Violation of the Conscience Clause? [Archive]

Skeptic Ginger

4th February 2012, 03:18 PM

Back in the day, landlords often denied access to rental units if you "lived in sin" aka, lived together but weren't married. Then of course were all the "we don't serve blacks here" forms of discrimination. While I suspect I'll get arguments about how this differs, attempts to couch all this discrimination in terms of religious rights is unfortunate because discrimination against other people's beliefs is the other side of this coin.

A Catholic hires a non-Catholic and insists that non-Catholic practice Catholicism. You can take the arguments presented in this Discovery Institute article, Free Birth Control vs. Freedom of Religion - The administration forces organizations to violate their religious beliefs, (http://www.nationalreview.com/articles/289536/free-birth-control-vs-freedom-religion-wesley-j-smith) and turn it around. You get people trying to force others on both sides to follow a religion they do not believe in.When Pliny the Younger was a provincial governor in the Roman Empire, he wrote a letter to Emperor Trajan asking whether he should execute Christians who refused to burn incense in worship of the emperor. Pliny, in keeping with the customs of the empire, did not care about forcing Christians to believe that the emperor was a god. But in public they had to behave as if they did. Thus, the Christians were in the dock not so much because of their faith in a risen Christ as over their willful refusal to declare themselves part of the reigning social order.

I thought of Pliny when I read that the Obama administration, in creating specific rules to implement Obamacare, will require all employers (with a very narrow exemption discussed below) to offer their employees health insurance that provides FDA-approved contraception, female sterilization, and other “reproductive” services free of charge — even if the employer is a religious organization and doing so violates its doctrine.

According to the Ron Paul ilk, it's a matter of private property rights if a lunch counter owner wants to not serve blacks. I understand how they see things from that point of view. It's a tempting argument. But this society decided that was not going to be the case. If you offer a product for sale to the public, you cannot discriminate against people for their skin color or beliefs. The same is true if you rent, sell your house, and so on, you cannot discriminate. So why should an employer be exempt from discriminating?

I don't believe in junk medicine but if I hire someone in this state the law says any insurance I offer employees has to cover 'alternative' medicine. No one sees this as violating my rights or my beliefs. I didn't claim it was religious. Suppose you said your religion doesn't allow you to serve blacks at your lunch counter. You could drum up some story about the Tower of Babel and make a convincing case that the races should not mix. This current controversy is just another version of discrimination.

Either only hire people who believe your same religious views or don't expect the people you hire to follow your beliefs.

On a different note, I wonder how many of these same employers include full coverage for childbirth in their insurance plans? It seems to me that denying coverage for birth control would be costly if the insurance company then had to cover more births. If the policies were cheaper when birth control was covered my guess is this problem would go away.

Insane Duck

4th February 2012, 04:08 PM

Sam.I.Am

4th February 2012, 04:31 PM

Other:

On planet X the contraceptives are mixed into the public water supply so this is a moot question.

mike3

4th February 2012, 04:51 PM

Here are the facts as they were presented to me:

50% of all hosptials in the U.S. are Catholic affiliated (but still receiving government accreditation and funding). With the Affordable Care Act, these hospitals are now required to comply with new standards including requiring them to provide free access to birth-control (and, I think, abortion) for their employees. Although it hasn't been widely reported on, I'm under the impression that a great deal of people oppose this decision on the grounds that it violates the long standing conscience clause precedent and encroaches on religious freedom.

Link (http://www.cantonrep.com/life/religion/x458334980/Does-federal-mandate-impose-on-faith) (finding facts on this has been pretty difficult, if anyone has any relevant information, please post it)

Do you support this move by the government?

It's not forcing anyone to use the services, so I don't see what the problem is.

Lamuella

4th February 2012, 05:23 PM

easy solution:

Nationalize all the hospitals and set up a single payer national health service. Then, they're run by a secular organization and we don't have the ludicrous situation of hospitals being "catholic affiliated".

jasonpatterson

4th February 2012, 09:41 PM

Someone clear this up for me. At first I thought the problem was that Catholic hosptials were being required to provide contraception to patients or lose government funding and approval. Now it looks more like all businesses are being required to provide contraception for their employees and this law makes it a legal requirement for Catholic hosptials to provide it to non-Catholic employees. What exactly does the law say?

The federal government is requiring religiously affiliated organizations (like catholic hospitals) who provide health insurance to cover contraceptives and sterilization along with other preventative health services like mammograms but not including abortion. Actual churches are exempt from the rule. The government's argument is essentially that the religious freedom of a church to do what they like does not extend to every business that church opens, but only to the actual religious organization.

I wonder if there would be an uproar if this were about the government requiring Jehovah's Witness affiliated organizations to cover blood transfusions.

Dancing David

5th February 2012, 06:22 AM

"You're not allowed to help anybody unless you help exactly the people I say, in exactly the way I say."

Yup, that is way the law works, isn't it grand. Govt. money comes with strings attached.

Beerina

5th February 2012, 07:04 AM

Back in the day, landlords often denied access to rental units if you "lived in sin" aka, lived together but weren't married. Then of course were all the "we don't serve blacks here" forms of discrimination. While I suspect I'll get arguments about how this differs, attempts to couch all this discrimination in terms of religious rights is unfortunate because discrimination against other people's beliefs is the other side of this coin.

...

According to the Ron Paul ilk, it's a matter of private property rights if a lunch counter owner wants to not serve blacks. I understand how they see things from that point of view. It's a tempting argument. But this society decided that was not going to be the case. If you offer a product for sale to the public, you cannot discriminate against people for their skin color or beliefs. The same is true if you rent, sell your house, and so on, you cannot discriminate. So why should an employer be exempt from discriminating?

Here's what people fail to realize -- you can't get to your statement "But this society decided that was not going to be the case" until you've spent decades using free speech to convince people that something was wrong.

It was like that for slavery, for female vote, for racial segregation laws, for abortion rights, etc. x 1000 different issues.

1. Almost nobody thinks X should be free, but some do.
2. They convince people.
3. More are convinced. More young people grow up with the idea, and hardened older people die off.
4. Eventually a critical mass is achieved. Laws are changed.

...then people come along and decide in courts that that's the proper way all along!

Which is philosophical nonsense, of course. You can't have courts overturning things until you've gotten a big critical mass of popular opinion to think so.

So, to bring the idea back around, you can't get to "Society decided that X was wrong, sorry charlie!" until you've spent decades with verbal persuasion.

Government should not be in the business of actively discriminating against people. But private citizens should continue to be persuaded, as that's what's gotten society as a whole to this point to begin with.

There's something that always disturbed me about this -- it was big, crowd-based activity that leads to the problems to begin with, which people lament. Then, rather than outlawing crowd-based behavior, they jump with joy when persuasion finally, after decades, builds up their crowd so it's big enough to force itself on everybody.

Slavery, government discrimination laws, laws forbidding abortion, laws forbidding women from doing things, these things wouldn't even exist to begin with if people didn't believe in their hearts it was Ok to force BS onto society as a whole as long as they had enough votes.

Merko

5th February 2012, 10:25 AM

Skeptic Ginger

5th February 2012, 11:43 AM

Here's what people fail to realize -- you can't get to your statement "But this society decided that was not going to be the case" until you've spent decades using free speech to convince people that something was wrong.

It was like that for slavery, for female vote, for racial segregation laws, for abortion rights, etc. x 1000 different issues.

1. Almost nobody thinks X should be free, but some do.
2. They convince people.
3. More are convinced. More young people grow up with the idea, and hardened older people die off.
4. Eventually a critical mass is achieved. Laws are changed.

...then people come along and decide in courts that that's the proper way all along!

Which is philosophical nonsense, of course. You can't have courts overturning things until you've gotten a big critical mass of popular opinion to think so.

So, to bring the idea back around, you can't get to "Society decided that X was wrong, sorry charlie!" until you've spent decades with verbal persuasion.

Government should not be in the business of actively discriminating against people. But private citizens should continue to be persuaded, as that's what's gotten society as a whole to this point to begin with.

There's something that always disturbed me about this -- it was big, crowd-based activity that leads to the problems to begin with, which people lament. Then, rather than outlawing crowd-based behavior, they jump with joy when persuasion finally, after decades, builds up their crowd so it's big enough to force itself on everybody.

Slavery, government discrimination laws, laws forbidding abortion, laws forbidding women from doing things, these things wouldn't even exist to begin with if people didn't believe in their hearts it was Ok to force BS onto society as a whole as long as they had enough votes.While I know this gets your Libertarian hackles up, Beerina, everything cannot be dealt with by laissez faire economics.

Making the case:

Women and the Affordable Care Act (http://www.healthcare.gov/news/factsheets/2011/08/women.html). Women Can Receive Preventive Care Without Copays. Thanks to the Affordable Care Act, all Americans joining a new health care plan can receive recommended preventive services, like mammograms, new baby care and well-child visits, with no out-of-pocket costs. See a list of preventive services for women. (Preventive services benefits apply if you’re in a new health plan that you joined after March 23, 2010.) Learn about new women's preventive care guidelines issued August 1, 2011.

Birth control has been spelled out as being part of preventative care (http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html). The law also requires insurance companies to cover additional preventive health benefits for women. For the first time, HHS is adopting new guidelines for women’s preventive services to fill the gaps in current preventive services guidelines for women’s health, ensuring a comprehensive set of preventive services for women....

...Contraception and contraceptive counseling: Women will have access to all Food and Drug Administration-approved contraceptive methods, sterilization procedures, and patient education and counseling. These recommendations do not include abortifacient drugs. Most workers in employer-sponsored plans are currently covered for contraceptives. Family planning services are an essential preventive service for women and critical to appropriately spacing and ensuring intended pregnancies, which results in improved maternal health and better birth outcomes.(emphasis mine)

A while ago there was a stink about the fact insurers covered Viagra but not birth control for women. The insurers were shamed into changing coverage. The right wing religious community did not make a fuss then. Wonder why not? :rolleyes:

Of course, just like the claim that "Right to Work" laws are really about a right to work, or the claim that union busting creates jobs, or that voter ID laws are about preventing dishonest voting, each and every one of these campaigns has an underlying anti-Democratic Party agenda. This one is no exception.

MatildaGage

5th February 2012, 03:13 PM

Skeptic Ginger

5th February 2012, 06:05 PM

I dunno. I am on the fence.

A church is a church. They might have social work programs for parishoners, food bank for the general public, etc. as part of their Christian support of the community, but they're still mainly a church.

That does seem vastly different than a multi-million dollar business they operate known as a hospital.

Taxpayers already fund Catholic Charities where they advise pregnant teens to keep their babies no matter what, and stop providing services to folks who use birth control. (So says someone I know who works at one.) I don't think we should fund that either.The question is how many of these Catholic or similar employers really ask their health insurance carriers to exclude birth control coverage? I'd like to see which employers are on the list.

I do not recall birth control being excluded from Catholic hospital employee health insurance plans until the Republic Party attack on the new health care reform bill. It never came up. This has come up like I said when it came to light that Viagra was covered while BCPs weren't. But this has never come up as an issue in other contexts. I smell a Republic Party rat.

ponderingturtle

5th February 2012, 07:06 PM

Wow. Imagine the uproar if they made them actually save women's lives if they need an abortion.

MattusMaximus

5th February 2012, 07:36 PM

Yup, that is way the law works, isn't it grand. Govt. money comes with strings attached.

Yup. Though too many religious organizations like the RCC want to have all the perks of government funds but no accountability. It's the same argument as they're using when they argue for government money for private school vouchers: they want the public money to run their schools but don't want to adhere to educational standards of public schools (like teaching sex ed). Kind of a pattern there... they seem to think the church-state door swings in only one direction :rolleyes:

MattusMaximus

5th February 2012, 07:42 PM

Hasn't even the Pope said contraception is under some circumstances the lesser evil? Providing access to something is not the same as encouraging people to use it. These institutions are still free to preach that ideally, unmarried people should never ever have sex.

The irony here is the number of U.S. Catholics who regularly use birth control (which includes condoms) is pretty large. (http://www.catholicsforchoice.org/Ninety-eightPercentofCatholicWomenUseBirthControl.asp) So it seems to me the Bishops are fighting a losing battle on this one.

:popcorn1

sylvan8798

5th February 2012, 09:32 PM

If the hospitals receive government funding they should adhere to the rules. If this is injurious to their consciences (or those of the catholic hierarchy calling the shots) they can decline further government funding; I'm sure the church will be willing to make up the shortfall.
I didn't see anywhere where they said that the penalty for non-compliance is loss of government funding. Do you have a link for that? It was my impression that it is a REQUIREMENT, as in government will start arresting people if they don't comply.

Insane Duck

6th February 2012, 09:04 AM

I didn't see anywhere where they said that the penalty for non-compliance is loss of government funding. Do you have a link for that? It was my impression that it is a REQUIREMENT, as in government will start arresting people if they don't comply.
Well, I think that the affordable care act actually imposes fines and penalties for those who don't comply. You don't *have* to get insurance, but if you don't I'm pretty sure there are financial repercussions.

sadhatter

6th February 2012, 01:49 PM

Skeptic Ginger

6th February 2012, 07:09 PM

You know we were on the subject of refusal to fill (Jargon for not filling a prescription for belief based reasons.) in my class, and i mentioned that i am in the odd situation of only having OTC products as the products i would refuse to sell. ( bunk medicine , homeopathy, etc.)

I got a lot of blank stares as if no one thought that maybe there were people out there who didn't agree with selling someone a pill that wouldn't do anything. Yet i know **** well that if i attached some religious reason for the same action, it wouldn't have gotten that reaction.

What is it about religion that gets people a pass? An action is the same action if it is committed for religious or secular reasons.I think your point is valid. And we restrict some snake oil but IMO, not enough. With OTC woo, we could control the ads more effectively without controlling the products. There is a free market option. But where you draw the line on the continuum of how far one can push the envelope of fraud is a different (but still valid) question.

I've been trying to see this campaign from the other side. I think it is motivated by an anti-Democratic Party agenda, making the health care bill look like it is biased against theists, which is not the intent of the bill by any means. It is the intent of promoting outrage against the BCP clause if you are in the Republic Party. However, there are people with legitimate concerns about the BCOP clause in the health care bill.

I like Joe Scarborough most of the time. He is a right winger I believe is still rational. Last night he was pointing out on his program that if we reversed this concept, and instead had a right wing government passing legislation denying the right to cover birth control, then the harm of this bill would be obvious.

I get his point of view. And I've tried to consider it in arguing that this legislation is indeed valid. I still come out agreeing with the legislation and of course wanted to scream at the TV that none of the left leaners on the program were debating the right points with cup a Joe.

When is it discrimination? When does it reach the level of needing government intervention? Who is being discriminated against?

Does the Civil Rights Bill discriminate against the lunch counter owner or rightfully protect the black patron?

How does gay marriage hurt any religious group?

Suppose you take that a step further, does the religious landlord have to rent to the gay married couple or the couple who are not married but live together? Whose rights trump whose in those cases?

All of these situations are one person's rights vs another's. Does the government rightfully intervene or is that overstepping? They are all judgement calls.

Scarborough's claim is that in this case the government is overstepping, is discriminating against certain employers within religious organizations. Well, what about the landlord or the lunch counter owner? Isn't the person who doesn't believe in religious restrictions on birth control or who is involved in a gay marriage also being discriminated against by the employer or the landlord?

From my viewpoint, the homosexual and the atheist (or other person who doesn't see BC as a sin) are being discriminated against. From Scarborough's viewpoint the religion based employer is the one being unfairly restricted. By what criteria do we decide?

In the case of the lunch counter owner the decision and current majority opinion is the lunch counter owner was unfairly restricting the lunch counter patron. The owner was in the position of power and the government stepped in to protect the less powerful lunch counter patron. The landlord has more power than the renter, the government steps in and protects the renter from discrimination. In the case of the employer, the employee would, if we use these criteria, rightfully deserve the government's protection against the discriminating employer.

What criteria are we using in the Civil Rights Bill? Are we using race or the powerful over the powerless? Discrimination by landlords? Religious beliefs? Personal beliefs? Is it OK to refuse to rent to unmarried or gay couples? Or is it powerful vs powerless?

I'm pretty sure Joe Scarborough was drawing the line claiming religious beliefs trumped the rights of the powerless. Back in the 60s many in the South felt that social beliefs about race trumped the rights of the powerless.

I don't agree with cup a Joe. I'm an atheist. I think the government should stop religious employers and owners from discriminating against their less powerful employees, renters and customers. I'm sure Joe would say the Constitution is supposed to protect the religious beliefs of the employer and owner.

I can see both points of view. I also think we need to define the problem fairly and truthfully. It is not about religious rights, period, end of story. It is not about individual rights, period, end of story. These rights conflict with each other. It's wrong to argue either side without recognizing this conflict.

We've decided as a society that we would not accept discrimination based on race, age or gender. (I happen to think homosexuality belongs with the physical criteria, race, age and gender but that's an off topic argument here so I defer that debate.) But these other areas we are currently debating are based on each individual's equal right to their beliefs.

If it is about a conflict between each individual's right to their own beliefs, do you defer to the owners/employers or the government? Does the government have a role to protect the less powerful against the more powerful? Does your religion trump mine because you own something?

Let's debate the real issues here, not the hot button framing issues.

Dunstan

6th February 2012, 07:29 PM

What is the "Conscience Clause"?

sylvan8798

6th February 2012, 09:38 PM

What is the "Conscience Clause"?

Kind of like being a conscientious objector to the draft. At the pharmacy, you (the pharmacist) can object to a regulation that you have to provide birth control to a customer on conscience grounds, but in general you would then have to tell the customer she could get them down the block at pharmacy X.

sylvan8798

6th February 2012, 09:51 PM

If it is about a conflict between each individual's right to their own beliefs, do you defer to the owners/employers or the government? Does the government have a role to protect the less powerful against the more powerful? Does your religion trump mine because you own something?

Let's debate the real issues here, not the hot button framing issues.
I think this issue is more complicated than people are realizing. It isn't about contraception, it's about the government dictating what the church has to do. While it may seem simple enough that the church just provides the coverage (against it's personal beliefs), they have to consider what else the government may mandate down the line. How far to you take the idea that the government decides?

It would not be a stretch at all for the administration, or some future administration, to mandate that every doctor or facility that provides OB-GYN services has to provide abortion services as well. Why not? Those are OB-GYN services, and there is a shortage of options in many areas of the country for women wanting an abortion. Easy solution. Mandate everyone add them to their services. Ponderingturtle even broaches that possibility upthread: Wow. Imagine the uproar if they made them actually save women's lives if they need an abortion.

While I hate slippery-slope arguments, I think there is a real issue here in whether the church can take a stand here against having their policy dictated to them, and where exactly they can or will draw the line.

ponderingturtle

7th February 2012, 03:18 AM

ponderingturtle

7th February 2012, 03:20 AM

I think this issue is more complicated than people are realizing. It isn't about contraception, it's about the government dictating what the church has to do. While it may seem simple enough that the church just provides the coverage (against it's personal beliefs), they have to consider what else the government may mandate down the line. How far to you take the idea that the government decides?

It would not be a stretch at all for the administration, or some future administration, to mandate that every doctor or facility that provides OB-GYN services has to provide abortion services as well. Why not? Those are OB-GYN services, and there is a shortage of options in many areas of the country for women wanting an abortion. Easy solution. Mandate everyone add them to their services. Ponderingturtle even broaches that possibility upthread:

While I hate slippery-slope arguments, I think there is a real issue here in whether the church can take a stand here against having their policy dictated to them, and where exactly they can or will draw the line.

Yep that is the main worry that the will be forced to save womens lives. They should also be against organ donation as that also stops a beating human heart.

sylvan8798

7th February 2012, 08:04 AM

Yep that is the main worry that the will be forced to save womens lives. They should also be against organ donation as that also stops a beating human heart.

I would think we would be hearing a lot more about all these women who are dying because they were unable to get an abortion at their catholic hospital. Perhaps you have links to some information on them?

ZirconBlue

7th February 2012, 09:40 AM

I think this issue is more complicated than people are realizing. It isn't about contraception, it's about the government dictating what the church has to do. While it may seem simple enough that the church just provides the coverage (against it's personal beliefs), they have to consider what else the government may mandate down the line. How far to you take the idea that the government decides?

It would not be a stretch at all for the administration, or some future administration, to mandate that every doctor or facility that provides OB-GYN services has to provide abortion services as well. Why not? Those are OB-GYN services, and there is a shortage of options in many areas of the country for women wanting an abortion. Easy solution. Mandate everyone add them to their services. Ponderingturtle even broaches that possibility upthread:

While I hate slippery-slope arguments, I think there is a real issue here in whether the church can take a stand here against having their policy dictated to them, and where exactly they can or will draw the line.

