In the recent, and apparently endless, dustup over a rule promulgated under the Patient Protection and Affordable Health Care Act (‘ACA’, or more accurately, ‘ObamaCare’), it is surprising how many near-sighted tree experts exist and how few far-sighted forest rangers there are.
Had such rulemaking mandated that religiously affiliated institutions be required to provide insurance to their employees to cover injuries specifically resulting from dancing or illnesses specifically caused by drinking, then Baptists would likely be upset. Had such rulemaking required that medical doctors be consulted every time a child fell ill, then Christian Scientists would probably be upset.
In these cases, it would not have mattered whether most Baptists danced and drank, or whether most Baptists favored dancing and drinking. Nor would it have mattered whether most Christian Scientists consulted medical doctors when their children fell ill or favored consulting doctors when their children fell ill. What matters is that the national government is perceived to be crossing the Free Exercise clause of the First Amendment by requiring an allegiance to a medical practice opposed by a religion.
The 50,000-foot view of the forest understands the following:
- The national government’s industrious rulemaking engine generates only one policy for the nation no matter where you live, no matter what you believe, no matter what you want, and no matter who you are.
- When national legislation, no matter how well intended, entwines local institutions in an intimate, pervasive, financial relationship with the national government, without which funding such institutions cannot survive, then these institutions become mere outlets of the foregoing voluminous, monolithic, policymaking machine.
Hence, it seems ill informed and myopic to cast the current situation as Catholics imposing their will on others, or as a renewed debate about access to contraception or abortion, or as a debate about the aspects of feminism, women's health, or wherever examining the tree bark of the consequences leads. The only real debate here is whether government is too big, generally, or too big under ObamaCare, particularly.
Trust me; health insurance companies saw this coming. They raised their rates in anticipation of this day. Sure enough, the incumbent socialist-in-chief, who believes that he knows what is best for all of us, is now demanding that non-governmental entities supply something for which they cannot charge.
Fortunately, for the shareholders, and unfortunately, for the premium payers, these health insurance companies beat the socialism of the ACA to the punch. However, you can bet that more mandates are coming from those in Washington DC who believe that they know best.
Be careful for what you ask of our government.
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Uncle Chris
Deborah Young
Peter Breschard
Jeana Morris
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Comments
Hey! Thanks for reading and commenting.
However, it appears that you may have missed the point of the post.
This is not an argument about a person being forced to have an abortion. This is not an argument about denying an abortion to anyone. No one is being forced in this manner.
This post tries to make the point that this should not be an argument about any ‘tree-bark’ topic arising from the consequences of the HHS ruling regarding what non-church employers must now provide in their health insurance policies for their employees. These employers, and their insurance companies, are the only ones being forced to do anything here.
The 'tree bark' arguments about women’s reproductive rights, women’s health, women’s rights to testify, women’s rights to sit on panels, women’s fashions, or women’s anything else are distracting and miss the view of the forest. These ‘tree-bark’ arguments are simply the ‘blowback’ of government forcing religiously affiliated institutions to underwrite medical practices to which their church sponsors are opposed. There are clear First Amendment issues in play because of this consequence; and the President, ignoring advice not to issue the rule in its original form, belatedly understood this shortly after 20 January.
In trying to correct these trespasses, Obama resorted to an accounting trick, which, of course, solved nothing for those Catholic institutions that are self-insured. However, his solution of diversion now has the additional consequence of our national government dictating to non-governmental health care insurers exactly what they must provide without charge.
Next thing you know, Obama will be telling you what products or services you must provide free.
No, ONL, the point of this post is that there is a much larger ‘forest’ argument here, which, if addressed properly, avoids all such issues. This is the argument about where the influence of government is not allowed.
As such, it is an argument that opposes, on its face, all those who believe that the solution to all of our social ills is more government. This is the argument that redefines the federal relationship of our national government to the government of the States. This is the argument that will recognize what local Baptist, Shriner, Methodist, Lutheran, Jewish, Catholic, etc., institutions do to mediate between us and our governments. This is the argument that will recognize again the cost efficiency and effectiveness of these institutions that are not controlled remotely by Washington DC policy makers who believe that they know what is best for us.
