Recently, a lot of talk has gone, back and forth and back again, regarding, specifically the Health Insurance Provider Fee (HIPF) and health insurance in general. Amidst all the talk about who’s screwing who and which SOB was lying about what and to whom, and what lies and misprisions to itemize upon the premiums… there begets a certain fuzziness of perspective, an unclearness of focus, and the argument devolves from there. There are some here who might have lost perspective, amid the details, and some here who might have had the wrong perspective (Hi Dan! *waves*) coming into this…
I’m here to help.
Health Care insurance is a large pool where everybody in the pool subsidizes everybody in the pool. That’s it. It’s not difficult. It is, in fact, to paraphrase John Kenneth Galbraith, “such a simple concept that the mind is repelled”[1]
I got paid last on Friday, Dec 27th. My employer deducted my health care premiums for me and my family of four: one beautiful wife, two strapping young sons.. and me. That money is already spent. None of it was spent on me or any other member of my family. I never once, nor did any member of my family, interact in any way with any component of the healthcare industry during that time. Somebody, maybe, got a prescription drug that my premiums helped pay for. Maybe somebody got their hernia fixed, payed for in part by the money my employer deducted and gave to the insurer. Perhaps, some portion of a doctors salary came out of my premiums. At least, that’s the ideal.
In point of fact, the total amount of money deducted from my paycheck for the entirety of last year is already spent and the bulk of it went to somebody else. I’m ok with that. In fact, I’m quite in love with that idea. That is exactly, and only, what healthcare insurance is.
Healthcare insurance is not banking. Many people have alluded to not wanting to subsidize others or have expressed concerns that many people are not paying their fair share. But Healthcare insurance is not banking: you are not stockpiling, storing, squirreling away or otherwise “saving up” for future medical catastrophe. You are not contracting with the insurers for escrow to be spent at a future date. You are, or ought to be, paying for yesterdays catastrophe that happened to somebody else in the certainty that they, or somebody else in the pool, will pay for you if and when it happens to you. Better yet, and cheaper too, you should be paying for somebodies annual visit to a doctor, who’ll then see potential catastrophe and avoid it altogether. I like to think that my premiums helped pay for a smoking cessation program and thus extended a life, or payed for a breast cancer screening and caught it early. That’s certainly better than paying for a mastectomy, but I’ll pay for that also if not caught sooner…
Other than a severe bout of pneumonia in 2009 I’ve been pretty healthy my entire life. Mild asthma but it hasn’t been a problem since I stopped hanging around with smokers. Healthier than I can expect to be for someone whose love of beer is inversely proportional to a willingness to exercise… So I can pretty much say that, up to this point, I’ve given much much more to insurers than I’ve taken out. If I had my choice, that would continue and if I die, many years from now still having paid in more than I’ve taken out I’ll neither regret not having spent that money elsewhere, nor begrudge those upon whom it was spent. If catastrophe does strike and I end up taking out more than I put in, I’ll also be thankful to those who’ll be paying my way, at that point.
What burns me up is the thought that my premium dollars are going to be spent on administrative overhead directed at care denial: the clear refusal to let people into the pool because they will cost a lot of money. But they, most often, cost so much money because they couldn’t see a doctor and, thus, didn’t get a cough looked at, which turned into bronchitis, which turned into pneumonia. One doctor visit, the cost if which is X, is denied and the ultimate care, that my premiums will have to cover anyways (and thus be raised) ends up casting 10x or 100x or even 1000x. I’ve discussed this at length, so won’t harp on it here except to say that it is a sad, sick, cruel and viciously inefficient cycle. It doesn’t need to be this way and I lay the blame for it completely, comprehensively and wholly at the feet of the healthcare insurers.
[1] Galbraith was talking about banking and the original quote goes thus, “The process by which banks create money is so simple the mind is repelled. With something so important, a deeper mystery seems only decent.“
I occasionally notice a lack of understanding of insurance. The Right places a large value on Personal Responsibility. From some view, insurance is the opposite. It is the socialization of risk. It diffuses everyone’s responsibility for bad luck. So maybe they just find it irritating.
In aggregate, though, diffusion of risk is a good thing. If everyone had to stockpile enormous amounts of money to protect herself or himself from every contingency (house fires, pneumonia, auto theft, accidents), we would all have less to live on and our economy would be poorer and less dynamic. In a good economy, after all, the financial risks people take should be on new business ventures not on betting whether they’ll get cancer or diabetes.
I have a lot of right wing libertarian leaning friends who actually want to blow up the system so that there are no more HMOs, they not only oppose public insurance but they oppose private insurance as well. For precisely that reason. This being America, we often times end up trying to socialize via private means, and we then wonder why this blows up and costs skyrocket. It never quite works.
YES! so better to have the government do it. Not just for healthcare, but for college education, and other big life purchases.
Naive empiricism is enough to suggest that government does a better job at health insurance than a regulated market. I have no idea whether that extends to other forms of insurance.
The market really is efficient at encouraging efficiency, but insurance is also unusual. The market for is not like the market for cucumbers.
The last sentence went through various versions before I hit submit. Cucumbers eventually won out over butternut squashes. It was a Pyrrhic victory. The word “it” was a casualty.
Health insurance pays for the costs of medical care. Fee for service allows you to choose your level of risk by applying deductibles, ideally backed by a medical savings account. This remains my favorite form of health insurance, as a dollar spent on premium is a dollar lost forever.
20-odd years ago, the Health Maintenance Organization (HMO) was developed. The (progressive) prevailing wisdom then was that people were too uninformed to make life choices, and by making counseling, health clubs, and wisdom a part of the premium along with ‘free’ checkups there would be an explosion of better health as people were guided to better choices instead of merely paying to offset risk for actual health problems. Yes, it would cost a little more, but the resulting benefit to society would result in lower health care costs overall.
How’s that workin’ out?
Point is, I wouldn’t mind having HMO’s blown up. the fee-for-pay midel should remain available. And I will make my own damn life choices and purchases unless the government is going to tell me what kind of stove to buy, like a GUM Department store?
Our research at Aveus and Blue Cross confirmed this. The vast majority of people surveyed don’t want to think about their healthcare plans and just want to be covered. They don’t want to look at the costs, they just want to know they will get the care they need and that it will be paid for. They don’t want to navigate bureaucracies or paperwork, they just want an easy button. A lot of our marketing to get the newly insured to choose ‘us’ on the exchange was initially to emphasize the ease of cost and the variety of benefits to choose from-essentially that there were lots of choices. Turns out people want less choice, they just want to make one choice and be done with it. They want an easy button. Our new marketing reflects that.
It was interesting work, unfortunately I was totally unprepared for the advanced statistical modeling and skills required and that’s part of why I was let go-and also that they were able to get a 20 year health care industry veteran to replace me at cost.
But largely the research showed, and this included a MA based survey, that people don’t want more choices. They just want someone to make the right one for them. I’d rather that be a public rather than a private entity-particularly since best practices from every other advanced democracy shows that its the single most cost effective way to deliver care.
Certainly in a single payer world you could still choose the HSA/ACO route for yourself-i want educated consumers to get add ons and extra care at cost. But the vast majority of consumers are not educated about this.
But the risk isn’t entirely yours. It affects everyone. It affects your children or your parents if you choose unwisely and are faced with a “pay $10,000 or die” scenario. It affects me if you are uninsured and get into a car accident and are sent to the hospital because the hospital will charge me more to cover what it spends on you. It even affects me if you need to declare bankruptcy due to your poor medical choices and my bank pays me lower interest because it has to cover the loss on your house.
This isn’t a case of you choosing badly and you’re stuck with Betamax videos when everyone else went VHS. Health care is a big thing, expensive, systemic, and very likely to hit the people who bet against it.
