Back in March, I argued that employers don’t have any moral right to prevent workers from using employer-provided insurance to buy birth control, any more than employers have the right to prevent workers from using employer-provided paychecks to buy birth control.
My view was met in comments with a degree of skepticism.
So forgive me if I’m pleased to note that Judge Carol Jackson, a H.W. Bush-appointee, said much the same thing in a ruling earlier this month (pdf link, emphasis added by me).
The health care plan will offend plaintiffs’ religious beliefs only if an employee (or covered family member) makes an independent decision to use the plan to cover counseling related to or the purchase of contraceptives. Already, [plaintiffs] pay salaries to their employees — money the employees may use to purchase contraceptives or to contribute to a religious organization. By comparison, the contribution to a health care plan has no more than a de minimus impact on the plaintiff’s religious beliefs than paying salaries and other benefits to employees.
The burden of which plaintiffs complain is that funds, which plaintiffs will contribute to a group health plan, might, after a series of independent decisions by health care providers and patients covered by OIH’s plan, subsidize someone else’s participation in an activity that is condemned by plaintiffs’ religion. This Court rejects the proposition that requiring indirect financial support of a practice, from which plaintiff himself abstains according to his religious principles, constitutes a substantial burden on plaintiff’s religious exercise.
[The Religious Freedom Restoration Act] is a shield, not a sword. It protects individuals from substantial burdens on religious exercise that occur when the government coerces action one’s religion forbids, or forbids action one’s religion requires; it is not a means to force one’s religious practices upon others. RFRA does not protect against the slight burden on religious exercise that arises when one’s money circuitously flows to support the conduct of other free-exercise-wielding individuals who hold religious beliefs that differ from one’s own.
Because this is about female sexuality and there’s all these sex-phobic and misogynist arguments being thrown around, the basic issue has gotten somewhat obscured, which is that your boss is not actually your master. […] If the door is opened to allowing employers to control how you use your compensation after you’ve earned it, god only knows what other kinds of restrictions on how you spend your money they’re going to start angling for.
I think this is one of the basic differences between conservatives (including, alas, most libertarians) and progressives. To paint in broad strokes: When conservatives talk about protecting liberty, they want to protect the bosses from the government; when progressives talk about protecting liberty, we want to protect the workers from the bosses.
Of course, this ruling is not the end of the matter; I’m sure eventually the Supreme Court will decide. Given the conservative majority’s dislike of rights for workers, I won’t be surprised if Judge Jackson is eventually overturned. One more reason to hope Obama wins reelection.
What needs to be dispensed with is the notion that employers, as businesses, have any “rights” in the first place! Rights belong to individual citizens, not corporations.
Your employer has no more right to exercise religious values on your pay and benefits than they do telling you how to vote. Both should be utterly unacceptable and grounds for immediate legal action.
This reminds me of the Civil War, where conservatives want the issue framed as an issue of States Rights, but really, the only “right” anybody in the South was really interested in was the right to own slaves. They resented even the possibility of anybody telling them they couldn’t own Slaves.
Now we have corporations promoting Libertarianism and wanting “rights” so they can better exploit their workers.
There seems to always be a certain class of people who resent higher authority because that higher authority prevents them from taking advantage of other people.
-Jeremy
To be sure, history is full of people who remonstrate endlessly about the evil of oppressive government, from Magna Carta right down to today. If your biggest worry is oppression by the king, that’s a sign that you’re not worried about oppression by the lesser noble, or the church, or the mob, or the slaveowner, or the boss, or the abusive spouse, or disease, or hunger, or cold, or earthquake…. In short, it’s a sign that you’re pretty privileged. It’s not that these people don’t have good arguments – I still quote Jefferson – but their perspective is not the ONLY perspective.
That said, I’d like to promote the liberty interest of both employees and employers. Arguably we could grant employers almost absolute discretion over how to structure the employment relationship – legalize racial discrimination, sexual harassment, outright prostitution – provided that government provided a sufficiently generous guaranteed minimum income for all citizens (or perhaps all residents; that’s a tricky one). I call it Checkbook Libertarianism: Virtually your only civic duty is to pay a (rather substantial) tax bill.
Short of that, I’m still inclined to grant employers broad discretion in structuring the employment relationship, and placing the burden on others (employees) to demonstrate a bona fide state interest in interfering with that relationship. And here, I honestly don’t see the bona fide state interest in compelling employers to offer birth control insurances as a form of compensation. Let employed people buy their own birth control if they want it.
As I understand it, ObamaCare doesn’t require employers to do anything other than pay money to government. 26 U.S.C. §4980(D), (H). Sure, ObamaCare permits an employer to avoid paying certain fees if the employer provides health insurance that meets certain minimum standards – including insurance for birth control. But the employer gets to choose which option to pursue. I find no problem with this outcome.
Copyleft:
So, there is no 4th Amendment right against search and seizure for a company? And, no 5th Amendment right against taking the property of a company?
No, you could not have meant that. But, the Bill of Rights does not really give you “rights.” It restricts the government.
Jeremy Redlien:
That ignores a great deal of history, particularly the Nullification Crisis of the 1830’s. There, South Carolina (sigh, what is wrong with the Palmetto State) was fighting with the Federal Government over tariffs, based upon state’s rights. So, I would turn it around on you and say that it is liberals who always frame the issue of states rights as one involving slavery (and that is because of the Civil War).