This seems to be a pretty good argument for why religious organizations shouldn't be allowed to run hospitals. ;)

Weak Kitten

7th February 2012, 10:11 AM

Kind of like being a conscientious objector to the draft. At the pharmacy, you (the pharmacist) can object to a regulation that you have to provide birth control to a customer on conscience grounds, but in general you would then have to tell the customer she could get them down the block at pharmacy X.

As someone who takes birth control pills to prevent extreme periods (nausea, vomiting, and pain so great it can cause me to black out) I strenuously object to pharmacists not providing necessary medication. What if that pharmacist is the only one in a small town? Does the girl just have to suck it up and take the bus a hundred miles or take three to five days a month to lie in agony on the bathroom floor?

If we are going to let pharmacists decide what they will and will not give to patients then at least force them to put up a great big sign in front of their shop. That way those of us who need medicine and don't want to have to worry about the pharmacist objecting to curing our particular illnesses can avoid such shops.

Dunstan

7th February 2012, 10:23 AM

Kind of like being a conscientious objector to the draft. At the pharmacy, you (the pharmacist) can object to a regulation that you have to provide birth control to a customer on conscience grounds, but in general you would then have to tell the customer she could get them down the block at pharmacy X.

Well, yes, I gathered that this is the kind of sentiment being referred to. But when I see a title like "violation of the Conscience Clause" (and talking about "conscience clause precedent"), I want to know what is the supposed legal authority. It's not in the U.S. Constitution. (And since we're talking about a federal law, it's irrelevant whether particular state constitutions or statutes provide such protection.) I'm reasonably familiar with First Amendment jurisprudence and have not heard of that term being used by the courts. The linked article simply quotes "Sister Judith Ann Karam, president and CEO of the Sisters of Charity Health System" making some references to the phrase.

So, absent some actual legal precedent, I'm not seeing much basis for a legal challenge here other than hoping that the Supreme Court's Catholic majority will create new law. The law doesn't force any church to do anything; it merely imposes conditions on the receipt of federal funds, which are reasonably related to the purpose of the spending.

ponderingturtle

7th February 2012, 12:27 PM

I would think we would be hearing a lot more about all these women who are dying because they were unable to get an abortion at their catholic hospital. Perhaps you have links to some information on them?

Why? The answer to the family is that there is nothing that could be done because as a catholic hospital they never preform any abortion. See the firing of the nun who agreed to save a womans life.

People die all the time because they end up at a hospital that does not provide the level of care they need. This shouldn't be news.

Dancing David

7th February 2012, 01:13 PM

I would think we would be hearing a lot more about all these women who are dying because they were unable to get an abortion at their catholic hospital. Perhaps you have links to some information on them?

I think you should tell me why my daughter should not have her birth control pill covered by insurance if she works for one of these organizations. Her need is not based upon contraception, so why should her medication be uncovered?

LTC8K6

7th February 2012, 01:55 PM

I think you should tell me why my daughter should not have her birth control pill covered by insurance if she works for one of these organizations. Her need is not based upon contraception, so why should her medication be uncovered?

Well, the government apparently says she shouldn't if she's in the minority...

Skeptic Ginger

7th February 2012, 03:58 PM

Skeptic Ginger

7th February 2012, 04:03 PM

I would think we would be hearing a lot more about all these women who are dying because they were unable to get an abortion at their catholic hospital. Perhaps you have links to some information on them?No direct abortion at Phoenix hospital, theologian says (http://ncronline.org/news/no-direct-abortion-phoenix-hospital-theologian-says)"The mother and fetus were both in the process of dying … It was not a matter of choosing one life or the other. The child's life, because of natural causes, was in the process of ending," wrote theologian M. Therese Lysaught in a 24-page analysis of the medical procedure performed by St. Joseph's Hospital and Medical Center in November 2009.
"The only morally good thing that can be chosen here is to save the life of the mother,'" wrote Lysaught, who reviewed the case at the request of Catholic Healthcare West, a three-state system of mainly Catholic hospitals to which St. Joseph's belongs.
NCR received a copy of Lysaught's report Dec. 21.
In a Nov. 22 letter to Catholic Healthcare West, Phoenix Bishop Thomas J. Olmsted said he appreciated Lysaught's analysis of the issue, but "I disagree with her conclusion." Olmsted described the 2009 case as a direct abortion in violation of church moral teaching and the U.S. bishops' "Ethical and Religious Directives for Catholic Health Care Services."

No Nice Things

7th February 2012, 05:26 PM

theprestige

7th February 2012, 08:25 PM

Yup, that is way the law works, isn't it grand. Govt. money comes with strings attached.

As far as I can tell, the Affordable Care Act imposes these requirements even on institutions that don't take government money.

Skeptic Ginger

7th February 2012, 08:35 PM

I voted other:

I support this decision - not all employees are Catholic and cannot be held to the same religious beliefs. Also free will and all that for the Catholic employees. However, only the first aspect is important to me here.
So like the black that can just chose another lunch counter, the nurse can simply choose not to work for the Catholic hospital?

Gives me an idea. Perhaps it it the nurses who should strike and demand a non-discriminatory health insurance plan rather than expecting the Democratic Party legislators to stand up to the usual right wing strong arming.

No Nice Things

7th February 2012, 10:00 PM

So like the black that can just chose another lunch counter, the nurse can simply choose not to work for the Catholic hospital?

Gives me an idea. Perhaps it it the nurses who should strike and demand a non-discriminatory health insurance plan rather than expecting the Democratic Party legislators to stand up to the usual right wing strong arming.

Yes, that is exactly why I made my post. It has nothing to do with the long term precedent of allowing religions their own way on "moral" healthcare. I assumed we were talking about how the law effected religious organisations that employed (and insured) people for their secular efforts.

For Merlin's sake, I think that coverage should be mandated universally. I accept that I can't get my way and am willing to stick my stake in the ground here.

Skeptic Ginger

9th February 2012, 07:25 PM

Naturally, this is a recent Republic Party interest that mattered not until they picked it for a campaign outrage issue.

Insurance Coverage for Contraception Laws (http://www.ncsl.org/issues-research/health/insurance-coverage-for-contraception-state-laws.aspx)At least 26 states have laws requiring insurers that cover prescription drugs also provide coverage for any Food and Drug Administration (FDA)-approved contraceptive. These states include: Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Hawaii, Illinois, Iowa, Maine, Maryland, Massachusetts, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Washington, West Virginia and Wisconsin.
An additional two states—Michigan± and Montana—require insurance coverage of contraceptives as a result of administrative ruling or an Attorney General opinion.
Two states—Texas and Virginia—require that employers be offered the option to include coverage of contraceptives within their health plans.
Some laws prohibit insurance plans from excluding contraceptive services or supplies.
Some states include an exemption for employers who object to such coverage for religious reasons.
Twenty states offer exemptions from contraceptive coverage (usually for religion) for insurers or employers in their policies: Arizona, Arkansas, California, Connecticut, Delaware, Hawaii, Maine, Maryland, Massachusetts, Michigan, Missouri, Nevada, New Jersey, New Mexico, New York, North Carolina, Oregon, Rhode Island, Texas and West Virginia. (These states are indicated with an * in the table below.)
Several states require employers to notify employees of their refusal to provide contraceptive coverage. So six states have no exception for religious beliefs of the employer. Funny no one noticed before. :rolleyes:

Dancing David

10th February 2012, 07:27 AM

As far as I can tell, the Affordable Care Act imposes these requirements even on institutions that don't take government money.

""You're not allowed to help anybody unless you help exactly the people I say, in exactly the way I say." " is what you said, so what does that have to do with the Affordable Care Act, they did not say they can't help people, now did they?

Trakar

11th February 2012, 02:09 PM

Insane Duck

11th February 2012, 09:32 PM

Your understandings seem incorrect.
True, although I think we established that a while ago. It's become even more apparent now that the ruling is getting front page coverage.

Toke

12th February 2012, 04:04 AM

Why should work place regulations be subject to somebody's religious beliefs?
E.g. "Minimum wage/safety regulations/environmental protection is against my religion"

How come there are no complains about government interference from the right when it is about preventing e.g. US-Aid or the UN from providing contraception?

And what is the big deal here, those catholic employees would not be using it anyway, so the hospitals could just shrug it off as irrelevant. ;)

Trakar

12th February 2012, 09:36 AM

Why should work place regulations be subject to somebody's religious beliefs?

Generally, they shouldn't be, but if you are going to work for a religious, or religion affiliated organization, why would you think that there wouldn't or shouldn't be some religious influences to the workplace rules, regulations and practices?

Toke

12th February 2012, 10:36 AM

Generally, they shouldn't be, but if you are going to work for a religious, or religion affiliated organization, why would you think that there wouldn't or shouldn't be some religious influences to the workplace rules, regulations and practices?

There could be assorted customs* decided by the majority, but the formal regulations would have to be secular in anything but a theocracy.

*e.g. with a Mormon employer I would accept having to bring my own coffee, or as currently with a Norwegian employer I got Lutefish for Christmas.

Trakar

12th February 2012, 11:20 AM

There could be assorted customs* decided by the majority, but the formal regulations would have to be secular in anything but a theocracy.

*e.g. with a Mormon employer I would accept having to bring my own coffee, or as currently with a Norwegian employer I got Lutefish for Christmas.

No theocracy required to expect that private businesses are going to have private interest influences in their rules, regulations and practices. If such are perceived to be at odds with federal or state laws and regulations, those are issues that will have to be ironed out between the private interest and the public interest. I'm satisfied that pressing issues have been addressed in this particular topic of discussion, and have no problem with the resolution achieved.

http://www.economist.com/blogs/democracyinamerica

brodski

12th February 2012, 11:33 AM

Why should work place regulations be subject to somebody's religious beliefs?
E.g. "Minimum wage/safety regulations/environmental protection is against my religion"

That happens to some extent, mostly in relation to Sikhs and hard hats.

ponderingturtle

12th February 2012, 11:41 AM

That happens to some extent, mostly in relation to Sikhs and hard hats.

Somewhat different as well. Would a Sikh business be able to ban all employees from wearing hard hats?

Toke

12th February 2012, 11:41 AM

No theocracy required to expect that private businesses are going to have private interest influences in their rules, regulations and practices. If such are perceived to be at odds with federal or state laws and regulations, those are issues that will have to be ironed out between the private interest and the public interest. I'm satisfied that pressing issues have been addressed in this particular topic of discussion, and have no problem with the resolution achieved.

http://www.economist.com/blogs/democracyinamerica

That resolution look like complete madness to me.
Why would the theist have a problem covering something their "faithful" employees would not use anyway?
And it sets a nasty precedent for accepting just about anything people claim as "their religion".

Trakar

12th February 2012, 12:29 PM

That resolution look like complete madness to me.
Why would the theist have a problem covering something their "faithful" employees would not use anyway?
And it sets a nasty precedent for accepting just about anything people claim as "their religion".

Your choice to not participate in, or support, this position. I don't believe in trying to force the rest of the world to think like and agree with me, do you?

rwguinn

12th February 2012, 12:39 PM

Your choice to not participate in, or support, this position. I don't believe in trying to force the rest of the world to think like and agree with me, do you?
You mean like Catholic employers do, he asked not expecting an acknowledgement of inconsistency...

Toke

12th February 2012, 01:30 PM

Your choice to not participate in, or support, this position. I don't believe in trying to force the rest of the world to think like and agree with me, do you?
Could you elaborate this?
It is everything but clear to me.

Trakar

12th February 2012, 04:55 PM

You mean like Catholic employers do, he asked not expecting an acknowledgement of inconsistency...

Catholic employers don't expect everyone to think like them or agree with them, or they would only offer employment to and treat Catholics. What they do expect is the ability to not have to be forced to pay for employee practices and choices that they consider morally and spiritually dangerous. They aren't telling employees that they cannot use birth control or have abortions, they are simply refusing to fund such choices.

rwguinn

12th February 2012, 05:06 PM

MatildaGage

12th February 2012, 05:16 PM

And what is the big deal here, those catholic employees would not be using it anyway, so the hospitals could just shrug it off as irrelevant. ;)
LOL!! Good point.

(I think it's their non-Catholic employees they're concerned about though?)

Trakar

12th February 2012, 05:23 PM

Originally Posted by Toke
That resolution look like complete madness to me.
Why would the theist have a problem covering something their "faithful" employees would not use anyway?
And it sets a nasty precedent for accepting just about anything people claim as "their religion".
Originally Posted by Trakar
Your choice to not participate in, or support, this position. I don't believe in trying to force the rest of the world to think like and agree with me, do you?
Could you elaborate this?
It is everything but clear to me.

Do you think that Mothers Against Drunk Driving should be forced to offer free super-size coupons to drive-through Daiquiri Huts for their clerical staffs and support vendors? Should committed Vegan advocacy groups be required to serve burgers and fried chicken at public rallys? These religion affiliated hospitals aren't telling their employees (Catholic or lay) that they cannot use contraceptives or have abortions, the hospitals are merely saying that they shouldn't have to have their rates raised for the coverage of elective procedures that they are morally and spiritually opposed to. The current compromise effectively and adequately addresses this issue from my perspective.

Skeptic Ginger

12th February 2012, 06:50 PM

Do you think that Mothers Against Drunk Driving should be forced to offer free super-size coupons to drive-through Daiquiri Huts for their clerical staffs and support vendors? Should committed Vegan advocacy groups be required to serve burgers and fried chicken at public rallys? These religion affiliated hospitals aren't telling their employees (Catholic or lay) that they cannot use contraceptives or have abortions, the hospitals are merely saying that they shouldn't have to have their rates raised for the coverage of elective procedures that they are morally and spiritually opposed to. The current compromise effectively and adequately addresses this issue from my perspective.This is a false analogy. It's also a false slippery slope argument. And you have some bad information tossed in.

It is cheaper to provide women's health care when birth control is included. That has been cited repeatedly. So why do you think it costs more to include it? It actually costs more not to.

And yet you end with a reasonable statement: "current compromise effectively and adequately addresses this issue". Interesting.

Trakar

12th February 2012, 07:29 PM

This is a false analogy. It's also a false slippery slope argument. And you have some bad information tossed in.

It is cheaper to provide women's health care when birth control is included. That has been cited repeatedly. So why do you think it costs more to include it? It actually costs more not to.

And yet you end with a reasonable statement: "current compromise effectively and adequately addresses this issue". Interesting.

I fully cop to the inappropriate analogy regarding the specifics of third party insurance v. Daiquiri Hut coupons/burgers and chicken, but I don't see the "slippery slope" interpretation? My analogies weren't intended to address equivilance of extended health insurance coverage to drink coupons or picnic refreshments, however, but rather the equivilance of organizations being forced to provide ancilliary benefits for elective procedures that violate their own moral and ethical standards.

The costs can be dramatically less, but this does not mean that insurance companies automatically provide such, nor do they automatically lower thier coverage rates for insured individuals who take advantage of such procedures. Some do, but such is not axiomatic.

We can disagree on the circumstances, rationales and justifications, but such make little difference when we agree on the resolution of the issue.

Skeptic Ginger

12th February 2012, 08:32 PM

I fully cop to the inappropriate analogy regarding the specifics of third party insurance v. Daiquiri Hut coupons/burgers and chicken, but I don't see the "slippery slope" interpretation? My analogies weren't intended to address equivilance of extended health insurance coverage to drink coupons or picnic refreshments, however, but rather the equivilance of organizations being forced to provide ancilliary benefits for elective procedures that violate their own moral and ethical standards.The OSH Act requires employers to provide workplace safety that includes certain medical evaluations and dictates to employers certain equipment they must use like the safer needle device mandate. They have to provide fire exits and reasonable accommodation for people with disabilities, just to name a few rules. No one is whining about those government mandates except the extremist Libertarians who are under the disproved concept the marketplace will take care of those things.

Of course off the job health insurance is in a different category, one could argue. Except in this country until it changes, employers are responsible for the health insurance of the workforce. Change that lunacy and shift health care into the same realm as police and fire services and we can drop this argument altogether. But until then, there is a legitimate reason for the government to set standards in health insurance coverage when it is deemed necessary. Preventative care is one of those necessary rules.

Toke

12th February 2012, 11:40 PM

LOL!! Good point.

(I think it's their non-Catholic employees they're concerned about though?)

I think the concern here is that these employers would love to be able to enforce their particular brand of morals/superstition on their employees.

Actually they would like to enforce it on all, it is just that the employees are easier to reach. See company town (http://en.wikipedia.org/wiki/Company_town#The_Pullman_lesson) for older examples.

Trakar

13th February 2012, 07:39 AM

The OSH Act requires employers to provide workplace safety that includes certain medical evaluations and dictates to employers certain equipment they must use like the safer needle device mandate. They have to provide fire exits and reasonable accommodation for people with disabilities, just to name a few rules. No one is whining about those government mandates except the extremist Libertarians who are under the disproved concept the marketplace will take care of those things.

Of course off the job health insurance is in a different category, one could argue. Except in this country until it changes, employers are responsible for the health insurance of the workforce. Change that lunacy and shift health care into the same realm as police and fire services and we can drop this argument altogether. But until then, there is a legitimate reason for the government to set standards in health insurance coverage when it is deemed necessary. Preventative care is one of those necessary rules.

I completely and fully agree with your assessment, but I don't see that elective issues like birth control or abortion are essential preventative care necessities outside of certain specific-case instances.

Personally, as stated before, I would prefer single-payer coverage public option to the current corporate welfare system solution, but would actually prefer National Health Care service to National Health Insurance.

Dunstan

13th February 2012, 08:11 AM

Catholic employers don't expect everyone to think like them or agree with them, or they would only offer employment to and treat Catholics. What they do expect is the ability to not have to be forced to pay for employee practices and choices that they consider morally and spiritually dangerous. They aren't telling employees that they cannot use birth control or have abortions, they are simply refusing to fund such choices.

Would your argument not also mean that Catholic employers should have the right to forbid their employees from using birth control or abortion services that weren't provided for free? After all, those employees would be using money paid by the employer. Why is it reasonable to say "I object to any of the money I have paid to the insurance company being used for services I disagree with" but not "I object to any of the money I have paid to employees being used for services I disagree with"? If it's all about the employer's money being used for objectionable things, it shouldn't matter whether it goes to the doctor through the insurer or through the employee.

Skeptic Ginger

13th February 2012, 10:44 AM

Would your argument not also mean that Catholic employers should have the right to forbid their employees from using birth control or abortion services that weren't provided for free? After all, those employees would be using money paid by the employer. Why is it reasonable to say "I object to any of the money I have paid to the insurance company being used for services I disagree with" but not "I object to any of the money I have paid to employees being used for services I disagree with"? If it's all about the employer's money being used for objectionable things, it shouldn't matter whether it goes to the doctor through the insurer or through the employee.Ding ding ding ding ding.

Good point I have not yet heard/read made.

Skeptic Ginger

13th February 2012, 10:46 AM

I completely and fully agree with your assessment, but I don't see that elective issues like birth control or abortion are essential preventative care necessities outside of certain specific-case instances. The experts who evaluated preventative medicine for the Health Care Bill found birth control was indeed valuable preventative care.

Trakar

14th February 2012, 12:05 AM

The experts who evaluated preventative medicine for the Health Care Bill found birth control was indeed valuable preventative care.

To my reading and understanding there are significant differences between an assessment of valuable preventative care, and essential preventative care necessities.

Trakar

14th February 2012, 12:18 AM

Would your argument not also mean that Catholic employers should have the right to forbid their employees from using birth control or abortion services that weren't provided for free?

Not at all. Neither Church nor employer have the right or obligation to dictate how an individual must spend their earned income. The church doesn't even have the right or obligation to forcibly keep its members from committing sins, in fact such could even be viewed as thwarting God's commitment to free-will. But there is a big difference between a church janitor using his paycheck to purchase the services of a hooker, and the church being required to provide its janitors the service of hookers as payment for his labors. I have a hard time seeing how this distinction is not clear to any reasonable consideration.

If it's all about the employer's money being used for objectionable things, it shouldn't matter whether it goes to the doctor through the insurer or through the employee.

Once the employer pays the employee, it is not the employer's money. If the employee uses their earnings for sinful pursuits that is between the employee and God.

casebro

14th February 2012, 05:33 AM

So where do I go to get my free condoms?

ponderingturtle

14th February 2012, 05:59 AM

So where do I go to get my free condoms?

