Monday, February 13, 2012

Churches, Contraception and My Blood Pressure

This latest debate on requiring churches to offer contraception has me all riled up. Here's how it breaks down to me:

I thought the core principle behind health care was that all medical decisions should be made by you and the doctor of your choice (with family, religion, and any other input being factored in at your discretion). In fact, the whole "government take over of health care" cry was so effective because it implied that the government was going to play a role in making your health decisions, and in the extreme case, deciding who may live and die (see: Death Panels).

Given this philosophy, it seems like the ideal situation would be that insurance plans offer every treatment option available at a reasonable rate, and you and your doctor pick the ones that fits you. You and your Doctor decide The Pill is right for you? You should be able to go on it. You and your doctor decide acupuncture is the best fit? Again, it should be available. Want to try botox for migraine relief? Again, if your Doctor gives you the green light, you should be able to get it.

Of course, we don't live in an ideal world, so every treatment option won't be available in every plan. That's just economics, I get it.

Along comes this contraception kerfuffle. Churches say they can't be expected to pay for procedures they don't agree with. OK, I can see that. In fact, after some reflection, I more than see the point, I think it's critical. I'd be mortified if my shul was required by the government to support something we as a congregation don't agree with. So, Obama re-jiggers things, and says, fine, churches don't have to pay for contraception. In fact, they'd have no involvement in contraception at all. The GOP responds by suggesting this isn't a compromise, and takes the rule further: any corporation should be able to deny contraception coverage.

And this is what ties me up in knots: doesn't this put individuals in a place where potentially who they work for limits what medical care they can afford, and therefore access? Isn't this the nightmare scenario conservatives painted, only with churches and corporations calling the shots instead of some government committee?

Put another way: it seems fair for a church or synagogue to say where they spend their money. But, it doesn't seem fair for them to limit what medical care their employees have. And it seems like that's what they are reaching for.

Why do I feel like Republicans are fighting for the rights of a churches and corporations over those of individuals?

Update: I feel like I should add, if churches and corporations do end up getting the right to pick plans that don't cover contraception, it won't be the end of the world. Heck, you could work for an employer who thinks that acupuncture is a sham, and refuses to cover it. Your options would be: get a new job or pay for it out of pocket. Not ideal options, but not the end of the world either.

It just seems disingenuous to say that the Government is going to ration your care, and then turn around and fight for another party to be able to do the same thing.

2 comments:

  1. Interesting blog, as always. :)

    I largely agree with most of your points -- especially concerning the behavior of many Republicans (and, in turn, many Democrats as well, who seem to simply represent the opposite side of an irrational and highly reflexive coin).

    The problems I have with the regulation concerning contraceptives are twofold -- one fairly concrete, the other more conceptual. First, while complete choice and availability of medical services are worthy ideals, there's the little matter of who pays for such services. In virtually all employee insurance setups, a large portion of the bill is covered by the employer -- which in this case is a religious organization that literally holds the services in question to be against God's will. Therefore, forcing coverage to include such services is to force the religious organization to pay for those services, which in turn is fairly clear-cut infringement of First Amendment free practice rights. The solution, to me, would be to somehow decouple the insurance from the employer.

    Second, and far more conceptual, is the definition of "healthcare." Is the definition "anything provided by a licensed medical professional" or is it "products and services that maintain (or seek to return a person to) good health?" If it's the latter, do prescription contraceptives even fit the definition? There's nothing intrinsically unhealthy about pregnancy (for most people). Heck, it's the core mechanism of species survival. So one needn't even take a side in the religion/healthcare debate to wonder whether prescription contraceptives might actually be more of a luxury consumer item (compared to condoms sold at the local 7/11) than a true healthcare necessity.

    Sorry for the absurdly long comment. Yours is one of the few posts I've seen on this issue that contains nuance, rather than all-too-familiar partisan talking points.

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  2. Rob -

    Thanks for the thoughtful comment. This circumstance definitely points out the absurdity of tying health insurance to an employer, as the employer is put in this odd position of potentially paying for something they don't agree with.

    There's an interesting clip here which argues fairly reasonably that this isn't a first amendment violation - but I don't have the Constitution law knowledge to know if it's a valid argument or not.

    Perhaps the most frustrating part is that this discussion is being pitted as Obama's war on religion or the Republican's war on Women (or something like that). When, really, it seems like a tricky argument about what employers and individuals are both entitled to, and how to sort out the conflict when what they each want differs.

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