-Jut
And if we want to maximize liberty, it’s important to recognize that there are a hell of a lot more employees than employers and that the employers are generally more likely to have the resources to be able to pursue their goals through other means. So if we can only protect ONE of these groups …
—Myca
myca, dont you mean employERs?
Why, I have no idea what you’re talking about.
(thanks)
—Myca
You understand the right to contract, don’t you? That right wouldn’t be of much use if it only worked for one side of the contract.
I’ll illustrate with a simple example of a few transactions:
1) Bob offers Mary $5 to go to church.
2) Bob offers Mary $20 to mow his lawn.
3) Bob offers Mary $25 if she mows his lawn and goes to church.
4) Bob offers Mary $20 to mow his lawn, but will only hire her if she’s been to church this week.
5) Bob offers John $10 if he can convince Mary to go to church.
Folks propose telling Bob and Mary that they can’t contract for some of those.
Any limits on that are an attempt to say “we know best about what is acceptable.” That’s a burden on Bob (who can’t get as much as he wants for his money) and Mary (who obviously wants to give as little as possible, but who also wants the transaction to go forward.)
And sure, there are some limits–but they involve tradeoffs and they’re not utterly unacceptable in the vast majority of contexts.
If employers really did prohibit people from using their resources to buy things they want (“we disapprove of Mr. Beiber’s so-called music and anyone caught using their paycheck to buy his albums will be severely sanctioned!”) then I would think that was a rotten injustice. If the Catholic Church tells Jane Smith, administrative assistant III in the Poughkeepsie office, that she may not buy condoms and use them to defer pregnancy when having sex with her boyfriend Chuck, I would be on the barricades for Jane. Fuck the man! (It would be different if Jane Smith were the Chastity Education Director for the diocese or something; I am assuming no bona fide occupational behavioral restriction. It’s OK to get mad at priests for buying porn DVDs, or what have you.)
Is anyone doing that? I’m not aware of it if they are.
The judge (and you) are quite right to say that employers (again barring bona fide behavioral rules for certain kinds of jobs) have no business saying what employees do with their voluntary compensation. But health coverage isn’t voluntary compensation; if it was, then the answer would have been different the many, many times in my 20s and 30s I had jobs with health coverage and I asked for cash money instead. The employer, in its paternal – one might say socialistic – wisdom, is deciding that a portion of the compensation needs to go to this particular type of consumption, one which is meritorious and virtuous and redounds to the benefit of the employee (or at least to the benefit of Blue Cross). The employee, much less the state, would seemingly have little bona fide claim on the management of that benefit, other than the employees’ voting privilege of “take this job and shove it”.
A query for Amp (and the judge): OK, if the employer’s choices for this benefit are to be subsumed under some right to have the benefits that one wants, so that the Catholics are putting birth control pills on the parish Visa bill because that’s what Jane wants…then what about the people who don’t want the benefit, and want the cash instead? Are they entitled to get money instead of health insurance? Arguably, money is quite useful in promoting one’s health so the “but they’re providing a HEALTH benefit” exception is weak – I could use the $200 a month to fund my medical savings account instead of paying an insurance premium.
If it’s a Violation of Liberty and Good Order for the government to not be able to demand I get prophylactics with that money, why isn’t it a VOLAGO for me not to be able to demand cash money?
Bob –
First of all, Catholics aren’t putting birth control on the parish bill. That particular sort of intellectual dishonesty – pretending that a portion of employee compensation that could lead indirectly to birth control, is the same as taking cash directly out of the donation plate and handing it to the handy condom salesman standing in the chapel — is exactly what the Judge argued against in her decision.
Second of all, I agree with you. I think employers should have to offer a cash option for employees who don’t want to sign on to the employer-provided health insurance. (I really don’t like the idea of employers being able to offer goods and services in place of money compensation, which is essentially what happens with employer-provided health care.)
Of course, that would in the long run lead to the employer-provided health care system becoming even worse than it is, increasing the demand for government-provided health care. But I’m okay with that.
Some employers do allow cash in place of insurance. I’ve certainly taken that option in the past. Employers, however are incentivized not to allow that option via the tax code.
Well, if you’re going to go around agreeing with my “but you’ll never dare agree with THIS” provisions, we’re not going to be able to have a loud and purposeless argument that solely measures our respective linguistic agility. So knock it the fuck off.
I did not mean any unjust they’re-taking-your-donations-and-buying-abortion-pills!!! misidentification; but Catholics (or other devoted group members) are going to see it that way. And that is where most all of the money comes from; no donation plate, no Catholic charities, no matter how big the government check. It’s a pretty broadly-supported mission. (If Greenpeace signs a big government contract, and part of that contract buys Hummers for the Greenpeace staffers to use to go out and drive around stomping nature, are you going to think twice about your contributions thereto? But you aren’t buying Hummers…)
Jake – bastards, where were they when I needed supplemental support for my whiskey and loose women bills but had no medical neeeds?
OK, Amp, you’re OK with gimme-the-money – and, joshing aside, I do appreciate you forthrightly just saying ‘actually that’s OK with me’ instead of dancing.
How about if the government mandates that all employers provide a political donation benefit? The employee even gets to choose which party gets the donation – the Democrats, or the Republicans. Greens not allowed, no commies or socialists need apply, bugger the Tea Party, Perotistas can fuck right off. Obama or Romney.
(Or, if you prefer, the government demands that you give the money either to the communists, to the New Party, or to the Tea Party, and the mainstream parties must pound sand. The government is “fair” – (any kind of birth control coverage will do) but are mandating an expenditure for an area of life, and foreclosing the option to simply not participate, or to allow totally free participation.)