You probably believe that government will never intrude where you won’t allow it. Here’s another aspect of ObamaCare about which you might care to learn and to comment.
http://en.wikipedia.org/wiki/Independent_Payment_Advisory_Board
Thanks to you also for reading and commenting.
Take a look at this chart showing how health care costs, as a portion of our GDP, have risen since Medicare was enacted. Then, let's chat.
http://en.wikipedia.org/wiki/File:Health_costs_USA_GDP.gif
Question: Given that birth control is already widely available and often inexpensive, what is the problem that the administration's mandate of free birth control is trying to solve?
Medications that control blood pressure, cholesterol, and blood glucose don't have to be offered for free, even though they control conditions that can lead to strokes, heart attacks, amputations, death, disability, and many other serious problems, and are arguably far more important than birth control. But none of these medications have to be offered for free. Only birth control must be free.
Leaving aside questions of religion and the proper role of government, for me the first issue is what medical goal the administration is trying to accomplish. I have not heard a good answer to that question.
If I understand your question regarding what problem the incumbent administration is trying to solve in mandating free contraception coverage, then the answer lies in the Free Exercise Clause of the First Amendment.
The original HHS ruling under the ACA effectively mandated that institutions sponsored by the Catholic Church (e.g., schools, hospitals, etc.,), as well as all other employers (except churches) would eventually be required to supply insurance to their employees that covered methods of birth control opposed by the Catholic Church. From the perspective of the Catholic Church, this was tantamount to governmental dictation of at least a portion of a national religion.
From the perspective of the Church, this view is correct. The national government was forcing the church to pledge an allegiance to forms of birth control that the church opposes. Under this ruling, Catholic Church affiliated employers would be forced to pay for insurance coverage of contraception methodologies opposed by their sponsoring religion.
Obama was advised not to allow this rule to be issued in its original form. He ignored this advice.
Hence, under the guise of issuing details of the implementation of this rule, President Obama ‘clarified’ its execution by indicating that it would be imposed only upon insurance carriers, and not upon employers; and, further, such carriers were to supply certain forms of contraception, like birth control pills, without charge.
This revision was designed to circumvent the moral objections of the Catholic Church. The Church could no longer claim that IT was being forced to support insurance coverage of methods of birth control it opposed, since not only were ALL secular insurance companies providing this coverage, but also, no funds were being expended by the premium payers (churches included) to provide such coverage.
Of course, the revision of the rule has two significant problems. First, it dictates to non-governmental institutions (the insurance companies) that they must provide certain services without compensation. Second, the revision does not work for institutions associated with the Catholic Church that are self-insured.
The Catholic Church has no doctrine that questions the morality of blood pressure, cholesterol, and blood glucose medications. Thus, there is no moral, or First Amendment problem, with these medications, at least among the known, well-established, theologies.
I am convinced that the goals of this administration relative to the ACA are not ill intended. There is among all collectivists a general empathy for the unfortunate. However, this empathy seems always coupled with an astounding lack of common sense.
Beyond the obvious jaw-dropping implication of our national government dictating to non-governmental insurance carriers what they must provide free of charge, there is a real financial burden being applied here. To use your example, among 47 million currently without health insurance in America, let’s presume half are women and one-third of those need birth control pills. At $4 per month per such beneficiary, the total annual cost the Obama administration is requiring insurance carriers to absorb exceeds $375 million.
However, if we assume that this ruling applies to the entire 315 million population of our country, then, under the same population presumptions above, the annual cost actually exceeds $2.52 billion. At $15 per month per such beneficiary, for the entire nation, this cost exceeds $9.45 billion.
These are not CEO salaries in the health care insurance industry. These numbers are far larger.
Nevertheless, these considerations don’t mean much to those who believe that throwing money at our society in this way achieves a Socialist Nirvana. Therefore, I have no good answer for you on this topic.