Right, and the health care insurers screwed that up too by, A) not deliberately expanding the pool but continuing to shrink it and 2) actively increasing the adminisitrative overhead: so much overhead was added to making the “primary care physician” ( term defined by HMO’s and still with us…) a gatekeeper and a warden and, frankly, an excuse to either bury the applicant in paperwork or default by which care was, again, denied.
If this is such a boondoggle, why did diMasi excise fee-for-pay and insist on HMO’?
I don’t like them, myself. I’m in a PPO, and am constantly asked for referrals – even when the doctor’s office acknowledges that the COMPANY doesn’t need a referral, they say that they’ve had to make it their policy, because the ‘state’ insists on a referral. I question who exactly has created the overhead.
The state does not insist on referrals. I have been in a PPO for years and never had this problem.
n/t
…because liberals have created a system of pooled responsibility.
V3PN does correctly worry about the absence of the usual market forces in setting prices and creating products. Like a lot of conservatives, he donates a fair bit of money. (A number of studies show conservatives donate more than liberals to charity. Most recently encountered this in Haidt’s book.) However, lots of conservatives overestimate how much money gets donated compared say to federal programs. We are nowhere near replacing SNAP with charity.
VPN also really likes the model of health costs being caused by bad choices. In a more theological era, one might even attribute one’s illnesses to having incurred the wrath of the Deity and so everything without exception is one’s personal responsibility.
the Roman Catholic Church is taking over health care in a lot of states. In some places, people have no local, secular alternative. The Obama Administration has to fight it for the sake of people who want and need contraception and abortions. Good thing the Christian Scientists aren’t in the hosptial business!
And don’t worry about the sisters. In spite of the NY Post playing on your heartstrings, the Sisters know how to take care of themselves, and they have their order and the diocese to provide support.
See ProPublica
Hard as this is to believe in Irish-Catholic Massachusetts, Catholics are about 24% of Christians nationwide; various Protestants comprise about 57%. In many states, you would be hard pressed to FIND a Catholic hospital, let alone be oppressed by one.
up other hospitals. For-profit hospitals are increasing. Catholic hospitals are increasing, though not at the same pace. Secular non-profits are in decline.
I knew someone from MInnesota who said there was not a hospital she could attend that wasn’t owned by Church. I can’t find anything to prove that, but that was 15 years ago. She was also a rabid atheist. Here are the states in which Catholic hospitals are the sole providers: CO, TX, KS, ME, WI, NE, SD, IA, ID, MT, AZ, MI, and the forementioned WA. The fact is that it doesn’t take a Catholic majority to have a hospital crop up.
I know you may have to hold your nose, but the link I posted to the ACLU report has the lists.
So in Maine (ME) the Catholic Hospitals are the sole providers?
Here’s a link to Pen-Bay systems, largest provider in the Mid-Coast area – http://www.penbayhealthcare.org/penbaymedicalcenter/service/history_of_pen_bay_healthcare/
Used to be Washington/Knox county, now a corporation. Nary a papist in sight.
If DFW can’t supply links from the New York Post, why should you post from the lying ACLU?
(My statistics on denomination breakdown came from Pew – sorry I didn’t post the link)
is a hospital that is a sole provider for an area in Maine, not the entire state.
I didn’t mean to confuse with what my atheist friend said about Minnesota.
The ACLU details its methodology and is checkable. You could look at the report, for example, and see the definition of sole provider and see where it was applied. The NY Post, like other rags of its ilk, don’t usually make their methodology clear.
Do you have any evidence that the ACLU lies beyond this example? Or was that hyperbole in the service of the war on hypocrisy?
I should have said “sole providers,” not “the sole providers.”
Which I knew to be untrue.
A minority religious faith with extremist views towards women is being allowed to dominate services available to women — believers and non-believers alike.
Am I the only one who thinks they should be part of our public infrastructure? Every jurisdiction in the country is served by public schools. Why can’t every jurisdiction likewise be served by public hospitals? This in no way means Catholics can’t set up their own hospitals just as they do their own schools, but the same rules should apply as they do for schools. That is public money and public regulation apply to public facilities only and the Catholic institutions are on their own.
and secular, but you’d have to get past the fact that Catholic organizations and for-profit organizations have the right to run hospitals and many can say that people can choose to go elsewhere.
It is against the law to deny service on the basis of race. It is against the law to deny antibiotics to children who need them, even if their parents oppose such measures. I see no problem with making it equally illegal to deny specific otherwise-legal procedures on the basis of religious belief.
I’d like to know how many of those “private” Catholic hospitals refuse public funding, turn away publicly-funded ambulances from nearby emergencies, and in a host of similar ways receive public funds.
For years, various organizations claimed an unfettered right to tell people to “choose to go elsewhere”. We changed that with civil rights legislation.
I see no reason why we can’t do the same here.
Not every business offers everything that it could. As kirth mentioned Lowell General doesn’t do cardiac surgery. IF they offer a procedure they need to be required to do it safely and IF they have an ER they should be required to do everything possible to stablize the person, but not offering a procedure is not quite the same as racial discrimination.
We’re not talking about hospitals like Lowell General who choose not to offer a procedure because they lack the resources to do it safely.
We are discussing hospitals who openly cite religious belief as their reason for refusing to perform needed and legal services. I suggest that we most certainly can and should regulate such practices.
As I wrote upthread, a starting point is to cut off ALL public funding for such a hospital. Ambulances can’t go there. No grants. Nothing.
I do NOT want public funds to enable an institution to perpetuate flagrant discrimination against women, and in my view the self-proclaimed religious motivations add a church/state distinction that only strengthens the case.
Absent other resources we should appreciate what they do offer. If they are the nearest hospital and can care for a patient where no objectionable procedures are involved, it would be unconscionable NOT to send an ambulance there. After all healing the sick is a key component of ministry and we should not stand in the way of that. Your anti-Catholic prejudices are showing again I’m afraid. As far as I’m concerned saying, “It’s against out religion,” and “We just don’t want to,” are legally equivalent reasons, or should be.
Picture this – you’re female, it’s 2 AM and you’ve just been raped. You manage to get yourself to the ER of the closest hospital, Our Lady of the Glorious Hereafter. You ask for emergency contraception and they say, sorry, it’s against our religion – there’s another ER 20 miles away that will help you.
Or you’ve been in an accident and you’re bleeding profusely – you get taken to the nearest hospital, this one is affiliated with the Jehovah’s Witness church. You’re going to die without a blood transfusion, which they deny you for religious reasons. See you in the next world!
If any religious institution wishes to open a hospital and serve sick people, they should serve sick people with medically safe procedures and leave their religious objections to such procedures in the pulpit where they belong.
…the blood transfusion should be absolutely required. (Due to that belief I can’t imagine the JWs ever setting up a hospital.) Frankly, sending someone twenty miles away for a pill that as far as I know will be just as effective a few minutes later doesn’t seem that onerous. There’s a balance we always have to strike. For me it’s life trumps free exercise, but free exercise trumps a medication or procedure that can wait just a bit.
Is that your Christian compassion speaking there? It’s akin to raping her a second time – I’m an atheist, but I’d be more Christian than you in this case, I guess.
Joe Lieberman got into massive trouble in the 2006 campaign when he said the same thing about St. Mary’s hospital in Waterbury, CT. He said it’s just a “short walk” to Waterbury Hospital, where emergency contraception would be available. 18 city blocks through one of the worst neighborhoods in the state – making someone who’s just been raped take that walk (where she could easily be abducted and raped again) was rightly seen as unconscionable, and Lamont supporters started calling him “Short walk” Lieberman.