Still OK? No? But…”By comparison, the contribution to a political party has no more than a de minimus impact on the plaintiff’s political beliefs than paying salaries and other benefits to employees.
The burden of which plaintiffs complain is that funds, which plaintiffs will contribute to a political party, might, after a series of independent decisions by politicians and party groups, subsidize someone else’s participation in an activity that is condemned by plaintiffs’ political views. This Court rejects the proposition that requiring indirect financial support of a practice, from which plaintiff himself objects according to his principles, constitutes a substantial burden on plaintiff’s political exercise.”
I don’t want to give Mitt Romney money. The government tells me that, via my employee benefit packages, that I have to face that terrible prospect, because after all, some of my employees might be Republican and might be giving Mitt donations anyway. Does that mandate impair my rights or impose a burden on me?
This isn’t quite accurate. There’s an additional tax penalty for employers who don’t provide health insurance that meets the requirements. That keeps being left out. It’s not “You must provide health insurance with these characteristics” but “Your taxes will be higher if you don’t provide health insurance with these characteristics.”
Honestly, if we can’t have single-payer (and clearly we can’t, because oh, horrors, socialism), and we’re stuck trying to make the best of an insurance-tied-to-employment system, I see no problem with tax incentives for employers to provide a certain level of insurance that meets minimum criteria. And for women, the ability to control reproduction is a very basic health issue. It should therefore be included in those minimum criteria.
What constitutes appropriate healthcare should be research-based, not religion-based. Likewise, a business owner who doesn’t believe in psychiatry should not be entitled to an exemption on covering mental health because they feel their employees should be getting religious counseling instead of seeing a psychiatrist and taking psych meds. I’m sure it horribly violates someone’s conscience that I’m on antidepressants instead of just, I don’t know, praying harder. But the health insurance that I pay the same amount for as a mentally healthy coworker shouldn’t provide me with crap care because good care is against an employer’s religion. (This would be a hypothetical employer, not my actual one who I seriously doubt has any religious hangups about mental health services.)
I wouldn’t have been opposed to the compromise being, “If birth control isn’t offered *and female employees are charged less for the inferior healthcare plan that they’re offered*, the employer still doesn’t have to pay the added tax.” But even without that, businesses who want to provide insurance that doesn’t meet those qualifications are totally free to do so.
I may personally feel that campaigning for marriage equality is every bit as valuable as going to church or feeding the hungry or helping abused animals. But that doesn’t mean that my donations to Marylanders for Marriage equality provide me with the same tax benefit as donations to my church or an animal rescue, because it’s a political campaign and not a 501c3. If I give them a hundred bucks instead of giving it to Oxfam or the American Cancer Society, I’ll pay more taxes. But, “I will end up paying more taxes if I make this decision than if I make a different decision,” is a far cry from, “I am forced to make a decision I don’t like.”
Kelly – you may well be correct about the actual rule being that health insurers who don’t provide the birth control at no cash price to the insured just have to pay a penalty or what-not. I don’t know; the ACA is so well-written and brilliantly designed, and has been the subject of so many executive actions and administrative rulings and waivers and policy changes that I have, at this point, about three things that I’m willing to say that it definitely says. The reporting in the media, for the most part, has however expressed the birth control question in absolute ‘must-provide’ terms (random example) and I don’t know who to believe.
Would you be willing to believe Kaiser?
How many of us are engaged in the job that offers us the highest money compensation, forgoing every other form of compensation? People making trade-offs between money compensation and other forms of compensation. Some people really value working for a social mission. Some people really value prestige. Some people really value flexible work schedules. Some people really value opportunities for advancement. Some people really value creative control and self-expression. Some people really value working next to that cute redhead in accounting. Some people really enjoy living on the coast. Some people really value dental coverage. I see no reason why all firms should – or even could — reduce all forms of compensation to cash.
The dynamics of insurance can lead to counterintuitive conclusions.
Yes, the tax code provides incentives for benefits that are extended to all employees on an even-handed basis, and not restricted only to highly-compensated employees. But I suspect that’s a small component of the issue here.
The larger issue is adverse selection. If you let employees opt out of any type of insurance, the people who opt out are likely to be the people who need the insurance the least. This means that the pool of people who continue to buy the insurance are likely to cost the insurer more, on average, than the original pool of employees. The insurer will have to charge more as a consequence. The increased price will cause more employees to drop out, now leaving only those employees that are very sure they will be filing a claim. And so on, and so on. THAT is why insurers, and consequently employers, don’t want to give employees the option to opt out of coverage.
Oh, and employers like to have their employees healthy.
Finally, if you could exclude contraceptive coverage from insurance and simply take cash instead, how much do you think you’d get?
If you think the cost of contraception is the cost of condoms or pills, you will reach one conclusion.
If you think the cost of contraception is the cost of condoms or pills offset by the cost of dealing with unwanted pregnancy and sexually-transmitted disease, then you may reach a different conclusion.
Under this analysis, you might need to pay EXTRA for the privilege of excluding contraception from your health plan coverage. And whether or not the employee should pay extra – after all, the employee may be a pretty good judge of the employee’s own conduct – the EMPLOYER might need to pay the increased premium because the employer’s choice to exclude contraceptive coverage is likely to alter the employee’s likelihood of incurring additional health-related costs.
Insurance – weird stuff.
