Friday, February 10, 2012

The first reviews are coming in...

... on Obama's "compromise" contraception mandate.  They pretty much confirm my own initial suspicions.  It's as bogus as a $3 bill.  Call it what you want.  From my perspective it's a cheap accounting trick that substantively changes nothing.  The insurance coverage, paid for by religious institutions STILL has to cover all sorts of morally inadmissible things.  The suggestion that the insurance companies are really footing the bill is risible on its face.  IF that were actually true it would be an illegal act since one cannot force people or businesses to provide goods or services at no cost.  That's pretty much elementary constitutional law.

I am inclined to agree with the usually over heated Bill Donahue on this one.  Obama has just added insult to injury.

13 comments:

Anonymous said...

The general idea seems to be that if religious institutions are unwilling to pay for certain aspects of medical insurance directly, then we'll just make them pay indirectly.

Matushka Anna said...

Kind of like money laundering.

Anonymous said...

How about financing unjust wars?

OOOOPS....that's too sensitive!

Matushka Anna said...

Anonymous, (assuming you are the left-coast one) are you merely a troll?

Visibilium said...

Anon, the jury's still out on what a just war is.

John, you're absolutely right about this compromise charade. Religious institutions will be forced to pay insurance companies to provide contraceptive services. Politically, this is a gratuitously stupid issue, and Obama will lose the election because of it.

Ochlophobist said...

John,

Allow me a moment to make a case here. Whatever one's view on the current battle between Obama and the American RC hierarchy we can say with assurance that the language being used by both sides is absurd. Obama's language in this "compromise" is of course specious, as those insurance companies are getting money to cover contraceptives from somewhere. But we need to apply that same logic to the statements from the RCC - say the statement that "we will be forced to pay for contraceptives" - uh, folks, insofar as they have already had contracts with major insurers (which pretty much all Catholic hospitals, large charities, and large school systems do), then they already have been paying for contraceptives, even if not for their own employees. Here is what I mean:


Even if Dolan & Co. are eventually granted the exemption they want, and employees at Catholic hospitals do not get contraceptive coverage, the monies spent on their premiums by Catholic institutions will still go into the same pot, and some of that money will still be spent on contraceptives and sterilizations, just not on behalf of the employees at the Catholic hospital in question. To my knowledge the vast majority of Catholic hospital, charity, and school employees have coverage through major carriers in the industry, all of whom provide levels of contraception/sterilization coverage.

Think of it this way - I had some friends in the War Resisters League back in the day who did not want any of their tax $$ spent on war. So they figured out the percentage of the U.S. govt's expenditures spent on the military, and they then took that % and applied it to the amount of money they owed in taxes, reducing what they paid that much. So if govt spending on military was 25% in a given year, and this War Resister dude owed $2000 in taxes according to his 1040, he would only pay $1500 and he would send a note saying he refused to pay the other $500 because he refused to pay for the military spending portion of the budget. As a political display, that ain't a bad thing to do (as long as you are willing to go to jail at some point, or pay a bunch of fines and back taxes later, though that would seem to defeat the purpose). But in terms of what one actually pays for, it is of course absurd. That $1500 goes into the federal revenue structures like any other money, and is divided up like any other source of revenue. The same is true with any money any Catholic institution gives to, say, Blue Cross / Blue Shield of NY. Regardless of whether their employees get contraception coverage, they are paying into health insurance revenue streams used (in part) to fund contraceptive and sterilization services.

Ochlophobist said...