And the fact that you can’t imagine the JW’s setting up a hospital doesn’t invalidate my argument – religious objections to medically safe health care should be banned. If you object to providing health care, get out of the business of providing health care, it’s pretty simple.
I say get her in an ambulance and rush her to the other facility. BTW, my own reaction, the one informed by Christian compassion, would be to give her what she needs on the spot. I’m only saying that I would not require a religiously owned facility to violate its beliefs in this case.
(OK, upon reading your comment again I realize that Joe Lieberman essentially did say send her back out into the night, but I most emphatically am not.)
Look, you’ve lost this argument – religious objections to medical care do not hold up to even casual scrutiny. If you want to be in the business of providing medical care, then you should provide medical care. If you want to be in the business of proselytizing your religion, then do that. But DO NOT mix the two!
It sounds like Lieberman suggested the patient be on her own exposed to the elements and people. An ambulance ride is safe. To me it is a fundamental principle not to require an establishment to offer services it wishes not to offer.
…that organizations in the business of providing health care be required to provide health care regardless of their religious beliefs. Superstitions about magical men who live in the sky and intercede on your behalf when you worship them have no place in the health care industry.
That would be wrong, but suppose we do it your way. We tell the Catholic Church if they set up a hospital they must provide services they object to. The Church then turns around and says, OK we’re a religious institution first and if you are keeping us from healing the sick our way we just won’t do it. Next thing you know – no more hospital and now EVERY patient regardless of need is going to have to find care farther away, especially in areas where it has been pointed out a Catholic hospital is the only choice within a reasonable vicinity. This isn’t at all about superstitions. What they are practicing is thoroughly modern medicine with well-educated licensed practitioners minus a couple of very specific items. The objection you’re making applies better to Christian Scientists than to Catholics. I can’t decide whether the better metaphor is throwing the baby out with the bathwater or cutting off your nose to spite your face, but you are definitely advocating one of those.
They got out of the business. Life went on.
Tom’s point is an important one. In many areas it’s not possible for a large number of hospitals to survive. Catholic hospitals that restrict their treatments in this way are just taking up space that could be filled by hospitals that don’t deny treatments by forcing their institutional “beliefs” on everyone in the community.
We’re talking about the belief system of the hospital administrators, I never once said anything about the patient’s belief or lack thereof. Just like the Catholic charities getting out of the adoption business, if the church decides not to be in the hospital business, so be it – they are the ones cutting off their nose to spite their face, not me.
You say it isn’t at all about superstitions – I beg to differ. Religion IS superstition – prove to me that god is real and I’ll happily change that tune, but you can’t. Religious objections to certain medically safe procedures are entirely based on superstition, and they have no place in modern medicine.
…it’s about teaching and the right to follow it. Superstition is believing seven years of bad luck will follow breaking a mirror. Teachings are about setting one’s moral compass. I still don’t think any establishment should be forced to offer at all something they wish not to. Catholic Charities got out of adoption because they were offering adoptions, but not following the state rules. It is their right to not offer adoptions at all and that is what I am saying here.
…are two sides of the same coin, Chris. Both are superstitions – both are the belief in some supernatural thing that rules your life. Are you saying atheists lack a moral compass? I hope not – this atheist takes serious exception to that kind of talk! If I lacked a moral compass, I might beat you up next time I see you – lucky for you that’s not the case! 😉
You’ve made it abundantly clear that you don’t think establishments should be forced to offer something they wish not to offer. In any other area, I’d agree with you, but not in the area of health care. You’re right when you said above that Jehovah’s Witnesses don’t set up hospitals, but what if your EMT is a JW and you need the transfusion started right away at the accident scene? Would you be content with dying on the way to the hospital because the EMT has a moral objection and didn’t want to offer you a transfusion?
As a health care provider, your moral compass should dictate that you should provide medically safe procedures without regard to your religious convictions. If you can’t do that, then you need to find another line of work.
What I am saying is that for many religion is the source of morality and to simply dismiss it as superstition betrays a lack of understanding as to what religion is. It goes so much deeper than mere superstition.
Religion is a system of control – when the Roman Catholic church dominated the world, it was called the “Dark Ages”, remember? In order to maintain control, they tried to keep the world ignorant, to the point of torturing Galileo because he dared report what HE SAW WITH HIS OWN EYES! How very moral of them, right? That must be part of that deeper message that I don’t understand…
In the Dark Ages much of Europe was not yet Christianized. The Renaissance saw the height of Catholic influence. Galileo suffered only house arrest and the Church even allowed for the possibility that he was on to something. In the better late than never department John Paul II apologized, and no human institution is going to be perfect, but the teachings about life are consistent and sincere. Laying the Inquisition at the feet of the modern Church is like holding modern Germany responsible for the Holocaust, modern Japan for Pearl Harbor, or even the modern US for slavery.
On the inquisition anyway, which somehow has entered a debate about health care coverage. And also suggest that a political forum, or at least this thread, might not be the best place to have these kinds of broader religious discussions.
To take it a step back and examine it from a policy standpoint the Church has a vested interested in having it’s religious liberty not infringed upon. We are all in agreement that the compromise HHS mandate is NOT an infringement by any means, like the USCCB and Beckett Center are arguing, and furthermore we are all in agreement that a public option in the least and a single payer system at best would eliminate our patchwork health care system and replace it with a far more cost-effective, efficient, and equitable one.
At the end of the day the U of C, in a private health care system, can turn away gun victims since it would rather spend the money on shiny new research centers than be known as a dumping ground for largely black victims of gun violence in Chicago. At the end of the day the Catholic Church does not want to perform elective abortions, which is something I understand and defend, but it also refuses to perform medically necessary abortions and provide basic emergency contraception services-let alone allow it’s own employees to freely get contraceptive coverage in their health insurance. All of those things are problematic, but the conflict of interest and fault does not lie exclusively with the Catholic church but with the entire system.
I would argue private health care companies, like my alma mater, perform egregious and unjust acts within the health care system. We were barely able to pass a ban on denying coverage to those with pre-existing conditions, a gross medical malpractice that was perfectly legal and some still argue, the logical thing to do in a free market health care system. Rather than try to shut down some of the few hospital systems that don’t turn away the poor or vulnerable, it is better to find allies within that system for the goal of creating a more just and equitable system over all. In a single payer system, as I’ve mentioned time and time again in this thread, this conflict of interest is non-existent. Free market healthcare is an oxymoron, and these kinds of fights are sideshows compared to that one.
…then no, Galileo wasn’t actually tortured, he was taken to the dungeon and they showed him what would happen to him, most likely by demonstrating on their current prisoners, then he was placed under house arrest and told to recant or he would suffer the same fate.
So you wouldn’t have a problem if I took you to a dungeon and showed you devices that would crush your fingers, rip out your fingernails and otherwise mutilate you, most often through your anus or genitalia, and then placed you under house arrest until you agree that rape victims should get emergency contraception?
I had not heard that and double-checked before writing this comment. He was originally sentenced to actual imprisonment which was commuted to house arrest the following day. Torture was mentioned as a possibility, but from what I can tell rather half-heartedly since the Pope had until very recently been an ally and the cardinals did not all agree, which was unusual. Anyway, we’re getting way off topic and I didn’t come here to defend the 16th century Catholic Church.
Which of their sincere, consistent teachings about life gave them the moral authority to hide child rapists among the clergy?
I don’t think anyone here is defending the actions of the cover ups or the abusers, and frankly the vast majority of conservative and liberal Catholics alike are appalled and upset these guys didn’t get prosecuted. I know I am.
Chris claims that the church refuses to supply emergency contraception because of their moral beliefs and sincere, consistent teachings about life and its meaning. My point is that they don’t have a moral leg to stand on, given their long history of abusive behavior right up to the present day.