Amp – broadly yes, but that flowchart appears to cover the issue of the penalties/rules for providing insurance coverage at all. There could be a rule that every plan must include free contraceptives – and the good kind, too, with the reservoir tip and the quality lube – or Barack Obama personally gets to kill the CEO and take his woman. There could be a rule that you gotta provide contraception or else, you know, you’re gonna get this letter and it’s going to have a really serious font and everything. It just doesn’t say.
Yes, Robert, the rule doesn’t say that Obama isn’t allowed to personally kill the CEO; therefore we should assume that’s what the rule does say. *rolleyes*
No, we shouldn’t assume anything. I am claiming ignorance, not knowledge. Kelly says the rule is X. The newspaper says the rule is A. You post a helpful chart indicating that on a largely tangential issue, the rule is (Q-1) ^ 0.334. So far I’m the only person who has posted any relevant evidence of what the rule is, and I freely acknowledge that my evidence is crap because it comes from the idiot press. I’m PRETTY SURE that Obama isn’t allowed to go around popping people, but that’s because of common sense and comparison to other issues where he doesn’t get to do that (drone strikes aside), not because anybody has provided any useful information.
Also, I see you talking but I don’t see any money or any PopTarts forthcoming. Surely you are aware that Jake and I have instituted a pastry-based takeover of your little blog, and that you work for us now. Dance, monkey, dance!
[I cross-posted with Robert]
Okay, that was a bit too snarky.
The rule about “women’s preventive services” is applied to insurance companies, not employers. All new insurance plans, starting in August of this year, have to include certain “women’s preventative services” with no copay. This is true both for plans on the individual market and plans sold through employer compensation. So as an employer, you (hypothetical employer who pays for employees health insurance you, not Robert you) don’t have to do anything to make this happen – it happens automatically next time the insurance company you work with updates your plans.
As with many laws – including some that have been proposed by Republicans, such as Medicare part D — the law itself is more of a set of guidelines, and the micro-detailed rules are going to be worked out by the agencies and then no doubt modified based on practical issues that come up in implementation. You can read an overview of the guidelines here.
“Have to” or else WHAT, though? I have to have a driver’s license. If I don’t, eventually the cops find out about it and start hassling me when they see me driving, and eventually they throw me in jail, and if I run away jail they shoot my ass. Or at least fine it heavily. So I have to get a license, or I will pay a lot of fines or go to jail or even die if I insist on being a dickhead about it. I understand “have to get a license”.
“Have to” provide coverage, or what? Punitive fines? Trivial fines? Stern letters from agencies that haven’t actually been funded yet and that President Romney is already planning to claim budget savings from axing? Orbital lasers from space that kill everyone at insurance company HQ? Or what?
Kelly’s claim, by the way, was that
The link I provided was not even slightly “tangential” to what Kelly said; it proved 90% of what Kelly said. It didn’t show that birth control was one of the “requirements” she spoke of, but it showed everything else she claimed.
I don’t know what the enforcement mechanism on insurance companies is. My bet would be that it’s a combination of potential fines, and of losing access to sell their products on the health insurance exchanges, but I don’t know for sure.
Why is this an issue that matters, for purposes of this thread?
Kelly was using it to quibble her way out of answering the what-if-it-was-political-speech hypothetical.
Bob:
I thought it was a fair enough quibble, since it did point to a significant difference between reality and your hypothetical. The fact is, no employer is forced to provide health care by law (although arguably, they are forced to provide health care by the marketplace, at times).
Which reminds me, I never answered your hypothetical. I’m kind of limited for time (trying to write Hereville book 3 currently), but my honest first reaction on reading your hypothetical was that it was obviously a horrible imposition on the first amendment rights of workers. What about a worker who didn’t approve of any political party (and there are a lot of those folks out there) – why should they be forced to make a choice between all the evils?
I’m not sure that I see any first amendment issue for employers, who aren’t being forced to speak, any more than the fact that I pay taxes which (in part) pay to build and maintain a town hall auditorium that is used for political debates, including speakers I disagree with, is an infringement on my first amendment rights.
But I think directly forcing employees to use part of their pay to pay for political candidates is dicey. (And unlike union dues, there’s no free rider issue here.)
In any case, the only reason I’m at all okay with health care being provided via employers is that there doesn’t seem to be any way out of that situation (which was brought about because of a peculiar set of historic circumstances.) It was a bad idea to connect health care to employment, if I could do it over I’d want to eliminate it, and it would likewise be a bad idea to connect political donations to employment.
As I said before, I don’t really approve of any sort of giving-employees-goods-and-products-instead-of-cash compensation, and I’d include “political donations” in that category.
(There is a similar “matching donation” program many employers run, where employers can choose to give money to charity, and the employer will match the donation. I think that’s great. But of course, participation in such a program is entirely voluntary. I also see employee discounts for the establishment the employee works at — i.e., Bookstore employees getting an employee discount on books — as different, since again the employee has the option of not buying any books at all.)
(And Nobody Really, I do see a distinction between goods like “pleasure in the work” and “the warm glow of helping people” – which are non-monetary compensations for working — and compensation in things that are products that are sold for money, like health insurance and (to a lesser degree) political donations. Although I’m sure you could find examples where the line is blurry, in general I don’t think being against paying employees in goods and services requires being against employees being paid with job satisfaction as well as cash).
You being all reasonable and coherent doesn’t excuse the fact that you are now a day derelict on your PopTart tithe.
But the only flavor I like is Chocolate! I’m worried that all the other pop-tarters with their fancy fruit flavors will make fun of me.
