Saturday, February 2, 2013

Politically Incorrect Mad Dog: Making Insurance Cover Contraception

What does it say about the college co-ed Susan Fluke [sic], who goes before a congressional committee and essentially says that she must be paid to have sex, what does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex. She's having so much sex she can't afford the contraception. She wants you and me and the taxpayers to pay her to have sex. What does that make us? We're the pimps. (interruption) The johns? We would be the johns? No! We're not the johns. (interruption) Yeah, that's right. Pimp's not the right word. Okay, so she's not a slut. She's "round heeled".[20]

                                                                                  --Rush Limbaugh on Sandra Fluke

Today's New York Times has an article  about efforts of the Obama administration to address objections of the Catholic church and other religious organizations, to refuse to provide funding for contraception through the health insurance they offer employees.

Mad Dog's initial reaction was the Catholic church, after years of shielding, protecting and virtually prolonging sexual abuse of children by priests has lost any moral authority to comment on the proper stance toward the management of sexual behavior. 
The second thought which percolated up through the Mad Dog's foamy brain, was the Catholic church, (and fundamentalist churches from Baptist to AME) hired employees to staff their hospitals, clean their buildings, maintain their grounds who are not Catholic, not Christian, without  regard to the religion of those employees. All the churches know or care about these employees are the names, social security numbers and pay levels of these people. They have contracts with them and wish to know nothing more. The churches do not attempt to convert these employees to Catholicism or to Baptize these employees. The relationship is one of employer and employee. 

How little the Catholic church in particular cared about the behavior of its employees is evident in the hiring, protection and on going employment of pedophile priests over decades.

When an employer hires an employee, however, our society now imposes on that relationship a certain level of obligation on the part of the employer. As an employer, Mad Dog was astonished about how much he owed the employee and society by the mere fact he had hired a receptionist to answer a phone and to schedule appointments. 
Mad Dog had  to pay into a state unemployment fund, so if he fired the employee that employee could draw unemployment payments. Mad Dog had to pay into a retirement fund for his employee if he wanted a Self Employment Pension Plan (SEPP). And Mad Dog paid into a state  fund for injured workers, in case his employee should develop carpal tunnel syndrome using the office computer.  Mad Dog thought, "Gee, I just wanted to hire a receptionist--I didn't want to adopt her."

Now, Mad Dog's grandfather was a die hard labor union man. ILGWU was a sacred name in Mad Dog's house, so Mad Dog has a well conditioned response to want to provide for the worker. And Mad Dog realized no matter how good Mad Dog was at his job, without someone to perform the simple (actually not so simple) task of scheduling "customers" his business was doomed. So Mad Dog could not function alone. He could not ride the range as a free agent; he needed other people, and the more he learned how much other people were necessary to his business, the more his obligation toward his employee made sense.  His receptionist solved problems Mad Dog did not know how to solve or have the time to solve--like when the photocopy machine broke or  when the insurance company balked. And his "customers" experienced Mad Dog's office not just during the time they spent with Mad Dog, but from the first moment they spoke with his receptionist. Mad Dog began noticing how his own perception of other organizations was shaped by the intelligence, or lack of it, on the part of the person who answered the phone.

So over time, Mad Dog realized all those obligations for health insurance, unemployment insurance, workman's comp insurance were simply part of what makes a business work, of being connected to other human beings and providing for them.

Mad Dog had one "customer" who struck it rich in real estate but unlike his two partners who retired to hunt country Virginia to live a Downton Abbey life on their country estates, this man continued to go to work every day because he provided jobs for a dozen people and a living for their families. He put his own financial winnings at risk every day by not folding his hand, by staying in the game.

And Mad Dog looks at the Catholic hospital where he worked for years and recalled that hospital employed more people who were not Catholic than were. From the people who scrubbed the floors to the chairmen of various medical departments, most of the workers were not Catholic. 
That Catholic hospital was happy to take the money of non Catholic patients and their insurance companies.  
One meeting continues to inform Mad Dog: some of the priests in the administration of the hospital complained about having to provide care to recent Guatemalan refugees, who had been admitted through the emergency room but had no health insurance. "Why doesn't the government just send them home?" one priest asked.  It was only after a Jewish doctor at the meeting said, "Wait, am I hearing you say you do not want to provide charity care for these poor patients? These Catholic poor? Did I just hear you say, 'Why doesn't the government send these people back to their own country?' You do know there's a war going on down there." 

So the argument that Catholic hospitals provide charity at their hospitals, out of the goodness of their hearts, runs counter to Mad Dog's experience. The Catholic hospital Mad Dog knew was a business, run like a business and treated its patients like customers, sending them to collection, wringing every dime out of them it could. And it regarded its employees as hired drones, charging them for parking, cutting back on their benefits, whenever it could. For the Church to worry about the souls of its workers when it is asked to pay for health insurance which includes the option for contraception sounds like a concern over money rather than dogma.