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They still have a right to adhere to those teachings, whether the rest of us judge them as moral or not. The claim we who are prochoice often rightfully make is that the government should not impose morality on those who dissent, but it works both ways. Government should also not impose morality on a church that believes otherwise.
I won’t defend how the Church handled that. They believe life should be protected from conception to natural death (though apparently that means don’t stop a potential life either). Thus no abortion, euthanasia, or death penalty. It is in that they are consistent, though I of course disagree.
You make fine points Christopher, and I appreciate your consistency on these issues. I also disagree with my church on this issue. That said, the consequences of the status quo are also difficult to grapple with.
I do feel there are instances though where, as the critics here are arguing, the Church’s morality does not apply to the non-church going public that attends their facilities which do receive public funding. I think that’s the real issue here, and I am unclear what can be legally or constitutionally done to mitigate that. Single payer solves the problem, but its’ a ways off. I think creating mechanisms that enable the people caught in this trap to get effective and immediate care somewhere else might be the trick. I also think the Church would still protest, over covering the costs and having to refer, but I think then they would be protesting too much-as they are over the mandate compromise.
There is a balance though, just as there is with free speech, and it will be up to the public to determine how endangered it is. I do not share the zeal or blase attitude about shutting down Catholic hospitals that the critics have here, but I also do not share your attitude of keeping the state entirely out of it. It should take more than a courageous nun risking her own position to ensure that life saving treatment is not withheld in a public institution. Since abortion is a constitutional right, it is going to be difficult for the church to have it’s cake and eat it to-mainly get federal funds but then inequitable serve the public providing them while keeping it’s hands entirely clean.
It will have to at least refer and ensure the patient can receive the treatment somewhere else, in instances where it’s the hospital of last resort, I am not sure how that would work to be honest. I don’t have an answer. I’m profoundly uncomfortable with the state dictating to a religious institution that it must perform actions that are contrary to it’s faith, but I am just, if not more, uncomfortable with the idea of a rape victim being denied emergency contraception she would get anywhere else at a hospital that is ostensibly just as publicly funded as any other, simply because it has a crucifex in the hallway. Ending federal funds or shutting down the hospitals would have profound consequences, similarly, letting the church dictate to the state the terms is also a terrible idea, so short of the kinds of compromises we saw on conscience clauses and pharmacies, I am not sure how we untangle the knots in a pre-medicare for all environment. I am entirely confident that Vermont won’t have this problem after 2017.
christopher — it’s true that the Catholic Church might well get out of the “hospital business” if forced to proved emergency contraception, etc. In fact, I’d say it’s likely.
But the hospitals themselves won’t disappear. They’ll be sold to some other organization, for-profit or not-for-profit. The prices may change, the specialties may change, some staff will certainly turn over. The hospital won’t just disappear though, particularly so if it is the only one in the area.
And will not expect to get reimbursed for any services, right?
We’re too close to the right margin.
Ambulance should be paid for same way the treatment itself would have been, either through insurance or as an ER matter, though of course in theory everyone will have insurance now.
We’re talking about a rape victim, not somebody who got a papercut. Good grief.
How does a woman without a car get to another hospital twenty miles away?
I am sorry, if you want to be in the hospital business, you must be required to offer all services that are applicable to the departments you operate. If you cannot do that because of you religious beliefs, then you should get into a different business.
These hospitals are not government-chartered monopolies, right? If they were then I would be more inclined to agree that the government of the respective jurisdiction would have the right, maybe even obligation to say if we grant you this monopoly then you had better provide certain things. Otherwise, religion or not, I still say it’s not for the government to decide what a private establishment provides or does not provide except in the most extreme of circumstances.
Hospitals are heavily regulated businesses. If a religious organization wants to run a restaurant, it should not be able to cite its religious beliefs to justify violating health and safety laws pertaining to restaurants. Same if it wants to construct housing for sale. Likewise, when it willingly enters the hospital business, there is no “free exercise.” First Amendment cases in this area have been clear that laws applicable across the board are not in violation.
…that whatever services are provided should be required to be done safely. We should require restaurants to adhere to health codes, but not tell them what to include on the menu. In fact I know of restaurants whose menus strictly adhere to religious dietary laws. If a Jewish restaurant wants to be kosher or a Muslim restaurant halal who are we to refuse to license them based on that choice?
Hospitals are not restaurants. We don’t have hundreds of them in a 10-square-mile area and people are generally in a more desperate situation when they go to the hospital. A lot harder to “just go to the next one” in the hospital context than the restaurant context. This whole idea of, private business, don’t tell them what to include on the “menu,” is absurd in the hospital context. It’s one thing if Lowell doesn’t have the funds for cardiac surgery, or NE Baptist doesn’t have an emergency room, period. Here we’re talking about dispensing a pill, something they do thousands of times a day, and they’re refusing to do it for no other reason than their own religious doctrine.
Plain and simple, a hospital doesn’t get to have “beliefs” that it imposes on the public. Just as Catholic Charities was not permitted to discriminate against same-sex couples in placing children for adoption. Even your proposal of public hospitals (which do exist in some places in the U.S.) doesn’t solve the problem. You’re going to say, at 3 AM, oh, gotta go to the one down the road 20 miles because this one doesn’t do that pill.
It’s easy for me to say distribute the darn pill already, but I still don’t think its right for any reason, and especially free exercise grounds, to say thou shalt carry x product.
The free exercise claim, constitutionally, is a joke. And there is no reason not to carry that “product” beyond religion. Refusing to carry a simple pill that all the other hospitals and clinics carry as a matter of course, purely because of religious beliefs, should not be tolerated.
…and as I said, we just don’t want to works for me as well. The intolerance I’m sensing regarding religious belief and practice is entirely unprogressive.
…at the end of your nose. You are absolutely free to worship any deity you want to worship – but when your religious practices infringe on someone else’s rights, your religious practices rightfully lose. A rape victim’s right to medically safe health care – or an accident victim’s right to medically safe health care – trump anyone’s free exercise of religion, sorry.
The Supreme Court has been quite clear that laws that don’t single out a particular religion for special treatment, but rather are generally applicable to all, do not violate the Free Exercise clause. We’ll see if this Court, which lets little get in the way of its ideology, throws all that away in the Hobby Lobby case this year.
In any event, a hospital should not have “free exercise of religion.” The owner of a hospital is a corporation, perhaps for profit, perhaps not for profit. Either way, a corporation. For example, Catholic hospitals in the Boston area, right from the archdiocesan website:
You cannot have it both ways: form a corporation to confer all the benefits of that form over individual ownership, but still claim intensely personal rights like the exercise of religion. Your repeated invocation of “free exercise” thus strikes me as wholly out of place in this discussion, and your take on this puts you to the right of the 2005 version of Mitt Romney.
An owner of a restaurant who claimed that his or her religious beliefs required them to serve raw milk would NOT be allowed to do so.
Period.
Realtors and housing builders attempted to block the sale of housing to minorities for decades. Many of them claimed “religious beliefs” (among others). Such practices are, correctly, long-since illegal.
The provision of medical care is among the LEAST appropriate domains to tolerate the imposition of religious belief on the public.
Pasteurization is a safety issue and as such should be required for the public sale of milk. If medical procedures are provided they must likewise be done safely.
Discrimination against various minorities is also unacceptable, especially on something like housing which is arguably a human right. If medical procedures are provided it must be without regard for the demographic characteristics of the patient.
However, simply deciding not to do something does not rise to the level of these examples.
You either aren’t making sense or you are even more self-centered than you seem. Do you have ANY empathy for rape victims AT ALL?