Men get Viagra instead. See ED is a vital problem that must be covered by insurance unlike birth control.

Of course there are lots of places that give out free condoms.

Trakar

14th February 2012, 08:19 AM

So where do I go to get my free condoms?

I believe most county health and planned parenthood offices dispense free condoms. While I think such is an admirable practice, condoms and even birth control pills, are relatively cheap.

Condoms 0.50 - 1.00/each so an average of $30-60/month

BC pills an average of $15-50/month
http://asktheexperts.plannedparenthood.org/?p=3889

Morning after (good for up to five days -120 hours- post fertilization) $10-70/dose
http://www.plannedparenthood.org/health-topics/emergency-contraception-morning-after-pill-4363.asp

Dunstan

14th February 2012, 08:23 AM

Not at all. Neither Church nor employer have the right or obligation to dictate how an individual must spend their earned income. The church doesn't even have the right or obligation to forcibly keep its members from committing sins, in fact such could even be viewed as thwarting God's commitment to free-will. But there is a big difference between a church janitor using his paycheck to purchase the services of a hooker, and the church being required to provide its janitors the service of hookers as payment for his labors. I have a hard time seeing how this distinction is not clear to any reasonable consideration.

Once the employer pays the employee, it is not the employer's money. If the employee uses their earnings for sinful pursuits that is between the employee and God.

So you're saying that in this chain of commerce:

Employer's bank account --> * Employee's bank account --> Cash in employee's pocket --> drugstore cash register (to pay for purchase of birth control)

"the money" ceases to be "the employer's money" where I've put the asterisk. But you continue to insist that in this chain:

Employer's bank account --> Insurance company's bank account --> bank account of doctor who has prescribed birth control for patient

"the money" continues to be "the employer's money" throughout?

How can you justify this? Why does transferring money to an employee's bank account make it "no longer the employer's" but transferring it to an insurance company's doesn't? Is transsubstantiation involved somehow?

Trakar

14th February 2012, 01:59 PM

So you're saying that in this chain of commerce:

Employer's bank account --> * Employee's bank account --> Cash in employee's pocket --> drugstore cash register (to pay for purchase of birth control)

"the money" ceases to be "the employer's money" where I've put the asterisk. But you continue to insist that in this chain:

Employer's bank account --> Insurance company's bank account --> bank account of doctor who has prescribed birth control for patient

"the money" continues to be "the employer's money" throughout?

How can you justify this? Why does transferring money to an employee's bank account make it "no longer the employer's" but transferring it to an insurance company's doesn't? Is transsubstantiation involved somehow?

Not at all, it ceases to be the employer's money as soon as the employer purchases the service from the insurance company. Why should the employer be forced to purchase an elective employee service from the insurance company that it considers morally and ethically objectionable and repugnant. I don't understand where this is eluding reasonable consideration and understanding. Is deliberate and obstinate obtuseness involved somehow?

Dunstan

14th February 2012, 02:13 PM

Not at all, it ceases to be the employer's money as soon as the employer purchases the service from the insurance company. Why should the employer be forced to purchase an elective employee service from the insurance company that it considers morally and ethically objectionable and repugnant.

What is "the service" that the employer is purchasing from the insurance company? It isn't "birth control." It's health insurance, i.e. reimbursement for medical expenses incurred. Neither the employer nor the insurance company is the one choosing to use or even prescribe birth control. Those would be the employee and the doctor, respectively.

The employer is not being "forced" to purchase birth control. It is simply being denied the power to say "you can't use money that came from me to pay for things I don't approve of." And since you agree that employers shouldn't have that right in the case where the money goes to the doctor through the employee's hands, what difference does it make when the money goes to the doctor through the insurance company's hands, when in both cases it is the employee, not the employer, who decides whether or not to use birth control?

I don't understand where this is eluding reasonable consideration and understanding. Is deliberate and obstinate obtuseness involved somehow?

Perhaps, but it's not on my part.

Trakar

14th February 2012, 03:53 PM

What is "the service" that the employer is purchasing from the insurance company?

If you don't understand the functional aspects of health insurance coverage then perhaps you should seek out that understanding before trying to argue the details of the issue.

It isn't "birth control." It's health insurance, i.e. reimbursement for medical expenses incurred.

No health policy coverage that I am aware of, is blanket coverage of all medical issues. Policies and coverages are limited in nature and generally cost different amounts per differences in coverage and requisite co-pay. This is why, while I oppose any stipulation that would force a religion-affiliate employer to pay for additional coverage of elective health procedures/treatments that violate their moral and ethical beliefs, I have no problem with Obama's resolution, that forces insurance companies to offer this same specific elective coverage directly to the employees of such organizations without any additional charge to the employer.

Neither the employer nor the insurance company is the one choosing to use or even prescribe birth control. Those would be the employee and the doctor, respectively.

Prescription isn't the issue, necessity vs electivity, and forcing a rights protected-class of people and organizations to violate their core beliefs to fund the non-medically necessary choices of its employees is the issue.

The employer is not being "forced" to purchase birth control. It is simply being denied the power to say "you can't use money that came from me to pay for things I don't approve of."

Birth control, as per original discussion (unsure where all its wandered to since), was not covered under the original Catholic hospitals' employee insurance plan. I do not agree with forcing the Catholic hospitals to purchase or co-pay employee insurance plans that do cover birth control. If, as Obama's resolution states, the insurance company wants to offer this additional coverage to the employees of such institutions without any additional charge to the employer,...I call that a win-win resolution!

Perhaps, but it's not on my part.

We shall see.

Skeptic Ginger

14th February 2012, 05:32 PM

To my reading and understanding there are significant differences between an assessment of valuable preventative care, and essential preventative care necessities.Nothing is "essential preventative care" by the standard you seem to be describing.

Is a mammogram "essential" or just "valuable"? The whole point of describing something as essential is saying it is economically better to provide it than not to. How are you defining the two?

Skeptic Ginger

14th February 2012, 05:36 PM

Not at all. Neither Church nor employer have the right or obligation to dictate how an individual must spend their earned income. And yet you claim the church has the right to determine what health insurance the employee may purchase. Health insurance provided by an employer is not really essentially different from wages provided by the employer. It's part of your pay package, not your work environment.

Perhaps a better solution then would be to pay the employees the benefit and allow them to buy their own insurance.

Dunstan

14th February 2012, 05:38 PM

If you don't understand the functional aspects of health insurance coverage then perhaps you should seek out that understanding before trying to argue the details of the issue.

It was a rhetorical question. Perhaps you should look that up.

No health policy coverage that I am aware of, is blanket coverage of all medical issues. Policies and coverages are limited in nature and generally cost different amounts per differences in coverage and requisite co-pay. This is why, while I oppose any stipulation that would force a religion-affiliate employer to pay for additional coverage of elective health procedures/treatments that violate their moral and ethical beliefs, I have no problem with Obama's resolution, that forces insurance companies to offer this same specific elective coverage directly to the employees of such organizations without any additional charge to the employer.

But how does that square with your earlier claim that it's still the employer's money? The employee is still getting birth control from a doctor who's getting paid by an insurance company who is paying that sum because the employer is paying it premiums. Whether it's listed as a separate "line-item" on the insurer's bill to the employer is irrelevant to your claim that the employer has the right to determine what is done with "its" money.

Again, we still have two situations. One where the employer pays the insurer, who says, "hey, by the way, I may use some of this money to pay for doctors to provide your employees with birth control. If they ask for it." And one where the employer pays the employee, who says, "hey, by the way, I may use some of this money to pay for doctors to provide me with birth control." And you're still claiming that the employer can object to #1 but not to #2.

Prescription isn't the issue, necessity vs electivity, and forcing a rights protected-class of people and organizations to violate their core beliefs to fund the non-medically necessary choices of its employees is the issue.

But you're back to the same problem. If the "core belief" is that it's wrong "to fund the non-medically necessary choices of its employees," then what does it matter whether the money goes through one channel versus another?

(And by the way, I'm just assuming that that really is a "core belief." My understanding is that the Church's dogma is "don't use birth control." Not "don't allow any of your money to be used towards the purchase of birth control.")

Trakar

14th February 2012, 06:23 PM

...But how does that square with your earlier claim that it's still the employer's money?

Where and in what context do you perceive me to be arguing that the employer's money does anything but purchase specific medical coverage for specific purchase prices?

The employee is still getting birth control from a doctor who's getting paid by an insurance company who is paying that sum because the employer is paying it premiums. Whether it's listed as a separate "line-item" on the insurer's bill to the employer is irrelevant to your claim that the employer has the right to determine what is done with "its" money.

Again, we still have two situations. One where the employer pays the insurer, who says, "hey, by the way, I may use some of this money to pay for doctors to provide your employees with birth control. If they ask for it." And one where the employer pays the employee, who says, "hey, by the way, I may use some of this money to pay for doctors to provide me with birth control." And you're still claiming that the employer can object to #1 but not to #2...

This seems a complete misunderstanding of the manner that insurance coverage and policies work. If the coverages change new policies must be written, agreed to by both parties and paid for. Policies are contracts, specified payments for specified coverages, they aren't something that can be altered or adjusted unilaterally at a whim.

But you're back to the same problem. If the "core belief" is that it's wrong "to fund the non-medically necessary choices of its employees," then what does it matter whether the money goes through one channel versus another?

The employer is not selecting or paying for the coverage. The insurer is offering the coverage directly to the employee with no charge to the employer.

(And by the way, I'm just assuming that that really is a "core belief." My understanding is that the Church's dogma is "don't use birth control." Not "don't allow any of your money to be used towards the purchase of birth control.")

Are seriously proposing that though the Church argues that any form of birth control (including coitus interruptus) is a sin, that they would(and should) willingly pay to have people commit that sin?

Skeptic Ginger

14th February 2012, 07:25 PM

.... though the Church argues that any form of birth control (including coitus interruptus) is a sin, that they would(and should) willingly pay to have people commit that sin?It's all in how you frame it.

People can get paid by the same employer and can buy birth control.

If the employer pays an insurance premium somehow that differs in some critical way? The employer is not buying the pills, they are paying an insurance premium as part of a pay package.

People are arguing the employer's rights as if the employee has no rights.

It is already mandated in 6 or 7 states without exception, no one cared until it became an election sound bite.

This is the same church that hid pedophile priests but somehow this issue is a moral outrage?

It's all in the framing.

Trakar

14th February 2012, 10:25 PM

...This is the same church that hid pedophile priests but somehow this issue is a moral outrage?

It's all in the framing.

You really caught some air going over that shark!

Skeptic Ginger

14th February 2012, 10:35 PM

You really caught some air going over that shark!I don't get how jumping the shark (http://en.wikipedia.org/wiki/Jumping_the_shark) applies. Perhaps you could explain?

Trakar

14th February 2012, 11:21 PM

I don't get how jumping the shark (http://en.wikipedia.org/wiki/Jumping_the_shark) applies. Perhaps you could explain?

Exagerated and over the top performance to continue flogging a dead horse.

If you prefer, we can just leave your irrational ad hom attack to stand as its own example of how to derail an attempt at honest and considered discussion.

Toke

15th February 2012, 01:16 AM

Exagerated and over the top performance to continue flogging a dead horse.

If you prefer, we can just leave your irrational ad hom attack to stand as its own example of how to derail an attempt at honest and considered discussion.

Perhaps you just don't get the part about how the church is not really in a position to issue any moral edicts/advice.
(It has kind of fallen from it's high horse. :))

How would you feel about as (mentioned elsewhere) a Jehovah witnesses employer denying employees blood transfusions in their coverage?

Trakar

15th February 2012, 06:43 AM

Perhaps you just don't get the part about how the church is not really in a position to issue any moral edicts/advice.
(It has kind of fallen from it's high horse. :))

How would you feel about as (mentioned elsewhere) a Jehovah witnesses employer denying employees blood transfusions in their coverage?

we come back to that issue of elective medical procedure/treatment vs. issue of medical necessity.

Insane Duck

15th February 2012, 06:51 AM

we come back to that issue of elective medical procedure/treatment vs. issue of medical necessity.
It hardly matters. Contraception is an important part of a healthy populace and everyone deserves access to it (access that was being denied by the objecting organizations). They are both cases where the health of the employee is being infringed upon by the preferences of the employer.

ETA: The health benefits of contraception would include STD prevention and smaller families, both of which lead to healthier lives. While abstinence would also work, it simply isn't a realistic prevention method.

Hellbound

15th February 2012, 07:06 AM

Just a side thought here.

The main argument by Trakar aseems to be this:

The organization is buying the service, and therefore (baring clear medical necessity) should be able to exclude services they feel are against their belief/policy/ideology. In other words, they get to decide how their money is spent by the organization they are funding.

That about right?

With that in mind, why are you then arguing that the government, when purchasing a service (in the form of providing public funding to these organizations) is excluded from this same ability? Your argument seems to inheritly include classing religion ina special category with preferrential treatment.

Trakar

15th February 2012, 07:28 AM

Just a side thought here.

The main argument by Trakar aseems to be this:

The organization is buying the service, and therefore (baring clear medical necessity) should be able to exclude services they feel are against their belief/policy/ideology. In other words, they get to decide how their money is spent by the organization they are funding.

That about right?

Not quite, more like: Employer gets to decide which services (barring clear medical necessity) they purchase for their employees, and should be under no federal obligation to purchase elective medical procedures/treatment services which they feel violate their moral/ethical positions. IOW, they get to decide what non-medically essential services they purchase as a benefit for their employees.

Trakar

15th February 2012, 07:30 AM

It hardly matters. Contraception is an important part of a healthy populace and everyone deserves access to it (access that was being denied by the objecting organizations). They are both cases where the health of the employee is being infringed upon by the preferences of the employer.

ETA: The health benefits of contraception would include STD prevention and smaller families, both of which lead to healthier lives. While abstinence would also work, it simply isn't a realistic prevention method.

The employer is not preventing access, they merely shouldn't and aren't being forced to pay for elective services/treatments that violate their moral and ethical positions.

Hellbound

15th February 2012, 07:36 AM

Not quite, more like: Employer gets to decide which services (barring clear medical necessity) they purchase for their employees, and should be under no federal obligation to purchase elective medical procedures/treatment services which they feel violate their moral/ethical positions. IOW, they get to decide what non-medically essential services they purchase as a benefit for their employees.

But the federal government has no say in how the money they provide gets spent?

I still don't see how this isn't a case of special pleading.

As I understand it, the issue here affects religious-affiliated hospitals that receieve government funds. Your stance is that the hospital is spending the money, so they should decide what it's spent on (to a degree, at least).

Yet, you're denying that same right to the government.

You didn't clarify that dichotomy in replying to my earlier post, can you explain the reasoning on why you differentiate the two?

ETA:

Just as an aside, what would you think if the federal government developed an "additional coverage policy", that covered birth control. This policy would be offered to all employees of these religious affiliations, and the cost of it would come out of the funds that had previously been provided to the hospital. Is that a violation? What if the government mandated that information about this had to be made available to employees?

Trakar

15th February 2012, 07:49 AM

But the federal government has no say in how the money they provide gets spent?

Not at all, I'm perfectly happy with the current resolution of this issue, in which the federal government has stated that insurace companies can offer this coverage directly to employees without charging the employer for that coverage.

Jalok

15th February 2012, 08:28 AM

I believe most county health and planned parenthood offices dispense free condoms. While I think such is an admirable practice, condoms and even birth control pills, are relatively cheap.

Condoms 0.50 - 1.00/each so an average of $30-60/month

BC pills an average of $15-50/month
http://asktheexperts.plannedparenthood.org/?p=3889

Morning after (good for up to five days -120 hours- post fertilization) $10-70/dose
http://www.plannedparenthood.org/health-topics/emergency-contraception-morning-after-pill-4363.asp

*Does some math*

You sir, are my hero.

jalok the married

Skeptic Ginger

15th February 2012, 09:15 AM

Exagerated and over the top performance to continue flogging a dead horse.

If you prefer, we can just leave your irrational ad hom attack to stand as its own example of how to derail an attempt at honest and considered discussion.So according to you that frame is not legit. Well, according to me, the moral outrage frame is wholly contrived. BC insurance coverage is already mandated in multiple states. Why no outrage when those laws were passed? Another contrived frame I suppose: it's OK for states but not the Fed? :rolleyes:

At least the hypocrisy frame is supportable with evidence. What evidence supports the moral outrage frame?

Skeptic Ginger

15th February 2012, 09:21 AM

we come back to that issue of elective medical procedure/treatment vs. issue of medical necessity.Sometimes blood transfusions are elective procedures and birth control is not. For an extreme example, a raped woman who would die if a pregnancy was attempted needs medical intervention and a person with a marginally low hematocrit could wait it out and one's own body could restore the blood loss but a transfusion would speed things along.

Your position lacks medical facts.

Skeptic Ginger

15th February 2012, 09:22 AM

.... While abstinence would also work, it simply isn't a realistic prevention method.And, there is overwhelming evidence supporting this conclusion.

Skeptic Ginger

15th February 2012, 09:25 AM

Skeptic Ginger

15th February 2012, 09:32 AM

We're also back to the moral outrage of renting an apartment or hiring discrimination against someone living as an unmarried couple, a gay couple, a Wiccan, an atheist, mandating your tenets or employees wear crosses or place "Jesus Loves Me" stickers on their cars, etc etc.

We as a society draw a lot of lines regarding this issue when individual rights vs the religious beliefs of owner/employers conflict with each other. There is nothing outrageous with the position of this particular line the government is drawing.

Toke

15th February 2012, 02:23 PM

All these employer/employee relations governed by regulations of a secular state should be very careful to avoid any favouritism. Whether it be reluctance on contraception or blood transfusions.

Trakars position can only exist in some christian pseudo secular state.

Skeptic Ginger

15th February 2012, 06:08 PM

Trakar

15th February 2012, 06:13 PM

Someone brought up the example of the Christian Scientists' belief in prayer over medical care. Should they be allowed to offer medical insurance that denied any coverage for life saving treatments the church believed prayer was a better option for?

Are we talking non-essential elective medical services/treatment or medically necessary procedures/treatments?

Trakar

15th February 2012, 06:20 PM

Your belief in what is or is not medically essential lacks expert knowledge.

What in my statements leads you to believe this?

Are you proposing we let the church decide what is medically necessary or do you suppose physicians are in a better position to make that determination?

Physicians are the only ones qualified to make those decisions. If a mother's life is at substantive risk from complications likely to result from pregnancy, then birth control, or more likely, sterilization, is a medical necessity, and such should be covered by health insurance regardless of any employer's moral or ethical issues.

I've already given a medical example revealing your lack of medical expertise.

Link?

Trakar

15th February 2012, 06:34 PM

Sometimes blood transfusions are elective procedures and birth control is not. For an extreme example, a raped woman who would die if a pregnancy was attempted needs medical intervention and a person with a marginally low hematocrit could wait it out and one's own body could restore the blood loss but a transfusion would speed things along.

Your position lacks medical facts.

If there is a situation where birth control (or sterilization which is much more likely the recommendation as no form of birth control except sterilization is 100% effective) are deemed by a physician to be medically necessary, then it should be covered by health insurance, the same with blood transfusions, regardless of any employer moral or ethical issues. Elective procedures, without medical necessity, are a different matter. A raped woman has 5 days, in which the morning after pill is considered strongly effective at pre-empting pregnancy, according to Planned Parenthood (http://www.plannedparenthood.org/health-topics/emergency-contraception-morning-after-pill-4363.asp). This is more than enough time for her to see her own doctor and take any medically necessary measures that need to be taken. Either way, if there is a medical necessity for birth control as determined by a qualified physician, then that should be covered by health insurance regardless of employer moral or ethical concerns.

Trakar

15th February 2012, 06:47 PM

So according to you that frame is not legit. Well, according to me, the moral outrage frame is wholly contrived. BC insurance coverage is already mandated in multiple states. Why no outrage when those laws were passed? Another contrived frame I suppose: it's OK for states but not the Fed? :rolleyes:

At least the hypocrisy frame is supportable with evidence. What evidence supports the moral outrage frame?

Try arguing against what I am actually saying rather than the arguments you seem to wish I was making.

In those states, there are either exceptions made for Catholic hospitals, the hospitals self-insure and avoid the state requirement, or they have dropped prescription drug coverage entirely. If these are the options that are preferred, I guess that is the way things will have to progress, but as repeatedly stated, I am perfectly happy with the resolution the Obama administration has provided.

(one of the very few things Obama has done since elected, that I can applaud without any reservation or qualification.)

