Contraceptives and Religious Freedom

The Obama administration is taking heat for a decision that requires all health care insurance plans to pay for contraceptive prescriptions. There is an exception for churches, but not for church supported institutions like hospitals and charitable organizations.

The objection is that this requirement infringes on religious organizations, especially Catholics, who believe any kind of contraception is a sin. The Church objects because they would be "paying" for contraceptives.

I think the rational for the requiring insurance plans to cover contraceptives is a women's health care issue. Most women will use contraceptives at some point and it is more likely that they will get contraceptives when needed if they are covered just like vaccinations. Religious institutions, like Catholic hospitals, are not exempted, because many of their employees are not Catholic.

The law would require that insurance plans cover contraceptives, but it does not require any woman to take contraceptives. If no employee used their insurance to pay for contraceptives, problem solved. Why can't the church just use its moral persuasion to convince women to not use contraceptives? Is the Catholic church's moral authority so weak that is must rely on its own version of the law to enforce its religious doctrine?

I appreciate strongly held ethical beliefs, but we live in a secular country governed by a constitution, laws, rules and elections. We all have to reconcile our personal beliefs with those of other people and the law. Why do we have a law that says no federal funds can go to support abortion, but we use federal funds to execute convicted felons? You may see a difference, but if the underlying moral concept is not taking a human life, what is the difference? The difference is that we, as a country, have decided to make that distinction. We all practice moral relativism, including the Catholic church. I'm not sure why they chose to fight this battle at this time in this way.

The Catholic hierarchy believes they should be exempt from the requirement that their insurance plans cover contraceptives because this is a religious and ethical issue. Excuse me, but that makes no difference. We don't allow Mormons to flaunt polygamy laws. We don't allow Muslims to escape punishment for honor killings. I'm sure we could find many examples of religious practices that are no longer accepted in the modern world. Times change. Values change. When I was a kid Catholics couldn't eat meat on Fridays. Now they can (at least most Fridays).

One argument I heard this morning is that Catholic hospitals provide much of the care for people in this country. I appreciate that Catholics provide this service, but what percentage of any Catholic hospital's cost are provided by the Catholic church? My guess is that these are self-supporting institutions. They may have started as charitable activities, but now they are businesses. Is it really Catholic religious money that goes to pay for employee health insurance?

I suppose I could change my position if Catholic hospitals only employed Catholics. And I would be even more swayed if they only provided services to Catholics. But then again, contraception being a sin, no one would be using contraceptives if these were purely Catholic only institutions so health insurance coverage of contraceptives would be a non-issue.

I heard one comment that said the church would be satisfied if they didn't have to pay for any contraceptives. Contraceptives could be provided if they were fully paid by the employee.
Most medical plans have the employer and employee sharing some portion of medical care costs. Why couldn't the church just state that any payments for contraceptives, by definition, come from the employees portion of the insurance payments and co-payments? Problem solved.

Or try this. If having the employee pay for their contraceptives is acceptable, presumably because the Catholic church is not directly involved, why can't you just push responsibility to the insurance company. The hospital pays an insurance provider to reimburse health care expenses. It the health insurance company pays for contraceptives, the sin is on their heads. Again, problem solved.

If this blog has seemed silly at times, that is intentional, but, seriously, I do not understand this issue. Catholic leaders are outraged over being forced to provide a service they believe is immoral, but most people, including Catholics, believe contraceptives are moral and provide health benefits for women. It might even be considered more moral to prevent a pregnancy when parents are not prepared to adequately care for a child.

If this is such as serious moral dilemma, why do the majority of Catholic women use contraceptives? If the moral authority of Catholic leaders can't convince Catholic women to not use contraceptives, why should we and therefore, the government, accept their moral authority? On what moral basis can they claim to be exempt from providing a health care service that citizens consider to be moral and beneficial and is required of other organizations?

The political line is this is an attack on religion and the First Amendment by the Obama administration. Once again, bull crap. This is a health care issue, not a debate about religious freedom. It might be politically expedient to grant Catholics an exception to the insurance requirement, but it would be morally wrong.

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Republic Plan To Ration Health Care

Republics screamed about rationing and death panels in the Democratic plans for health care reform. Of course there has been health care rationing forever. As I've written before, unless there are unforeseen changes to health care in the future, there will always be rationing of health care. The question in whether we can find rational, humane ways to ration.

Republics plan to save Medicare by giving people tax credits and having them buy insurance on the open market. From the reports we've heard, the plan is to control and reduce health care costs by giving people less in tax credits than insurance is expected to cost. Therefore people will have an incentive to buy only the coverage they need and use only the services they need. This is self rationing. In addition, the amount of tax credit the government will give will not be tied to the rising cost of health insurance. So as rates go up, individuals will have to pay ever more out of pocket costs or decrease their coverage.