Chocolate? The man brought before the court on charges of murdering his parents threw up his hands. “Have mercy on me, your Honor, a poor friendless orphan!” True, technically his plea ought to have merited some sympathetic concern…yet, in reality, he was only making it worse for himself.
Because of our long friendship, I’m just going to pretend you didn’t say that about chocolate PopTarts. I’m just going to fucking let it go. I don’t think I can do that more than once. The other website pirates, they would understand me letting it go once, for friendship. If it happens again, they’ll decide I’m soft and it’ll be my threads getting PopTartJacked. I’m not gonna have that happen.
So you like regular fruit-flavored PopTarts, LIKE THE OTHER KIDS, right?
Okay, then to address your main “what if it was political speech?” hypothetical, that’s wildly different from health insurance for a bunch of reasons.
Unlike health insurance:
-Companies have not typically provided political donations as a benefit
-Employees don’t have significantly less ability to make political donations without their employer’s assistance
-Every political donation ever is specific support of a candidate or party and the positions associated with them. The vast majority of money spent on healthcare makes no statement whatsoever, unless you count things like “Dying of treatable conditions is bad,” or “Allergy meds are useful to people with allergies,” as a moral/ethical/religious position.
Also, your analogy is “must give money to a political campaign,” when the real situation is more akin to “must provide a set of benefits that some employees will put towards political campaigns and some won’t.”
And I would like to state for the record that I also like chocolate Pop-Tarts, especially the Smores flavor.
Which is another important point. Insurance coverage with contraception is more cost-effective than insurance coverage without it. So, with Robert’s analogy, it’s much less like having to provide political donations as a benefit and much more like providing a flexible spending plan that employes can use for political or charitable donations, which costs half as much to administer as the one that only allows charitable donations, that the business was using previously.
So, for religious organizations to fairly opt out of contraception coverage, they’ll actually be paying *more* for insurance. However, I still think that their female employees’ share of the premiums should be *less,* since it’s an inferior product. If Bob gets all the meds he needs covered without issue, and Sally is stuck explaining to HR the personal details about why it’s not safe for her to be pregnant and why, no, she can’t just pay out of pocket for generic birth control pills, and has to keep a straight face when the rhythm method is suggested as a credible alternative, she shouldn’t be paying the same for insurance.
Who pays all the non-existent premiums that would have been paid into long-term social welfare programs that all those contracepted kids would have paid?
The causal chain is a little too distant to say “this causes that” quite that glibly, of course. But I do suggest that contraception-is-cheaper analysis works on the assumption that children are a net expense, and do not as adults repay their capital formation costs. If that assumption is true, then social transfer programs *cannot work* (barring the invention of magic robots) in the long term and we gotta scrap them for vouchers or something.
I don’t think many of the people who are pro-contraception are also yay-vouchers; y’all think these programs can be made to pay. OK, in that case, it really isn’t kosher to claim prevented children as a *savings*. They’re an expense, just a deferred one and one that is ‘paid for’ over a very long time frame.
The existence of cherry PopTarts proves the existence of Satan, and Chocolate Smores PopTarts prove that he is a genuinely evil being; it’s not all just handwaving and relativism. Real, pure, to the bone kitten-murdering evil.
That’s not the tax code incentive I was referring to. For a thing, it is now flat out illegal to not offer benefits equally to all qualifying employees. We are no longer allowed to have crappy insurance for the mass of workers and awesome insurance for highly compensated employees. What I meant was that paying for employee insurance is money that a company can classify as an expense when filing taxes, thus reducing their tax burden. If the company pays cash in lieu of the benefit, the company has to kick in their share of payroll taxes, raising their tax burden. This is what really disincentivizes companies from offering the “benefit or cash” option.
Robert:
No, no. Contraception is cheaper than pregnancy. The insurance company doesn’t give a rat’s ass about the cost of kids — that’s a separate person, who they can charge separate insurance for. Contraception and abortion are simply way, way cheaper than trying to carry a pregnancy safely to term and through delivery, which is insanely expensive.
Whether a child is a net drain or benefit on society is, of course, their own account, but insurance companies really, truly, absolutely do not give a fuck.
If I recall correctly, Minnesota had a policy of offering a refund of up to $50 for people who could document having made a $50+ political contribution. You could say that this policy subsidized every taxpayer’s ability to make a political contribution, thereby causing politicians to be more responsive to the Common Man. Alternatively, you could say that this policy compelled every taxpayer to subsidize every OTHER taxpayer’s political contributions.
No, it wasn’t a mandate on employers; it was a “single-payer system.” So I guess it doesn’t implicate the employer’s freedom of speech/association. I guess I subscribe to the idea that money flowing through the employer implicates the employer’s freedom of speech/association, whereas money flowing through government does not — even if it’s mostly the same money.
Anyway, I think the policy died under the administration of Minnesota’s last Republican governor, Pawlenty. Not surprising, given the guy’s love of chocolate PopTarts. Chocolate Fudge, even. Anyway, Fecke might know more about it….
Because of that sentence right there, I am going to buy a box of chocolate PopTarts on my way into work today. If I can manage to choke one down, I plan to keep a box on hand, and every time we have (a) eaten all the food in the house and (b) I decide that Robert is being wrong enough on the Internet that I must address it … I will eat another chocolate PopTart.
Until this moment, I was neutral on PopTarts (except to say that they rank near Twinkies for nutritional value and therefore best avoided entirely). I have never eaten one.
