This is something I posted on my facebook today, somewhat randomly, but despite the simplifications, I think it makes sense.
"An exercise in thought: Why should my employer be forced to pay for me to get orthopedic care if I break my leg? I don't even need a leg for this job. (This is all hypothetical, my leg is fine) You could argue that it would make me a better and happy employee if they did provide this service. You could argue it would be the decent thing to do. You could argue that proper bone health and care is important to overall health. But if they made a rule today, for any reason they like, that orthopedic care on legs (or anything else) was no longer covered, I don't think the government should be able to do a damn thing about it… Health insurance is a nice, and productive, service many employers offer. If they want to provide it fully, partially, randomly….whatever, I just don't see why they shouldn't be allowed to do so.
Mental Image: A Company Personified is walking down the street and comes across a homeless person right near his property. He decides to give the guy 20 dollars. The government steps in and says not so fast evil businessman. This guy needs way more than 20 dollars. I know you think you're doing a good thing here, but this guy needs rehab, job training, housing and education to really improve his life, so we are FORBIDDING you to give him just 20 dollars unless you give him all those other things.
That's stupid. It's just as stupid to tell a company they can't provide any health insurance unless they provide everything the president's administration says they should provide."
I think there's an idea worth fleshing out in here. I'll try to get to it soon. March will end eventually and life will go on. For now, back to work.
If your analogy held water, I think you'd see a lot more companies decide to keep their $20 in their pocket, rather than attempt charity with the evil government breathing down their throat.
ReplyDeleteWhich would be fine. Let them go. People could pay for health care out of their own pockets. The market would adjust. But it's not charity. It's something that companies use to attract quality employees. It's a perk.
Sigh... The whininess of your blog is the same as the whininess of general conservative speech nowadays and the whininess of lefties several years ago.
Try thinking about what YOU would do instead of what sucks so bad about lefty Obama and his god-hating PC police. Make a HC refit of your own, take some responsibility. Or don't.
If there's something to your idea, then you might as well "flesh it out" as an attack on all regulatory law, because that IS - in essence - what you're talking about here. It boils down to: If you want to do THIS then the government has a say on HOW you do THIS.
ReplyDeleteNo, you misunderstand.
ReplyDeleteThe analogy, like all analogies, isn't perfect, but the point holds. Whether companies are engaging in charity or not is irrelevant in this case.
They're not, I know. They can attract better employees and keep them productive by providing insurance, that's why they do it. I know. But that doesn't really matter.
What matters, if you believe the stated goals of the president's administration, is to get more people healthcare. But that's a bold-faced lie. They're saying they want more people to have healthcare, as long as they're in control of how it works.
I understand regulation, but there's no need for it here. The government can decide to have a say in whatever it wants I guess, but it shouldn't in this case.
Whether it's a perk or a charity, the fact of the matter is that employer provided healthcare gives coverage to a lot of people who might otherwise not have it.
Forcing this regulation with HHS will cause many private companies that at this time provide insurance to cease doing so, and thousands will lose insurance.
I blame the administration for making them choose between offering healthcare of following their beliefs. You'll probably blame the companies who decide to cease offering for choosing ideals you find irrelevant over the welfare of their employees.
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ReplyDeleteYou want my healthcare plan? Before I give it, let me say I don't need to have one.
ReplyDeleteI didn't put myself up as a candidate to lead the nation or represent a state or district.
But since you asked....
Leave it the hell be if you can't come up with a good idea rather than leave it mostly the way it is and toss an extra regulation on for good measure.
I don't mind the way things are/were. I didn't have insurance most of my time at the newspaper, but there was an income based clinic nearby, and that's where I went. I'd pay between 25-50 per appointment, more for lab work. Much more for more than that.
If Portsmouth has more than one of those, I bet the rest of the nation does too. Sometimes getting meds was expensive....too damn bad for me. I didn't sit there and bitch that the government should make someone pay for my blood pressure meds.
Did I get great healthcare pre-insurance? No. Did it suck? At times.
Is that anyone's problem but mine? No.
"I didn't put myself up as a candidate to lead the nation or represent a state or district."
ReplyDeleteYou're not a politician, so you're not obligated to think about policy?? Uh, excuse me? I would expect that nonsense from hate-mail writing Portsmouthians, but not you.
The spirit of ths whole post and your follow ups is one of know-nothingism.
You don't HAVE to think about what a good solution is.
You don't NEED solutions!
The problems don't EXIST anyway.
It was fine the way it was.
Government solutions aren't perfect. I can spot a flaw, so it's all hokum.