From reports I've heard, Republics believe this difference between what people will have to pay and what the government will pay will incentivize private health insurers to control costs. It's nice to know Republics still have a sense of humor.

The Republic plan is guaranteed to work just as they plan. The costs to the government will go down and Medicare will be destroyed. Will the health of Americans be better?

Pop-Top Health Care

Health care reform took another step forward last night with the passage of a bill in the House.

I don't know if we will ever get a bill or if it will cost a lot of money or if it will accomplish what I hope needs to be done. I hope it passes, but I don't have a lot of hope. If a bill passes and becomes law, flawed as it will be, at least we will have a framework which future generations can build on. Assuming they have more guts and foresight than current and previous generations.

Personally, I believe a single payer, government run system would be better, but we are not good at legislating big, contentious issues like health care. Isn't that a good reason for government to stay out of health care? Yes, except everyday we live with evidence that the alternative is worse.

I try to listen to lots of different ideas so I was interested in listening to stories about health care systems in other countries. Contrary to what you often hear, I think most people in these countries are satisfied with their health care systems. I heard about one country on NPR (National Public Radio, if you don't listen to it, you should) where you can call and talk to health care professionals day or night, and if your condition warrants it and you can't come in, they will send a doctor to make a house call. Amazing.

In the U.S., I believe we pay about twice as much per person for health care as other countries with government sponsored health care. We do benefit from some of the best health care in the world, if you can afford it.

But two other anecdotes really bother me.

I believe it was the man in charge of health care in Great Britain who said that no one in his country ever goes bankrupt trying to pay for health care. In the U.S., health care bills are the number one cause of personal bankruptcy. He also pointed out the people in Great Britain never have to worry about losing their health care because they lose their job.

In my office we have containers to recycle soda cans. Someone recently added old gallon milk jugs and asked people to tear off the pop-top tabs and put them in the jug to help pay the medical bills for a very ill two year old girl. I heard an official from a foreign country comment on NPR that they were taken aback the first time they saw such an appeal in the U.S.. He was shocked that a parent in the United States of America had to resort to begging to get money to pay for health care for their seriously ill child. That was unheard of in his country.

Think about, some parents in the United States have to beg for health care for their sick children!

The news this morning talked about a few Democratic members of Congress who threatened to stop the health care reform bill unless harsh anti-abortion language was added to the bill. The language was added to gain their votes. Abortion is a serious ethical issue and I understand that people can have strong beliefs on both sides of the issue, but this move really bothers me. Supporters of a woman's choice could take the same stand and refuse to vote for the bill unless the abortion restrictions are removed (the Hyde Amendment would still apply).

I have a question for people who think the current health care system is fine or would rather not have reform if they can't have their personal needs satisfied.

What do you think when you pass the milk jug begging for help for a sick child?

Universal Health Care and Rationing

In the current debate over a national health care system, we have heard a lot about how this will lead to rationing. The truth is that we have a lot of health care rationing under the current system.

Anyone who isn't rich or have a job with health care benefits suffers from rationing.

Elective surgeries, experimental procedures and procedures that are considered to be ineffective are usually not covered by health insurance. This is certainly rationing and who determines what is covered? The health insurance company. Or in some cases, your employer, who opts for a less expensive plan.

If you are not covered by health insurance at work and you have the money and you haven't already been diagnosed with a serious condition, you can sign up for any number of insurance plans. Every plan has limits (rationing) and you pay more for less rationing. For example, many of the lower cost options for women do not have any maternity benefits.

Rationing is often used as another term for "cost control".

Another complaint against universal health care is that people don't want to pay for other people's health care. They accept the shared costs of insurance, but object to paying for people who don't contribute any thing to the cost of the insurance. I believe these people think it is a matter of fairness.

But, of course, people without health insurance go to the emergency room and the cost of that care is passed along to people who use health care and can pay.

But even for many people with insurance, the costs are not shared fairly. Every employer plan I've been in charges different fees to the employee depending on how many people are covered. Covering just the employee costs the employee a lot less than covering the employee and a spouse. A family plan costs the employee even more except a family plan is the same cost whether the family has one child or ten. How is that fair?

Life's not fair, so why should paying for health care be fair? Health care costs must be controlled and that will inevitably lead to what some people will call rationing.

So lets have a discussion of the best way to create a health care system that is "fair" and affordable. "Rationing" will be one of the tools we use to achieve this.