Grace
Under the new rules that Bloomberg put into place for NYC public schools about what kinds of foods can be served or sold there, I there there were two flavors of Pop-Tarts that were just barely within the guidelines, so school cafeterias and vending machines can sell those two, but no others. (I think it was the brown sugar and maple flavors, or something like that.)
Oh…no….your self-torture will…uh…be irrelevant to me? But hey, if it floats your boat :)
Bwahahahahahahahaha! Go ahead! Throw your vote away!!!!
KellyK:
Yes. Arguing that the average woman’s basic health needs are extra, or deserve special scrutiny, is a bit like saying that there’s no discrimination in marriage because a gay man can get married to any woman who will have him. Amusing in the right light, but beside the point. The important point is the disparate impact. If it’s actually health CARE, so that it CARES FOR YOUR HEALTH, then charging the same amount for a package which results in lesser outcomes seems an example of disparate impact.
Average men can mumble all they want about uterus-havers and their special needs and how they never need a pap smear, and where the hell is the pap and why do you have to smear it regularly anyway … but that doesn’t change the fact that the average men are getting a better deal.
And if the average men point out that their care costs less (as it does for birth control), well, nobody who has to live with this system designed it, and the lesser cost does not magically make the disparate impact disappear.
Grace
The quality of the product is immaterial (well, not to the people consuming it – but to what it costs the consumer). What it costs to provide the product is the relevant material. If every man thinks their insurance is wonderful and the average male health care bill is $800 a year, men’s insurance will come in somewhere around that figure. If every woman thinks their insurance is god-awful crap and the numbers back them up, and the average female health care bill is $90 billion a year, women’s insurance will be somewhere just shy of $100 billion. Quality will impact how happy people are with the product, but in even the medium run, you will pay what it costs or you won’t get it.
I’m pretty sure the actual differential is less than the umpteen orders of magnitude I’ve slung casually here, but I do believe the differential is fairly substantial. Women live longer, and those extra years come at the time of peak health care expenditure. Reproductive health, other than contraception, is pricy. Women have a tendency – beneficial to their individual health, but damaging to a cold hard bottom line – to go to the doctor when they are sick or feel bad, rather than waiting for actual organs to start exploding out of various orifices, so their ordinary use is a bit higher. Arguably, the reproductive health stuff ought to get charged to the women’s partners as well as to the women, but even assuming that, seven freakin years is a looooot of Medicare. Chicks are gonna have a whackin’ great extra bill, and a big part of it is going to be completely fair. (I’ll cop to half the costs of my ex-wife’s reproductive life during our union, I wanted that kid the way Satan wants more chocolate PopTarts…but she gets the seven extra years. She can pay for them.)
Oh, very good! I had precisely this same discussion during the Sandra Fluke brouhaha.
Yes, as measured by GDP, the average American will produce more than she consumes over her lifetime. By this reasoning, the greatest threat to American productivity growth is all this goddam CHASTITY. Not only is chastity harming productivity, it’s making sex more dangerous!
I humbly observe that, while stats support this thesis regarding the AVERAGE American, we have cause to doubt whether those averages apply to the average UNWANTED American. Studies suggest that unwanted kids are more likely cause negative externalities such as crime. Even if these negative externalities do not entirely offset the kid’s productivity, unwanted kids may end up displacing WANTED kids and the productivity those kids would have contributed (i.e., people who have unplanned kids in their teens may have fewer planned kids in their 30s), and may even displace productive immigration.
Again, it may make more sense to consider these costs from a social perspective rather than an individual one. As Robert alludes, it is far from clear that the cost of contraception should be attributed to women, given that much of the cost of contraception would be entirely unnecessary if it weren’t for men. So we’re justified in socializing the cost of contraception just as we socialize the cost of firefighting: to deal with a social problem. Yes, we provide money to certain people to administer the program, but the purpose of the program is to benefit society, not to benefit the administrators.
If people really, truly, absolutely did not give a fuck, we wouldn’t need to address contraceptive in the first place. Or much of anything else, for that matter.
Robert: As interesting as your speculation is about how Men are from Mars and Women are from Venus, your characterization of regular preventative care as more expensive than emergency-only care is, once again, flat wrong. Insurance companies would very, very much like to only have clients who go to the doctor regularly plus whenever they feel like someone is bad or wrong. Those clients are much, much cheaper than clients who wait for emergency care only.
Indeed, this is tied into the whole reason why health care is so expensive in the US (for shitty results, no less) and not nearly as expensive in other OECD countries (for much better results). Public insurance (of one kind or another) means people go to the doctor before emergencies hit, which in turn means lower costs (preventative care being about an order of magnitude cheaper than emergency care). That these costs are lower provides cheaper care, as well as higher quality and more rapid response for the truly unpreventable emergencies (since resources aren’t stretched nearly as thin).
As for whether men or women are more likely to do this, I can’t imagine you have any sort of source for that: I imagine you just made it up based on experiences or stereotypes or whatever. But since we’re making stuff up based on random inaccurate prejudices, I’ll note that in my personal life — hypochondriacs aside — I have noticed the exact opposite: the women I know tend to put off dealing with physical pain and illness and minimize it and the men I know tend to freak the fuck out about physical pain and illness.
yrs–
–Ben
nobody.really
I realize that corporations are people now but I really did mean insurance companies in particular, not people in general.
