Health care reform is about more than reducing insurance premiums, says this Catholic health care executive. It’s about caring for the sick.

On March 5, 2009, Sister Carol Keehan, a Daughter of Charity and president of the Catholic Health Association (CHA), which represents more than 600 Catholic hospitals and medical facilities, participated in a White House roundtable on health care reform. The gathering included members of Congress, journalists, and invited interested parties, such as Keehan.

"When we came together, you got that sense that we really have to get this done," says Keehan, a 35-year veteran of Catholic health care as both a nurse and an administrator.

A year of rough-and-tumble politics took the shine off that early gathering. "I don't know if it was other issues or just that we can only stay positive so long in Washington," she says. "There has been a lot of fear-mongering and deliberate misinformation, and so people were frightened."

Keehan pitched a Catholic case for health care reform on Capitol Hill right up until its passage in March. But CHA's support of the final legislation was not without controversy: Her endorsement of the reform bill on March 15 was followed the next day by a U.S. bishops' conference statement rejecting it. At issue was whether restrictions in the final bill are sufficient to maintain the ban on federal funding of abortion.

"The legislation is not going to fund abortions," Keehan says. "Still, we need to carefully review its provisions, its safeguards, and its implementation."

Why should Catholics support comprehensive health care reform?

Because everybody needs it. If you are poor and uninsured, you desperately need it. If you're a working person, you need it because your wages have been depressed for at least the last decade and your insurance premiums, your out-of-pocket expenses, and deductibles have all gone up.

We have 18,000 unnecessary deaths a year because of people not being able to get the care they need due to lack of insurance, according to the Institute of Medicine; a more recent Harvard study put that number at 45,000. Right now about 18 percent of a family's income goes just to health care expenses, and it's slated to go up to 24 percent.

If you're concerned about the nation's economy, we are moving today from spending 16 percent of our gross domestic product on health care to 17.3 percent. The industrialized nations we compete with spend 8 to 9 percent, and they have better health outcomes than we do.

There was a study released last year of cancer survivors. It found that four out of every 10 have spent every cent they had to get to where they are. One out of every 10 survivors no longer has a roof over their heads because they've spent all their assets. Seventy percent of the personal bankruptcies in this country last year were because of medical expenses. We can't ask people to live like that.

For us as Catholics it's very hard to be pro-life when we don't give care to many mothers who are pregnant or when we don't provide pediatric care and well-baby care and sick-baby care to children. We have 9 million uninsured children in this country. That's not pro-life.

Where have you seen the need for reform in your own work?

I could give you a million examples. There's the pregnant woman who comes to the emergency room ready to deliver who hasn't had an ounce of prenatal care. Or maybe she is not ready to deliver but is toxic because her blood pressure is out of control. This is a mother who has never, ever had any kind of maternity care, any kind of counseling.

Or there's the woman who has a tumor so large it is actually coming through her breast. She knows she doesn't have the money to afford chemotherapy so doesn't do anything.

We see elderly people in the emergency room who don't take their medicine because they were waiting for their Social Security check. We see people with ulcers on their legs that have become grotesquely infected, which could have been easily addressed much sooner if we simply had access to them.

Then there are people who try to use home remedies when they have symptoms that make most people go straight to the doctor. A classic would be blood in the urine. Often people who don't have coverage will just drink a lot of fluids, or maybe somebody told them cranberry juice was good. By the time they come into the emergency room, they've got a bladder cancer that's eaten into the wall of the bladder and may even be in the intestines.

By then it is imposssible to cure their cancer; they're not even going to be reasonably comfortable for the rest of their lives. They're going to be utterly miserable.

If from a Catholic perspective we say these are people in the image and likeness of God, then we ought to be pushing to get them treated as if they're made in that image.

What are some components of an ideal health care system from a Catholic perspective?

An ideal health care system would first of all provide everybody with high quality care. It would reach out to everyone, it would focus on preventive care, and it would give special attention to the vulnerable. It would be transparent, so people would know what they were getting, and it would be financially responsible. Clearly care must be available for everyone from the moment of conception until the moment of natural death.

Additionally, the goal is for everybody, regardless of income, to have the dignity of being able to choose a provider that will treat them with respect.

When you need to get health care for your children, you shouldn't have to come looking for charity. It's a point of pride for parents to be able to support their children and get them what they need.