dealing with.

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quote:

"This policy of potentially allowing providers to refuse to provide contraception or family planning runs counter to the [Obama] administration's goal of reducing abortions and unwanted pregnancies," the official said. "It also could lead into other areas of medical care."

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It's not discrimination. Calling it that clouds the issue.

The health care provider isn't refusing to treat someone because they are Black, or gay or Mexican, etc. That would be discrimination.

They are simply refusing to provide a medical procedure.

You come to me with your car and the transmission is shot. I tell you I won't replace your transmission. Same deal. I'll do a tune up, but not the tranny.

If that same person came to any one of the health care providers with a broken arm there would be no question that they'd treat them.

If the dollars are intended for PUBLIC services, and members of the PUBLIC are NOT SERVED based on some arbitrary thing, that's discrimination.

There is no debate on this.

We have a law in this nation that the right to choose lies with the woman. If we fund health services with PUBLIC dollars, then we serve THE ENTIRE PUBLIC, in ACCORDANCE WITH THE LAW.

Anything else is discriminatory.

Either we change the law, or we withdraw the funding, or people choose to accept the funding based on their willingness to SERVE ALL OF THE PUBLIC.

...and they are refusing it on religious grounds. The procedure might be medically ethical (and early abortions are exactly that, ACCORDING TO THE LAW OF THE LAND), it might be necessary too and that would be determined by peer review case history.

If then, the person is denied the procedure, they are being discriminated against, on the basis of THEIR RELIGION not being aligned with that of the practitioners.

Edit: Or worse, the practitioner does not see the patient as worthy. I once had this happen with a clown that thought retarded people didn't need eye and ear care as they were not smart enough to appreciate the full use of their senses.

My wife and I nailed that clown. Pulled the entire state account from his discriminatory ass. Held up in court too. He got schooled on what Federal and State funding means.

It means those that take the dollars, uphold the law of the land, not do what they want.

The car example is not equatable to a human example. We are not cars. Different dynamics apply.

If the conscience of the doctors in question have a moral opposition to performaing an abortion, crap, who can't at least relate to that? If they choose not to perform that procedure, nobody is forcing them to do that. Don't they usually refer that to doctors who DO perform those procedures?

Maybe I'm missing something obvious. But what's stopping a doctor from saying " That's not a thing we do here." I can think of all sorts of procedures that my doctor doesn't perform. It never occured to me that it may be because of moral grounds.

Is it?

If then, the person is denied the procedure...

They are not being denied the procedure. A particular doctor has said that they wouldn't do it.

There are plenty of places that they can get it done.

If the doctor alienates the patient by saying they won't do it, there is nothing preventing the patient from finding another doctor.

CJ, that's exactly right.

...nobody is forcing them to do that...

But that's what the feds are trying to do.

A person should not have to check their morals or ethics at the door when they come to work.

I don't think it always is. And that's not really at issue. Nobody is arguing that. It's necessary, simply because areas of expertise need to be defined, or liability and risk are too excessive. That's rational care management and a whole different story.

However, if that same doctor refuses to refer, that's a clear sign that it is a moral thing. Why bother otherwise?

The only reason I can think of is said referral would not be medically sane. That's a professional call, and is a clearly different thing.

The deal here is that many health care providers must work within the framework of a greater body. If that body discriminates, they then must discriminate to, or be unable to practice.

That's where Obama has the problem.

Also patients must also work within a greater body. So then, they are employed by somebody who ties them to their particular insurance plan. That plan ties them to a network of providers, or the costs are prohibitive.

(some plans are worse than others on this matter)

Finally, then their Doc not referring means they have to pay out of pocket and might not be able to do so, or if they could do that, suitable care is not geographically practical to obtain.

It's better to tie the federal dollars to a non-discriminatory structure, so that the public interest is served equally. From there, health care providers, who choose to exercise their moral obligations, can totally do so. But, since they are clearly not serving the PUBLIC, but only a sub-set of it, they don't get the funds.

Where it gets ugly is on contraception and abortion. Lots of conservative providers don't want to provide those services, despite the patient having a right to them BY LAW.

I totally support them in this, but I can't support funding them to do it, because it's discriminatory.

