US Supreme Court "Hobby Lobby" decision on contraception

[Shady]

No but the fact that more than half of Viagra prescriptions in the US are covered by insurance and birth control isn't makes it pretty clear a lot of Americans think so. Be interesting to know if this company's plan is one of them.

Because you don't need a prescription for some birth control.

[Wilber]

To be honest, while this comment is often made derisively, I would think that for people that need "boner pills", getting those is a significant issue that affects their life and health considerably. I don't think there's any point comparing what should be more important, but to me it seems obvious that both should be covered, to hell with what some religious zealots want to impose on their employees (better yet would be de-coupling healthcare from employers of course).

I was being facitious but you wonder where the hell some peoples priorities are. I daresay that for a good number of people, an unwanted pregnancy resulting from the use of a covered boner pill and the lack of a uncovered contraceptive would have a greater effect on their lives.

[Shady]

To be honest, while this comment is often made derisively, I would think that for people that need "boner pills", getting those is a significant issue that affects their life and health considerably. I don't think there's any point comparing what should be more important, but to me it seems obvious that both should be covered, to hell with what some religious zealots want to impose on their employees (better yet would be de-coupling healthcare from employers of course).

The only people imposing anything is their idea that abortifacients should supersede somebody's constitutional rights.

[Wilber]

Because you don't need a prescription for some birth control.

And health plans don't cover things without a prescription. What's your point?

[Bonam]

The only people imposing anything is their idea that abortifacients should supersede somebody's constitutional rights.

No one has any constitutional right to pick and choose what types of health care procedures or drugs should be offered to their employees. Either provide healthcare coverage, or don't. Let the doctors and the patients decide for themselves what that healthcare should entail.

Edited June 30, 2014 by Bonam

[TimG]

Either provide healthcare coverage, or don't.

Making choices about what to cover *is* what insurance companies do. That is how they control costs. This is what *customers* do in a free market (i.e. they pick policies that are cheaper because they only cover the things that they need). It makes no sense to tell a private company that they must offer an all-you-can-eat buffet or not offer anything at all. On top of that, the ACA is depending on companies choosing to cover their employees because if they don't the fines won't cover the costs of the providing it so the ACA should not be adding rules make it more likely for companies to drop it.

That said, the "exemption from (bad) regulations for religious reasons" bothers me.

Bad regulations should be changed - not by granting exemptions.

For that reason I am not convinced this decision is a good one in the long term.

Edited June 30, 2014 by TimG

[Bonam]

Making choices about what to cover *is* what insurance companies do. That is how they control costs. It makes no sense to tell a private company that they must offer an all-you-can-eat buffet or not offer anything at all. On top of that, the ACA is depending on companies choosing to cover their employees because if they don't the fines won't cover the costs of the providing it so the ACA should not be adding rules make it more likely for companies to drop it.

Insurance companies provide the coverage, other employers just pay the insurance company to do so. Is it really so onerous for the employer to simply pay the insurance company whatever standard sum that they agree to pay, and not meddle in the details of what is covered?

Edited June 30, 2014 by Bonam

[TimG]

Is it really so onerous for the employer to simply pay the insurance company whatever standard sum that they agree to pay, and not meddle in the details of what is covered?

There are no 'standard sums'. Insurance rates are based on a company's claim history. A company with a lot of older employees will pay more for the same policy than a company with young employees. The only way a company can control its costs is to restrict what the plan offers which is why employers have no choice but to "meddle" in what is covered. Edited June 30, 2014 by TimG

[Moonlight Graham]

No one has any constitutional right to pick and choose what types of health care procedures or drugs should be offered to their employees. Either provide healthcare coverage, or don't. Let the doctors and the patients decide for themselves what that healthcare should entail.

I'm pretty much with this. Employers shouldn't be micro-managing people's health based on their religious beliefs. Christian Scientists don't believe in medical intervention and think God will heal or not heal as he wants. That could mean a wide lack of coverage from a Christian Scientist employer with a religious agenda. This decision is too big of a can of worms to open.

[Bonam]

There are no 'standard sums'. Insurance rates are based on a company's claim history. A company with a lot of older employees will pay more for the same policy than a company with young employees. The only way a company can control its costs is to restrict what the plan offers which is why employers have no choice but to "meddle" in what is covered.