Trakar

15th February 2012, 06:51 PM

*Does some math*

You sir, are my hero.

jalok the married

LOL!

(it's been a while since my personal expenses would have ranged that high, but I wasn't trying to lowball the figure, and at that price you have to figure in some breakage and water balloon allowances! ;) )

Skeptic Ginger

15th February 2012, 07:46 PM

Try arguing against what I am actually saying rather than the arguments you seem to wish I was making.

In those states, there are either exceptions made for Catholic hospitals, the hospitals self-insure and avoid the state requirement, or they have dropped prescription drug coverage entirely. If these are the options that are preferred, I guess that is the way things will have to progress, but as repeatedly stated, I am perfectly happy with the resolution the Obama administration has provided.

(one of the very few things Obama has done since elected, that I can applaud without any reservation or qualification.)You should check your facts. In 28 states birth control in health insurance policies is mandated with exceptions for religious reasons in some but not all states. I linked to this earlier. (http://www.guttmacher.org/statecenter/spibs/spib_ICC.pdf)

I know you are OK with Obama's solution, I posted that already also. But you continue to bring up additional issues and I continue to address them regardless of your being happy with the current solution.

HIGHLIGHTS:
 28 states require insurers that cover prescription drugs to provide coverage of the full range of FDAapproved contraceptive drugs and devices; 17 of these states also require coverage of related outpatient services.
 2 states exclude emergency contraception from the required coverage.
 1 state excludes minor dependents from coverage.
 20 states allow certain employers and insurers to refuse to comply with the mandate. 8 states have no such provision that permits refusal by some employers or insurers.
 4 states include a “limited” refusal clause that allows only churches and church associations to refuse to provide coverage, and does not permit hospitals or other entities to do so.
 7 states include a “broader” refusal clause that allows churches, associations of churches, religiously affiliated elementary and secondary schools, and, potentially, some religious charities and universities to refuse, but not hospitals.
 8 states include an “expansive” refusal clause that allows religious organizations, including at least some hospitals, to refuse to provide coverage; 2 of these states also exempt secular organizations with moral or religious objections. (An additional state, Nevada, does not exempt any employers but allows religious insurers to refuse to provide coverage; 2 other states exempt insurers in addition to employers.)
 14 of the 20 states with exemptions require employees to be notified when their health plan does not cover contraceptives.
 4 states attempt to provide access for employees when their employer refuses to offer contraceptive coverage, generally by allowing employees to purchase the coverage on their own, but at the group rate.Upon what evidence do you claim that religion based employers, in particular Catholic hospitals, simply decline prescription drug coverage for all employees rather than provide health insurance that includes birth control?

Ceritus

15th February 2012, 08:35 PM

The government has no business in any of this.

Trakar

15th February 2012, 10:34 PM

You should check your facts. In 28 states birth control in health insurance policies is mandated with exceptions for religious reasons in some but not all states. I linked to this earlier. (http://www.guttmacher.org/statecenter/spibs/spib_ICC.pdf)

http://www.nytimes.com/2012/02/11/nyregion/catholic-institutions-reluctantly-comply-with-ny-contraceptives-law.html?_r=1

I know you are OK with Obama's solution, I posted that already also. But you continue to bring up additional issues and I continue to address them regardless of your being happy with the current solution.

I am not bringing up any new or additional issues. My statements are consistent and repeating what I have stated from the beginning, despite repeated attempts by numerous people to rearrange my words into statements they would apparently rather argue against.

Upon what evidence do you claim that religion based employers, in particular Catholic hospitals, simply decline prescription drug coverage for all employees rather than provide health insurance that includes birth control?

One of the primary sources I used was the NYTimes article linked above, but what you state in the above quoted material is not equal to my previous response. (http://forums.randi.org/showpost.php?p=8027991&postcount=109)

Skeptic Ginger

15th February 2012, 11:14 PM

http://www.nytimes.com/2012/02/11/nyregion/catholic-institutions-reluctantly-comply-with-ny-contraceptives-law.html?_r=1Did you read your link? It cites numerous instances where Catholic employers 'grudgingly' provide policies that include covering birth control. ...One of the most contentious laws was approved in California in 1999; the measure effectively provided an exemption to churches but not to religiously affiliated hospitals, universities or social service organizations. Catholic Charities of Sacramento unsuccessfully challenged the law in court.

“It was pretty much a useless exemption, because the large employers are not churches,” said Carol Hogan, a spokeswoman for the California Catholic Conference. She said many large Catholic institutions in California, like hospitals, have since elected to sidestep the law by insuring themselves."Many large institutions" is not the same as 'all' now is it? And in fact, “Some Catholic employers are complying with the law under protest,” Funny the mainstream media didn't notice until the right wing made it an Obama issue.

Trakar

16th February 2012, 06:50 AM

Did you read your link? It cites numerous instances where Catholic employers 'grudgingly' provide policies that include covering birth control. ..."Many large institutions" is not the same as 'all' now is it? And in fact, Funny the mainstream media didn't notice until the right wing made it an Obama issue.

Please quote the precise statement in this article (http://www.nytimes.com/2012/02/11/nyregion/catholic-institutions-reluctantly-comply-with-ny-contraceptives-law.html?_r=1)which indicates to you that Catholic hospitals have done anything other than what I have indicated (http://forums.randi.org/showpost.php?p=8027991&postcount=109). Students at catholic affiliated schools are a much different issue to my considerations, as the students are not employed by those universities, they are merely enrolled and attending classes at those universities.

Kestrel

16th February 2012, 09:03 AM

Someone brought up the example of the Christian Scientists' belief in prayer over medical care. Should they be allowed to offer medical insurance that denied any coverage for life saving treatments the church believed prayer was a better option for?

That is a good point. The GOP controlled House is working on a bill that would allow an employeer to drop coverage for any health care procedure due to moral or religious grounds.

Kestrel

16th February 2012, 09:27 AM

Funny the mainstream media didn't notice until the right wing made it an Obama issue.

Fox News has been busy comparing the birth control mandate to NAZI Germany. Jon Stewart had a lot of fun with this on the Daily Show (http://www.huffingtonpost.com/2012/02/14/jon-stewart-birth-control-mandate-fox-news-christians-war-video_n_1275835.html).

What I find rather scary is that many Americans would not see a problem with Sean Hannity's panel of experts on this subject having about 20 men and no women. (See the first part of the video in my link.)

AvalonXQ

16th February 2012, 09:34 AM

I don't have a problem with a Catholic hospital refusing to provide contraceptive services to their patients.

But I really don't have a problem with requiring that the health insurance provided to employess covers certain services, and contraceptive services are definitely an example that should be on the list for the benefit of the public.

Insane Duck

16th February 2012, 09:34 AM

The employer is not preventing access, they merely shouldn't and aren't being forced to pay for elective services/treatments that violate their moral and ethical positions.
In cases where the employees wouldn't otherwise be able to afford (or would neglect to purchase because of a tight budget) contraception, the employer is restricting their employee's access to important health care.

Skeptic Ginger

16th February 2012, 10:25 AM

New point heard on the news today about this fake moral outrage: The Quakers don't have a consciousness clause allowing them not to pay taxes that support wars.

Skeptic Ginger

16th February 2012, 10:32 AM

And we have this in yesterday's LA Times: Before current birth-control fight, Republicans backed mandates (http://www.latimes.com/health/la-na-gop-contraceptives-20120216,0,3392996.story)

And of course there is this news, Dems decry all-male oversight hearing on WH contraception rule (http://www.cbsnews.com/8301-503544_162-57379351-503544/dems-decry-all-male-oversight-hearing-on-wh-contraception-rule/).

Of course the Republics might find this fake outrage backfires given how many men want those women taking birth control. :cool:

Trakar

16th February 2012, 10:55 AM

That is a good point. The GOP controlled House is working on a bill that would allow an employeer to drop coverage for any health care procedure due to moral or religious grounds.

Though the vast majority of Republicans do seem to be a part of, or at the least condoning of, the Strong Social Conservative movement, this isn't true of *all* Republicans. I, for instance, would and do strongly object to any such bill.

bookitty

16th February 2012, 11:01 AM

If there is a situation where birth control (or sterilization which is much more likely the recommendation as no form of birth control except sterilization is 100% effective) are deemed by a physician to be medically necessary, then it should be covered by health insurance, the same with blood transfusions, regardless of any employer moral or ethical issues. Elective procedures, without medical necessity, are a different matter. A raped woman has 5 days, in which the morning after pill is considered strongly effective at pre-empting pregnancy, according to Planned Parenthood (http://www.plannedparenthood.org/health-topics/emergency-contraception-morning-after-pill-4363.asp). This is more than enough time for her to see her own doctor and take any medically necessary measures that need to be taken. Either way, if there is a medical necessity for birth control as determined by a qualified physician, then that should be covered by health insurance regardless of employer moral or ethical concerns.

http://www.guttmacher.org/media/nr/2011/11/15/index.html

The most common reason U.S. women use oral contraceptive pills is to prevent pregnancy, but 14% of pill users—1.5 million women—rely on them exclusively for noncontraceptive purposes. The study documenting this finding, “Beyond Birth Control: The Overlooked Benefits of Oral Contraceptive Pills,” by Rachel K. Jones of the Guttmacher Institute, also found that more than half (58%) of all pill users rely on the method, at least in part, for purposes other than pregnancy prevention—meaning that only 42% use the pill exclusively for contraceptive reasons.

This is why you don't let the church define "medical necessity." Why should 58% of women who use birth control for multiple reasons need to justify that to their employer? That should be between her and her doctor.

Trakar

16th February 2012, 11:11 AM

In cases where the employees wouldn't otherwise be able to afford (or would neglect to purchase because of a tight budget) contraception, the employer is restricting their employee's access to important health care.

Which employees cannot afford a couple of bucks for a box of condoms? or afford a stop by a local planned parenthood/county health office to pick up free condoms? If the employee is that broke how are they going to make the co-pay to go visit their doctor to get a prescription for these condoms?

bookitty

16th February 2012, 11:15 AM

Skeptic Ginger

16th February 2012, 11:28 AM

Which employees cannot afford a couple of bucks for a box of condoms? or afford a stop by a local planned parenthood/county health office to pick up free condoms? If the employee is that broke how are they going to make the co-pay to go visit their doctor to get a prescription for these condoms?A lot of people making minimum wage or slightly more live from pay check to pay check.

Not getting by on minimum wage (http://money.cnn.com/2011/09/27/news/economy/minimum_wage_jobs/index.htm)

Trakar

16th February 2012, 11:42 AM

http://www.guttmacher.org/media/nr/2011/11/15/index.html

This is why you don't let the church define "medical necessity." Why should 58% of women who use birth control for multiple reasons need to justify that to their employer? That should be between her and her doctor.

It is not that there are not other regimens, that are therapeutically effective for other needs but not efficient at birth control, which could be used to achieve those ends,...which would be one way to go to address those issues, but, personally, if a doctor was willing to prescribe the medications as a necessary treatment for specific medical condition, or even if there is a strong medical likelihood that pregnancy would create a significant critical compromise of the health of the patient, then I have no problem with it being covered by a Catholic hospital's insurance, regardless of how the Church feels about the issue. My objection lies in the employer being forced to cover elective medical procedures that it considers morally objectionable. And in the interest of clarity, birth control is not the only elective medical procedure I would object to. If there were a law trying to force employers to cover plastic surgery, body alteration, or any other elective procedure that is not a legitimate medical necessity, I would feel the same way, but especially so when such procedures violate the long established ethics and moral positions of the employer.

bookitty

16th February 2012, 11:48 AM

It is not that there are not other regimens, that are therapeutically effective for other needs but not efficient at birth control, which could be used to achieve those ends,...which would be one way to go to address those issues, but, personally, if a doctor was willing to prescribe the medications as a necessary treatment for specific medical condition, or even if there is a strong medical likelihood that pregnancy would create a significant critical compromise of the health of the patient, then I have no problem with it being covered by a Catholic hospital's insurance, regardless of how the Church feels about the issue. My objection lies in the employer being forced to cover elective medical procedures that it considers morally objectionable. And in the interest of clarity, birth control is not the only elective medical procedure I would object to. If there were a law trying to force employers to cover plastic surgery, body alteration, or any other elective procedure that is not a legitimate medical necessity, I would feel the same way, but especially so when such procedures violate the long established ethics and moral positions of the employer.

OK, so what about viagra? It could be argued the Viagra is completely elective (heaven knows how many people have been pushing for "just don't have sex" in various threads on birth control and abortion.)

Right now the Catholic church thinks Viagra is nifty, they are all for it (moar babies!!!) However, should a man be forced by his Catholic employer to prove that he will only use viagra with his wife? Adultery is a pretty huge biblical no-no. Jesus himself was so busy speaking against it that he forgot to mention abortion and hating gays. Should a man who is know to have had affairs be denied viagra or should that be between his doctor and himself?

AvalonXQ

16th February 2012, 11:55 AM

bookitty

16th February 2012, 12:01 PM

Absolutely it is. Do you know of any attempt by the government to mandate that employers must pay for Viagra?

Prior to this there was no mandate to provide birth control. It was just properly lumped in with medical care. Right now, viagra is also lumped in with medical care, it has not been targeted.

KingMerv00

16th February 2012, 12:13 PM

My objection lies in the employer being forced to cover elective medical procedures that it considers morally objectionable.

My objection lies in the public being forced to cover 62% (http://en.wikipedia.org/wiki/Catholic_Charities) (TAX FREE) of the employer's medical insurance it finds morally objectionable.

bookitty

16th February 2012, 12:17 PM

My objection lies in the public being forced to cover 62% (http://en.wikipedia.org/wiki/Catholic_Charities) (TAX FREE) of the employer's medical insurance it finds morally objectionable.

By george, I think you're on to something! If the church wishes to enter the political arena, it should start paying the taxes of a corporation. Any church which invests in trying to sway secular policy should lose tax-exempt status. The church can then start any sort of minimal care hospital they choose and the taxes can go towards building secular hospitals.

KingMerv00

16th February 2012, 12:38 PM

By george, I think you're on to something! If the church wishes to enter the political arena, it should start paying the taxes of a corporation. Any church which invests in trying to sway secular policy should lose tax-exempt status. The church can then start any sort of minimal care hospital they choose and the taxes can go towards building secular hospitals.

Funny how the whole "pay taxes" idea never occurs to a group that guilts people out of money once a week.

Insane Duck

16th February 2012, 01:51 PM

Which employees cannot afford a couple of bucks for a box of condoms? or afford a stop by a local planned parenthood/county health office to pick up free condoms? If the employee is that broke how are they going to make the co-pay to go visit their doctor to get a prescription for these condoms?
A lot of people making minimum wage or slightly more live from pay check to pay check.

Not getting by on minimum wage (http://money.cnn.com/2011/09/27/news/economy/minimum_wage_jobs/index.htm)
Not only do many struggle to get by, but I also think that the issue is with the pill and other contraceptives that while more effective, are also definitely not free.

Trakar

16th February 2012, 02:04 PM

So the employee who is paying for health coverage must now pay more or use their own time to obtain birth control which is less effective?

If the employee is paying for his own health coverage, they should buy the coverage they want, desire and require. If the employer isn't offering the coverage they want, they indeed should look for the coverage that they require elsewhere. If they want to accept the coverage being offered in a company sponsored health care insurance plan, then that is the way they should go. All that I am saying is that no organization should be required to provide coverage for non-medically essential, elective procedures/treatments.

Skeptic Ginger

16th February 2012, 02:11 PM

Absolutely it is. Do you know of any attempt by the government to mandate that employers must pay for Viagra?Are there any insurance policies where this drug is specifically excluded?

Skeptic Ginger

16th February 2012, 02:12 PM

Breaking news, vasectomies are covered in these policies. I have not yet confirmed this but it was just brought up on the news.

Trakar

16th February 2012, 02:12 PM

A lot of people making minimum wage or slightly more live from pay check to pay check.

Not getting by on minimum wage (http://money.cnn.com/2011/09/27/news/economy/minimum_wage_jobs/index.htm)

Agreed, but I'm not aware of any hospital position the pays minimum wage and offers health insurance coverage. Using such a hypothetical as a rhetorical example, however, how do you get cheaper than free (from Planned Parenthood/county health clinic)?

AvalonXQ

16th February 2012, 02:15 PM

Are there any insurance policies where this drug is specifically excluded?

Absolutely yes. Many insurance policies treat it as an elective medication and don't cover it. And, again, I'm not seeing its mandatory coverage under Obamacare; did I miss it?

AvalonXQ

16th February 2012, 02:18 PM

Breaking news, vasectomies are covered in these policies. I have not yet confirmed this but it was just brought up on the news.

My Google-fu says no. The plans generally don't cover contraceptive drugs, tubal ligations, or vasectomies.

Skeptic Ginger

16th February 2012, 02:19 PM

... My objection lies in the employer being forced to cover elective medical procedures that it considers morally objectionable. ...You ignored the issue I raised: you and many employers are not qualified to make medical decisions. I cited examples where your medical statements in this thread were wrong. Yet you continue to insist you know which treatments are elective and which are necessary.

In addition, are you saying it's OK for an employer to object to birth control for women while allowing vasectomies if the employer claims that is consistent with their beliefs?

bookitty

16th February 2012, 02:19 PM

Agreed, but I'm not aware of any hospital position the pays minimum wage and offers health insurance coverage. Using such a hypothetical as a rhetorical example, however, how do you get cheaper than free (from Planned Parenthood/county health clinic)?

Why should the employee who pays for some portion of health insurance and counts it as part of their income have to take time out of their life to go to Planned Parenthood/county health clinic in order to get birth control that is less effective? Catholic charities is more than hospitals, they also do fund-raising and there are many positions there that are minimum wage.

Also, if you're a conservative, you have been voting for people who are cutting funding to Title X programs. In rural areas of the country, free condoms are not easily obtained. Even if it were, forcing the employee to seek them out when their secular government is paying for a significant amount of that health care coverage just doesn't make sense.

Trakar

16th February 2012, 02:21 PM

OK, so what about viagra? It could be argued the Viagra is completely elective (heaven knows how many people have been pushing for "just don't have sex" in various threads on birth control and abortion.)

Right now the Catholic church thinks Viagra is nifty, they are all for it (moar babies!!!) However, should a man be forced by his Catholic employer to prove that he will only use viagra with his wife? Adultery is a pretty huge biblical no-no. Jesus himself was so busy speaking against it that he forgot to mention abortion and hating gays. Should a man who is know to have had affairs be denied viagra or should that be between his doctor and himself?

I see no reason that achieving an erection should ever be considered a medical necessity.

bookitty

16th February 2012, 02:23 PM

I see no reason that achieving an erection should ever be considered a medical necessity.

Fine, may I please see the medical credentials which give you the necessary background with which to make this judgement? or is it merely just opinion?

Trakar

16th February 2012, 02:24 PM

My objection lies in the public being forced to cover 62% (http://en.wikipedia.org/wiki/Catholic_Charities) (TAX FREE) of the employer's medical insurance it finds morally objectionable.

I think the public should provide 100% of all citizens' and residents' medical necessities, single payer would work, but I prefer government healthcare. Government run and managed hospitals, clinics, and long-term skilled care services.

then all such issues are moot.

Skeptic Ginger

16th February 2012, 02:27 PM

I see no reason that achieving an erection should ever be considered a medical necessity.That is not how the condition is viewed. In order to have legitimacy in insurance coverage, the inability to get an erection is defined as a medical problem.

And this gets back to your ignorance about medicine. Is a mammogram elective or necessary? Is treatment for acne a medical necessity or not? When is treatment for arthritis a necessity and when is it elective?

Your little bubble viewing this as being about elective vs necessity is chock full of holes you are completely refusing to even look at, let alone address.

Here's another hole in your bubble: We have right to privacy laws in this country regarding what an employer may or may not ask an employee about their medical problems. So how would you manage such a distinction, the doctor must say a procedure is necessary as opposed to elective and still maintain the employee's right to privacy?

Trakar

16th February 2012, 02:34 PM

Funny how the whole "pay taxes" idea never occurs to a group that guilts people out of money once a week.

I have never been guilted into anything, though I generally support the works and charities of the Catholic church, as I do the works and charities of the Red Cross and several other religious and secular, national and international charity organizations,...why do you feel that some of these should be excluded from tax-exempt status and others should get to retain/maintain them?

Trakar

16th February 2012, 02:41 PM

Breaking news, vasectomies are covered in these policies. I have not yet confirmed this but it was just brought up on the news.