Same thing for schools for example. If you don't want to teach evolution, you can do a private school. Lots of stuff can happen there, and I support that too.

But it's not a PUBLIC thing. Neither is this.

The clown that got hammered essentially held the belief that public dollars spent on retarded people was a waste, because HE BELIEVED the care would be lost on them.

That was not science, it was just ignorance and discriminatory behavior. Not ok.

Had he been a private practice, not taking state dollars, the path would have been different. But he was accepting State of Oregon care dollars, but would not actually deliver care.

That's how this is.

But wait a minute, if a doctor that I choose doesn't perform a particular procedure, they don't get funds? Funds for what? What funds are the Feds supplying - and for what purpose - that I don't already pay for when I go in to my doctor's office or via insurance? 3-D Diagrams of my wife's vagina?

Plus, I don't WANT a doctor to perform a procedure that he or she is morally against. I bet there are some that play that card for cosmetic surgery. Shit, some of them won't even give me medicine that I want for pain. And look at me now; I'm fine and still got what I wanted and still like my doctor. If doctors are so worried about the money they'd lose, I bet that could be off-set by promoting themselves and a dolphin-safe/ tuna-free or whatever clinic. They should rent billboards announcing that they don't perform abortions.

That would be good information to have as a potential patient.

AND, they practically guarantee they'll get into Heaven.

Frankly, I would bend on this, if referrals were mandatory. That would give some outs, and that might be enough to settle the matter for more people.

Because of how health care works, not getting at least a referral means not getting the care to a whole lot of people. That's a problem.

On the matter of contraception and abortion, many who are in this position would then essentially be forced to not exercise their rights.

For people of solid means, this is an inconvenience at worst. No question. For people of modest to low means, it's a judgment. Not ok.

We have the federal funding so that people of modest to low means can get the freaking care in the first place! So, this is messy on a lot of levels.

CJ's right. The Dr. only gets "funds" for procedures they perform. Although there are some Dr's that bilk the system and bill for things they don do. They should be in jail.

If Jane Doe comes in and Dr. Jones doesn't treat her, he doesn't get paid.

Even if they don't give a referral, there are typically lots of Dr's and/or clinics to choose from in any particular providers system.

I'm sure the patient can find one that will provide the services they are requesting.

Yeah, I'm there too CJ.

As private people, they get to do that. And I absolutely would support them advertising, "abortion free" care. They will get a ton of pro-life takers. More power to them. All good.

Federal dollars are used to make hospitals viable for any number of reasons. Where that's true, care should be non-discriminatory however, or some referral option needs to be in place so that the federal dollars can do their job.

I don't want anybody forced to do things either. Totally there. It's not right, and it's dangerous. If I were the Doc, I wouldn't do it, and I wouldn't either practice in a field where it's at issue, or take the funding. That's the price of calling the moral shots.

That said, a simple referral would take care of the problem in a lot of cases, and the old regulation allowed them to deny that too. Not ok.

Which is exactly why I said I would bend on this, if referrals were obtainable. There is some slack to be had there.

Probably the old regulation has issues, so pull it. Then write a new one that sorts more of this out. I'm up for that too.

The one as written is a problem.

This is not a loaded question nor is it rhetorical. I do not know and I wish to;

Which Governmental agency provides funds to doctors and for what purpose?

Skybill, if a PRIMARY care provider pulls this crap, and the insurance plan doesn't provide for the option, the patient then is forced to seek that care on their own dime, despite having paid for insurance to cover it.

The referral deal is a big part of my support for pulling this regulation.

Hell, want to sort a lot of it out?

Do a single pay system where we don't have insurers, primary care people and all the BS. People go see providers, the market works nicely, and we write regulations such that the single pay system does not enforce morals on people.

Done.

It's a whole lot less complicated that way.

Given that, people can then go pick and choose, advertise their morality, and we all get along happy chappy.

http://www.northjersey.com/news/nationalpolitics/40335457.html

Here's some of the background behind this deal.

I don't know who funds who or why. That's a great question. I suspect it's part of many religious hospitals non-profit status.

Here's another side:

http://articles.latimes.com/2008/aug/22/nation/na-birthcontrol22

Thorny.

In the last article, being forced to even refer seemed a bit much to me. Not performing the procedure is one thing. Refusing to refer is another, and for the reasons I gave earlier.

