OK..Some of you all have been trying to coax me into addressing the ongoing controversy between President Obama and the Roman Catholic Church over a new federal mandate requiring all employers to include health insurance coverage for contraception, sterilization and abortion. If your views have been shaped by corporate media, you probably believe that this is a straightforward, deontological dilemma between "religious rights" and "reproductive rights." Sorry...but I won't address that issue! Why not? Well...it's NOT because I teach at a Roman Catholic college and it's NOT because most of my friends and colleagues are liberal women. The reason that I refuse to address that debate is that it's not the ultimate source of the conflict and therefore, to do so would be tantamount to a physician treating the symptoms of the disease rather than the underlying disease.
So what's the disease? Well, it's President Obama's decision to "reform" the U.S. health care system by expanding and revising employment-based health insurance. Kronke and I have already dealt with the various problems associated with employment-based health insurance in our essay: The Modern Health Care Maze. So in this use blog I'll try to explain how and why this mindless system inevitably alienates not only religious employers like the Roman Catholic Church, but also their employees. Ultimately, I might even question why an otherwise saavy politician like Obama failed to "anticipate" the consequences of this policy.
First of all, let's ask the most basic question. Why would I want my employer, the federal government, and/or the state of Ohio to choose my health insurance coverage for me? Do these governmental entities or my employer know something that I don't know about what I need in terms of coverage? President Obama sent me an e-mail message the other day. It said: "Sorry Ron, but even though you and your wife are well beyond your reproductive years, I decided that you really NEED health insurance coverage for contraception, sterlization, and abortion?" Then the bishop sent me an e-mail that said: "Sorry Ron, but the Roman Catholic Church won't pay for that mandated coverage because we believe that contraception, sterilization, and abortion are immoral." Note that both the President and the Bishop believe that they are acting in good conscience on my on my behalf. But the fact of the matter is that I really don't need contraception, sterilization, or abortion coverage. I also don't need in vitro fertilization coverage. If I did, I guess it's good to know that if my wife and I end up with octuplets, my health insurance will cover up to $1,000,000. per child toward treatment in a neonatal intensive care unit. The government and my employer might also decide that we also need insurance coverage for mamograms, a hair transplant, cosmetic surgery, and/or a sex change operation. I know that pharmaceutical companies believe that I need insurance coverage for a test Low T (low testosterone), and for the expensive, patent-protected drug that cures it. That's why their lobbyists are are swarming state governments hoping to force insurance companies to cover those tests and drugs.
Now if the health insurance offered to me by my employers was offered as a gift, I wouldn't be so critical. But the fact is that I pay for that insurance via diminished salary and co-pays. Moreover, although the President and the Bishop are willing to force me to pay for insurance coverage that I mostly don't need, neither of them are anxious to provide me with reasonable coverage that I really might need someday: dental care, eye care, or long-term nursing care. So one of the unanticipated consequences of employment based health insurance is that I'm stuck paying for health insurance that I wouldn't otherwise purchase. And of course, over time, the quality of that insurance coverage has decreased, while the costs have increased. So as a result, every year I pay more for my health insurance and more out-of-pocket for my uncovered health care. Now I can't blame the Bishop for my lousy health insurance. There are only a few health insurance companies licensed in the state of Ohio, and they all are well-represented by powerful lobbies. But I do blame President Obama for attempting to recussitate such an irrational, convoluted health care system.
Now let's look at another related issue. Why do we continue to support a tradition whereby access to some birth control methods requires a prescription from a physician; a stranger that probably doesn't know much about you, or the drug being prescribed? Moreover, that same physician is financially motivated to prescribe expensive, recently patented new drugs and devices (whose safety and effectiveness are not well known), rather than prescribe generic old drugs and devices (whose safety and effectiveness are well known)? As a result of this wacky system, every few years these new drugs and devices, whose safety and effectiveness were initially declared by the Food and Drug Administration, turn out to be unsafe and/or ineffective. Then, we have those highly paid lawyers, specializing in "class-action lawsuits," taking pharmaceutical companies to court. When the pharmaceutical companies lose those class-action lawsuits and are ordered to pay out huge settlements to the victims, those payoffs are either covered by their own liability insurance and/or passed onto consumers in the form of higher prices. Do you got all that?
In conclusion, the debate over contraceptive covereage is really a sideshow; a byproduct of a woefully convoluted health care system. As much as I'd like to write a convincing deontological argument reconciling religious freedom with reproductive freedom, it's really not the real issue. I thought Kroncke and I articulated the problem pretty well! "In hindsight, did it ever really make sense to set up a health care system whereby fourth-party corporate employers purchase health care insurance for their first-party employees from third-party corporations, which in turn pay second-party providers for health care products and services? Does any other industry insulate buyers from sellers in this way?" So, the conflict between religious rights and reproductive rights disappears if we just dump employment-based health insurance, and replace it with a system where we buy our own health insurance (and health care). Unfortunately, insurance companies, physicians, pharmaceutical companies, and hospitals won't like that new system. They all want us to buy more health care than we really need.
Finally, we must ask the question: Why would President Obama risk politically alienating Catholics, Evangelical Protestants, Jews, and Muslims in an election year in order preserve such an irrational, ill-conceived, and convoluted health care system? God only knows!