The employer should specify to the insurance company how much per month it is willing to pay on average per employee, and the insurance company should then provide all the coverages that that affords, starting from the most basic/important on up, as per the opinion of some set of experts at the insurance company, subject to some set of regulations. This then focuses coverage selection on just a small number of companies (the insurance companies) rather than all employers in the country, and coverage selection can then be more intelligently and efficiently done and regulated, free from input from people who know nothing about healthcare. A businessman, owner, lawyer, accountant, or HR person at a company with no knowledge of or expertise in medicine or healthcare should not be making these decisions.

Edited June 30, 2014 by Bonam

[TimG]

The employer should specify to the insurance company how much per month it is willing to pay per employee, and the insurance company should then provide all the coverages that that affords, starting from the most basic/important on up, as per the opinion of some set of experts at the insurance company.

That could work - but that is not the way it is (especially with the ACA now mandating coverage).

I thought this commentary was interesting:

http://www.the-american-interest.com/blog/2014/06/30/hobby-lobby-ruling-shows-deeper-flaw-in-us-health-care/

The fact that most Americans get their health coverage through their employers is something that we all take for granted but has no logical purpose behind it whatsoever. No other industrialized country in the world does it this way, and the system didn’t develop in the United States because it made sense from any standard of efficiency, cost or providing superior benefits to citizens. It was an accident of history

Edited June 30, 2014 by TimG

[Bonam]

I thought this commentary was interesting:

http://www.the-american-interest.com/blog/2014/06/30/hobby-lobby-ruling-shows-deeper-flaw-in-us-health-care/

I have been commenting on the inefficiency and problems of coupling healthcare to employers on every single thread we've ever had here about healthcare. It has many negative impacts, imposes far larger costs on employers than if they simply had to pay money (all the employer-side administration costs a lot), it reduces labor mobility (people have to consider not only the job and the pay, but the implications for healthcare for themselves and their family), it creates far greater difficulties with regulation, etc etc etc. It's just a terrible terrible system.

You can have a private health care system (as the US seems to want to have) but have it have nothing whatsoever to do with employers, other than that they provide money to their employees to participate in the private healthcare system.

Edited June 30, 2014 by Bonam

[Bitsy]

Here you have a better argument. Religion should not be an exemption from regulation. The trouble in this case is the only reason provision is in the ACA because the democrats wanted to impose their religious views on the entire nation (the clause has limited public heath benefit given the other options available). So we have a battle between religious ideologues and it is hard to pick sides. I tend to go with the individual/corporation over government.

That was always part of my argument. Birth control is not mutually exclusive to Democrats and to suggest that was the purpose for its inclusion in the ACA is beyond the pale. This is not a victory for religious freedom. Lost in the argument are the women who work for these corporation who are also practicing Christians that use birth control for family planning or health reasons, they have no religious freedom according to the men on the Supreme Court. Their rights and freedom are trumped by certain corporations based on the owners religious narrow beliefs.

[scribblet]

This is a fairly narrow ruling really. HobbLobby actually does provide coverage for 16 types of contraceptives; it’s those they believe contain ‘abortifacients’. This is really about abortion.

http://www.becketfund.org/hobbylobby/

[Bitsy]

This is a narrow ruling, involving a small sliver of employers, involving not contraception but really abortifacients.

I think a estimated 52% of private employment is a significant number of people.

http://www.slate.com/blogs/moneybox/2014/06/30/hobby_lobby_supreme_court_ruling_how_many_people_work_at_closely_held_corporations.html

There are only two drugs considered abortiofacients by the FDA and the medical profession, RU-486 or methotrexate/ misoprostol combination, and they are not included in the mandate. The birth control methods objected to by these religious zealots are designed to prevent a pregnancy not cause an abortion but in this case dogma outweighs science, as is the case in IUD's which were part of the case.

Edited June 30, 2014 by Bitsy

[Bitsy]

Because you don't need a prescription for some birth control.

And just what would those forms be, and how successful are they in preventing a pregnancy in comparison to prescription drugs. Further, do they serve any other health benefit for the woman other that birth control?