As much as I disagree, I'm not going to waste the time arguing if you're not going to listen. Every post you make is getting more extreme in rhetoric, and more entrenched. Matt is right - my dissent is making you more hard-line, not less. Why should I bother?
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ReplyDeleteI don't believe a solution was needed or that a major problem existed. Why is that not a valid view to your enlightened mind?
ReplyDeleteI'm saying I don't have too come up with something only in response to your statement that implied I don't get to speak unless I have a better idea. You know from knowing me and reading this that I do think about policy a great deal, what I am saying is the obligation in this matter isn't on me and I'm allowed to dissent with or without a better idea.
I'm fine with the government tinkering with healthcare. I even don't care if they want to create their own parallel system. But if they're going to keep the free-ish market system we have, then tossing on additional regulations that will lead to a shut down is a bad idea.
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If you saw this before the edit....sorry for being a whiny bitch. Just got frustrated.
I did see it. Truth be told, 75% of my perspective on this is being a pouty baby too. Work is crappy for me this week, and personal crap is making be depressed. Taking it out on old John... My anger is sour and un-righteous.
ReplyDeleteBUT, 25% is still valid point.
You are contributing to a discussion on the contraceptive controversy (a tiny particular in the merits of Obama-care) - when deep down and actually, you don't even see the point of health care reform in the first place. That is dishonest. In you're book, the whole exercise of government reform is a misguided attempt from the start. Why weigh in on contraceptives then???
I would like to counter each point that I disagree with in what you're saying here today, but at this point I disagree at virtually every turn (even side points, and basic assumptions). Even if you were super-open to being corrected, it would be an uphill battle to counter all of that. The onus is on me to prove to you, even the necessity of reform. My attitude is, why bother?
It would be a massive undertaking to build a case, starting with the necessity for reform, following through on how to get universal coverage, and ending with the justifications behind every reform.
I simply don't have the energy for that. Even if I did, I would do all that. We'd go back and forth for a few rounds. Best case scenario, I'd convince you on some points. You'd abandon those points, then you'd come back in 5-6 weeks when you write ANOTHER blog exactly like this one. I don't have the energy for that kind of theatrical exercise.
Here's my best effort.
ReplyDeleteHealth Care:
Look, I know you don't like the idea of government interference, but most people agreed that a pure, free-market approach wasn't working. Thus the need for reform. The reasons stated were:
Not enough people could afford adequate health care, because the costs had become too high.
Insurance that was affordable sometimes used rather shady practices of denying coverage in order to keep THEIR costs down.
This system was contrary to the popular good. Thus Obamacare.
Regulation of what is considered acceptable health insurance coverage is absolutely necessary if we're going to keep a capitalistic system, rather than a single payer one (which most conservatives claim to want). That means having some standards set.
I'm sorry that religious institutions (note: not churches themselves) feel they're toes are being stepped on. But it basically boils down to whether it's acceptable to ignore regulations (which are their for the public good) based on conscience. And I'll remind you. These organizations have a choice to not provide health care, or to give the employees the money which would have been spent on it, to buy health care on their own.
There are many ways "out" of this situation for religious orgs. And I don't think the government should be blamed for enforcing standards. It's done in many, many other situations, and is, I believe, a good thing.
First, I sincerely appreciate the effort.
ReplyDeleteI wrote an answer to this three times but I wasn't satisfied. Will try again tomorrow.
Concerning HC as it was (and still largly is, as ObamaCare's provisions largely have not gone into effect):
ReplyDeleteIt's good that you weren't caused any great inconvenience or serious difficulties by your lack of insurance. But that's anecdotal evidence, it doesn't necessarily say anything - much less prove anything - about the situation at large.
If I can offer my own anecdotal evidence. Were it not for my health insurance plan (payed for in part my my employer, and in part by me through monthly premiums deducted from my pay, and deductibles) I would probably not have a functioning kidney, and would be on dialysis now. If the hospital had been charitable enough to let me pay after the fact, I would currently owe in excess of $150,000. Probably much more since the recipient is responsible for the health care costs of the donor. So it might likely be more like $250,000.
Assuming I had to stay on dialysis, the costs would have been more but I wouldn't have payed more than $100 a month, thanks to Medicare. But I doubt helps your point, since Medicare is payed for, almost entirely, by taxes. Obamacare at least tries to use the current market-based system rather than switching to a medicare-inspired single payer system.
My situation is rare. Yours is more common for folks without insurance. But the cumulative effect of all cases taken together is that the uninsured cause health care costs to rise.
People without insurance are less likely to get preventative care, which makes more serious problems likely down the road. Expensive treatments for those not covered makes the cost of care rise, which in turn makes it even more difficult for the poor to pay for their own coverage.
