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This blog is the work of an educated civilian, not of an expert in the fields discussed.

Sunday, February 05, 2012

Women's Health x 2

Taking things at face value is often not the best policy. A leading breast cancer association's decision to defund Planned Parenthood for the allegedly neutral reason of it being under investigation is a case in point. First, we learn the connections to Palin among other red flags.  Then:

An internal Komen memo written by President Elizabeth Thompson and obtained by Jeffrey Goldberg of The Atlantic states that if "an applicant or its affiliates" is under investigation "for financial or administrative improprieties by local, state or federal authorities," then "the applicant will be ineligible to receive a grant." Penn State, the Pennsylvania university that the Hershey center is affiliated with, is currently under investigation by the federal government over the sexual assault scandal involving former assistant coach Jerry Sandusky, who has been indicted on multiple counts of sexual abuse of children. In 2008, the Komen foundation awarded a five-year, $7.5 million grant to the Hershey center to study treatments that could reduce the risk of breast cancer.
This is far from surprising since the fact something or someone is under "investigation" can mean any number of things and even if you just assume guilty until proven innocent, it is hard to apply such a rule to everyone.  Suddenly, you will determine "this is different."  On the other hand, if you are just looking for reasons to target, a ready made "neutral" excuse can be found.  Those looking for an out can find one.
Under President Barack Obama’s health care overhaul law, most employers and insurance plans will have to cover birth control free of charge as preventive care for women. Churches and houses of worship do not have to follow that requirement, but administration officials recently announced that many religious-affiliated institutions such as hospitals, colleges and charities must comply after a year’s phase-in period.

Chris Hayes,* who I'm liking in particular among the many progressive talking heads (btw, Keith seems to be out a lot), talked about this and other issues this morning.  One issue raised was the matter I raised last week concerning new rules regarding birth control, just one of many aspects of that oh so lame (according to some) PPACA law that might help lots of people. Washington Post had a good article on the new policy, providing some important details, including something I don't think Hayes was careful enough to underline -- the exemptions even for the Catholic Church, who was out on the ramparts (statements at mass) railing at the injustice of it all.  The exception:

That rule, however, exempted houses of worship and their employees, as well as other institutions whose primary purpose is to promote religious belief. Churches, synagogues, mosques and other places would not be required to cover contraceptives, it specified. Neither would religious organizations whose purpose is to promote belief, and that primarily employ and serve people of the same creed.
The horror of it all.  I don't know what exactly "promote religious belief" means, but that sounds like even Catholic schools would be covered though that was the big issue in the NYT article I talked about concerning state requirements.  I think abortion is a matter of health care too, but under Hyde and so forth, it is excepted from the rules given strong societal opposition in some quarters.  And, not just at those institutions morally opposed.  The problem with lines was raised on the show and the designed conservative basically admitted he couldn't deny problematic cases can be raised.  A cop-out.  Are Catholics special?  Well, yes, numbers-wise and all.  As Scalia noted:

It may fairly be said that leaving accommodation to the political process will place at a relative disadvantage those religious practices that are not widely engaged in; but that unavoidable consequence of democratic government
The ruling also underlines neutral requirements that might negative affect certain religious institutions (another recent case made an exception for institutional membership decision-making) are allowed.  Just how far are we to go here?  Any number of health requirements might be opposed by any number of religious faiths on some grounds.  These institutions might run institutions that involve many members of other faiths. The article also notes that the regulations don't even go into effect until mid-2013, the employees benefits kicking in at the beginning of 2014. And, "secular enterprises from profit-making companies" will provide "access" to workers at the beginning of 2013. Sounds like the religious organizations are being given some real respectful treatment here. 

One panel member on Hayes show noted this is a reason for health insurance to be separate from employers, which many say is good policy overall.  But,  what about the student on campus whose best health option is the campus health care center?  And, we are a long way from separating health care from employment.  So, we have some sister being real upset that the rules are "telling the church what it has to buy," but such are the breaks -- that is what regulating health care does.  Duly noted you want to deprive even people outside of churches and the like of basic health care here. With government involvement comes strings.
At issue is a provision of the health care law that requires insurance plans to cover preventive care for women free of charge to the employee. Last year, an advisory panel from the respected Institute of Medicine recommended including birth control on the list, partly because it promotes maternal and child health by allowing women to space their pregnancies.
Birth control is but part of a set of proposals the panel -- last year -- set forth that are part of a reasonable approach to health care. And, it is unclear if it is the only possible red flag. There is a mention of HPV testing, though only for those over thirty.  What if that is tweaked to include some option for teenagers? The HPV vaccine was a major controversy for some religious conservatives.  What about "counseling on sexually transmitted infections" -- should that only be allowed for those over eighteen?  Can't encourage sexual activity!  Will screening for domestic violence in some cases violate the man's role over the family? 

On the issue of morning after pills, I wavered on the proper rules, particularly in those areas with diverse providers. So, I respect the arguments for religious freedom here, but even in that area, there were problems.  Lest we forget the infamous Lieberman stance on women who were raped easily having the ability to travel after being denial Plan B at the Catholic hospital to which they are first taken.  But, some balance is being used here, including additional time to arrange the best policy for the Fordham University health center type situation. If health care is going to be employer based, there has to be a balance.

The Catholic Church is too entwined with the weeds to claim purity here.  Again, to me, this is a moronic thing to draw the line in the sand for, especially with the special graces provided.


* Hayes added some further links to today's show here. This includes a link to the White House blog that warrants an extended citation.  As with ending "Don't Ask Don't Tell," this matter ALONE is a significant reason to be glad Obama is President rather than Mitt Romney, who opposes both. 
  • Churches are exempt from the new rules: Churches and other houses of worship will be exempt from the requirement to offer insurance that covers contraception.
  • No individual health care provider will be forced to prescribe contraception: The President and this Administration have previously and continue to express strong support for existing conscience protections.  For example, no Catholic doctor is forced to write a prescription for contraception. 
  •  No individual will be forced to buy or use contraception: This rule only applies to what insurance companies cover.  Under this policy, women who want contraception will have access to it through their insurance without paying a co-pay or deductible.   But no one will be forced to buy or use contraception.
  • Drugs that cause abortion are not covered by this policy:  Drugs like RU486 are not covered by this policy, and nothing about this policy changes the President’s firm commitment to maintaining strict limitations on Federal funding for abortions. No Federal tax dollars are used for elective abortions.
  • Over half of Americans already live in the 28 States that require insurance companies cover contraception: Several of these States like North Carolina, New York, and California have identical religious employer exemptions.  Some States like Colorado, Georgia and Wisconsin have no exemption at all.
  • Contraception is used by most women: According to a study by the Guttmacher Institute, most women, including 98 percent of Catholic women, have used contraception.
  • Contraception coverage reduces costs: While the monthly cost of contraception for women ranges from $30 to $50, insurers and experts agree that savings more than offset the cost.  The National Business Group on Health estimated that it would cost employers 15 to 17 percent more not to provide contraceptive coverage than to provide such coverage, after accounting for both the direct medical costs of potentially unintended and unhealthy pregnancy and indirect costs such as employee absence and reduced productivity.
Thank you, Cecilia Muñoz, Director of the Domestic Policy Council.