What that means to me is that if Catholics were really serious about not wanting to (help) fund any contraceptive or sterilization services, they would have long ago started their own health insurance companies (the Catholic "insurers" out there now are not what I am talking about - I mean actual large scale licensed carriers, like the ones that virtually all large Catholic employers use) - ones that didn't cover pills and procedures Catholic bishops find questionable, and in states where this is illegal they would have protested and gone to court arguing that they must have such carriers to exercise religious freedom, but they have not done this. [There are some rather large scale religious run insurance companies - Lutheran Insurance is one example]. I have never heard any conservative Catholic pundit in the mainstream or Catholic media assert that this is the way to go (perhaps there are some?), and I have yet to hear one conservative Catholic voice assert that there is a moral problem with paying into a health insurance provider who covers "unnatural" and "gravely sinful" pills and procedures with the money Catholic institutions pay into it, even if not for the employees of those institutions. Yet these same conservative Catholics use rhetoric insisting that Catholics will be "forced to pay for contraceptives." This should be, on its face, ridiculous. BC/BS of wherever is not going to charge substantially less money for the premiums which don't cover contraceptives - indeed, usually you pay more, thus putting more into the revenue stream out of which contraception is paid for.

Ochlophobist said...

In analogy form: St. Agnes Catholic Hospital has 1500 employees. They give pay BC / BS of their state 2 million a year to cover insurance premiums for their employees. The BC / BS of their state insures 1.5 million people, so St. Agnes hospital's employees amount to 0.1% of all people covered by BC/BS in that state. So the 2 million they pay goes into the revenue stream for BC/BS, which pays for any medically indicated contraceptives and sterilizations for the other 99+% of the people they insure, out of money from a "pot" that the St. Agnes hospital money is a part of. Extend the analogy to all the Catholic institutions in that state. Say they all get BC/BS insurance. Say they constitute 4% of all the people BC/BS in that states insures. Now they are putting hundreds of millions into the BC/BS revenue stream, a revenue stream which potentially pays for contraception/sterilization of 96% of the people it insures. So there you have it - whether the Catholic hospital employees are covered for contraception or not, the Catholic institutions are INDIRECTLY paying for a portion of contraceptive and sterilization services. The only thing they do my disallowing their employees from getting contraception coverage is very slightly reducing the number of people the insurer will potentially provide contraception for. And this has been going on for a long time. Thus the "Catholics are being forced to pay" argument is moot. They are not directly paying for these services now or in the event HHS regs go through. They have been indirectly paying for contraception for as long as they have been doing business with major insurers, a business partnership conservative Catholics have, to my knowledge, never protested.

Let's pretend that Planned Parenthood had one major revenue stream out of which it paid for all the services it provides. Setting aside the differences between insurance and a direct payment for services, the current insurance situation would then be somewhat akin to Catholic organizations contracting with Planned Parenthood to provide pelvic exams only for their employees, but not abortions, and then saying that they aren't paying for abortions. We know how well the pro-life movement would take that.

What I can't figure out is how many of these bishops and major pundits genuinely don't understand this, and genuinely don't understand the way health insurance works.

John (Ad Orientem) said...

Owen
Excellent and very cogent post. Thanks...

John

Visibilium said...

The insurance company pools the risks, not the RCC. That the risks being pooled include contraceptive users doesn't morally equate to the RCC's participating in those risks. In fact, I'd suspect that the RCC has eschewed the large-scale insurance biz precisely because its moral stances would insufficiently diversify its risks.

Is the RCC benefiting from a lower premium because of an outside insurer's larger risk diversification? Sure.

Suppose that the guy I hire to cut my grass is the father of the local juvenile car thief. I'm indirectly supporting crime, but am I responsible for the crime? Fewer degrees of separation doesn't translate into more culpability.

Ochlophobist said...

Vis,

The insurance company pooling the risk and not the RCC has nothing to do with the question of whether or not the rhetoric of "paying for contraception" applies to the RCC institutions in question. I've run my outline above by several thomists and one moral theologian and all of them have said the same thing - that with regard to the use of major insurers, both in the past and in the future in the event the desired exemption is granted, there is a material aid given by the church to the business of contraception/sterilization provision. What makes the Obama/HHS mandate worse, from a Catholic point of view, is that it requires not only material aid, but formal complicity. That is worse, from the perspective of Catholic moral theology.