As you can perhaps tell from the comments, a number of disagree with your last sentence, which is purely a matter of your own opinion.
The solution to this problem is not to demean the religious beliefs of people in various faiths, or to argue that they can’t operate hospitals, the solution is to do, as the administration did, as even an incompetent person like Gov. Blagovejich did, and find compromise solutions. Of course the bishops will reject it-but in doing so we can then say they are the extremists who rejected moderation. As I stated elsewhere in the thread, what jury wouldn’t penalize a Catholic hospital that allowed a middle aged women to die rather than give her a medically necessary abortion?
Framing this question as one of secularization vs. religious freedom is not the way to win the fight. It’s a question of balancing religious freedom and public health and there is a right way to do it-the way Sen. Kennedy championed when he was alive, the way Blago did it in IL, and the way the Obama administration artfully did it on the mandate issue. And overarching, let’s get any employer out of the healthcare business by enacting universal healthcare. Then we can have a true compromise where public health is a right and not a privilege and Catholic hospitals will only get funding for the services they provide that the state does not as is the case in Britain and it’s NHS. I think all of us can put aside our differences for that goal.
I don’t think I’ve demeaned the religious beliefs of people in various faiths (well, maybe a little), and I haven’t argued that they can’t operate hospitals — so long as they are willing to operate those hospitals within the constraints of reasonable regulations.
I enthusiastically agree with your last paragraph, and yet as I wrote upthread we must still do something in the meantime. In my view, our collective experience with civil rights is a reasonable model for “balancing religious freedom and public health”.
I’m quite certain that a legion of hotel and motel operators, real estate brokers, and restaurant owners continued in their strongly-held personal beliefs that whites and blacks should not sleep in the same building, live in the same neighborhood, or eat in the same room even after the civil rights legislation of 60s was adopted and enforced. Sadly, religion (specifically Protestant Christianity) and the Bible were frequently cited (sound familiar?) as justification.
Yet those same people were forced to hold their noses and obey the law — or close their establishments. While there was much wailing and gnashing of teeth about all the awful consequences that would unfold (not enough hotels, real estate values plummeting, no places to eat), the truth was that — because this was a minority view in larger society (even in the south) — few if any of those consequences actually came to pass.
Christopher has expressed fear that he won’t be able to get treatment for his heart attack. I note that stomv nailed the reality — when a Catholic hospital “closes”, another organization buys and operates the facility.
In fact, I think this is the real truth behind this issue. I think the proponents of this misogyny KNOW that society left these attitudes behind GENERATIONS ago. I think they, correctly, view themselves as holdouts, bastions of the faith, zealously guarding these bizarre restrictions in the full knowledge that when they pass (as they must), the restrictions will pass with them.
So the truth — which I suspect even Christopher will admit — is that a Catholic hospital that chooses to close rather than conform to regulations requiring that it perform emergency contraceptive services for rape victims will be replaced by another organization that WILL provide those services. Both will provide the cardiac care that Christopher expressed concern about.
What WILL happen is that these regulations will mean that most women will have full access to the full range of medical care options that they are entitled to.
That outcome is why the zealots of the RCC, and those who defend them, are truly concerned. And that outcome is inevitable — because it is the RIGHT outcome.
…in terms of civil rights, between refusing a service you generally provide to certain people based on who said people are, categorized by race or sexual orientations, and not providing the service at all. If the hospital because of some racial prejudice and desire for a master race said we’ll abort all the colored fetuses you want, but not white babies that would be more analogous to what you describe.
People can believe whatever they want. People of faith can operate hospitals. What they shouldn’t be able to do is run the hospital – a multi-million-dollar business concern with a major impact on the public welfare – in a way that forces those beliefs on the general public.
The Plan B compromise is silly and clearly won’t work when an entire hospital won’t prescribe a pill. Hospitals are scarce. And the constant Obama compromises have been absurd. Moving the goalposts each time. We’ve now seen (1) churches don’t have to pay for contraception in their insurance plans; (2) then church-affiliated universities, etc. don’t have to; (3) then they didn’t want to spend a single premium dollar on any plan that covered contraceptives. Done. Let’s create separate plans that the insurance companies have to pay for. This is offset by reduced fees charged by the government. In other words, paid for by the rest of us who aren’t being catered to. And is it good enough? No. We still have about ten federal lawsuits going, litigated by a single group (Becket).
Taxpayers (real live human beings who are protected by freedom of exercise) don’t get to do this: oh, my religion abhors war, so make sure none of my tax money goes to the Pentagon. Enough of this nonsense. What you call smart compromises I call foolish surrenders. The bishops already look extreme but they’re still getting their way. What have they given up in the “compromises” so far? And I don’t see a jury verdict after a woman dies, as in Ireland, as a success. Not to mention, that if the Roberts Court adopts the Hobby Lobby standard, there won’t be a jury verdict because religious freedom.
I’ll retract lumping you with with John who did spout some Dawkinisms while you two refrained and were respectfully disagreeing.
I think all of us-Christopher included-agree on the merits. Nobody is actually defending the theology here-and all of us want public healthcare precisely so that individuals get the healthcare they need without any undue burdens from employers, insurance companies, or bishops. Having established that I have a strong disagreement on two points:
First from Tom
Until you provide empirical evidence for this assertion, that’s all it is. Non-profit hospitals may get into the game, but their resources are stretched as it is, public control, while optimal on policy grounds, is politically untenable, which leaves us with for profits and insurance companies grabbing up the bulk of the hospitals and possibly* offering lower standards of care to underserved populations.
As Fenway noted elsewhere, they did shut down rather than do adoptions in MA. In IL, the adoption wing renamed themselves and cut off affiliation but are hard pressed for funds. The gay adoption case though does show the legal knots we are tied into with our patch work healthcare system. Had we nationalized when Britain did, before Catholic hospitals picked up so much of the slack, particularly in poorer and immigrant communities, we wouldn’t be in this mess. But I would argue they would close rather than provide contraceptive or emergency abortion services, and their loss would hit the poorest communities the hardest.
I also don’t see the ACLU suing the University of Chicago to re-open its level 1 trauma center to help out the predominately poor black victims of gun violence on the South Side. What hospitals do they go to? Northwestern on the North Side and Holy Cross run by Carmelite Nuns on the South Side. If those nuns close that hospital no private sector force would take it over, it’s in an awful neighborhood and only serves poor patients. It’s not a money maker but a mission. And this is the kind of discrimination that will continue if we have a private health care system.
This is why compromise is important. I would argue the bishops look like morons demanding too much, and Obama covered himself sufficiently so that these legal challenges will lose. And then the hospitals can go back to doing what they do, and the workers can get their reproductive health coverage without any burden while the Church doesn’t have it’s “hands dirty”. I am sure some similar compromise can be forged on the other issues, as Ted Kennedy did. And I am sure the more dogmatic Bishops may reject it still, but they will now appear to be the extremists and they will lose.
…how often and how quickly religious complainants in my mind have gone from sympathetic to petulant. I think the administration has tried their best to accomodate, but then the religious side says no compromise. Personally I think that if a religious body owns an establishment they should be given reasonable leeway, but individuals or non-religous entities should not use their religious beliefs as a shield. In other words, no Hobby Lobby scenarios.
I have plenty of empathy for rape victims and personally would help them in any way I could, but this isn’t about me. In case you haven’t noticed I am defending the rights of others to make decisions I personally would make differently. That doesn’t seem self-centered at all.
Because there is absolutely nothing with adhering to kosher/halal rules that violates health codes. People don’t need to go to restaurants for health emergencies, and they don’t pay for their meals with insurance. No one has an expectation of walking into a restaurant and being able to be served arbitrary cuisine.