If a new regulation were drafted that kept referrals in place, even with some mandatory advocacy education attached, I would be much better with this.

http://ruralhealth.hrsa.gov/funding/flex.htm

http://www.hhs.gov/grantsnet/

(this appears to be one major source --grants in exchange for improving PUBLIC services)

http://taggs.hhs.gov/Reports/GrantsByRecipClass.cfm

(a sample of generic classes and award dollar amounts)

Here's a detail record of awards over time for Providence Portland. They are developing a new cancer center, and some of the awards reflect that.

http://taggs.hhs.gov/RecipInfo.CFM?SelEin=LCYqIyw%2FLEJEQkw%2FXlIqOEsK

There is more on that site than I care to examine.

This is your classic "strawman" argument put forth by conservatives feigning outrage - namely, that the Federal Government is going to force doctors who happen to oppose abortions to perform them. (Never mind that for 7.5 years, the Bush Administration did nothing about this supposed outrage; Obama is trying to overturn a rule instituted only at the end of the Bush administration.)

First of all, I can't believe for a minute that any doctor or nurse anywhere who opposes abortion would be forced to perform one. Give me a real example of when that has happened. What the government is surely trying to do is ensure women who want an abortion have access to them, without fear of intimidation, even if they can't afford to have one privately (the rule here applies to Federally Funded clinics, not private hospitals).

Now, if you are a doctor or nurse who is in a position of having to perform abortions, I'd ask: what the hell are you doing there? Find another place to work. I mean, don't join the Marines if you are a pacifist, either, and then complain that they are making you point guns at people. There are lots of ways to practice medicine. Don't pick one that involves potentially involves doing something you find morally objectionable and then complaining about it. Find another job.

As for doctors/nurses who may claim to be forced into this kind of work against their moral beliefs? I don't believe for a minute it wasn't a deliberate choice to provoke a political statement on abortion. Sorry. Don't buy it.

and the insurance plan doesn't provide for the option...

If the insurance plan doesn't provide for it, then even if the primary care physician does provide those services, the patient is going to have to pay for it.

As for doctors/nurses who may claim to be forced into this kind of work against their moral beliefs? I don't believe for a minute it wasn't a deliberate choice to provoke a political statement on abortion. Sorry. Don't buy it.

Andrew, using that line of logic, then every OBGYN should perform an abortion if their patient requests it?

...if they are working within an institution that takes federal dollars?

That answer is way different from their private or group practice, isn't it?

And what I meant was if the insurance won't cover without a referral, not that the insurance didn't provide the option at all. Two different things.

Skybill: Andrew, using that line of logic, then every OBGYN should perform an abortion if their patient requests it

If you are an OB/GYN who opposes abortion and you are working at a clinic or hospital that receives federal funding, either you need to make sure others in the clinic would be able to perform abortions without you or you need to find somewhere else to work. Seems pretty simple to me.

I can imagine there are some small federally-funded clinics in rural areas where there is only one OB/GYN. That person should not be in a position to deny a woman an abortion because of his/her moral beliefs. I can certainly see abortion foes engineering that sort of situation, actually, and then claiming a moral conflict.

In any case, why would an OB/GYN who opposes abortion want to work in a place where they are performed with federal funding, anyway, whether they personally are performing them or not?

Exactly.

...if they are working within an institution that takes federal dollars?

If they are, then it shouldn't be too big a problem to find a Dr. who is willing to do it.

How about a Dr. in private practice who has Medicaid/Medicare patients? Those are federal funds. What to do in that case?

And what I meant was if the insurance won't cover without a referral, not that the insurance didn't provide the option at all. Two different things.

OK. I misunderstood your statement.

I repeat: it's a strawman, a fake issue dreamed up by abortion opponents. They pretend that innocent health care providers who happen to be opposed to abortion are being forced to perform them or lose their jobs. Bullshit. If you are a health care provider without a political agenda, it's quite easy to avoid being put in that position in the first place. I don't buy it.

Exactly, a strawman.

The actual intent here is to make sure we don't have idiot pharmacists unwilling to despense birth control. If you have a moral objection, get another job!!

"If you have a moral objection, get another job!!"

Amen!