Getting everyone covered, and covered well, has always been the stated purpose of health care reform. It's in everyone's collective best interest. The simplest solution is to tax everyone evenly for the total cost of covering the nation. But we didn't go that route because the Right wouldn't have it. So, we took one of the most conservative plans in history instead. It involves forcing individuals to buy coverage, and forcing providers to provide consistent coverage for everyone.
Birth control helps keep costs down. It should be covered. Whether it's absolutely necessary to enforce it on religious institutions is a matter of debate. If we can let it slide without taking a significant hit to costs, as a purely pragmatic compromise, I guess I'd let it slide. I don't think it's right, but I'm willing to look the other way just to shut people up, if only for a little while.
But it's not a matter of principle. Your analogy about giving money to a homeless guy, and being forced to give more, is an analogy that anyone could give as a justification to exploit people, going back to the industrial revoltion.
Factory owners in the 19th centure were, after all, offering wages to people who had nothing. These factory workers knew going into it that they were getting slave wages to do extremely dangerous work. They freely chose to participate anyway. Techincally, the analogy is valid there. They weren't forced to take the job. But the lack of work elsewhere, combined with the fact that the factory owner could afford to pay a decent wage, made it exploitative.
In principle, it was fine. In practice it was absolutely wrong. That's a harsher situation than this one, granted. But it's still valid. If your conscience won't allow to you provide coverage as regulated by the state, then don't. Nobody will blame you, and you're not obligated. Take the money that you would have payed and give it back to the employee in an HSA. Let them pick their own insurance plan.
I think I need to look in to HSA's a little more, but I think in principle, I agree at least that there is a solution for religious groups right there.
ReplyDeleteHowever, I'm not giving a hard commitment to this agreement, because a quick google search shows proponents of HSA's are pretty upset with HHS because of things a little beyond me. Gist of it seems to be that Obamacare in general is going to make HSA's obsolete, or possibly illegal because they can't meet something called a minimum loss requirement.
Otherwise, HSA's would be a fine option I think.
As for paying them all enough to get their own insurance, I'd need to see a lot of numbers, but I'm guessing that would be an undue burden on a lot of small Christian charities and groups.
Also, I understand your point with the workers. A fair point to be sure and I retract my analogy.
However, I do believe this is different. I have only anecdotal evidence for how my family (4 women) had no real trouble with Dad's church insurance not covering this stuff, but I believe there is a big step between saying "Here's 1 dollar a day for back breaking labor" and "Here's health insurance that covers all but a few things."
I still believe, as even you indicate, that we'd have been ok not having this HHS contraception mandate.
But, all that said, if there is a legit "out" of sorts for religious groups, like an HSA, then while this is a very annoying move by the government, at least we'd be able to move forward.
I should add that your comment quite convincingly argues for some of Obamacare's other precepts, which I do not categorically oppose.
ReplyDeleteI need to think a little more, but as a quick response to one thing:
ReplyDeleteI threw out the HSA thing because I have one, and I'm really familiar with it. I didn't expect it you to consider it and focus on it so much. It's almost no different than the employer simply putting money in your paycheck, except the HSA is a tax shelter (for you). It doesn't change much, if anything for the employer. They pay neither more nor less.
I'm essentially saying, if a company was going to negotiate a modest group insurance rate for it's employees. Say, negotiating with insurers for a $150 monthly premium plan for it's employees, with the company paying $75 and the employees paying $75 from their pay, then why not take the $75 that the employers were GOING to pay and give it to the employees instead (either in HSA or not). Then the employee can use the money to buy their own plan.
The employer isn't paying any more than they would have anyway, the employee can pick their own coverage, and nobody's conscience is being violated. That's my general idea. But like you, I'm pretty ignorant of the details. So i should do some homework too.
Word. Knowing that about HSA's and how it wouldn't cost anyone any more....I think that's a great solution to this.
ReplyDeleteI still don't think we needed to create this problem, but since we have, this is a good solution.
Unless of course HSA's can't happen in the future...Something. Science?
"I still don't think we needed to create this problem, but since we have, this is a good solution."
ReplyDeleteThis is the attitude that made me so angry in the first place. Now, I'm not going to get angry again. I'm going to be assertive, but not mean. Or do my damnest, anyway.
The government didn't create a problem, here. This isn't a design flaw in the legislation, it was done on purpose. It IS a problem, but it's a problem for Catholics (and some protestants). I want to make it clear that I'm not apologizing for this legislation, and I'm not trying to be a peacemaker. I feel I have to reject the "burden of proof" that the government is responsible for cleaning up a mistake, and making peace with Catholics.
