What are the moral implications of the proposed changes in health care coverage? If you are on Medicare, or expect to be in the near future, will the changes in proposed federal health care legislation affect you? What about supplements and Medicare Advantage plans? And by the way, how can costs be contained for such a behemoth overhaul? These questions, among many others, were addressed by the participants at the public forum, “Proposed Medicare Reforms: The Nitty-Gritty Made Clear,” sponsored by Pennsylvanians for Health Care Reform on November 8th, at New Covenant United Church of Christ. With about 50 people attending, the forum was moderated by Reverend Sam Hwang of Williamsport’s First Presbyterian Church. Reverend Hwang opened the event by recalling the Christian duty to care for others, and denounced the misinformation rampant about health care reform.

The Reverend J. Jeffrey Zetto, Pastor of Bethany Lutheran Church, outlined the evolution of the Christian ethics concerning health care and community responsibility. The Old Testament puts forth the idea of a duty to help those who cannot help themselves. The idea of the Social Contract, as discussed by 17th- and 18th-century philosophers, states that the purpose of governments is to promote the welfare of their citizens; this Social Contract was embodied in our Declaration of Independence and in the U.S. Constitution. But just how is this to be put into practice, and specifically what is the proper role of government in caring for the health of the people? The question isn’t easy to answer, yet the debate is as valuable as it is important.

Janet Witt, of the National Committee to Preserve Social Security and Medicare, discussed Medicare supplements; these are private insurance policies that cover the services outside the reimbursement scope of Medicare. HMO-type Medicare Advantage plans are heavily marketed, because insurance companies currently receive from the federal government an average $850/year subsidy per participant. But this subsidy is paid for by other Medicare participants. The proposed plan would eliminate this subsidy. It would also close the “donut hole” in Part D coverage, decrease drug prices, pay for vaccines, and restore payments to doctors that had been previously cut by Medicare. According to Marc Stier, Pennsylvania regional director of Health Care for America Now, people who called and wrote to their representatives should take credit for success of the reform bill in the House. Representative Chris Carney (D) of the (largely Republican) 10th District feared his constituents’ disapproval of the bill, but receiving many expressions of support persuaded him to vote for the bill.

What changes would the bill bring about? It would permit regulation of insurance companies, permit small businesses to buy insurance as cheaply as large ones, provide tax credits for low income people, and create a public option. But it is less specific concerning how this reform is to be paid for. Questions from the audience focused on Medicare fraud, penalties for not buying coverage, and the idea of a single payer plan. And (this is your reporter talking here) there remain many important questions we all need to ask about the bill. What about the anti-abortion provisions? Will the public option survive, or will the bill end up enshrining a private insurance system in which a few large companies dominate the market? And how would the program actually be paid for? Would it funnel billions of taxpayer dollars into the private insurance system with few fundamental changes? So stay tuned, folks. This issue is going to get even more complicated in the next few months. And all our lives—with the exception, perhaps, of the very rich—are going to be affected by it.