Strangely enough, I actually support some kind of single payor or national health plan. I worked as a medical data analyst for over twenty years, and saw first-hand the tremendous administrative costs of the current system. Call it socialized medicine or whatever, it is my belief that the only way to lower the administrative overhead -- almost one-third of what we spend on health care -- is through some kind of single payor plan. And whatever kind of system we eventually end up with, I'm sure that there will be some kind of significant governmental component. And I'd like to see a health insurance system that got employers completely out of the business of providing health insurance.
What I object to in the situation under discussion is not governmental action per se. It's that the government is meddling with employer-sponsored health plans for political purposes. And frankly, even though I support a single payor plan, I am concerned that politicians will be tempted to play political football with the health plan.
But the current system is becoming unworkable. It is far too expensive, bankrupts many people, often doesn't provide good outcomes, and leaves tens of millions of people outside of the system. And an employer-based system of health care leaves millions of people without coverage whenever the economy goes south.
So I find myself in a conundrum. I think the only solution to the health insurance problem is some kind of government-managed health plan, while at the same time I don't necessarily trust the government to do the right thing.
Credit card number please.
Rated!!!
Your expert knowledge has motivated the appropriate revision.
Thank you.
Also, I am grateful that you were here and left your endorsements of this view. We, however, are in the minority.
Our daughter did convince me, one time, that I should buy her six pairs of shoes. I bought at least four for her, I know. The mystery of the relationship between women and footwear has only deepened for me since that time.
Nevertheless, as soon as I find my credit card, I will write you a PM.
Frankly, I struggle with the concept that something can be “half-rhetorical”. However, someday women might be ‘half-pregnant’. One never knows how far, or in what direction, society will advance.
Your observation that politicians are pandering is undoubtedly correct, but not unique. Most who are elected quickly become rental politicians to those sectors that secure for them sufficient votes to maintain a career of ‘public service’. Few at the national level these days are principled enough to act in the best of the country, preferring instead to act in the best interest of themselves.
With all due respect, let me suggest that, in this environment just admitted, your hunger for more government involvement in health care is misguided, to say the least. Further, given nearly 50 years of historical outcomes of programs like Medicare and Medicaid, your hunger for more government in health care might also be classified as illogical.
Today, there are likely few areas in our society riper for political pandering than health care, a service needed more now than at any other time in our brief history. With the current health care environment, history of health care outcomes, and further degradation in the quality of our national political leaders, now would not seem the time to favor further collectivist policies and greater governmental involvement in our health care choices.
Your best observation, in my view, is the one in which you note that administrative expenses for our health care system are high. In fact, America’s expenses for health care administration are about twice as high as the OECD country average and about twice what it is in most countries that implement the Nordic welfare model. Further, many believe that such administrative expenses have increased greatly because of the amount of effort that governments require to report on social entitlement programs such as Medicare and Medicaid.
Three other reasons often offered for the excessively high cost of American health care are:
•lack of tort reform
(often stated as pressure on doctors to practice “defensive medicine”)
•low Medicare and Medicaid reimbursement rates
(forcing physicians to charge non-publically insured patients more and to perform more services on non-publically insured patients to make up for ‘lost income’ and outright losses.)
•existence of life extending medical technology and medicines
(thereby increasing costs for treating chronic diseases associated with old age and increasing costs for maintaining life in circumstance not possible before)
Out of these four reasons, the government could reduce costs simply by pulling back in two areas from its current level of involvment in health care delivery. In a third area, if governments simply insured that losers in medical tort cases were on the hook for the attorney’s fees and court costs of the winners, then we might see less passion for frivolous and dilatory litigation, more fact-driven cases in court, and quicker settlements outside of court - while not forestalling anyone's right to sue.
Then, we are simply left with the problem of what to do about the increased medical expenses of living longer. This would seem a more pleasant conundrum than the one you claim you now have.
http://en.wikipedia.org/wiki/File:Health_costs_USA_GDP.gif”
Let’s chat here, since this post is addressed to you (note: it contains several charts):
Ballooning health care cost: is Medicare the culprit?