But, Catholic moral theology maintains that material aid should not be given if any other options are available, it insists that other options should be diligently pursued within reason, given the abilities and options of the institutions in question and the RCC in America as a whole. That has not been done, and that is a failure of the American RCC. The Obama HHS mandate has been in the works for years. Numerous states are already essentially there, and others have been headed in that direction, the EEOC has had stricter mandates than what HHS is now proposing since 2000 and has been acting on them through the Bush and Obama admins, etc. The RCC, to be consistent with the rhetoric it is using today, should have started (or fought in court for the right to start) its own non-profit health insurance company(ies), in order to avoid this problem. There are "Catholic" insurers out there, but these contract through major carriers, hence the material aid problem remains.

Ochlophobist said...

cont'd -

Your analogy fails because it doesn't correlate to as close a material aid as what occurs when doing business with a major insurer. It's not just a question of the thief living in the same house as the lawn guy, and benefiting from the lawn guy being able to pay his mortgage or rent. Presumably the lawn guy is not out buying gas for the kid's getaway car or buying the mask he wears to cover his face, or buying the gun he carries, etc., etc. And when you pay the lawn guy, you may know his son is a crook, but you at least assume that lawn guy is not giving direct material aid to the thievery business, or at very least you know that you are giving money to the lawn business, which is a different revenue stream than the thievery business. When a conservative Catholic institution contracts with a major insurer, they know that that insurer is doing business they find gravely evil, they know that the money they give to the insurer will go into a revenue stream from which the purchase of contraceptives/sterilizations will be paid directly (essentially) - that isn't the only business the insurer is in, of course, but it is one the insurer is up front about, and one which you know you provide material aid to by putting money into the revenue stream which pays for contraceptives/sterilizations. Further, health insurers charge less for policies that include contraceptive/sterlization coverage because they know in the long run the aggregate of those policies costs them less money, and while the Catholic institution may pay more for a plan that does not include contraceptive/sterilization coverage, they still end up paying less than they would pay if that insurer were not covering contraceptives/sterilizations for all of its customers, because that would increase the overall costs of the insurer, and that overall cost would be passed on to all customers. Because the Catholic institution is only a small fraction of the major insurer's risk pool, it may have slightly higher policies by not covering contraception, but it still benefits from the overall lowered risk to the insurer when 99% of policies do cover contraceptives - thus at that point there is a material benefit from doing business with a company involved in the provision of what conservative Catholics believe to be gravely evil. Another moral complication. So you have a situation where this Catholic institution both grants material aid to the provision of contraceptives, and gets material benefit from it. This all may seem like moral scruplizing in the extreme to someone who hates the RCC with a passion (except, it seems, when standing with them is expedient for political purposes), but this is how the RCC traditionally approaches moral issues.

Ideally, what would be best would be for there to be a severance of health care from employer decision making. It would be great if employees chose their own plans directly, like we do for car and house insurance. Money spent on health insurance could come tax-free out of our incomes. There could be, and I think should be, a number of govt, non-profit, and for-profit plans to choose from. The govt programs could be sliding scale in cost based on income. Non-profits could fit the need of organizations like the RCC. It would lower costs for individuals, because we would all be individuals approaching insurers instead of having the group plan via employer vs. individual issues. The govt programs could cover people with pre-existing conditions, and there might be a way for govt to allow non-profits to cover pre-existings without going under as well. If we go to that sort of a situation, it takes the moral issue away from the employer, as the employer has no moral scruples about what the employee spends his or her money on. But, of course, this would require a radical restructuring of insurance in this country, something which neither party is keen on doing. Both seem addicted to for-profit insurance via employer plan models being normative.

Visibilium said...

This all may seem like moral scruplizing in the extreme to someone who hates the RCC with a passion (except, it seems, when standing with them is expedient for political purposes), but this is how the RCC traditionally approaches moral issues.

Oh, please. If I were an expedient hater, I'd be your biggest cheerleader on this issue. How better to assist in clipping the RRC's wings than to deprive her of competitively-priced intermediation via a strong dose of her infamous casuistry?

On second thought, hold your riposte until I've retrieved my pom-poms.