Ben – maybe, on the which-is-cheaper. It’s possible for you to be right; it’s also possible for you to be wrong. It depends on the locus of costs being considered as well as the epidemiological reality of the disease. The numbers come out very differently if the screening test for Puking Asscyst disease costs $100k to run, if there are eight cases of PA per year and they cost a million bucks per, and every person takes the screen but that does nothing to prevent acute cases – versus – a screening test that costs $1, a million PA cases per year at ten million dollars apiece, and a 5% screening rate that eliminates 78% of the acute cases. Preventive care CAN be cheaper than reparative care, but it can also be more expensive. There’s no conceptual basis for a preference; it depends on the actual numbers, condition by condition and disease by disease and even population by population.
On the women-don’t-consume-preventive-care, you’re flat wrong. Maybe you know weird people. This is just one study, there have been lots, they generally show that the “stereotype” is the stereotype because it’s true: men Iron Man it up and women are generally more sensible.
Yes, but on the “in general across the US population, which is cheaper” issue my understanding is that preventative care is far cheaper.
There is no general issue. There is a long, long list of very specific issues. And each specific issue has an infinitely tunable set of specific inputs. Its akin to saying “in general, the Seattle Mariners are superior to the Grand Ole Opry.” It’s not a meaningful comparative, because the sheaf of questions being oversimplified into “which is better” includes “who’s more likely to be able to explain the designated hitter rule”, “which aggregation weighs the most”, “which is gayer” and “which group contains the man or men paying my child support”.
It may be true that in the United States for a spceific time period, $1 spent by a hypothetical omniscient technocrat on preventative care produced more “improved health car outcomes” than would $1 spent by Fred Jones on more Propecia for his bald spot. But I don’t think that fact, if it is a fact, tells us very much that’s of any use.
nobody.really:
I’m sorry, but this is in direct contravention to Pournelle’s Iron Law of Bureaucracy – and is thereby demonstrated to be invalid. For those of you unfamiliar with the same:
I’m sorry, RonF, but “Jerry Pournelle said so” is not exactly a stunning rebuttal, particularly when it’s one of the dumber things Pournelle has said.
Jerry Pournelle’s name does not conjure instantaneous truthiness, but his ‘law of bureaucracy’ isn’t dumb. It’s so profoundly true as to be a cliche among people who study organizations and their workings.
I agree it’s a cliche, but that doesn’t mean it’s true.
And I suspect it’s a cliche that mainly rings true for conservatives eager to have their own anti-government bias confirmed.
“This group that I am predisposed against is made up of two subgroups. The first is essentially good and is an exception to my negative statements. The second conforms exactly to every negative stereotype and belief about the group that I have ever spouted. Unfortunately, the bad’uns outnumber/overpower/outvote (delete as necessary) the good’uns, so even though I accept that my negative statements about the group are not universal, I must conclude that they are correct”.
Why, yes, this is definitely a wise way to make argument, and not an empty way to deflect criticism about having simplistic, ideology-driven generalizations while actually restating these very same generalizations, without actually providing any substantive arguments. And it’s not like it could be applied to any and every group one would happen to dislike with relative ease.
I mean, the fact that in the last five minutes I’ve been able to formulate Zweig’s Irons Laws of Conservatives, Libertarians, Boyscouts, Pop-tarts and Ukelele Players – and that if I actually were to post them online I bet I could get quite a few people to agree with them – must mean I am a deep and insightful thinker, not that it’s really easy to say things that sound nice to people who agree with them already.
Ampersand:
True, but, the fact that Pournelle said it does not mean it is untrue (which is what I understood Mythago’s critique to be). Frankly, I have never heard of Pournelle or his Iron Law, but I thought it made sense.
I think it is always a fair question to ask whether it is true, but Mythago did not do that; she just said it was one of the dumber things he said. For all I know of Pournelle, it is kind of like saying that “E=mc2” was not the most insightful thing Einstein ever said. So, her critique was pretty weak.
-Jut
Jut – it’s nor a matter of being true or untrue. It is a restatement of a basic tenant of (a popular branch of) conservative thought, expressed by a popular author who has been a public advocate of that belief for decades. Some people believe in it, others do not. RonF, in @49, specifically presented it as a knock-down argument. He’s the one who set the tone of the discussion – Mythago just responded in kind.
If RonF can shoot down nobody.really’s point with no more than “But that doesn’t fit into Pournelle’s world view so it must be wrong”, Mythago is entirely correct to respond with “but Pournelle was being stupid when he said that”. The fact that she conceded that Pournelle had said less stupid things (which is true – he is a pretty good consumer technology reviewer) is irrelevant.
It’s an observation/hypothesis/theory about organizations and how known data about human psychology predisposes them to operate. It is not a ‘conservative’ or a ‘liberal’ o/h/t except that, to the very limited extent that conservatives are somewhat more likely to believe in a singular (and jaundiced) view of what ‘human nature’ entails, a conservative with little experience of organizations might find it more facially plausible a priori than a similarly-wet-eared liberal would.
Then anyone wishing to use it as an argument and expecting it to carry any weight should provide some of that known data.
And also to the extent that those same views of human nature shape the observation/hypothesis/theory itself.
It is, however, an incredibly stupid formulation of the recognized feature of all organizations that one of the main objective of organizations is the continuation of the organization. March of Dimes (founded to fight polio in the US) is perhaps the most famous example of this feature.
Note, however, that the fact that the upper echelon of March of Dimes chose to continue the organization’s existence beyond the defeat of polio in the US does not actually support RonF’s and Pournelle’s claim. While March of Dimes changed its purpose rather than ceasing to exist when its original purpose was completed does not mean that it only serves to enrich its administrators rather than serving the purpose it claims to serve.