I'm trying to act as an advocate of this legislation, in some limited way. Because I do believe in it. But I don't apologize for it. I want to be persuasive, but I don't accept the burden of proof for finding a solution. In my eyes the legislation is fine the way it is. But you and many others perceive a problem and I want to persuade.
As an aside, if this were exclusively an issue with Muslims or Jews over some other regulation on insurance providers, it's likely that we wouldn't be having this conversation. Despite the fact that it would still be a crisis of conscience for some. But those groups are small enough that their gripes would largely be ignored as not relevant, and we'd basically be telling them, "Ah, that's too bad. Guess you can't sell insurance if you can't obey the laws". But Catholics have a larger presence and they can make bigger waves, so here we are. It's a matter of politics and pragmatism.
You are perfectly free to feel outraged and disappointed in the legislation that has been written. For whatever reasons - your reasons are you're own. But I don't acknowledge this as a problem for SOCIETY, just one subsection of it. And I want to engage in the conversation, so I can show that it doesn't HAVE to be a problem for Catholics.
OK, back to business..
ReplyDeleteHSA's aren't a magic bullet. An HSA is basically the same as Catholic orgs giving the money directly to the employee, so he can self-insure. So, HSA or no, it's basically the same thing. I kinda wish I hadn't mentioned them.
What I'm trying to get across here is this. The way this conversation is playing out in the media (and here too), you'd think that Catholic orgs are completely boxed in, and have no choice but to pay for contraceptives. The government is forcing them to buy contraceptives.
But that's not true. It's not difficult for religious orgs to find a way through this. Out of the infinite array of possibilities, only one is blocked to them: providing health insurance without contraceptive coverage. That's ONE avenue that's blocked. They're not boxed in at all, they can work around it easily.
What I'm trying to say is that religious orgs don't have to fight their way through that blocked avenue. They can simply go around. If they can't provide every service that's mandated, then don't. It's as simple as that. Ethically, they cannot walk down this path, so don't. Employees can buy insurance on their own. The employers can help by furnishing money they they would have spent - or not. They can keep that money. It doesn't matter. Either way their in compliance.
That's not a matter of finding a clever or innovative solution to the problem. It's not finding a way out of the woods. It's just walking away from the problem. That's all they have to do - simplest thing in the world. Walk away. Can't provide insurance that meets your moral standards - then don't! HSA or not, makes no difference.
Whether employers provide insurance or not - the money is coming from the same pot. Whether employees realize it or not, they're paying for insurance. So it's not as if money is being lost here, it's just being shifted from one hand to the other.
Which, in this case, is exactly right. Shift the moral responsibility for the decision to the employee, the individual. Win-win.
I guess I'm down to just one thing, because you make a very good point here and I think I agree. They can avoid this issue. It is not convenient, but such is life.
ReplyDeleteMy only argument then is not really even an argument. I still just don't think the administration had to do this, or that they should have done this. But they make the law right now, so it is what it is.
I'm not convinced that the president and his administration aren't a little anti-religion, or at least anti-traditional Christian. I've got no smoking gun here, as this particular issue does not appear to be just anti-catholics, but in their view it's pro healthcare.
As such, the bishops see this as an attack, even though it's an attack that also furthers the administration's health care agenda. So I'm ok with them fighting it, but realizing what you've said here, I believe they can "fight it" without crazy rhetoric and lawsuits.
OK, that's fair enough.
ReplyDeleteI'm not going to disagree or make argument, since you didn't make an argument, but I'll share my sentiment too.
I don't sense that it's anti-religion, but I do maybe sense a sort of "screw em if they don't like it" possibility that went into it. Policy advisors were probably aware that Catholic hospitals and the like - people who self insure - would be upset, but legislators chose to keep it anyway. I don't suspect that their motivation was anti-religion, but anti-anti-contraception. They really, really, really want people to have access to birth control. And I sympathize with that, naturally.
I had another fleeting thought. If Republicans had chose to participate in the crafting of this legislation, rather than straight opposition under any circumstances, I have no doubt that they could have negotiated something that Churches would like, along with a lot of other things Christian groups or conservative interests in general would like. This would have came up under debate before the passing of the bill, rather than after. But whatever, that's water under the bridge.
Well, I can't speak for the Republican involvement, but if they were just stonewalling and now trying to pretend to be defenders, I'm not shocked.
ReplyDeleteAs for the bishops, they were in some ways part of this discussion and archbishop and now cardinal Timothy Dolan spoke with the president long in advance as was under the impression that the president wasn't going to do this. The president isn't required to keep his loose assurances to anyone of course, and he can change his mind, but I think that turnaround also stoked the fire.
Hmm, I didn't know that.
ReplyDelete