You are just making lazy anti-intellectual arguments at this point.
Might there be a drugstore closer than 20 miles?
And I would be curious to see if there are ANY JW hospitals that deny transfusions. Anywhere.
And if the nuns have to offer abortions, then Lowell General can jolly well begin to offer cardiac care as well.
What about the EMT who is a Jehovah’s Witness and refuses to start life-saving transfusions, Porcupine? Would you defend their right to not begin your transfusion as you bleed out on the ambulance ride?
…that there isn’t another EMT who could do it? If I had a problem with blood transfusions I’d never become an EMT. In fact, why would you ever license an EMT who would not do something that common, basic, and necessary? Before you say it, because I know you are thinking it, the reason the same does not apply to what we’ve been discussing is those things are very specific and less significant part of the work, whereas blood transfusions are often THE job, plus they are lifesaving, which in my mind means different rules.
Why should we license hospitals that refuse to provide common, basic and necessary medical care to patients in need?
Blood transfusions are a common element of life saving while there is a whole host of things that can be done without the procedures and medicine in question here.
…is a common element of care for a rape victim, Chris. You lost this argument days ago.
…and still does not have the lifesaving aspect of a transfusion. You don’t have to convince me that emergency contraception is the best course of action, but I haven’t lost because you declare it so. This is a philosophical debate in which there is no winning or losing, though I suppose if SCOTUS gives a definitive answer that side can claim to have legally won. I’m not conceding, but I’ve run out of new things to say and stand by all that I have said on this matter.
Emphasis mine. Source: http://www.nwlc.org/sites/default/files/pdfs/ECsexualassaultAug09.pdf
Now please tell the “Christians” at these hospitals that the Christian thing to do is to provide medical care when it’s needed. Sending rape victims on ambulance tides to get needed care elsewhere is akin to raping them a second time, and it’s not Christ-like AT ALL.
I’ve said multiple times my own decision would be to provide it, but the Church won’t violate its teachings and you could get to the next facility in the 12-24 hour window.
Because I think a woman who has been raped or is suffering from an ectopic pregnancy has a right to be treated by a recipient of public funds, I’m “anti-Catholic”? Sorry, but your own religious myopia seems to be showing. I do not believe that religious belief excuses misogyny.
I do plead guilty to being “anti-religious” when it comes to medicine. Of all the areas where religion and superstition has done the most harm to humanity, medicine surely ranks near the top. Of all the areas where objective science has yielded the most benefits to humanity, medicine surely ranks near the top.
In my view, religious beliefs should have NOTHING to do with the availability of health care — especially for non-believers. I believe that society has an obligation to make health care available FOR EVERYONE, and I have very strong objections to public funding of providers who are unwilling to meet that obligation.
To your last point, the two are most certainly NOT equivalent (not to mention that neither should be acceptable). Surely you know as well as I that there is a very long list of differences across a wide spectrum of behaviors. I’m not allowed to decline paying property taxes because “I just don’t want to”.
Finally, the rub with “absent other resources…” is that the effect of what you propose is to provide an obstacle to the creation of those “other resources”. I disagree that “we should appreciate what they do offer”. We do not, for example, allow faith healers to call themselves “doctors” and receive public payments — nor should we. I’m sure that many people believe they have benefited from, for example, Reiki Healing”. Nevertheless, I do not believe that we should “appreciate what a [Reiki healer] has to offer” and pay public funds to that healer.
I similarly do not believe that we should license or direct public funds to a Christian Scientist “Practitioner” who believes that illness is an “illusion” born of “mistaken beliefs” and therefore has a religious objection to the use of antibiotics or other standard medical practices. We do not excuse such rubbish out of a misguided attempt to “appreciate what [they have] to offer”, nor should we.
We already have strict licensing requirements for hospitals. In my view, those requirements should specifically NOT allow practitioners to exclude treatments for “religious” reasons.
I hope we can agree that the real way around this problem is public hospital systems like we have public school systems. Meanwhile, what hospitals do safely provide we should allow and if they are being paid through Medicare, Medicaid, CHIPS, Obamacare for certain procedures, that should not be contingent on their willingness to provide others. If I had a heart attack and wound up at a Catholic hospital, I wouldn’t want the government to refuse payment because the hospital does not do abortions which have absolutely nothing to do with my heart attack.
We do agree that public hospital systems are a better answer. Perhaps some day we will get there. In the meantime, we must deal with the system we have.
The unfortunately reality is that the Roman Catholic Church does, in fact, set up hospitals (would that they would follow the lead of Jehovah’s Witnesses and Christian Scientists). Hospitals that, in today’s environment, block other hospitals from being created. Hospitals that, in today’s environment, refuse to perform crucial and legal procedures claiming “religious belief”.
Once again, you seem willing to impose your personal beliefs about what procedures are important on those who do not share your beliefs. For the rape victim discussed above — who, for the sake of discussion, has no heart condition — the availability of cardiac services is irrelevant.
In my view, it is just as important to provide emergency services to women who have been raped as to provide different services to men who have heart attacks.
We should not allow Jehovah’s Witness hospitals to deny emergency blood transfusions. We should not allow Christian Science hospitals to deny emergency antibiotics and regular emergency care. We should not allow Catholic hospitals to deny emergency women’s services.
In my view, the only justification you offer amounts to “I’ve got mine, so screw them”. That’s just not good enough.
How and why would the creation of a Catholic hospital block the creation of others? That doesn’t seem right at all.
To be clear, these are not my personal beliefs, religious or otherwise. If I were to set up a hospital I would offer all of these services we have been discussing without the slightest moral hesitancy. In fact my own view of what it means to be Christian would pretty much obligate me to do so. I am taking the tack similar to words attributed to Voltaire regarding speech, to paraphrase I don’t agree with your religious objections, but I will defend your right to act upon them.
I think we are all talking about hypothetical situations without examining actual examples, percentages, etc. I think Christopher underestimated the burden on a woman in that situation to have to go to a desperate hospital while Tom, Fenway, and John are far too blasé about losing a critical component of the American healthcare system. My point is the Obama administration came up with a sensible compromise regarding the insurance issue-one the Church should stop wasting time and money fighting and one that should be satisfactory to women’s health advocates. A similar compromise should be conducted regarding conscience clauses and hospital care.
For all his faults, Blago required pharmacies to cover the morning after pill, RU486 and Plan B. He did state that a pharmacist can opt out of filling it so long as another is able to do so. That’s a sensible compromise. No healthcare worker should be forced to perform a procedure against their conscience so long as someone else is able to ensure the critical care is delivered. I don’t see why a single payer system couldn’t solve most of these issues as it does in Britain, and we could gradually transition to a system where Catholic care can be protected without impeding the general welfare.
I think civil liability rather than any mandate from the state may force them out of some healthcare specialties. I know if I had to choose a life saving medically necessary abortion to save my wife’s life I wouldn’t want some celibate bishop making that decision for me. The vast majority of Americans, including pro life Catholics, wouldn’t want that. What jury would side with the church?
A hospital, like most other businesses, depends on a mix of core bread-and-butter services and less frequently used and much more lucrative “dessert” options. Many restaurants break even on entree costs, and make their money on appetizers, drinks, and desserts. Authors write “pot boilers” (the very term refers to a work written to make money rather than for its literary merit) so that they can occasionally also create more artistic works.