Also, RonF is really racking up the troll points on this one (number of comments by the troll*10 – number of comments responding to the troll = troll score). If we keep going, he can probably trade them in for a toaster.
From comment 49, his troll score would be 1; 1 post, 9 people responding/discussing.
Using points to buy a toaster is immoral. Cylons are people too.
JutGory @54: You’re missing a step. nobody.really made an argument, which RonF claimed contradicts an aphorism put forth by a famous science-fiction writer, and nobody.really’s point is “therefore shown to be invalid”.
(You don’t have to know who Pournelle is; you can simply click RonF’s link to see all the massive data and logical proof (spoiler: none) behind the generalization, which as I understand it, is quite a bit less than that offered by Einstein to support his theory of relativity.)
RonF didn’t really explain why nobody.really’s statement was problematic; he did a nonhumorous version of the Internet “your argument is invalid” meme.
A rule, by the way, that RonF has never applied to his own arguments in defense of the Boy Scouts central administration.
FEMA under Bush and Obama is a nice example of the way in which this sort of blind, stupid disbelief in the effectiveness of government at providing public services is a self-fulfilling prophecy rather than any sort of Iron Rule. Put people in charge at the highest level who believe that government is just an ideological and patronage tool, and you get “Heck of a Job” Brownie. Put people in charge of government who believe that government can serve the public good, and you get a well organized machine providing critical life saving services.
Eytan Zweig and Mythago:
Now that you put it into context, Ron.F.’s point is even stronger.
Yes, it is. That is exactly what Ron.F’s point was and exactly what Amp call him out about.
nobody.really made a bald-faced declarative statement. (I presume it was probably a throw-away line that he was assuming was non-controversial and provided no argument for.)
Ron.F. pounced on that, contradicted it, and provided a basis for his contradiction. Yeah, his words were pretty strong, but perhaps that was appropriate (as, for example, if nobody.really had said that the balance of supply and demand has no relationship to price-again, I don’t know Pournelle or his law). But, he did not simply shoot nobody.really down by uttering Pournelle’s name. He presented an (apparently) well-known theory in direct contravention of nobody.really’s unsupported delarative statement.
Then, what happened?
Mythago attempts to rebut it by impugning Purnelle and provides no argument about the ideas. In short, she did not respond in kind.
Robert agrees that it is profoundly true and provides no argument.
Amp questions whether Pournelle’s law is true, but does not address nobody.really’s statement (and whether that is true).
So, Mythago, I think Ron.F. did explain why (he thinks) nobody.really’s statement was wrong. It was wrong because it contradicts this theory.
If the theory is correct, can we agree that nobody.really’s statement was incorrect?
Of course, if the theory is incorrect, nobody.really’s statement might be correct. But, neither Mythago nor Eytan Zweig have presented a real counterargument.
(Sorry, Amp, if you think this is a derail. I am not a Pop-Tart person, so I have to take my tangents where I finds ’em.)
-Jut
He presented an (apparently) well-known theory in direct contravention of nobody.really’s unsupported delarative statement.
You’re using that term ‘theory’ a little loosely, JutGory.
I declare that RonF is wrong because of Mythago’s Imaginary Law of Organizations Are Awesome, which says that everybody in an organization pulls together for the good of the organization and its goals. Since it rings true to me, it would be unfair of you to criticize it as a counterargument and if you do, it’s like saying Einstein was just making shit up when he said E=mc(2). QED!
Mythago:
True, if by “loosely,” you mean, in a less cumbersome way than the term, “observation/hypothesis/theory,” which was used by Robert and KellyK.
As for your Imaginary Law (and I use the term, “Law,” loosely), do you really believe that? If not, you are being disingenuous, aren’t you?
But, for sake of argument, let’s take your Law as true. How would your theory (sorry, “Law”) explain the uproar we saw in Wisconsin over the teacher’s union? If all the teachers “pulled together for the good of the organization and its goals,” they would not be worried about their own pensions, cuts in salaries, etc. Those things did not threaten the organization or its goals; instead, they ran counter to the profit motive of the organization and its members. Those members should be willing to endure whatever cuts are necessary for the good of the organization.
But, they are not; reductio ad absurdum; Mythago’s Law is false; QED.
-Jut
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Jut – you do realize your “example”, if it were a true interpretation of events, would be just as much a counter-example to Purnell’s Law as it is to Mythago’s Law, right?
Though, of course, neither Pournelle’s Iron Law nor Mythago’s Imaginary Law are as true as Eytan’s Irrefutable Law of Institutions, which is that everybody in an organization would look a lot sillier if they wore a red clown nose and a bowler hat.
Do we seriously win arguments by quoting science fiction writers on this blog? Because if we do I am just letting you know right now that I’m going to win every argument about everything.
@JutGory, you seem very fond of Pournelle’s ‘law’ because it feels good to you; I can’t see any other reason for going to such lengths to defend it. Even RonF isn’t sticking to that hand.
What uproar, specifically, are you referring to in Wisconsin? I’m sure the teachers would say (and likely did say) that cutting teacher salaries and pensions, per basic economics, would attract less-qualified people to the profession and would lead the best-paying teachers to seek better-paying jobs elsewhere and would thus destroy not only the union, but the school system, QED.
Of course I don’t believe Mythago’s Law, any more than I believe Pournelle’s Iron Law.