If these are non-medically essential vasectomies, that would certainly be a hypocritical allowance by religious representatives. But along the lines of earlier discussion, if pregnancy is considered a medically dangerous condition for some women, it would seem from an insurer's perspective that sterilization would be preferrable to any other birth control form as the best means of addressing that potential.

Trakar

16th February 2012, 02:43 PM

You ignored the issue I raised: you and many employers are not qualified to make medical decisions. I cited examples where your medical statements in this thread were wrong. Yet you continue to insist you know which treatments are elective and which are necessary.

In addition, are you saying it's OK for an employer to object to birth control for women while allowing vasectomies if the employer claims that is consistent with their beliefs?

Take off your presumptive filters and try reading my statements and responses again.

Trakar

16th February 2012, 02:50 PM

Why should the employee who pays for some portion of health insurance and counts it as part of their income have to take time out of their life to go to Planned Parenthood/county health clinic in order to get birth control that is less effective? Catholic charities is more than hospitals, they also do fund-raising and there are many positions there that are minimum wage.

we have been discussing Catholic hospitals, if you are aware of minimum wage positions being offered Catholic hospital employee insurance coverage please present linkage supporting this circumstance and I will be happy to review it and provide some response.

Also, if you're a conservative, you have been voting for people who are cutting funding to Title X programs.

I am not conservative. I am highly progressive, though I find liberals to be not much better than conservatives.

In rural areas of the country, free condoms are not easily obtained. Even if it were, forcing the employee to seek them out when their secular government is paying for a significant amount of that health care coverage just doesn't make sense.

I think the secular government should provide all health care freely to all citizens and residents, and again, I'm talking public run hospitals, clinics and lon-term skilled care facilities.

Skeptic Ginger

16th February 2012, 02:57 PM

My Google-fu says no. The plans generally don't cover contraceptive drugs, tubal ligations, or vasectomies.Did you check or just make that assumption?

I found a number of declarations that vasectomies were not covered but nothing of authority. So I went to one direct source:

Sister's of Providence Hospitals (http://oregon.providence.org/patients/healthconditionscare/vasectomy/Pages/carelocations.aspx)Providence Medical Group clinics offer vasectomy procedures for their patients.Abortion and therapeutic abortion are not even listed in the index.

In their own individual and family insurance plans: (http://www.providence.org/healthplans/getcoverage/individualplans/planoverview/exclusions.aspx#rs)Exclusions that apply to Reproductive Services
All Services related to sexual disorders or dysfunctions regardless of gender, including all Services related to a sex-change operation, including evaluation, surgery and follow-up Services;
All Services for the treatment of infertility, including all Services related to surrogate parenting. For the purpose of this exclusion, infertility is defined as the inability to become pregnant after a year of unprotected intercourse or the inability to carry a pregnancy to term as evidenced by three (3) consecutive spontaneous abortions;
Termination of pregnancy, unless there is a severe threat to the mother, or if the life of the fetus cannot be sustained;
Sterilization (tubal ligation and vasectomy) Services;
Reversal of voluntary sterilization;
Condoms and other over-the-counter birth control products; and
Home births and all related Services.That suggests prescription birth control is a covered benefit.

And in fact in the employer provided insurance coverage formulary (http://www.providence.org/healthplans/pdfs/pharmacy/phcformulary.pdf), low and behold, contraceptives are listed. Contraceptives
AMETHYST GENERIC
APRI® GENERIC
ARANELLE® GENERIC
AVIANE® GENERIC
BALZIVA® GENERIC
BREVICON® GENERIC
CRYSELLE® GENERIC
ENPRESSE® GENERIC
GIANVI GENERIC
JOLESSA® GENERIC
JUNEL FE® GENERIC....The list goes on for another full page and a half.

And for those not familiar with the Sister's of Providence Hospitals (http://www2.providence.org/phs/Pages/default.aspx), Providence Health & Services is a not-for-profit Catholic health care ministry committed to providing for the needs of the communities it serves – especially for those who are poor and vulnerable. Providence continues a tradition of caring that the Sisters of Providence began more than 155 years ago..

Providence’s comprehensive scope of services includes 27 hospitals, 214 physician clinics, senior services and supportive housing, a health plan, a liberal arts university, a high school and many other health and educational services. The health system spans five states – Alaska, California, Montana, Oregon and Washington – with its system office located in Renton, Washington.

Manufactured outrage.... check.

As for the vasectomies, it would appear to be a commonly excluded elective procedure in many policies, Catholic or not.

Trakar

16th February 2012, 03:00 PM

Fine, may I please see the medical credentials which give you the necessary background with which to make this judgement? or is it merely just opinion?

You made the statement, I agreed with you and *now* you want to see credentials?!

LOL

It is my opinion. Sex itself is not a medical necessity, therefore, I cannot see a situation where therapies or treatments designed to facillitate sexual congress should ever be considered a medical necessity.

Skeptic Ginger

16th February 2012, 03:06 PM

Take off your presumptive filters and try reading my statements and responses again.I have read your posts. You declare repeatedly what is and what is not an elective medical procedure.

When you rationalize that difference you ignore the very real problems trying to make such a distinction. Here, let me spell them out for you again:

Who decides?

Define elective: How would an employer manage such a distinction given the definition of elective is on a continuum from life saving (not elective) to disease treating to life choice that has medical repercussions?

How do you manage employee privacy?

Trakar

16th February 2012, 03:16 PM

That is not how the condition is viewed. In order to have legitimacy in insurance coverage, the inability to get an erection is defined as a medical problem.

And this gets back to your ignorance about medicine. Is a mammogram elective or necessary? Is treatment for acne a medical necessity or not? When is treatment for arthritis a necessity and when is it elective?

mammograms are a necessity (though currently the appropriate frequency of such is under some reconsideration), Acne can be a medical necessity, depending upon casuation and degree. Likewise Arthritis can be, depending upon type, causation and degree.

Your little bubble viewing this as being about elective vs necessity is chock full of holes you are completely refusing to even look at, let alone address.

I have addressed every substantive issue I've seen (aside from the red herrings and ad homs). If a doctor is willing to certify and defend medical necessity for treatment with synthetic pregnancy hormone drugs, I've no problem with forcing church hospital insurances to cover the co-pay on those drugs.

Here's another hole in your bubble: We have right to privacy laws in this country regarding what an employer may or may not ask an employee about their medical problems. So how would you manage such a distinction, the doctor must say a procedure is necessary as opposed to elective and still maintain the employee's right to privacy?

No, the doctor and the insurer must agree that such issues are a medical necessity and this must be covered under the particular policy that the employer buys from the insurer.

Skeptic Ginger

16th February 2012, 03:16 PM

we have been discussing Catholic hospitals, if you are aware of minimum wage positions being offered Catholic hospital employee insurance coverage please present linkage supporting this circumstance and I will be happy to review it and provide some response.I'm pretty sure housekeeping, dietary, food services, and laundry staff are poorly paid. Security staff is not much better off.

Service Healthcare Jobs (http://www.healthcarejobs411.com/service-healthcare.html)Food Service/Cooks

Healthcare facilities that house patients and provide food service to them must employ cooks and other food service preparers in order to ensure patients are fed when they need to be. For most of these organizations, they employ professional dietitians who are responsible for the planning of each patient's meal to ensure it meets any dietary restrictions a doctor may be prescribed. However, it is up to the cooks or food service employees to prepare the meals as directed and get them to the patient. For their time and hard work, these individuals can expect an hourly wage between minimum wage and $10.00 per hour.

Laundry

Another service job found in healthcare facilities housing patients is laundry. These facilities all provide beds with bedding to patients, and this bedding is usually changed everyday. In addition, laundry personnel must also clean any towels used for bathing, clothes or gowns worn by patients, and other clothes, towels, blankets or materials used by doctors, nurses or patients. While this may seem like an easy job, the demands of a 500-person hospital or nursing care facility keeps laundry personnel on their toes and busy throughout the day. The average pay for laundry personnel varies from minimum wage to $9.00 an hour.

Hospital Security

Many healthcare facilities, especially hospitals, now have security personnel on site to handle any problems they may have with disgruntled, emotionally charged or mentally unstable patients or visitors. Some facilities employ security only at night, while others have them on site 24 hours a day. Their job is to monitor the facility and the area around it for any suspicious behavior and respond to requests for security by nurses, doctors and other employees. The pay for security personnel is $7.15 to $15 per hour.Try living on $9/hr, let alone minimum wage in the city of Seattle. I don't know about other markets.

Skeptic Ginger

16th February 2012, 03:24 PM

mammograms are a necessity (though currently the appropriate frequency of such is under some reconsideration), Acne can be a medical necessity, depending upon casuation and degree. Likewise Arthritis can be, depending upon type, causation and degree.

I have addressed every substantive issue I've seen (aside from the red herrings and ad homs). If a doctor is willing to certify and defend medical necessity for treatment with synthetic pregnancy hormone drugs, I've no problem with forcing church hospital insurances to cover the co-pay on those drugs.

No, the doctor and the insurer must agree that such issues are a medical necessity and this must be covered under the particular policy that the employer buys from the insurer.You have an opinion but it is not an informed opinion, nor is your solution realistic.

Elective surgery, for example, is defined as something that can wait, but it is not necessarily defined as something the person does not need. Whether treating pain is a necessity or not is a very subjective opinion.

You claim over and over that birth control is elective in some cases. It has been determined by medical experts to be a beneficial preventative health care service. Yet a mammogram that is also a beneficial preventative health care service you claim is not elective. ARE YOU UNAWARE THAT PREGNANCY IS A KNOWN HEATLH RISK TO A WOMAN, EVEN WHEN SHE HAS NO OTHER HEALTH PROBLEMS?

AND going back to your other position, can said Catholic hospital provide vasectomies and birth control in their clinics and pharmacies and still declare they have a moral objection to including these things in employee's coverage?

Skeptic Ginger

16th February 2012, 03:31 PM

....
It is my opinion. Sex itself is not a medical necessity, therefore, I cannot see a situation where therapies or treatments designed to facillitate sexual congress should ever be considered a medical necessity.Again there are different ways to view these things you are so convinced are black and white. But in this case, how on Earth do you figure sex is always optional? You must be single or young or both. That is naive.

It's not a medical necessity that anyone treats their arthritis pain but if not treated their quality of life is at risk. Sex is the same way for lots of people. It's just as important to one's quality of life as being pain free.

Abstinence Only education and 'Pledge' programs do not work. This is what the evidence shows. Some men demand sex of their wives and the wives cannot refuse, or if they did refuse it would mean divorce.

You're position is unrealistic.

bookitty

16th February 2012, 03:34 PM

You made the statement, I agreed with you and *now* you want to see credentials?!

LOL

It is my opinion. Sex itself is not a medical necessity, therefore, I cannot see a situation where therapies or treatments designed to facillitate sexual congress should ever be considered a medical necessity.

I was not saying that Viagra should be targeted. I was pointing out a bias. I have no background in medicine. I don't know anything about the negative impact of erectile dysfunction. So I would never presume to say that viagra was not a medical necessity. Even if I had evidence that the negative impact was minimal, I would not presume to step between patient and doctor for the proven treatment of a common condition. Especially for such a frivolous reason as the church's archaic stance on such medication when the organization had a large number of employees who do not belong to that religion.

Trakar

16th February 2012, 03:35 PM

I have read your posts. You declare repeatedly what is and what is not an elective medical procedure.

I give my opinion when asked, I support that opinion when support is asked for, but for the most part we are talking about general and specific third party determinations (eg the Catholic church, Insurers, various doctors and medical professionals, journalists, etc.,). I have on at least four occassions now, specifically stated that if a doctor diagnoses a patient with a medical condition that is best addressed with the provision of birth control pills, that this should be good enough to merit coverage over any moral or ethical concerns. I object to the blanket assessment that employers should be forced to pay for coverage of non-medical necessity, elective procedures and therapies.

How do you manage employee privacy?

If a doctor codes diagnoses and treatments that are not covered by the plan the employer purchases, the bill goes to the patient instead of the insurance company. The only involvement the employer has is in chosing the coverages they are required to provide and the coverages they wish to provide. As far as I'm concerned that is the only employer involvement there should be, unless the employer self-insures, then they are forced to be much more involved in the process.

Trakar

16th February 2012, 03:38 PM

I'm pretty sure housekeeping, dietary, food services, and laundry staff are poorly paid. Security staff is not much better off.

Service Healthcare Jobs (http://www.healthcarejobs411.com/service-healthcare.html)Try living on $9/hr, let alone minimum wage in the city of Seattle. I don't know about other markets.

Are you sure this is true of religious affiliated hospitals, and are these positions offered full hospital employee insurance coverage?

Kestrel

16th February 2012, 03:40 PM

Do any of the religious faiths that object to birth control allow women into the clergy?

Skeptic Ginger

16th February 2012, 03:46 PM

Are you sure this is true of religious affiliated hospitals, and are these positions offered full hospital employee insurance coverage?Oh for pity's sake. Yes, I'm sure in both questions. Full time workers have the same benefits regardless of pay scale and hospitals all pay the industry standard wages. Did you think Catholic Hospitals paid workers above the industry standard out of charity or good will? I've worked in hospital for 30 years, I know what the pay scales are.

Kestrel

16th February 2012, 03:49 PM

Agreed, but I'm not aware of any hospital position the pays minimum wage and offers health insurance coverage. Using such a hypothetical as a rhetorical example, however, how do you get cheaper than free (from Planned Parenthood/county health clinic)?

In 2014, the Affordable Care act will require employers with more that 50 employees to offer health insurance to all full time employees.

Trakar

16th February 2012, 03:53 PM

You have an opinion but it is not an informed opinion, nor is your solution realistic.

Elective surgery, for example, is defined as something that can wait, but it is not necessarily defined as something the person does not need. Whether treating pain is a necessity or not is a very subjective opinion.

You claim over and over that birth control is elective in some cases. It has been determined by medical experts to be a beneficial preventative health care service. Yet a mammogram that is also a beneficial preventative health care service you claim is not elective. ARE YOU UNAWARE THAT PREGNANCY IS A KNOWN HEATLH RISK TO A WOMAN, EVEN WHEN SHE HAS NO OTHER HEALTH PROBLEMS?

AND going back to your other position, can said Catholic hospital provide vasectomies and birth control in their clinics and pharmacies and still declare they have a moral objection to including these things in employee's coverage?

The patients who make use of the hospitals, clinics and pharmacies are not employees, and the employer is not being required to pay for the patient's choices. Personally, I would consider it more than a little hypocritical to make a profit off selling something that you morally object to, but that is my opinion and it presumes that these services and therapies are provided for elective birth control rather than medically necessitated procedures and therapies.

Trakar

16th February 2012, 03:57 PM

Again there are different ways to view these things you are so convinced are black and white. But in this case, how on Earth do you figure sex is always optional? You must be single or young or both. That is naive.

and back we go to the ad homs.

It's not a medical necessity that anyone treats their arthritis pain...

Citation or reference?

but if not treated their quality of life is at risk. Sex is the same way for lots of people. It's just as important to one's quality of life as being pain free.

Abstinence Only education and 'Pledge' programs do not work. This is what the evidence shows. Some men demand sex of their wives and the wives cannot refuse, or if they did refuse it would mean divorce.

marriage is not a medical necessity.

You're position is unrealistic.

We obviously perceive reality differently.

Trakar

16th February 2012, 04:01 PM

I was not saying that Viagra should be targeted. I was pointing out a bias. I have no background in medicine. I don't know anything about the negative impact of erectile dysfunction. So I would never presume to say that viagra was not a medical necessity. Even if I had evidence that the negative impact was minimal, I would not presume to step between patient and doctor for the proven treatment of a common condition. Especially for such a frivolous reason as the church's archaic stance on such medication when the organization had a large number of employees who do not belong to that religion.

Please indicate anywhere that I have indicated that doctors should not be the ones to decide issues of medical necessity vs elective care.

bookitty

16th February 2012, 04:05 PM

and back we go to the ad homs.

Citation or reference?

marriage is not a medical necessity.

We obviously perceive reality differently.

Neither is red meat, cigarettes, excess body weight, driving too fast, etc to eternity for common things that can result in a medical condition.

If you don't think health coverage should pay for the most effective birth control because "marriage is not a medical necessity" than you obviously don't think it should cover diabetes, heart conditions, lung cancer, obesity, injuries from car crashes, etc again to eternity.

Skeptic Ginger

16th February 2012, 04:07 PM

and back we go to the ad homs.I was commenting on the claim sex was an elective action. It may be for some, but it is naive to think that is true for everyone.

Citation or reference?Definition of "elective" in a medical dictionary (http://medical-dictionary.thefreedictionary.com/elective)pertaining to a procedure that is performed by choice and is not essential, such as elective surgery.

non-urgent; at an elected time, e.g. of surgery.

adjective Referring to that which is planned or undertaken by choice and without urgency, as in elective surgeryIt is always a choice to treat pain or not.

marriage is not a medical necessity.You missed the point. Quality of life is one measure of medical necessity. You think pain matters but marriage doesn't? Some people live with pain, some live without marriage but both conditions matter to people's quality of life.

We obviously perceive reality differently.Goes unsaid.

Skeptic Ginger

16th February 2012, 04:08 PM

Please indicate anywhere that I have indicated that doctors should not be the ones to decide issues of medical necessity vs elective care.Are you a doctor? No, yet you declare here in multiple posts what is an elective medical procedure.

Skeptic Ginger

16th February 2012, 04:10 PM

The patients who make use of the hospitals, clinics and pharmacies are not employees, and the employer is not being required to pay for the patient's choices. Personally, I would consider it more than a little hypocritical to make a profit off selling something that you morally object to, but that is my opinion and it presumes that these services and therapies are provided for elective birth control rather than medically necessitated procedures and therapies.When is a vasectomy medically necessary by your criteria?

AvalonXQ

16th February 2012, 04:15 PM

Trakar

16th February 2012, 04:29 PM

Oh for pity's sake. Yes, I'm sure in both questions. Full time workers have the same benefits regardless of pay scale and hospitals all pay the industry standard wages. Did you think Catholic Hospitals paid workers above the industry standard out of charity or good will? I've worked in hospital for 30 years, I know what the pay scales are.

I know of no minimum wage positions that are covered under hospital insurance at the only catholic hospital I am familiar with well enough to be able to investigate in any depth. The only positions that are minimum wage that I know of are some of the contracted services that are not direct employees of the hospital and not covered under hospital insurance programs. In the case of this hospital there is multi-tier coverage dependent upon (initially the length of time with the organization, typically for most entry scale positions insurance coverage does not begin until after a year, six-months for low-level staff/management) the employee's choice of co-pay/premium and the range of offered coverage. I've never seen unconditional, blanket medical coverage,...but it sounds nice!

Please link to any evidence you can find to support the position that Catholic hospitals have minimum wage employees who are covered under hospital insurance plans that should provide birth control coverage because the expense of birth control puts them at undue medical risk due to their own uncontrollable personal behavior. Sounds like they need a therapist and a financial counsellor more than a script for birth control pills (BTW - I think therapy for all and periodic financial education classes and annual personal finance counselling would probably be one of the wisest investments in ourselves our nation could ever make).

Trakar

16th February 2012, 04:31 PM

In 2014, the Affordable Care act will require employers with more that 50 employees to offer health insurance to all full time employees.

At what level of coverage?

bookitty

16th February 2012, 04:35 PM

Trakar

16th February 2012, 04:38 PM

Neither is red meat, cigarettes, excess body weight, driving too fast, etc to eternity for common things that can result in a medical condition.

Where are we mandating employers pay to cover non-medical necessity, elective procedures/therapies to address these issues?

If you don't think health coverage should pay for the most effective birth control because "marriage is not a medical necessity" than you obviously don't think it should cover diabetes, heart conditions, lung cancer, obesity, injuries from car crashes, etc again to eternity.

No, I don't think that a Catholic hospital should be required to pay for the coverage of non-medically necessary, elective procedures that they find morally objectionable.

AvalonXQ

16th February 2012, 04:39 PM

Staying healthy includes not getting pregnant. Pregnancy has far more risk than not-pregnant.

That's an interesting argument -- namely, we define "pregnancy" as a medical disorder so that avoiding pregnancy is medically necessary.
I'm not sure I buy it, but it's a reasonable argument.

Dunstan

16th February 2012, 04:39 PM

Look, I don't think it's that hard to define "elective procedure". It's any procedure that's not performed to fix something that's wrong with you or keep you healthy.
It's very reasonable to consider contraception for family planning purposes to be elective -- they're certainly not medically necessary, in that a person that receives the contraception and a person that doesn't are both expected to be healthy. Family planning reasons are not medical reasons.