[Bonam]

This is a fairly narrow ruling really. HobbLobby actually does provide coverage for 16 types of contraceptives; it’s those they believe contain ‘abortifacients’. This is really about abortion.

http://www.becketfund.org/hobbylobby/

16 of 20 different types of contraceptives. Do employers get to pick which painkillers their patients are allowed to have? Which cancer drugs? It just doesn't make sense that a random business owner who I'm sure knows a lot about their business but nothing about healthcare should be making such specific decisions about healthcare.

An employer knows about the budget of his/her business. He/she should make a decision like "well, we can afford to spend about $5000/year per employee on healthcare coverage this year". But beyond that should business owners be tasked with poring over lists of thousands of drugs and procedures and hand-picking each and every one? It just makes no sense! It's sheer lunacy.

Edited June 30, 2014 by Bonam

[Shady]

No one has any constitutional right to pick and choose what types of health care procedures or drugs should be offered to their employees. Either provide healthcare coverage, or don't. Let the doctors and the patients decide for themselves what that healthcare should entail.

Yes, actually they do.

[Shady]

16 of 20 different types of contraceptives. Do employers get to pick which painkillers their patients are allowed to have? Which cancer drugs? It just doesn't make sense that a random business owner who I'm sure knows a lot about their business but nothing about healthcare should be making such specific decisions about healthcare.

An employer knows about the budget of his/her business. He/she should make a decision like "well, we can afford to spend about $5000/year per employee on healthcare coverage this year". But beyond that should business owners be tasked with poring over lists of thousands of drugs and procedures and hand-picking each and every one? It just makes no sense! It's sheer lunacy.

Not at all. The lunacy is thinking you have a right to force somebody else to violate their faith by using their money for your gain. Where is this right coming from?

[Shady]

And just what would those forms be, and how successful are they in preventing a pregnancy in comparison to prescription drugs. Further, do they serve any other health benefit for the woman other that birth control?

Um, for one, condoms. They're 99.9% effective! If we're gonna pay for women's birth control pills, I want my condoms paid for too!

[Shady]

I think a estimated 52% of private employment is a significant number of people.

http://www.slate.com/blogs/moneybox/2014/06/30/hobby_lobby_supreme_court_ruling_how_many_people_work_at_closely_held_corporations.html

There are only two drugs considered abortiofacients by the FDA and the medical profession, RU-486 or methotrexate/ misoprostol combination, and they are not included in the mandate. The birth control methods objected to by these religious zealots are designed to prevent a pregnancy not cause an abortion but in this case dogma outweighs science.

It's actually about 4%.

And guess what? Ontario doesn't cover any of it.

Edited June 30, 2014 by Shady

[TimG]

Do employers get to pick which painkillers their patients are allowed to have? Which cancer drugs?

Yes. Drugs which are deemed experimental or off label can be excluded. Generic drugs can be covered but not the name brand. Health care plans are complex - it is completely unreasonable to expect companies to simply outsource this kind of decision making to the companies that make money selling them something. Perhaps they should engage some third party to make decisions based on medical science but that only gets you so far. In the end, the decision on what to include or not to save costs is often completely arbitrary. Edited June 30, 2014 by TimG

[Shady]

This is a fairly narrow ruling really. HobbLobby actually does provide coverage for 16 types of contraceptives; it’s those they believe contain ‘abortifacients’. This is really about abortion.

http://www.becketfund.org/hobbylobby/

Yep, it's the abortion zealots that feel the need to force their views on people of faith. Providing coverage for perfectly acceptable, and efficient 16 contraceptives just isn't good enough.

[Bonam]

Yes. Drugs which are deem experimental or off label can be excluded. Generic drugs can be covered but not the name brand. Health care plans are complex - it is completely unreasonable to expect companies to simply outsource this kind of decision making to the companies that make money selling them something.

Yes so clearly every small business owner should educate themselves on the details of health care and medicine so they can make the best cost-benefit analysis on behalf of their employees to make sure they get the coverage they most benefit from for a cost that the employer can afford. Because clearly this is something that every machine shop owner, mechanic, window cleaning business owner, painter, electrician, store owner, restaurant owner, etc, is capable of doing well and has the time to do this well. Or... we could have people whose business it is to determine these things figure it out. I wonder which way would be better...

[bush_cheney2004]

...And guess what? Ontario doesn't cover any of it.

Wow...must be all the Catholics...eh?