Having said all this, Mad Dog has got to admit, it does strike him as a violation of the idea of freedom of religion to force the Catholic church, or other churches, to pay for insurance coverage for contraception, when the church is, for whatever reason, opposed to contraception as a matter of dogma.   If the law required funding for abortion by every health insurance policy, how many Americans would say the Catholic church should be forced to pay for that? The fact is, most people, outside of a few (not all) Catholic clerics believe contraception is a good thing, but that belief should not be forced on the intransigent belief of the Catholic who disagrees.

Suppose the federal government required the Church to pay taxes to support the war in Afghanistan? Is the exemption from paying property taxes and other taxes not a part of the separation of church and state?  If the government requires an employer which is a church to pay health insurance, is that not a tax on the church? On the other hand, if the church is running a business, has the church not crossed a line from being a religious institution to an ordinary business?

And the whole idea of any health insurance plan paying for contraception is pretty new. For the most part,  health insurance plans have not covered over the counter medications (which birth control pills could be)  or treatments which are elective, i.e., not required to treat an illness. It is true, health insurance covered treatments for illnesses caused by behavior employers condemn: smoking related lung disease has to be covered, but until recently, health insurance did not cover nicotine gum, or Chantix or methadone, or any drug used to treat smoking or alcohol or heroin addiction. The attitude was, you have chosen to behave in a way of which we disapprove, and it's on you to find your way out of that bad behavior. We are not going to pay for costs related to that behavior.  We may pay for the consequences of that behavior, but we will not pay for the behavior or its treatment.

To bring it to reducto ad absurdum, one might argue health insurance ought to pay for alcoholic drinks or cigarettes or heroin in patients addicted to these substances who would suffer severe withdrawal should they stop. 

Avoiding unwanted pregnancy is a social good and government should support that, but there are other ways of supporting that--supporting Planned Parenthood, making free or low cost contraceptives available through pharmacies, grocery stores, liquor stores. But requiring Catholic employers to pay for a health insurance program which includes contraception or abortion coverage is a stretch. The strongest argument for making the Catholic hospital pay for contraception is the hospital is a non-religious business, run by the hospital as a business and it cannot impose its beliefs on its employees.  The strongest counter argument is that no business should be required to support what it considers bad behavior--but then what do you do with a Catholic hospital which refuses to cover the homosexual partner of an employee?


  1. Mad Dog,
    Stating that Catholic doctrine is rife with hypocrisy and confused thinking may be politically incorrect but it's also accurate. The Church's position on birth control is a fine example since it doesn't forbid the use of all birth control methods, just the ones that actually work. Practicing Catholics are still allowed to use the Rhythm Method-you know, the ineffective one (and the reason, I believe, that I have so many first cousins..). Birth control is just one of many topics that the Church has a perplexing position on, however ,questionable dogma isn't a trait confined to Catholics. Lift the lid on most religions and you'll find some craziness lurking. So why should employee health coverage be tied to the whims of a religion they may not even belong to. Shouldn't customary coverage be offered and the individual employee can then decide based on their own religious and moral beliefs whether to take advantage of the coverage or not.

    As you point out though, what is customarily covered changes over time, so it is not inconceivable that abortion could at some point be widely covered under health plans. That does bump the no exceptions line of thinking up a notch and I guess I to am ambivalent about requiring that the Catholic Church offer an insurance plan that covers abortion. But that is not the issue at hand-for now it's contraception and I believe it's fine for the administration to attempt to have it covered even if means the insurance companies pick up the tab for the religious institutions. ( ..and hope it doesn't become one more instance of the insurance companies passing on the cost to the consumer but instead remain satisfied with reaping the financial benefits of not having to pay for a pregnancy...)

  2. Maud,

    You are persuasive, as usual.
    The one element which makes me stumble is the idea of cost. Birth control pills should cost only slightly more than condoms, but as usual in our supremely fracked system, pharmaceutical companies are allowed to charge whatever the market will bear. Having said that, what does a month's Birth Control Pill cost? I am told $40 is full price, but through Planned Parenthood and variety of similar sources in the New Hampshire community, it is closer to $20. At the risk of sounding like Mr. Limbaugh, is this too much to ask a citizen to pay on her own? Males who buy condoms are not getting those covered through insurance.
    On the other hand, from a government policy point of view, you would think it would be better to give away BCP's, to remove any impediment to their use you can because unwanted pregnancy is so much more expensive for the government, for everybody.

    Mad Dog

  3. Mad Dog,
    No you don't sound like Rush-you have a point regarding the cost- I was just talking to a friend today about it and she felt the same as you....