Saturday, February 11, 2012

The Birth Control Mess

True or false: an ounce of prevention is worth about 7 lbs. 6 oz. of cure. Somewhere buried in the dust-up over contraception as a health benefit is the the claim that it pays for itself in economic terms. As a result, insurance companies "forced" to give it away will be like Br'er Rabbit hurled mercilessly into the briar patch. As will those Catholic institutions which, their hands clean of actually endorsing contraception, will have lower health insurance bills on account of the preventive benefits that the insurance companies with which they deal are compelled by Big Brother to provide.

So, in effect, The Church is willing to pay for its employees to eschew contraception; indeed, it will help them do so by not paying for contraception. But if an employee chooses to get it on her own, the Church will, presumably, receive the savings as the preventive benefits reduce the cost of the employer's insurance. Moreover, because using contraception saves money, the employee can get it at no charge from the insurance company - which will provide it at no charge only because it is also providing coverage to the employer. In a logical universe, that "only," not to mention the cash benefit, would somehow implicate the institution in the provision of the services. But, fortunately, we're not in a logical universe. We're in church.

1 comment:

  1. Well, it's a few weeks later, and it appears this issue has become a big deal, especially with Rush Limbaugh going mean girl on Ms. Fluke. The issue has been framed from the left as being about "access" to contraception and from the right as religious freedom. The religious freedom argument has been supplemented by a "moral freedom" argument in the form of a bill that would allow any employer to deny any healthcare to which the employer had a moral objection. I like that bill, not because I would want it to become law, but because it clarifies the issue.

    First, the Left is nuts. Contraception can be accomplished in several ways, running from abstinence to rhythm to barriers to spermicides to prescriptions drugs. Women have access to all of these now and under all pending Constitutional legislation. So this is not about access to contraception. It is, rather about subsidization of the most expensive form of contraception, the pill.

    I'm not clear on why any healthcare plan would not reject a claim for birth control pills on the grounds that it is not medically necessary, except perhaps in some case where pregnancy would be life-threatening. Otherwise, I would think that birth control pills fail the "medical necessity" test written into every health plan in the country. "Sexual convenience" is not medical necessity. Or at least the law ought not to be that it is.

    And why, of all people, would an unmarried woman be the best person to advance the moral claim to subsidized, non-procreative sex? Objections to her behavior are far broader than the more narrow Roman Catholic objection to contraception in marriage. Lots of people probably oppose paying for a single woman's choice of the most expensive form of contraception. Handing out condoms to teens is one thing; subsidizing the pill for law students is quite another.

    But at the other end of the spectrum, we can't have employers deciding what health benefits they will pay for if the employer-paid model is to remain the national solution to a national challenge. If we switched to a single-payer plan, we could argue over what the single-payer would pay for, but we do not allow people who oppose any particular use of tax money to withhold the part of their taxes allocable to those expenditures. Properly understood, any mandated benefit is a tax, and the standard for obeying the mandate should be the same as the standard for paying a tax.

    The Obama solution of making the insurance company pay for the pill makes political sense because we are all paying for the benefit one way or another, so it does not matter who writes the check. If moral opponents of a particular benefit feel better about some other structure, then so be it. Making the insurance company "pay" is just a step toward single payer, and as such, it affords the moral plausible deniability of merely acquiescing rather than actually doing.


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