Suppose I had a problem with my knee or legs. It doesn't inhibit me from walking short distances or doing my job; I could live, eat, breath, sleep, feed and clothe myself just fine. But it leaves me unable to run or go for long walks or hikes, which are activities that I enjoy. Would fixing this condition be an "elective" procedure?

Dunstan

16th February 2012, 04:40 PM

Please link to any evidence you can find to support the position that Catholic hospitals have minimum wage employees who are covered under hospital insurance plans that should provide birth control coverage because the expense of birth control puts them at undue medical risk due to their own uncontrollable personal behavior. Sounds like they need a therapist and a financial counsellor more than a script for birth control pills (BTW - I think therapy for all and periodic financial education classes and annual personal finance counselling would probably be one of the wisest investments in ourselves our nation could ever make).

In other words, minimum wage workers should have no sex lives and should STFU about it?

AvalonXQ

16th February 2012, 04:44 PM

Suppose I had a problem with my knee or legs. It doesn't inhibit me from walking short distances or doing my job; I could live, eat, breath, sleep, feed and clothe myself just fine. But it leaves me unable to run or go for long walks or hikes, which are activities that I enjoy. Would fixing this condition be an "elective" procedure?

I wouldn't say so, no. It's fixing a medical problem.

Are we defining pregnancy as a "medical problem" now?

Skeptic Ginger

16th February 2012, 04:46 PM

Look, I don't think it's that hard to define "elective procedure". It's any procedure that's not performed to fix something that's wrong with you or keep you healthy.
It's very reasonable to consider contraception for family planning purposes to be elective -- they're certainly not medically necessary, in that a person that receives the contraception and a person that doesn't are both expected to be healthy. Family planning reasons are not medical reasons.Sorry but as I posted and as the facts overwhelmingly support, pregnancy is dangerous. Avoiding pregnancy just by itself without any other medical need meets your definition of 'not elective'.

Skeptic Ginger

16th February 2012, 04:48 PM

I wouldn't say so, no. It's fixing a medical problem.

Are we defining pregnancy as a "medical problem" now?Yes, it is a medical problem. It's one with a benefit (the baby) so we often choose to take the risk but pregnancy always poses some increased medical risk for the woman.

Skeptic Ginger

16th February 2012, 04:50 PM

I know of no minimum wage positions that are covered under hospital insurance at the only catholic hospital I am familiar with well enough to be able to investigate in any depth. The only positions that are minimum wage that I know of are some of the contracted services that are not direct employees of the hospital and not covered under hospital insurance programs. In the case of this hospital there is multi-tier coverage dependent upon (initially the length of time with the organization, typically for most entry scale positions insurance coverage does not begin until after a year, six-months for low-level staff/management) the employee's choice of co-pay/premium and the range of offered coverage. I've never seen unconditional, blanket medical coverage,...but it sounds nice!

Please link to any evidence you can find to support the position that Catholic hospitals have minimum wage employees who are covered under hospital insurance plans that should provide birth control coverage because the expense of birth control puts them at undue medical risk due to their own uncontrollable personal behavior. Sounds like they need a therapist and a financial counsellor more than a script for birth control pills (BTW - I think therapy for all and periodic financial education classes and annual personal finance counselling would probably be one of the wisest investments in ourselves our nation could ever make).
My link wins your unsupported anecdote. It's your turn to back up your claim that no minimum wage workers are employed at Catholic hospitals.

As for "unconditional, blanket medical coverage" that is nothing but a red herring in this discussion.

RandFan

16th February 2012, 04:53 PM

We live in a society. If your conscience dictates that fornicators can't rent in your building then sorry, it takes a back seat. If you conscience dictates that you have a right to a slave (Leviticus 25:44) sorry. Conscience isn't a trump card to allow you to do anything you want.

The Case for Insurance Coverage of Contraceptive Services And Supplies Without Cost-Sharing (http://www.guttmacher.org/pubs/gpr/14/1/gpr140107.html)

In short, the scientific evidence and the balance of costs and benefits all point to the same conclusion: As the IOM panel and DHHS work to establish guidelines for women’s preventive care and screenings, they have every reason to incorporate family planning. Such incorporation should include the full range of reversible and permanent contraceptive drugs, devices and procedures; related clinical services necessary to appropriately supply those methods, such as injections and the insertion and removal of an IUD or implant; and the counseling and patient education necessary to help women and men gauge their contraceptive needs and practice contraception most effectively. It only makes sense. This is a no brainer. Provide the coverage.

Skeptic Ginger

16th February 2012, 04:56 PM

That's an interesting argument -- namely, we define "pregnancy" as a medical disorder so that avoiding pregnancy is medically necessary.
I'm not sure I buy it, but it's a reasonable argument.You and Traker both keep throwing this "medically necessary" crap around and around while ignoring the fact birth control was determined after careful evaluation to be part of preventative care.

PREVENTATIVE CARE, as in it keeps one healthy, determined by people who looked at the actual medical data.

Mammograms are preventative care, programs to quit smoking are preventative care, birth control is preventative care.

If you want to change the category for birth control to "unnecessary" then explain how it differs from other preventative medical care, not how it differs from emergency heart surgery.

Dunstan

16th February 2012, 04:57 PM

I wouldn't say so, no. It's fixing a medical problem.

Are we defining pregnancy as a "medical problem" now?

That wasn't my point. (Although I would say that an unwanted pregnancy is indeed a medical problem.)

My point is this: I don't need to run or hike in order to live. But if I couldn't do so, it would affect my quality of life and would deprive me of a normal healthy human existence.

For most people, sex is just as much -- actually, more so -- a part of a normal healthy human existence than running or hiking or playing basketball or whatever. And so telling someone that they must either deny themselves that important part of their humanity, or else risk pregnancy and STIs, is a much more serious deprivation than denying my hypothetical knee surgery.

Trakar

16th February 2012, 05:10 PM

It's not a medical necessity that anyone treats their arthritis pain but if not treated their quality of life is at risk. Sex is the same way for lots of people. It's just as important to one's quality of life as being pain free. Posted by Trakar
Citation or reference?

Definition of "elective" in a medical dictionary (http://medical-dictionary.thefreedictionary.com/elective)It is always a choice to treat pain or not.

Not when the pain is extreme enough to restrict or negate the ability to accomplish even routine daily activities and tasks. This is a widely recognized and accepted medical and legal understanding.

http://medical-dictionary.thefreedictionary.com/medically+necessary

here's an aetna doc indicating that they consider at least some treatment for back some types of back pain to be a medically necessary

http://www.aetna.com/cpb/medical/data/1_99/0016.html

and here a pain management specialist describes the processes for determining and establishing medical necessity according to BCBS.
(many more available upon request)

Trakar

16th February 2012, 05:23 PM

When is a vasectomy medically necessary by your criteria?

That would probably depend upon the specific problems or issues that the doctor was trying to address in the patient. When the procedure was first developed in the early 1800s it was used exclusively to treat enlarged prostrates, and vasectomies did have success in causing prostrate atrophy. More than a hundred years later, during the WWII timeframe, it began to be used as a means of permanent sterilization and birth-control.Now, there are nemerous ways to deal with many conditions of medical necessity. I'm perfectly willing to let a doctor and their patient chose the most appropriate option when there is a medically necessary reason for treatment.

Trakar

16th February 2012, 05:30 PM

My link wins your unsupported anecdote. It's your turn to back up your claim that no minimum wage workers are employed at Catholic hospitals.

Your link doesn't address private religious hospitals (which generally do pay above minimum wage scale for jobs they don't contract out) or even whether or not these minimum wage employees at some hospitals have a level of insurance coverage that one might expect the general business world to provide with regards to birth control coverage.

KingMerv00

16th February 2012, 05:58 PM

I think the public should provide 100% of all citizens' and residents' medical necessities, single payer would work, but I prefer government healthcare. Government run and managed hospitals, clinics, and long-term skilled care services.

then all such issues are moot.

And in the meantime the church can just ignore the legal responsibilities attached to the 2.9 billion dollar gift and its tax exempt status?

Trakar

16th February 2012, 06:07 PM

Mammograms are preventative care

I would argue that mammograms are early detection. to my consideration, preventative care would be more along the lines of genetic screening of both parents prior to conception, the natal/lifetime awareness and avoidance of risk-factor exposures to known chemical and radiative carcinogens (often, breast cancers are instigated while still in the womb, or in early youth they just aren't usually triggered to growth and metastasis until later in life).

programs to quit smoking are preventative care,
I would probably consider programs to quit smoking to be elective and only medically necessary in the case of companion diagnoses dealing with any variety of respiratory, circulation or neural disorder that would be severely impacted by smoking. But that is my considered response to a hypothetical, I'm perfectly happy letting the patient's doctor and the covering insurance company make that decision of medical necessity or not.

birth control is preventative care.

Off the cuff - only if you consider pregnancy to be a disease, illness or injury. In a more complete fashion, preventative care is great but this isn't about labels it is about whether or not a religious affiliate employer should be required to pay for non-medically necessary elective healthcare service that violates a core issue of that religion's beliefs. If you want to argue that all contraception is medically necessary, and I agreed, there would be disagreement about whether or not it should be covered. So far, I have seen no compelling argument supporting the implied obverse, that contraception is a universal, medical necessity for all women (or people, if you wish).

Skeptic Ginger

16th February 2012, 06:08 PM

Not when the pain is extreme enough to restrict or negate the ability to accomplish even routine daily activities and tasks. This is a widely recognized and accepted medical and legal understanding.You are changing the argument to one you can argue against. That's a straw man of sorts. Stick with the example as I posted it, not the example as you changed it.

Your whole post simply avoids the issues you cannot address. Try again.

Skeptic Ginger

16th February 2012, 06:11 PM

That would probably depend upon the specific problems or issues that the doctor was trying to address in the patient. When the procedure was first developed in the early 1800s it was used exclusively to treat enlarged prostrates, and vasectomies did have success in causing prostrate atrophy. More than a hundred years later, during the WWII timeframe, it began to be used as a means of permanent sterilization and birth-control.Now, there are nemerous ways to deal with many conditions of medical necessity. I'm perfectly willing to let a doctor and their patient chose the most appropriate option when there is a medically necessary reason for treatment.So all the doctor has to say then is, medically necessary, and not explain that to the employer.

You're really reaching here to ignore reality.

Have you ever considered someone has pointed out the flaws in your thinking? All you have to do is note you hadn't thought of it that way and stop trying to win a debate you've already lost.

Skeptic Ginger

16th February 2012, 06:13 PM

Your link doesn't address private religious hospitals (which generally do pay above minimum wage scale for jobs they don't contract out) or even whether or not these minimum wage employees at some hospitals have a level of insurance coverage that one might expect the general business world to provide with regards to birth control coverage.Give up. Even at just above minimum wage certain service jobs in hospitals are extremely low wage jobs. Your argument is a FAIL.

Skeptic Ginger

16th February 2012, 06:14 PM

I would argue that mammograms are early detection. to my consideration, preventative care would be more along the lines of genetic screening of both parents prior to conception, the natal/lifetime awareness and avoidance of risk-factor exposures to known chemical and radiative carcinogens (often, breast cancers are instigated while still in the womb, or in early youth they just aren't usually triggered to growth and metastasis until later in life).

I would probably consider programs to quit smoking to be elective and only medically necessary in the case of companion diagnoses dealing with any variety of respiratory, circulation or neural disorder that would be severely impacted by smoking. But that is my considered response to a hypothetical, I'm perfectly happy letting the patient's doctor and the covering insurance company make that decision of medical necessity or not.

Off the cuff - only if you consider pregnancy to be a disease, illness or injury. In a more complete fashion, preventative care is great but this isn't about labels it is about whether or not a religious affiliate employer should be required to pay for non-medically necessary elective healthcare service that violates a core issue of that religion's beliefs. If you want to argue that all contraception is medically necessary, and I agreed, there would be disagreement about whether or not it should be covered. So far, I have seen no compelling argument supporting the implied obverse, that contraception is a universal, medical necessity for all women (or people, if you wish).More failed logic. Sorry. Not convincing. And it continues to demonstrate your ignorance about the medical dangers of pregnancy.

Trakar

16th February 2012, 06:16 PM

That wasn't my point. (Although I would say that an unwanted pregnancy is indeed a medical problem.)

My point is this: I don't need to run or hike in order to live. But if I couldn't do so, it would affect my quality of life and would deprive me of a normal healthy human existence.

For most people, sex is just as much -- actually, more so -- a part of a normal healthy human existence than running or hiking or playing basketball or whatever. And so telling someone that they must either deny themselves that important part of their humanity, or else risk pregnancy and STIs, is a much more serious deprivation than denying my hypothetical knee surgery.

Where is anyone trying to deny anyone condoms, pills, shots, implants, sterilization or what ever, if that is what they want? I'm just saying that their employer (particularly a Catholic Hospital) shouldn't have to pay for their coverage for these choices, unless there is a medical necessity diagnosis by their treating physician which indicates that treatment (eg endometriosis history, etc.,). Barry seems to agree.

Trakar

16th February 2012, 06:20 PM

And in the meantime the church can just ignore the legal responsibilities attached to the 2.9 billion dollar gift and its tax exempt status?

Church tax exemption is a seperate issue. If you'd like to make a case for its repeal, I'd be interested in reading what you have to say,...in an appropriate thread dedicated to that discussion.

Trakar

16th February 2012, 06:22 PM

You are changing the argument to one you can argue against. That's a straw man of sorts. Stick with the example as I posted it, not the example as you changed it.

Your whole post simply avoids the issues you cannot address. Try again.

No. My post simply addresses the referenced realities that you prefer not to recognize, much less rationally grapple with.

Trakar

16th February 2012, 06:23 PM

So all the doctor has to say then is, medically necessary, and not explain that to the employer.

You're really reaching here to ignore reality.

Have you ever considered someone has pointed out the flaws in your thinking? All you have to do is note you hadn't thought of it that way and stop trying to win a debate you've already lost.

ad hom rant

Trakar

16th February 2012, 06:25 PM

Give up. Even at just above minimum wage certain service jobs in hospitals are extremely low wage jobs. Your argument is a FAIL.

you suggest that even if your supporting points were incorrect, that my argument fails. LOL

Trakar

16th February 2012, 06:28 PM

More failed logic. Sorry. Not convincing. And it continues to demonstrate your ignorance about the medical dangers of pregnancy.

that's a compelling argument.

BTW I've been providing references that actually support what I argue, give it a try some time.

KingMerv00

16th February 2012, 06:48 PM

Church tax exemption is a seperate issue. If you'd like to make a case for its repeal, I'd be interested in reading what you have to say,...in an appropriate thread dedicated to that discussion.

It isn't a separate issue. If a Catholic charity accepts tax exemption and government funds, they are legally bound to follow certain rules just like every other charity. That's why the government has the authority to tell them what services to provide in the first place.

No one is FORCING tax exemption or government grants down their throats. If they don't want to provide birth control, they don't have to. They just have to stand on their own two feet financially.

Skeptic Ginger

16th February 2012, 06:50 PM

No. My post simply addresses the referenced realities that you prefer not to recognize, much less rationally grapple with.

Baloney!

Did I say extreme arthritis pain? No. But you changed what I posted so you could address extreme pain. That is how straw man arguments work. Most of us know that tactic here.

You have not presented evidence low wage workers in Catholic hospitals can easily afford birth control.

You have not addressed the issue I pointed out: Mammograms are preventative care, programs to quit smoking are preventative care, birth control is preventative care.

If you want to change the category for birth control to "unnecessary" then explain how it differs from other preventative medical care, not how it differs from emergency heart surgery.

Your rationalization of how these differed was not a legitimate argument. You made up your own personal definition of preventative care.

Dunstan

16th February 2012, 06:51 PM

Where is anyone trying to deny anyone condoms, pills, shots, implants, sterilization or what ever, if that is what they want? I'm just saying that their employer (particularly a Catholic Hospital) shouldn't have to pay for their coverage for these choices, unless there is a medical necessity diagnosis by their treating physician which indicates that treatment (eg endometriosis history, etc.,). Barry seems to agree.

YOU and Avalon keep harping on this "elective" distinction, as reflected again in your "medical necessity" reference above. I'm simply trying to pin you down on what you think it means.

You two seem to think that sex is just some silly little frill that people only deserve to enjoy if they make a sufficient amount of money. I'm simply pointing that out.

Giordano

16th February 2012, 07:13 PM

It isn't a separate issue. If a Catholic charity accepts tax exemption and government funds, they are legally bound to follow certain rules just like every other charity. That's why the government has the authority to tell them what services to provide in the first place.

No one is FORCING tax exemption or government grants down their throats. If they don't want to provide birth control, they don't have to. They just have to stand on their own two feet financially.

Yes, this exactly the point that the Catholic church is trying to obscure. No one is violating the right of a religion to make their own doctrine. But if you want public money you must agree to a non-sectarian application of the rules that go with that money!

As far as I'm concerned, it should go even further than that. You can try to change an unjust law or rule by civil disobedience, with all the consequences that has for the protestor. But no one should simply be able to avoid a rule or a law in a democratic country by saying "It goes against my religion." How ironic that the same right wing politicians taking the Church's side on this are against any hint of Sharia law. How are the concepts different?

Trakar

16th February 2012, 10:09 PM

YOU and Avalon keep harping on this "elective" distinction, as reflected again in your "medical necessity" reference above. I'm simply trying to pin you down on what you think it means.

You two seem to think that sex is just some silly little frill that people only deserve to enjoy if they make a sufficient amount of money. I'm simply pointing that out.

Again, no one is even talking about anything even vaguely related to what you are saying.

People can enjoy whatever legal options they care to choose to participate in. I'm simply arguing that employers (particularly and specifically Catholic affiliated hospitals) should not be required to pay to cover the price of non-medically necessary, elective procedures and therapies that go against the employer's long established ethical and moral principals.

Skeptic Ginger

16th February 2012, 10:24 PM

Again, no one is even talking about anything even vaguely related to what you are saying.

People can enjoy whatever legal options they care to choose to participate in. I'm simply arguing that employers (particularly and specifically Catholic affiliated hospitals) should not be required to pay to cover the price of non-medically necessary, elective procedures and therapies that go against the employer's long established ethical and moral principals.
Your answer remains in an idealogical bubble removed from all the, "yes, but" realities.

RandFan

17th February 2012, 02:29 AM

People can enjoy whatever legal options they care to choose to participate in. I'm simply arguing that employers (particularly and specifically Catholic affiliated hospitals) should not be required to pay to cover the price of non-medically necessary, elective procedures and therapies that go against the employer's long established ethical and moral principals.Why should anyone be forced to pay to cover the price of anything? We live in a society. Sometimes the good of society takes precedent over conscience. Take the case of landlords that don't want to provide accommodations to fornicators. Business owners that don't want to serve someone for religious reasons. Given that this is a societal good then the religious can make allowances.

Trakar

17th February 2012, 05:53 AM

Why should anyone be forced to pay to cover the price of anything?

so you are arguing that all goods and services should be available free of charge to everyone?

We live in a society. Sometimes the good of society takes precedent over conscience.

Agreed, but what about non-medically necessary birth control coverage makes this an issue that is better handled by forcing employers to pay for it than providing it free to everyone who wants it via the public health system?

Skeptic Ginger

17th February 2012, 08:16 AM

so you are arguing that all goods and services should be available free of charge to everyone?This kind of absurd literalism wastes time in a thread. Or do you really have to be told what he meant?

Agreed, but what about non-medically necessary birth control coverage makes this an issue that is better handled by forcing employers to pay for it than providing it free to everyone who wants it via the public health system?Ignoring your continual refusal to address the issues surrounding your unqualified opinion about what is "medically necessary", just how is Obama supposed to accomplish that public health option given the current absurd position of cutting taxes for the rich and decreasing the deficit regardless of cuts in services like public health?

Dunstan

17th February 2012, 08:20 AM

Again, no one is even talking about anything even vaguely related to what you are saying.

People can enjoy whatever legal options they care to choose to participate in. I'm simply arguing that employers (particularly and specifically Catholic affiliated hospitals) should not be required to pay to cover the price of non-medically necessary, elective procedures and therapies that go against the employer's long established ethical and moral principals.

Wow, that's some weapons-grade fail there. You just insisted that my posts about what is medically necessary and elective aren't relevant because your position ... revolves around what you deem to be medically necessary and elective.

RandFan

17th February 2012, 08:59 AM

so you are arguing that all goods and services should be available free of charge to everyone?No.

