Friday, September 17, 2004

HR 3664

The CNN article was accurate. Maya gives us the correct information [and, in the process, causes my synapses to malfunction]. The Bill in question is HR 3664.

First, the context, kindly provided [I almost wrote "translated"] to us by Maya:

Current law says that physicians (and only physicians) can refuse to participate in training or licensing for abortion procedures if they are morally opposed to the abortion. The law would change it so that "other health care providers" (e.g., nurses, pharmacists, etc.) and "a hospital, a provider sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization or plan" can also refuse to do things based on moral objection. Additionally, the things that doctors or other entities can refuse to do is expanded from just training and licensing to include "perform, provide coverage of, or pay for induced abortions".

So this means that insurance companies can refuse to pay for abortions, companies can choose health insurance that won't cover abortions, hospitals can refuse to provide facilities for abortions, etc., etc., etc...

Second, the Bill's text:


To prohibit certain abortion-related discrimination in governmental activities.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,


This Act may be cited as the `Abortion Non-Discrimination Act of 2003'.


Section 245 of the Public Health Service Act (42 U.S.C. 238n) is amended--


(2) in subsection (a)(1), by striking `to perform such abortions' and inserting `to perform, provide coverage of, or pay for induced abortions'; and

(3) in subsection (c)(2)--

(A) by inserting `or other health professional,' after `an individual physician';

(B) by striking `and a participant' and inserting `a participant'; and

(C) by inserting before the period the following: `, a hospital, a provider sponsored organization, a health maintenance organization, a health insurance plan, or any other kind of health care facility, organization or plan'.

Even in my current state of almost complete stunnedness I can't help but notice the Bill's title: "Abortion Non-Discrimination". Say this aloud as you read it: ABORTION NON-DISCRIMINATION! Apparently the Bill's sponsor, Rep Bilirakis, Michael [FL-9], and it's 15 cosponsors--Rep Bartlett, Roscoe G. [MD-6], Rep Barton, Joe [TX-6], Rep Burr, Richard [NC-5], Rep Davis, Jo Ann [VA-1], Rep Deal, Nathan [GA-10], Rep Ehlers, Vernon J. [MI-3], Rep Hall, Ralph M. [TX-4], Rep Pickering, Charles W. (Chip) [MS-3], Rep Pitts, Joseph R. [PA-16], Rep Smith, Christopher H. [NJ-4], Rep Stearns, Cliff [FL-6], Rep Tauzin, W. J. (Billy) [LA-3], Rep Taylor, Gene [MS-4], Rep Upton, Fred [MI-6], Rep Whitfield, Ed [KY-1]--can't even afford us a modicum of respect by avoiding the use of dubious euphemisms for their Bill. This is a free country. If you are a politician and you wish to legislate denial of medical treatment for female patients just say so. Have the courage of your convictions.

Abortion discrimination means a patient is refused medical treatment (she's refused an abortion). Abortion non-discrimination means a patient isn't discriminated against because proper medical care (an abortion) is provided. Medical treatment is about the patient, and the discrimination can only be effected against said patient [you know, the person in need of medical care]. Patients, by definition, do not render medical care to their health care professionals. Maybe this necessitates further explanation: the woman on the operating table does not perform surgery on her physician; the woman at the drugstore counter does not dispense drugs to the pharmacist. It is impossible for the patient to medically discriminate against her health care professional.

Of course, it's quite possible for the patient to discriminate in other ways. For example, my best friend--a blond, blue-eyed Caucasian--is an ophthalmologist (eye doctor) in Germany. Patients often refuse to have her examine them because she isn't a native German. Other examples are the patients who refuse to see a male, or a female, physician, or patients who refuse care from a resident, etc. Despite all the possible instances of patients discriminating against their health care provider, medical discrimination isn't one of them. Thus [insert whatever medical treatment you wish here] discrimination/non-discrimination can only occur one way: from the health care person to the patient, not the other way around.

Just because a patient needs treatment (or, for that matter, is HIV-positive/a Jehovah's Witness/a prostitute transvestite) doesn't mean that that patient is discriminating against the physician.

You cannot protect the physician from the patient's discrimination, when that "discrimination" is the patient's need for medical treatment. Why? Because in this instance there's no discrimination. A hypothetical religious pharmacist who is fired for refusing to dispense medication to his patient (or who fails to insure a proper referral) isn't dismissed because there was any type of discrimination against his religious beliefs. The pharmacist is fired because he failed to perform his professional duties.

The Bill's title, Abortion Non-Discrimination is disingenuous. This is a Refusal-to-Treat Bill. Incidentally, being a health care professional and refusing to treat your patients (or issue a referral) are incompatible. Up to now I also thought refusal-to-treat was malpractice. Apparently, if the patient is a woman, not so much.

There's more to this story but, unfortunately, I'm too stunned to go on. I'll address the rest in another post.

Note: If the direct link doesn't work for you, try this. Go to
here, click on Bill Summary & Status. On the new page, enter HR 3664 in the Bill, Amendment, or Public Law Number search box, then click Search. This brings you to the Bill's page. Click CRS Summary for the summary.


At 5:14 PM, Anonymous Anonymous said...

Hi there-
Got to your blog by way of Anne's posting (annejumps), and I noticed the HR 3664 link didn't work for me. This one did, however:

Question - in the status, it says the last major action was December of last year. What in the world have they been doing with it this whole time? Is this already law? I'm going to do some more poking around and see what I find.

At 6:57 PM, Blogger annejumps said... Ema, does that seem accurate?

At 11:21 PM, Blogger ema said...

Evelyn, thank you; I added a Note. I'm not sure what the status is. I'll try to call Monday and find out. Here's the # for the House's clerk office: 202-224-3121.

Anne, yes it does. In any case, we need to keep a close eye on this Bill. Part of what troubled me so much about it was the fact that I wasn't even aware it was out there.

At 1:14 AM, Anonymous Anonymous said...

On the issue of its current status:

Frequently, bills that used to be stand-alone bills are added to larger bills. This is what happened with this one. This bill (the language from HR 3664) was inserted as an amendment to a much, much larger appropriations bill, then passed by the House. This language has passed the House.

I'm still looking for the bill it passed in--as of yesterday, it looked like the Clerk's office didn't have the most current version up. Sometimes it takes a few days for them to get a new bill, espcecially one this large, updated online. I'll let you know when I find it.

Thanks for readdressing this, ema. This is the next frontier of reproductive politics. If they can't outlaw it, they'll just make it impossible to obtain. Nice folks, really.

(Sorry for causing your synapses to malfunction...)


At 1:56 AM, Anonymous Anonymous said...

Thanks for the note. I've emailed both my senators and my representative with the hope that they might be able to shed some light on the situation (I also urged them to vote no, if it should come to a vote). I will let you know if I hear anything to clarify!

At 4:07 AM, Blogger mitsugomi said...

I went through the same confusion. They passed the Federal Refusal clause as an amendment to the FY’05 Labor, Health, and Human Services and Education spending bill. I've written about it too, on BOP News:

At 5:20 AM, Anonymous Anonymous said...

Hey. Nice blog. You seem to have a good idea here. Just wanted to leave a comment, enjoy.

health immediate insurance online quote


Post a Comment

<< Home