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Friday, July 4, 2014

Insurance for contraceptives and abortions?

Honestly, I might just be out of touch.  But today I happened to read two different articles, both of which rubbed me the wrong way in the same way.  First there was this by Elias Isquith in Salon (followed soon thereafter by this, touting Ruth Bader Ginsburg as the greatest justice since sliced bread).  Then there was this by Loren Clark-Moe in the Washington Post.  I know that abortion and contraception are sensitive topics and I sense that they are particularly sensitive for women, which is why I am trying to be sensitive here.  I'd like to ask the question wholly apart from the normative issue of whether one is pro-contraception (I am) or pro-choice (I am, sort of, but I'm also disturbed by abortion).  Isquith seems furious that Hobby Lobby doesn't have to pay for contraception for its employees, just because of some made-up test about closely-held corporations, courtesy of the Supreme Court.  I get (and agree with) some of the complaints about that case -- yes, the Court has told us that corporations are people, but really, do they have religious beliefs and sensibilities too?  But Isquith is really mad at something else -- just the fact that those poor Hobby Lobby employees have to pay for their own contraception.  And that brings me to poor Ms. Clark-Moe -- who considers it a "punishment" that she had to pay for her own $480 abortion.

My question is WHY HAVE WE GOTTEN USED TO THINKING THAT INSURANCE IS SUPPOSED TO PAY FOR EVERYTHING??  Don't we realize that just means the cost of insurance will go up?  Wouldn't it be more efficient to just let us pay for the small -- and routine and predictable -- stuff ourselves?

But that's the problem with things like ObamaCare -- everybody, including the insurance companies, now is motivated to make insurance as expansive as possible, in the sense that the more transactions are covered by insurance, the more the insurance companies stand to make.  It would  have been so much smarter to provide a system where the "uninsureds" got access to insurance for catastrophic problems.  And if we want to pay for their doctors visits too, then give them tax breaks.

[btw I just had a random unrelated idea -- why don't emergency rooms have a bus service that will drive uninsured, non-urgent patients to nearby clinics?  Sometimes it can take forever to get help in an emergency room (I know, I've been there), whereas a clinic is often much faster.  In fact, it could simply be a service paid for by the clinic, since they would get more business as a result.  On check-in at the emergency room lobby, patients would be told how long they might have to wait and how much they'd have to pay for emergency room treatment, and let them know that a van is waiting to take them to the clinic which will treat them much faster and cheaper]

Again, I understand the basic complaint -- since ObamaCare is a law that was duly enacted by the legislature, and since it apparently requires employers above a certain size to pay for contraception of employees, then that's a legislative judgment that can't be overturned unless it's unconstitutional.  And it's pretty obnoxious of all those Catholic men on the Supreme Court to call it unconstitutional the way they did.  But my point is simpler -- since when can't we pay for our own contraception?  And that goes double for Ms. Clark-Moe.

UPDATE (July 5, 2014) ( the next day):  The NYT reports that the Obama administration is trying to figure out ways to work around the Supreme Court's ruling and deliver contraceptives to these women.  The rationale is that without easy access to contraceptives, there are unwanted pregnancies and overall bad effects on women's health.  This is true enough.  But it's still a distribution question.  ObamaCare (from what I understand from the Hobby Lobby ruling) only requires that employers with greater than 50 employees have to provide contraceptive "insurance."  Isn't that a somewhat skewed distribution?  The only people who get access are the people who happen to work for bigger companies.  Often, the people working for smaller businesses need the financial assistance (and that's what free contraceptives are) the most.  If simply giving all women free contraception is a good idea -- and I honestly believe that maybe it is -- then just do that, and stop creating weird and arbitrary arrangements trying to get other people to pay for it.  In the end WE (the consumers and taxpayers) pay for it, in the form of higher taxes and higher prices.

And now I see this from MSN:  This piece echoes some of what I've said above -- that this is just a "bonus" of Obamacare to the already-insured (like the provision allowing kids up to age 26 to stay on their parents' plans).  It says that the free birth control is worth about $269 a year to the women who get it, but interestingly, the article mentions that it does not appear that more women are going on birth control because it's free.  If that's the case, then it's just a simple wealth transfer to a somewhat arbitrarily selected group of women, which specifically excludes the neediest women.

There's a caption here that makes the point ("No, it doesn't cover hip replacements, but you're eligible for free birth control!")


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