Agreed, but what about non-medically necessary birth control coverage makes this an issue that is better handled by forcing employers to pay for it than providing it free to everyone who wants it via the public health system?The idea came about, in part, because of studies of productivity in the work place. Unwanted pregnancies cost employers in lost productivity. It cost employees. It cost society.

Dancing David

17th February 2012, 09:26 AM

Are we talking non-essential elective medical services/treatment or medically necessary procedures/treatments?

My daughters treatment is medically necessary, why should she be denied coverage if her agency affiliates with a catholic organization?

KingMerv00

17th February 2012, 09:33 AM

Traker skipped over my post so I'll cut and paste it here:

It isn't a separate issue. If a Catholic charity accepts tax exemption and government funds, they are legally bound to follow certain rules just like every other charity. That's why the government has the authority to tell them what services to provide in the first place.

No one is FORCING tax exemption or government grants down their throats. If they don't want to provide birth control, they don't have to. They just have to stand on their own two feet financially.

Skeptic Ginger

17th February 2012, 09:44 AM

Traker skipped over my post so I'll cut and paste it here:While that does apply to lots of employers we are talking about here, the current issue relates to the Health Affordability Act, and is not about regulating facilities that receive public funding.

Trakar

18th February 2012, 08:05 AM

My daughters treatment is medically necessary, why should she be denied coverage if her agency affiliates with a catholic organization?

If it is medically necessary and she works in a position at a catholic hospital that would be covered under that organizations medical insurance, I would argue that she should be covered. My argument isn't that the hospitals should not be required to cover anything that they choose not to, merely that they shouldn't be forced to cover non-medically necessary elective procedures that violate their moral principles. If a doctor states that a procedure is medically necessary and essential to the health and well-being of an individual then I have no problem with an employer being forced to help provide coverage of that need, regardless of the organization's moral or ethical consideration of the issue.

Trakar

18th February 2012, 08:25 AM

This kind of absurd literalism wastes time in a thread. Or do you really have to be told what he meant?

more ad hom

Ignoring your continual refusal to address the issues surrounding your unqualified opinion about what is "medically necessary",...

more unsupported ad hom

...just how is Obama supposed to accomplish that public health option given the current absurd position of cutting taxes for the rich and decreasing the deficit regardless of cuts in services like public health?

I see no sign, that Obama ever intended to try to create a public healthcare organization. However, argument that real healthcare is too hard to accomplish, is not a good or valid argument for forcing employers to pay for non-medically essential, elective procedures/therapies that directly violate their moral and ethical principles. If you feel that it is eesential for every woman to have this coverage, then why limit yourself to Catholic affiliate hospital organizations? Why do you feel that they specifically should pay for elective procedure coverage for their employees, but that the public in general should not be afforded this coverage through a dedicated and established public health organization?

Trakar

18th February 2012, 08:30 AM

Wow, that's some weapons-grade fail there. You just insisted that my posts about what is medically necessary and elective aren't relevant because your position ... revolves around what you deem to be medically necessary and elective.

No, it revolves around what treating physicians and the insurance companies who write the policies deem to be medically necessary and elective. If any of these therapies or procedures are deemed medically necessary by treating doctors and the policies of the insurance company, then the employer should be forced to buy coverage that includes that procedure/therapy. This is a consistent position as I have stated it from the beginning.

rwguinn

18th February 2012, 08:34 AM

so you are arguing that all goods and services should be available free of charge to everyone?

Agreed, but what about non-medically necessary birth control coverage makes this an issue that is better handled by forcing employers to pay for it than providing it free to everyone who wants it via the public health system?
Wow.
If all that straw were hay, we wouldn't have people committing Reverse Cattle Theft down here in Texas!

RandFan

18th February 2012, 08:42 AM

If you feel that it is eesential for every woman to have this coverage, then why limit yourself to Catholic affiliate hospital organizations? Why do you feel that they specifically should pay for elective procedure coverage for their employees, but that the public in general should not be afforded this coverage through a dedicated and established public health organization?? Where did you get this idea? It isn't limited. FTR: to be sure it's moot as the plan has now moved to insurance.

...is not a good or valid argument for forcing employers to pay for non-medically essential, elective procedures/therapies that directly violate their moral and ethical principles.Agreed. The valid argument is that it is good for employers their employees and society in general. It's quite simply a no brainer.

And let's bear something else in mind. Huckabee, a minister, signed into law this very requirement in his state. This was entirely non-controversial in the past. The simple truth is that folks are up in arms for political reasons. A nominal fee for something that will do so much for everyone is just such a non-issue.

Trakar

18th February 2012, 08:52 AM

Trakar -
so you are arguing that all goods and services should be available free of charge to everyone? No.

then please explain more completely exactly what you mean when you say "Why should anyone be forced to pay to cover the price of anything?"

The idea came about, in part, because of studies of productivity in the work place. Unwanted pregnancies cost employers in lost productivity. It cost employees. It cost society.

this does not address the issue of how it becomes incumbent upon the employer to pay for the willful behavior and elective decisions of their employees outside of the workplace and unrelated to workplace activities.
And again, if it is a widespread and urgent coverage issue that overrides such issues, why is requiring Catholic hospitals to provide insurance coverage for their employees a better option than mandating complete and free coverage for everyone regarding contraception. And finally, why don't you like the resolution the Obama administration has come up with for this concern?

RandFan

18th February 2012, 09:34 AM

then please explain more completely exactly what you mean when you say "Why should anyone be forced to pay to cover the price of anything?"? Not sure what the problem is here. If you answer the question you will have your answer. BTW: You already conceded my point. So, I'm not sure why you think it follows from my question that everyone should get everything for free. It doesn't. But, if you really don't understand then just answer the question and I'll then explain it.

this does not address the issue of how it becomes incumbent upon the employer to pay for the willful behavior and elective decisions of their employees outside of the workplace and unrelated to workplace activities.I'm not saying it's incumbent. I'm saying it makes sense. I'm saying we live in a society and we can make decisions that are in the best interest of everyone. It's not incumbent to fortify breakfast cereal. One could argue that a child's nutrition is the responsibility of parents. But we require cereal makers to fortify cereal and childhood disease has decreased. It's called living in a society. It's simply looking at facts and weighing costs to outcome. This one is a no brainer. Employers gain productivity. Employees gain needed medicine. Society wins. This is the requirement in California and it has worked well. And it has worked in other states also. Given the societal good I think it is reasonable to ask why not? If we can set aside religious objections for housing why not set it aside for the health of employees?

And again, if it is a widespread and urgent coverage issue that overrides such issues...It's neither widespread or urgent.

And finally, why don't you like the resolution the Obama administration has come up with for this concern?A.) I do like it. B.) I prefer it. C.) That doesn't mean that there is not an argument to be made for employers to cover the fee.

Trakar

18th February 2012, 09:37 AM

Trakar -
If you feel that it is eesential for every woman to have this coverage, then why limit yourself to Catholic affiliate hospital organizations? Why do you feel that they specifically should pay for elective procedure coverage for their employees, but that the public in general should not be afforded this coverage through a dedicated and established public health organization?

? Where did you get this idea? It isn't limited. FTR: to be sure it's moot as the plan has now moved to insurance.

I apologize, but I don't understand how your response relates to the issues I was discussing with Skeptic Ginger or the particular statement I made in the above quoted statement. Could you explain? The confusion may well the result of my own poor wording choices, in which case I'd be happy to address that issue, but I really don't understand your response above, at all.

Agreed. The valid argument is that it is good for employers their employees and society in general. It's quite simply a no brainer.

Which elective medical procedures from the list below, do you feel should employers be forced to cover or not forced to cover and why?

tummy tucks
breast augmentation/reductions
cataract surgery
laser vision correction
hair implants
infertility treatments
chiropractic treatment
Angioplasty
pace-maker implantation
hysterectomies
birth control
hip replacement
knee replacement
Biopsies
general exploratory surgery

(there are more, but this is a representative sample of the types of procedures and therapies that are currently considered by docotrs and insurance companies as elective, non-medical necessity procedures that typically are not covered in most health care insurance policies.)

Do you feel that all employers should be forced to pay for the coverage of these elective issues.

And let's bear something else in mind. Huckabee, a minister, signed into law this very requirement in his state...

Huckabee also compared failure to act on debt reduction to ignoring Nazi holocaust issues (and has used the same analogy with regards to abortion), equates homosexuality with pedophillia and beastiality, and somehow conflates Mormonism with the concept that Jesus and Lucifer are brothers.

I can't hold either his religious or political perspectives in very good consideration, besides that, he is both a social and political conservative, which is basically the antithesis of my beliefs and considerations in both the political and social agenda realms.

Skeptic Ginger

18th February 2012, 09:41 AM

Ignoring your continual refusal to address the issues surrounding your unqualified opinion about what is "medically necessary",...
more unsupported ad homIt's not an ad hom when it is true and relevant. You continue to call birth control 'not medically necessary' You have addressed, superficially, how certain medically necessary uses of BC should be covered.

But you refuse to address:
Your medical qualifications to state so self-assuredly that just preventing pregnancy is not medically necessary The quality of life issues which you note do matter when declaring pain treatment medically necessary but ignore in the case of pregnancy prevention Why this objection is legitimate and it was a non-news event when this same law was enacted in 2/3 of the states in the US including a handful that had no exceptions

I see no sign, that Obama ever intended to try to create a public healthcare organization.You didn't look very hard. He said it was politically unviable, not that he was against it.

However, argument that real healthcare is too hard to accomplish,Who argued that?

...If you feel that it is eesential for every woman to have this coverage, then why limit yourself to Catholic affiliate hospital organizations? Why do you feel that they specifically should pay for elective procedure coverage for their employees, but that the public in general should not be afforded this coverage through a dedicated and established public health organization?Again, who argued that?

I can make up things you've said and argue against them too. But it doesn't help the debate.

RandFan

18th February 2012, 09:53 AM

I apologize, but I don't understand how your response relates to the issues I was discussing with Skeptic Ginger or the particular statement I made in the above quoted statement. Could you explain? The confusion may well the result of my own poor wording choices, in which case I'd be happy to address that issue, but I really don't understand your response above, at all.Okay, but could you answer my question? Who said it was limited to Catholic organizations? If SG did then I don't even understand that aspect of the discussion. That has nothing to do with reality, right?

Which elective medical procedures from the list below, do you feel should employers be forced to cover or not forced to cover and why?
How many of them have been shown to significantly improve productivity for the employer and are also economical?

Do you feel that all employers should be forced to pay for the coverage of these elective issues.
If they are shown to A.) be economical and B.) significantly increase productivity, yes. Have they been shown to be both economical and to boost productivity? (I'm not sure you are getting my point).

Could you acknowledge that I'm arguing that contraceptives are both economical and will boost productivity?

Huckabee also compared failure to act on debt reduction to ignoring Nazi holocaust issues (and has used the same analogy with regards to abortion), equates homosexuality with pedophillia and beastiality, and somehow conflates Mormonism with the concept that Jesus and Lucifer are brothers.

I can't hold either his religious or political perspectives in very good consideration, besides that, he is both a social and political conservative, which is basically the antithesis of my beliefs and considerations in both the political and social agenda realms.This makes no sense. Ostensibly Huckabee is concerned about religious freedom, right?

Skeptic Ginger

18th February 2012, 10:36 AM

Which elective medical procedures from the list below, do you feel should employers be forced to cover or not forced to cover and why?

tummy tucks
breast augmentation/reductions
cataract surgery
laser vision correction
hair implants
infertility treatments
chiropractic treatment
Angioplasty
pace-maker implantation
hysterectomies
birth control
hip replacement
knee replacement
Biopsies
general exploratory surgery

(there are more, but this is a representative sample of the types of procedures and therapies that are currently considered by docotrs and insurance companies as elective, non-medical necessity procedures that typically are not covered in most health care insurance policies.)There are more than a few on that list which in no way are considered elective in the sense they are not covered even if it is claimed they are elective in the About.com web page (http://healthinsurance.about.com/lw/Health-Medicine/Healthcare-industry/Elective-Surgeries-What-Elective-Surgeries-are-Covered-By-Health-Insurance-.htm) you got the list from. About.com is about as good as Wiki, some entries are accurate, some not so accurate.

First, as I pointed out earlier with a legitimate source, (a well known medical dictionary), "elective" simply means a procedure that could be postponed without serious consequences because of the delay.

What is a little more accurate in that About.com page is:In general, insurance companies will cover procedures they deem medically necessary. But what is judged medically necessary can vary from plan to plan.But even that is not quite precise.

Insurance companies make business decisions to not cover certain procedures. Cosmetic surgery is probably the most universally not-covered procedure.

Lots of companies don't cover vision or dental. That doesn't mean the treatment is necessary or not. When lasik surgery came along it was typically put in the cosmetic category. But if cataract surgery is not covered that would be a business decision putting the surgery in the vision care category. That is unless you are seriously trying to say correcting blindness is not medically necessary. :rolleyes:

Joint replacement surgery was initially not covered on many insurance policies because at the time it was deemed "experimental". It is more commonly a covered procedure now that it has become standard care. Bariatric weight loss surgery is beginning to be recognized as medically necessary rather than cosmetic. But insurance companies are not all jumping on the band wagon to cover the procedures. A few more progressive companies are covering the procedures now with limits on how obese one must be to qualify.

I've never heard of an insurance company that excluded angioplasty, pace-maker implantation, hysterectomies, biopsies or general exploratory surgery. I have no idea why anyone put those procedures on that list unless they are some arbitrary exclusions of various policies or were excluded at some time in the past when the procedure was new like angioplasty.

You are making a lay person mistake about what "medically necessary" means and whether or not you dismiss my observation as an ad hom, the problem is you are not an expert and don't know what you are talking about. YOU HAVE A PERSONAL OPINION about what is medically necessary. But that opinion lacks the expertise in the field to really understand what medically necessary means.

One of the reasons the Affordable Health Care Act addresses MANDATORY PREVENTATIVE CARE is specifically because leaving it up to private insurance companies to decide what to cover resulting in a system that was more costly, not less. For example, insurance companies used to exclude vaccine coverage. Now why is that? It is undoubtedly more expensive to treat illness than to pay for a vaccine. But as a business decision there are many other variables to consider.

One, public health dollars were picking up the slack. The free market doesn't work perfectly because the cost of disposal of a product is not included in the cost we pay at the store. The public is on the hook for disposal and it used to be on the hook for the cost of cleanup of pollution. A business is not going to voluntarily pay for disposal as long as they are not required to do so. So society picks up the cost, the product is cheaper at the store, profits are higher for the manufacturer.

So you can't say that the market is working here. It isn't. Business decisions are leaving the public (aka society) a bill for something the business should be including in the cost of their product but aren't. And that happens with insurance policies as well. If the company can shift costs to the public, they can offer their products at a lower cost and make more profits. But the public pays.

The Affordable Health Care Act included addressing some of this cost shifting by determining which preventative care medications and procedures saved the entire society medical costs. These included among other things, preventative care that may have cost the insurance companies more than they saved, but either saved society health care costs, or saved lives. (Separate topic but insurers have been accused of declining preventative care because it was cheaper if people died.)

And this is where the politically motivated contrived claim this is about religious beliefs and not about birth control is revealed. A purely and legitimately expert medical opinion looking just at the benefit of birth control as a preventative health care measure determined birth control was indeed preventative care on the same level as vaccines and mammograms. Any religious or moral connotation of using birth control is made without affecting the fact that birth control is a preventative health care measure.

People like yourself cannot seem to recognize you are applying a moral connotation to your valuation of the medical aspects of birth control that you are not equally apply to vaccines or mammograms.

Trakar

18th February 2012, 11:14 AM

? Not sure what the problem is here. If you answer the question you will have your answer. BTW: You already conceded my point. So, I'm not sure why you think it follows from my question that everyone should get everything for free. It doesn't. But, if you really don't understand then just answer the question and I'll then explain it.

I still don't understand it. The only reason I can see to force anyone to pay for coverage for anything is because they are unfairly benefitting from not having to pay for that coverage.

I'm not saying it's incumbent. I'm saying it makes sense.

Sense, to a business, is more than just bottom line economics. It also must take into account the corporate culture and identity of the organization. In the case of a Catholic affiliate hospital, that means not only generating enough funds to cover costs and expenses, it also means doing so within a framework that preserves and is consistent with the Catholic identity.

I'm saying we live in a society and we can make decisions that are in the best interest of everyone. It's not incumbent to fortify breakfast cereal. One could argue that a child's nutrition is the responsibility of parents. But we require cereal makers to fortify cereal and childhood disease has decreased.

The FDA's 1941, and most subsequent (with the temporary 1943 War Foods Order as an exemption) regulations did not require all grain products to be fortified/enriched, they merely mandate the standards and application of the terms "fortified" and "enriched." That is why you can still walk into most grocery stores and find "natural," "artisan" and other breads and cereals that are not fortified/enriched.

It's called living in a society. It's simply looking at facts and weighing costs to outcome. This one is a no brainer. Employers gain productivity. Employees gain needed medicine.

If doctors and the covering insurance agencies determine that such is medically necessary, I have no problem with an employer being forced to provide such coverage.

Society wins. This is the requirement in California and it has worked well. And it has worked in other states also.

worked at getting catholic affiliate hospitals to self-insure and in some cases drop all prescription drug coverage in order to side step the issue entirely.

Given the societal good I think it is reasonable to ask why not? If we can set aside religious objections for housing why not set it aside for the health of employees?

It's neither widespread or urgent.

A.) I do like it. B.) I prefer it. C.) That doesn't mean that there is not an argument to be made for employers to cover the fee.

What about contraception, do you feel, makes it an issue that should be paid for by an individual's employer?

I accept it and find it a workable policy, I don't prefer it. I would prefer that Birth Control and health care in general to be considered a public (read as government) issue and dealt with in the same manner that we deal with problems of crime, natural disaster etc., with a publically funded national health care system that where such issues are removed from the realm of employer pay (or not pay) and insurance coverages. Where cradle to grave health issues are properly dealt with between individuals and their treating physicians.

Trakar

18th February 2012, 12:44 PM

It's not an ad hom when it is true and relevant.

whenever you attack, slur or insult the people you are engaging in dialog, as opposed to addressing the issues under discussion, you are taking your argument "ad hominem" (to the person), this may or may not be a logical fallacy, but it is, in nearly every instance I can think of, unnecessary and irrelevent to the substance of most issues of discussion.

You continue to call birth control 'not medically necessary' You have addressed, superficially, how certain medically necessary uses of BC should be covered.

I continue to cite and quote both physician and insurance organizations that have made that qualification. I am not and have not pulling this out of thin air nor trying to claim any especial or particular expertise in such a qualification.
I have not attempted to use my personal health care administration/information experience and expertise to support my statements and responses, as they are both unnecessary and inconsequential compared to the established professional organizations and individuals that I do cite as support for my responses and comments.

But you refuse to address:
[list] Your medical qualifications to state so self-assuredly that just preventing pregnancy is not medically necessary

as explained, unnecessary and irrelevent

If a treating physician decides that their patient's birth control is medically necessary, I would support the patient receiving the process/therapy, and some way to get such medical necessity determination covered under employer insurance regardless of the employer's considerations of the issue. I see no reason to argue against issues that physicians have evaluated based upon their training and experience, to be medical necessity or not of medical necessity.

Section 1.11 of the AMA Model Managed Care Contract defines medical necessity as:
Health care services or procedures that a prudent physician would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease or its symptoms in a manner that is
(a) in accordance with generally accepted standards of medical practice;
(b) clinically appropriate in terms of type, frequency, extent, site, and duration; and
(c) not primarily for the economic benefit of the health plans and purchasers or for the convenience of the patient, treating physician, or other health care provider.
http://www.ama-assn.org/ama1/pub/upload/mm/368/mmcc_4th_suppl_1.pdf

A medical procedure that a patient and doctor plan in advance for a condition that is not life-threatening.
www.health.state.mn.us/clearinghouse/glossary.htm

Elective: In medicine, something chosen (elected). An elective procedure is one that is chosen (elected) by the patient or physician that is advantageous to the patient but is not urgent.
Elective surgery is decided by the patient or their doctor. The procedure is seen as beneficial but not absolutely essential at that time.
http://www.medterms.com/script/main/art.asp?articlekey=14354

The quality of life issues which you note do matter when declaring pain treatment medically necessary but ignore in the case of pregnancy prevention

Not all pain rises to the level of medical necessity, though some definitely does, the decision of medical necessity and whether or not such therapies are elective or required is the call of the individual's treating doctor and insurer representatives. Replace "pain" with "birth control" and my considerations change not one iota.