Microsoft was, for decades, a master at maintaining monopoly status in application domains by providing, for free or nearly free, applications that did the easy 80% — thus cutting the legs out from under the competition that was thus forced to focus its marketing on the remaining 20%. MSProject, for example, did everything a purchasing agent thought necessary for project planning (project managers knew better, but purchasing agents make the “buy” decision). It met virtually all the bullets of every “requirements” specification. It did all those things while being essentially useless (or worse) for complex projects that actually needed a project planner. As a consequence, the offerings that DID meet that need were unable to get ANY revenue from the bulk of the market (“I don’t need more than XYZ, why should I pay you when I get XYZ for free from Microsoft?”). The result was that a real, functional project planning tool came at a cost of thousands or tens of thousands per seat. A generation of project managers either made do with Microsoft or did nothing.
The hospital business is similar. In many regions, there simply isn’t enough demand for the bread-and-butter services that keep a hospital alive to sustain more than one. That hospital ends up exercising essentially monopoly control in its region, because it’s the only game in town.
Like Microsoft using its monopoly power to simply not offer the functionality that it found hard to develop, that hospital ends up using its monopoly power to impose restrictions based on its religious beliefs onto an entire region.
That is “how and why [] the creation of a Catholic hospital block[s] the creation of others”.
How much do you think it costs to build a hospital? Is anyone going to build a hospital near another one that is already adequately serving the community? Of course not.
The solution to this problem is to build a better public health care system. This is one of the many thousands of good reasons why single payer health care is the best policy solution to this problem rather than the oxymoron that is the free market healthcare system.
We are all progressives.We are all in favor of single payer. I would argue Catholic hospitals are put between a rock and a hard place. Most of them were founded long before Social Security, let alone Medicare, and they were the first hospitals to serve immigrant and indignant communities at low cost. Some of them now are clearly money making ventures, others have been ditched by archdioceses (such as Boston’s) trying to lower costs, but they serve a purpose, one that is essential until we have a truly single payer system.
They also have a right to conduct medicine in accordance to their beliefs, within reason. Establishing that boundary will require working with the Church to achieve compromises. Under Cardinal Bernadin and Senator Kennedy, this was much easier, but unfortunately even though the Chaput’s have been shown the door we still have Dolan giving cover to Ryan’s budget and blasting the administration over it’s already generous compromise with the Church. So this is difficult. But we have a new Pope, we also have a growing consensus within Massachusetts that a public option is a viable next step in the evolution of our experiment in universal healthcare. Let’s fight for that, let’s also provide free reproductive healthcare to anyone that wants it, let’s have the state continue to fund planned parenthood and other reproductive services, and thus fill the gaps the Catholic hospitals cannot fill.
…that they are NOT adequately serving the community because there are some things these hospitals refuse to provide. You build one for the same reason you establish any type of business close to a similar one – you think you can do better. I believe I have heard that Walgreens often locates very close to an existing CVS for just that reason. If a full fledged hospital is not feasible someone could set up a clinic to focus on the services not provided by the hospital.
Other than these issues, they may well be serving the community adequately. Particularly in that context, it’s not such a simple thing to just open a competing hospital across the street.
fighting for legislation that would get people who need treatment into hospitals and not to allow some hospitals to throw them out.
Like I said above, as is the case for education, the existence of universally available public hospitals would in no way impinge upon the ability of the Church to set up their own, nor should it. All hospitals should adhere to basic safety regulations, but only the public ones would get public financing. If this were to come to pass then the Catholic hospitals would be absolutely correct in saying patients could go elsewhere (ie the public hospital in their jurisdiction).
I don’t see an easy answer to the Washington State issue, do you?
Get’s the church and any employer out of being an insurer. GM should be in the car business-not the pension or health insurance business. Similarly-the Catholic church should be saving lives and souls-not worrying about who is paying what co-pay. Single payer solves that problem.
In Britain, their Cardinal is choosing to opt out of NHS funding voluntarily to avoid this and make up the difference. Catholic hospitals could easily do that, if they can get conservative billionaires to pony up for cathedrals they can get them to pony up for theologically sound healthcare for the needy no?
The administration is insisting upon their inclusion.
…is that the administration offered them an out and their complaint comes down to having to do additional paperwork.
It’s not just in Washington. It’s nation-wide. In some places, the Catholic hospital is the only hospital serving the area.
Here’s a report by the ACLU.
We have a responsibility to build public hospitals there. In Britain the NHS has a monopoly on reproductive and neonatal care- the Catholic Church opted out of it entirely rather than tie itself in dogmatic knots.
I don’t see why it’s hard.
Hospitals, physicians, nurses — the entire supply system — are heavily regulated. It is already illegal to turn away patients based on the color of their skin. It should be similarly illegal to refuse to perform legal procedures.
By the way, what is the RCC position towards vasectomies?
…unless one’s life is at stake or would cause serious health complications. Any private establishment should be able to say they offer services a, b, and c, but not x, y, and z.
Hospitals commonly limit the procedures they will perform. Lowell General doesn’t do cardiac surgery; they’ll send you to Lahey for that. It might be difficult to enforce a ban on religion-based limits on procedures, because you’d have to prove intent.
for inferring intent, in discrimination law.
Upon a prima facie showing (here it would be (1) you’re a licensed hospital; (2) you don’t offer X or Y medicine or service), the burden shifts to the hospital to justify not offering that exclusion. The patient/regulator/whoever can argue that proferred justification is a pretext, and the real reason is religion-based antipathy to the particular service at issue. In the case of cardiac surgery, a legit reason would be pretty easy to show. In the case of contraceptive pills, it wouldn’t.
Or just say, look, you want to be legally authorized to run a hospital in this state, you’re going to have to offer A, B, and C.
This article is particularly interesting.
It’s like how I feel regarding the anti-gay policies in hiring and firing. We can argue legally that they have a right to set these policies. Sure. We can even argue theologically if these policies conform to scripture, reason, or tradition. Sure. But we cannot argue-even the defenders-that these policies are not enforced in an arbitrary and ham handed way that actually hurts the faithful as much as the non-faithful.
I think a fair standard could force hospitals-which get federal funds and are in the business of saving lives-to perform clear life saving procedures. But I respect conscience clauses and the right to practice mission in accordance with faith based guidelines-so long as that practice does not endanger the health and welfare of the general public and so long as they don’t ask for special treatment. Pretty hard to argue Obama is killing religious freedom when they have every right to turn federal money back and run without any strings attached. Pretty unfair for a non-profit religious hospital to be held to lower standards of care than a private, public or non-Catholic non profit counterpart.
it’s simple, not easy.
Religious exclusions should be ended, I agree.
I’m pretty sure I sat through homily where vasectomies were a no-no. Canon law requires letting nature take its course. I also sat through a homily saying it was sinful to take extra measures to conceive. Totally f-ed up.
I’m not aware of any of these institutions objecting to offering health insurance that covers vasectomies — if they did, they’d have to refuse virtually EVERY health insurance plan.
You’re right, it is totally f-ed up.
It’s a mortal sin.
Generally, mortal sins are the big Ten. Almost everything else is a judgment matter.
Abortions and whacking off, however, these are mortal sins.
…isn’t having sex the moral equivalent of whacking off? You may not be flying solo, but you won’t be doing any procreating with it – seems both parties would get at least a venal sin out of that…;)
… bloggers say the darndest things!
And besides, as an atheist, I have no moral qualms about most any sexual activity, as long as no one is harmed!
… but I wasn’t referring to anything having to do with sexytime as such. I was referring to your use of the term “moral equavalent” when discussing what is, and is not, sin. Yes, technically, it’s not incorrect, just glistening with comic irony.
Sterilization of any kind is a mortal sin unless it is part of a procedure to protect the health of the whole body, such as removal of organs as part of cancer treatment.
Mortal sins require three things:
1. It’s a serious matter
2. It’s committed with knowledge, both of the sin itself and of the gravity
3. It is committed deliberately, with consideration.
Procreation is clearly a serious matter in the Church, and vasectomies are deliberate actions following significant consideration. The only way a vasectomy isn’t a mortal sin is if the dude didn’t know it was going to happen, or didn’t know it was a sin at all. Both of those are extremely unlikely situations.
…than cry with the saints – the sinners are much more fun!
But also dumb in light of the fact that they are not like the Duggers-they are perfectly ok with natural planning in accordance with a cycle. To the extent that the inventor of the birth control pill thought he was contributing to fulfilling Catholic dogma. Within the theology that values the unitive as well as procreative reasons.
So if Monty Python was incorrect and God will NOT smite you down for every sperm that’s spilt in vain-I really don’t see why it’s own internal logic does not allow birth control within marriage. But while I am eligible to be Pope, it’s highly unlikely I, or the current one, will make the crooked straight on this one.
I assumed that was the answer, I appreciate the explanation.
Virtually every health insurance policy written covers vasectomies. So how does any institution currently squawking about insuring contraception cover any insurance for anybody?
Seems to me that those institutions are, in fact, singling out women. Even though a vasectomy is a “mortal sin” (like contraception), the church seems to have no problem paying coverage that includes vasectomy.
It seems like perhaps a gender-based double standard.
But I think they are singling out Obama. Case in point, where were they complaining when similar and frankly more onerous architectures were built into the Romneycare proposal? It’s because Obama is a pro-choice Democrat that anything he does is an assault on the Church. One of his first legislative priorities was the Freedom of Choice Act, and I recall petitions being circulated as soon as the ink dried on his inaugural in RCC parishes to get legislators to vote against it. Granted, I may have voted against it myself to be honest, since I am against third trimester abortions and federal funding, but I would not have made it’s legislative defeat the first civic priority of the faithful immediately after that inauguration. Particularly since the bishops, even the right wing ones, have been aching for immigration reform, opposed to the wars, and supportive of universal healthcare (until Obama proposed it anyway).
It will take some time, but I am glad to see Francis move the Church away from it’s single minded focus. Universal healthcare has long been a tenant of the faith, far longer than life begins at conception, which is a 20th century innovation. And it’s ultimately a tragedy of the Benedict years that the USCCB could have been standing on the right side of history achieving a long standing policy goal of several Popes and instead acted like a bunch of perpetually upset and unsatisfied whiners.
I’d love to find out if, say ten years ago, somebody on a “Catholic” health care plan [e.g. leity employees of the RCC] with insurance had coverage of vasectomys, or if the RCC had a policy written which removed that (and related) procedures.
As far as I know, there isn’t a non-birth control reason for a vasectomy, right? I mean, there are non-BC reasons for lots of different forms of women’s BC and sterility treatments, ranging from dangerously high monthly flow levels to cancer treatment.
Would be interesting to find out…
There’s no medical reason to snip the vas deferens and then cauterize it closed. Treatment for testicular cancer is removal of the testicles, which sterilizes the man but is a little drastic as far as a method of BC.
losing perspective in the details. I think its all well and good to keep the broader policy goals in focus, but the details are the means by which the policy ends will be met (or not). The details are important, understanding the details are important, and I don’t think having an in depth discussion of the details of a policy implementation means that you’ve lost focus on the broader goals.
And I’m not sure many people take such a community/socialized view of insurance where they are “in love” with the idea of paying for health care for other people. That sounds more like charity to me. There is a very tangible individual benefit to insurance that does not depend on the charitable motives of others. The quid pro quo that the individual gains in exchange for paying the premium is the transfer of risk away from that individual.
I don’t think we’re actually that far off, but I think your view is a little more “charitable” than most, while ignoring the very individualized benefit of transferring a risk.
Not to mention – isn’t the real goal not just to increase the percentage of people who have health insurance, but to increase the quality of care that people receive?
… as it was not my intent to make such claim. I do not mean say the minutia and the various data points and the differening policy perspectives and prescriptions directly cause a loss of focus and/or perspective.
I say that, amidst the accusations of who’s lying to and screwing whom and how, why and under what motivations… and the resultant “needer-needer” and “nyah-nyah-nyah” and “so there” retorts and so forth, all of which rides amid the storm of details, valid and, as you say (and I agree) important as they are. The details are neither cause of the problem nor to be discarded to get at the fundamentals. I do not wish to leave you with the notion that I I am saying that the details are getting in the way. They are not.
Can’t we do both?
I wouldn’t buy insurance, at all, if there no possible benefit to me. So it’s not charity. But if I take this view, solely and only that it’s for my benefit solely and only, then I will have to come to the end of my days either regretting that I spent so much money on insurance that never paid out in medical costs, that is to say, threw it away, or end my life more or less commensurate, perhaps in length, perhaps in vigor, with the amount of money I did spend in health insurance with no expectation of any more. Perhaps some people would like that system better. I do not. I further contend that, like it or no, it is not the system we have. We pool risk. Whether you call it ‘charity’ or something else, the fact remains, whether I like it or you hate it, or the converse is true, the money I paid today gets spent on somebody else tomorrow. And, the next time I incur a medical bill somebody else will pay for it. That’s the system we have.
I could, I suppose, also argue that paying into such a system, even if I never realize the benefit directly, protects both me and the society I’m in: somebody floating around with TB, or Ebola or any of a number of deadly infectious nasties is likely to be found out much sooner if everybody is seeing a doctor regularly.
I’m not sure I wrote anything that is at odds with this…? Going from no health care to health care is an increase in the quality for the previously uninsured. If the costs can be kept in check (that is to say if a wider pool causes utilization of ER to drop) and more catastrophes are averted then next years premium dollar spent will get more health care than last years dollars…
Yes, insurance is a critical component. And yes, eventually the conversation migrates to another critical eliminate in the health care debate: costs.
But seldom, if ever, does the discussion move to a third critical element of health care…and that is our health. I don’t want to go into the minutia of ways we need to get healthily (as my wife once said, sitting is the new smoking) but this is one major piece of the “health” issue we ignore and that is the foods we eat. Specifically how the bulk of the food we eat is essentially manufactured to achieve the goal of market-orientated company. They care little about nutrition and focus on cutting cost and increasing revenue and profits. That would be OK of we were talking about widgets. But we’re not, we’re talking about the food we eat.
Until we tackle the “health” part of health care, we can move to single payer; we can dictate to hospitals and drug companies what to charge, but we still won’t be any more healthier.
It will be interested to see what happens in Vermont, but Obamacare only entrenches the power of the health insurance industry. It never was a progressive solution, just a way to get people insured and make some improvements in health care.
I agree that Obamacare is only about healthcare insurance. It doesn’t change the way that healthcare is provided in this country. There are two aspects of Obamacare that get very little attention:
1. Expansion of Medicaid: Approximately, half of un-insured Americans are now eligible for Medicaid, with the expansion subsidized by the federal government. That’s a big deal!
2. Federal subsidies: For those not qualifying for Medicaid, depending on income level, insurance premiums and out-of-pocket expenses are subsidized by the federal government. That’s also a progressive forward step.
Basically, Obamacare is simply about access to health insurance. But that access is critically important. For low-income families, and for middle-income families, it means that an illness won’t also result in an impossible financial burden. As Elizabeth Warren pointed out, medical bills are a common reason for middle-class family bankruptcies. Obamacare provides a level of financial security for low and middle income families. That’s a big deal. And, it’s progressive!
It’s the best we can get. But it was a conservative, market-based solution first posited by the Heritage Foundation.
I’m very much in favor of it, but it’s not not a theoretically progressive idea.
<a href="” target=”_blank”>If that doesn’t work (again…)
http://www.youtube.com/watch?v=qEtygP1Qfjk