Why this objection is legitimate and it was a non-news event when this same law was enacted in 2/3 of the states in the US including a handful that had no exceptions

I am unconcerned with issues of politicization or popularization, or even any inconsistancies of the arguments put forth by those trying to distort and utilize ginned up controversy for their own ancilliary agendae (regardless of their political druthers). I am arguing my own understanding and position and supporting that position with proper and substantive references and cites if you feel that my argument is not legitimate then that is an issue you must compellingly demonstrate.

You didn't look very hard. He said it was politically unviable, not that he was against it.

I never said he was against universal public health care service (note: I was, and am not talking about single-payer national health care insurance) I simply said that "I see no sign, that Obama ever intended to try to create a public healthcare organization." Please focus on the arguments I am making, not how you would prefer to interpret my words into arguments I am not and have not made.

Trakar -
However, argument that real healthcare is too hard to accomplish Who argued that?

You stated:...just how is Obama supposed to accomplish that public health option given the current absurd position of cutting taxes for the rich and decreasing the deficit regardless of cuts in services like public health?

Why do you feel that they specifically should pay for elective procedure coverage for their employees, but that the public in general should not be afforded this coverage through a dedicated and established public health organization?

Again, who argued that?

Please excuse me, that was Bookitty who seemed to be arguing that county health and planned parenthood contraception offerings were insufficient and inadequate alternatives to employer health insurance coverage.

I can make up things you've said and argue against them too.

I could for instance point to examples where you have done this in the post I am responding to here.

But it doesn't help the debate.

Agreed

RandFan

18th February 2012, 01:01 PM

I still don't understand it. It benefits the employer directly. It also benefits the employee. It is a good for society. I'm just not sure why that is hard to understand. But I will add that it's an easy model to put into practice. It's economical and the employer can easily track it and pay for it with the other payments to insurance.

Sense, to a business, is more than just bottom line economics. It also must take into account the corporate culture and identity of the organization. In the case of a Catholic affiliate hospital, that means not only generating enough funds to cover costs and expenses, it also means doing so within a framework that preserves and is consistent with the Catholic identity.That argument would also apply to the landlord that doesn't want to house fornicators. The contraceptive policy has been tried in California and other states with no harm and no outrage from churches. This is a manufactured storm because a Democrat is in office.

The FDA's 1941, and most subsequent (with the temporary 1943 War Foods Order as an exemption) regulations did not require all grain products to be fortified/enriched, they merely mandate the standards and application of the terms "fortified" and "enriched." That is why you can still walk into most grocery stores and find "natural," "artisan" and other breads and cereals that are not fortified/enriched. I don't want to get into that debate. It's a fact that fortification and/or enrichment has been mandated. (http://www.foodinsight.org/Newsletter/Detail.aspx?topic=Food_Fortification_in_Today_s_Wo rld)

If doctors and the covering insurance agencies determine that such is medically necessary, I have no problem with an employer being forced to provide such coverage.
Traffic lights aren't medically necessary but we have them because they are good for society. Since the employer benefits directly and it's economical and easy to handle it at that point then I'm okay if we do it there. You feel that the religious question is significant. Perhaps from a political pov. It's really not a big deal though. It works fine for California and other states. It's a manufactured outrage. We found a work around and that's fine. But it would work fine if the employer paid for it and it would be good for him.

What about contraception, do you feel, makes it an issue that should be paid for by an individual's employer? Same reason I feel we should have traffic lights. It's a societal good. It's good for the employer, the employee, society in general. The reason to have the employer pay for it is that it benefits him or her directly. It's a simple and economic model. Not the only one but it works.

I accept it and find it a workable policy, I don't prefer it. I would prefer that Birth Control and health care in general to be considered a public (read as government) issue and dealt with in the same manner that we deal with problems of crime, natural disaster etc., with a publically funded national health care system that where such issues are removed from the realm of employer pay (or not pay) and insurance coverages. Where cradle to grave health issues are properly dealt with between individuals and their treating physicians.That's fine with me.

Trakar

18th February 2012, 01:25 PM

Okay, but could you answer my question? Who said it was limited to Catholic organizations? If SG did then I don't even understand that aspect of the discussion. That has nothing to do with reality, right?

Ah, a combination of quipping and language! The original clipped quote was from this larger statement, where the section you clipped and quoted referred to "non-medically essential, elective procedures/therapies" it was the coverage of one of these procedures to catholic hospitals, as opposed to the entire category of such procedures for all hospitals. That is the nature of the limitation to which I was referring. My apologies for the unclear nature of my statement.

How many of them have been shown to significantly improve productivity for the employer and are also economical?

all of them are considered non-medical necessities, and elective medical procedures. Medical necessity precludes consideration of economic benefits to any of the involved parties in its determination. Personally, I think many preventative screening and treating programs would far outweigh in economic terms the expenses of later having to cover medically necessary required procedures/therapies resulting from the conditions addressable with preventative care. And if bottomline dollar amounts are the only consideration, it would be ridiculous for an organization not to willingly invest in such,...requiring organizations to hold this as a government mandated perspective, however, is repleat with problems that goes far beyond this example of BC and Catholic affiliated hospitals.

If they are shown to A.) be economical and B.) significantly increase productivity, yes. Have they been shown to be both economical and to boost productivity? (I'm not sure you are getting my point).

I guess not, I don't understand why or how the government should mandate productivity and economical efficiency into private corporate organizations. I can see that it is a primary motivator and market force in corporate organization, but not that it is the supreme and over-riding concern or that government mandates should or could be used to establish such.

Could you acknowledge that I'm arguing that contraceptives are both economical and will boost productivity?

I agree that they can be, depending on the work force and the general environment in which such are considered, but I don't see that government mandates for employer coverage is the only or best means to achieve the health, economic or productivity gains objective.

This makes no sense. Ostensibly Huckabee is concerned about religious freedom, right?

Doubtful, being a politician, his primary concern is most likely political and his distortion of not only other religions, but also the one he obstinsibly represents speaks to the low priority he apparently places on both religion and more general religious freedom.

Skeptic Ginger

18th February 2012, 01:27 PM

whenever you attack, slur or insult the people you are engaging in dialog, as opposed to addressing the issues under discussion, you are taking your argument "ad hominem" (to the person), this may or may not be a logical fallacy, but it is, in nearly every instance I can think of, unnecessary and irrelevent to the substance of most issues of discussion.From the Free Dictionary:ad ho·mi·nem ...
attacking an opponent's character rather than answering his argument.When the argument is the opponent's making declarations of fact said opponent lacks the expertise to make, that is the argument. Sorry, can't get around that problem without pointing it out.

[snipped irrelevant claims]Your posts are evidence of your lack of expertise. Claiming you have some related experience doesn't help you.

If a treating physician decides that their patient's birth control is medically necessary, I would support the patient receiving the process/therapy, and some way to get such medical necessity determination covered under employer insurance regardless of the employer's considerations of the issue. I see no reason to argue against issues that physicians have evaluated based upon their training and experience, to be medical necessity or not of medical necessity. While at the same time you continue to ignore the fact it was qualified medical professionals that put birth control on the list of preventative care in the first place.

So, if all physicians follow the advice of the medical standard set by the group of experts that developed the standard, all voluntary birth control is medically necessary. Guess we're done here. :)

Section 1.11 of the AMA Model Managed Care Contract defines medical necessity as:
Health care services or procedures that a prudent physician would provide to a patient for the purpose of preventing, diagnosing, or treating an illness, injury, disease or its symptoms in a manner that is
(a) in accordance with generally accepted standards of medical practice;Check.
(b) clinically appropriate in terms of type, frequency, extent, site, and duration;Check.
(c) not primarily for the economic benefit of the health plans and purchasers or for the convenience of the patient, treating physician, or other health care provider.Check.
http://www.ama-assn.org/ama1/pub/upload/mm/368/mmcc_4th_suppl_1.pdf

A medical procedure that a patient and doctor plan in advance for a condition that is not life-threatening.
www.health.state.mn.us/clearinghouse/glossary.htm

Elective: In medicine, something chosen (elected). An elective procedure is one that is chosen (elected) by the patient or physician that is advantageous to the patient but is not urgent.
Elective surgery is decided by the patient or their doctor. The procedure is seen as beneficial but not absolutely essential at that time.
http://www.medterms.com/script/main/art.asp?articlekey=14354This is the definition I've been trying to point out to you. It applies to everything except life-threatening emergencies. It doesn't help your argument birth control is elective and every other elective procedure covered by insurance isn't.

You are ignoring the purpose of mandating certain preventative medical care. So given you are apparently trying to claim any employer should be able to deny any coverage it finds objectionable except life threatening treatments, (meaning an employer can intrude on the life of its employees just about any way it chooses when it comes to medical insurance) let's look at the issue from that approach.

Say an employer refused to include certain coverage for employees in their medical plans but the result was taxpayers then had to pay the cost, not the employee. Walmart has been accused of this because some of their full time employees qualify for Medicaid. This is one of the dilemmas coming to light with our system of employer sponsored medical insurance coverage.

Again, one purpose of the Affordable Care Act is to decrease costs overall, decrease the cost of everyone's medical care. By claiming a religious exemption to such a weak "moral mandate" (as evidenced by the fact the vast majority of Catholics in this country do not adhere to the belief), these employers are essentially shifting costs they are responsible for to the taxpayer. As a taxpayer I am morally outraged I have to pay for these employer's hypocritical position on birth control. :)

I am unconcerned with issues of politicization or popularization, or even any inconsistancies of the arguments put forth by those trying to distort and utilize ginned up controversy for their own ancilliary agendae (regardless of their political druthers). I am arguing my own understanding and position and supporting that position with proper and substantive references and cites if you feel that my argument is not legitimate then that is an issue you must compellingly demonstrate.You are also UNAWARE how a political or moral implication of a medical procedure is affecting your perception of that procedure. You are applying a different standard to birth control compared to other medical procedures. This is why you are having a difficult time rationalizing what is or is not "medically necessary". You can put birth control in the not medically necessary category but 90% of the rest of what we do in medicine follows birth control into your definition. You cannot articulate why quality of life matters with pain but not with sex because they are the same, they both affect quality of life.

RandFan

18th February 2012, 01:29 PM

I agree that they can be, depending on the work force and the general environment in which such are considered, but I don't see that government mandates for employer coverage is the only or best means to achieve the health, economic or productivity gains objective.Let me be clear. This particular issue was the result of a study that showed that contraception boosted productivity. I'm not arguing that it's the only or best. Only that it was done in the past with no outrage and it's an effective and efficient model. But, politics, the Republicans used it as an issue so the WH changed strategy. Had there been no outrage like before when the states implemented it no one would give a damn.

Trakar

18th February 2012, 02:30 PM

There are more than a few on that list which in no way are considered elective in the sense they are not covered even if it is claimed they are elective in the About.com web page (http://healthinsurance.about.com/lw/Health-Medicine/Healthcare-industry/Elective-Surgeries-What-Elective-Surgeries-are-Covered-By-Health-Insurance-.htm) you got the list from. About.com is about as good as Wiki, some entries are accurate, some not so accurate.

While there is some overlap in my list and the About.com page you link, it is not at all as comprehensive or extensive as the listing i provided, much less as the listings from which I derived this information, which primarily is the 2011 ICD-9/10 CM manual with some confirmation and support from a few online insurance references like:

http://www.bcbsms.com/index.php?q=blue-care-limitations-and-exclusions.html

http://www.medicare.gov/Coverage/Home.asp

First, as I pointed out earlier with a legitimate source, (a well known medical dictionary), "elective" simply means a procedure that could be postponed without serious consequences because of the delay.

That is a partial definition that I do not object to, nor does it substantively change or alter any statment or qualification I have made.

What is a little more accurate in that About.com page is:But even that is not quite precise.

Insurance companies make business decisions to not cover certain procedures. Cosmetic surgery is probably the most universally not-covered procedure.

Lots of companies don't cover vision or dental. That doesn't mean the treatment is necessary or not. When lasik surgery came along it was typically put in the cosmetic category. But if cataract surgery is not covered that would be a business decision putting the surgery in the vision care category. That is unless you are seriously trying to say correcting blindness is not medically necessary. :rolleyes:

curious that you roll your eyes at your own strawmen?!

cataract surgery is elective and considered non-medically necessary until cataracts create a level of vision reduction that significantly impacts necessary activities of daily living. It must be evaluated on a case by case basis, a single individual working in a skill profession that demands visual acuity would probably have a very low threshold of impairment before surgery was considered a medically necessary requirement

(clip of unsupported opinions)

You are making a lay person mistake about what "medically necessary" means and whether or not you dismiss my observation as an ad hom, the problem is you are not an expert and don't know what you are talking about. YOU HAVE A PERSONAL OPINION about what is medically necessary. But that opinion lacks the expertise in the field to really understand what medically necessary means.

You presume a lot in your continued push to characterize me and my perspective (which you continue to misunderstand) rather than actually addressing the information statements and supporting references I continue to post.

I am perfectly comfortable allowing treating physicians and the various insurance companies they are dealing with to define and apply the terms elective and medically necessary, it is you who seems to disagree with allowing them to do so, and seem to want to force insurance companies and doctors to abide by your applications of the terms, which so far continue to stand supported only by your assertions and interpretations rather than any clear-cut definition from a valid and compelling medical source.

Skeptic Ginger

18th February 2012, 02:37 PM

...curious that you roll your eyes at your own strawmen?!Cataracts were on YOUR list.

I am perfectly comfortable allowing treating physicians and the various insurance companies they are dealing with to define and apply the terms elective and medically necessary, it is you who seems to disagree with allowing them to do so, and seem to want to force insurance companies and doctors to abide by your applications of the terms, which so far continue to stand supported only by your assertions and interpretations rather than any clear-cut definition from a valid and compelling medical source.Then we are in agreement, ALL voluntary birth control can be justified as medically necessary.

Trakar

18th February 2012, 02:46 PM

It benefits the employer directly. It also benefits the employee. It is a good for society. I'm just not sure why that is hard to understand. But I will add that it's an easy model to put into practice. It's economical and the employer can easily track it and pay for it with the other payments to insurance.

all quite irrelevent to whether or not the *employer* should be forced to provide this coverage.

That argument would also apply to the landlord that doesn't want to house fornicators.

I don't see the analogous connection.

The contraceptive policy has been tried in California and other states with no harm and no outrage from churches.

This is obviously false, or the church affiliated organizations would not have sued the state, and taken on self-insurance, the cancellation of prescription drug benefits and the various other measures they have taken to insulate or remove their benefit offerings from these state actions.

This is a manufactured storm because a Democrat is in office.

The current controversy is largely ginned-up on both sides of this popular debate, but both are largely irrelevent to my position and reasons for discussing it.

I don't want to get into that debate. It's a fact that fortification and/or enrichment has been mandated. (http://www.foodinsight.org/Newsletter/Detail.aspx?topic=Food_Fortification_in_Today_s_Wo rld)

read the history and laws

Dietary Reference Intakes: Guiding Principles for Nutrition Labeling and Fortification (2003)
Food and Nutrition Board (FNB)
http://www.nap.edu/openbook.php?record_id=10872&page=46
...About that time FDA first established a standard of identity for enriched flour that identified specific nutrients and amounts required for addition to any flour labeled as “enriched” in order to improve the nutritional status of the population (FDA, 1941). The approach of using a standard of identity, which establishes the specific type and level of fortification required for particular staple food to be labeled as enriched, has remained a key aspect of fortification regulations and policy in the United States. These standards have been amended over the years, but they continue as the basis for the addition of thiamin, niacin, riboflavin, folic acid, and iron to enriched flour, with the addition of calcium as optional.
...The voluntary cooperation of bakery-associated industries led to 75 percent of the white bread in the United States being fortified by the middle of 1942 (Quick and Murphy 1982). The first War Food Order, enacted in 1943, stated that all flour sold for interstate commerce would be enriched according to FDA standards. This order was later repealed in 1946, but was followed in 1952 with official standards of identity for enriched bread (FDA, 1952a, 1952b). Under this new regulation, fortification of flour and bread products was not mandatory, but if a product was labeled as “enriched” it was required to meet the standards of identity described in the regulation.

Trakar

18th February 2012, 02:55 PM

Cataracts were on YOUR list.

indeed cataract surgery in general is non-medically necessary elective surgery unless it meets certain individual criteria that push it into the medically necessary and required status.

Your strawman was the line you chose to highlight with bolding to help it stand out: "That is unless you are seriously trying to say correcting blindness is not medically necessary."

Then we are in agreement, ALL voluntary birth control can be justified as medically necessary.

Please provide compelling supporting evidence that physicians consider all voluntary birth control as medically necessary, or withdraw the assertion.

RandFan

18th February 2012, 04:13 PM

all quite irrelevent to whether or not the *employer* should be forced to provide this coverage.Asserting that it's irrelevant doesn't make it so. Why should we force an employer to do anything? When you answer that question you will have answered your own question.

I don't see the analogous connection.
Both require a business person to do something for the public good that is counter to their conscience.

This is obviously false, or the church affiliated organizations would not have sued the state, and taken on self-insurance, the cancellation of prescription drug benefits and the various other measures they have taken to insulate or remove their benefit offerings from these state actions.
Give me a source?

RandFan

18th February 2012, 04:17 PM

all quite irrelevent to whether or not the *employer* should be forced to provide this coverage.

Why should we force an employer to do anything? When you answer that question you will have answered your own question.BTW: You have ignored this question from the start. Instead of answering it you simply created a non-sequitur. It's an important question. Please to answer it? Seriously.

rwguinn

18th February 2012, 09:10 PM

indeed cataract surgery in general is non-medically necessary elective surgery unless it meets certain individual criteria that push it into the medically necessary and required status.
...."

Please provide compelling supporting evidence that physicians consider all voluntary birth control as medically necessary, or withdraw the assertion.

contradict yourself much?
You don't think insurance should pay, since only sometimes it's Necessary.
You didn't read about the Catholic care who was excommunicated and fired for performing an abortion that saved one life, instead of letting two expire?
Being essentially blind, or dying, is an acceptable consequence, to you...
I understand your position, now.

Skeptic Ginger

19th February 2012, 04:22 AM

...

Please provide compelling supporting evidence that physicians consider all voluntary birth control as medically necessary, or withdraw the assertion.Why do you think it was on the list? And who do you think contributed to the position in the first place? Think there were any physicians on the task force that made the recommendation?

You need to add 'SOME' "physicians consider all voluntary birth control as medically necessary", to your words. It is extremely rare to find ALL physicians agreeing on anything.

In addition, the definitions of "medically necessary" and "elective" need context to be meaningful.

Trakar

19th February 2012, 08:17 AM

BTW: You have ignored this question from the start. Instead of answering it you simply created a non-sequitur. It's an important question. Please to answer it? Seriously.

I thought I answered this back in post #226?

"The only reason I can see to force anyone to pay for coverage for anything is because they are unfairly benefitting from not having to pay for that coverage."

I don't see the unfair benefit that necessitates a government interference mandate.

Trakar

19th February 2012, 08:35 AM

Why do you think it was on the list? And who do you think contributed to the position in the first place? Think there were any physicians on the task force that made the recommendation?

unless the physicians were speaking only to some specific instances or conditional settings, they were speaking outside their area of expertise and direct knowledge.

You need to add 'SOME' "physicians consider all voluntary birth control as medically necessary", to your words. It is extremely rare to find ALL physicians agreeing on anything.

"ALL" was your word, not mine. I'll let you decide on the proper way you wish to revise your own statements before examining your position further.

In addition, the definitions of "medically necessary" and "elective" need context to be meaningful.

Which has been my position from the beginning. We are left to examine individual cases, where individual doctors are given to examining and deciding in each case whether or not an individual's request of birth control is medically necessary or as is currently most often the case, deemed to be non-medically necessary and predominantly an elective choice to undergo treatment due to other issues and concerns.

When a treating physician states that a particular woman's confluence of health states and conditions are such that treatment with birth control drugs is a medically necessary requirement, I have no problem with forcing an employer to provide coverage for the drug therapy. When the circumstances, however, do not rise to the standard of a medically necessary requirement for the therapy, and are thus based upon other issues and concerns, I do not see a compelling reason to force the employer to pay for coverage. The employer is not providing economic security insurance, they are merely trying to address reasonable health insurance coverage for medically necessary treatments and therapies.

RandFan

19th February 2012, 09:51 AM

I thought I answered this back in post #226?

"The only reason I can see to force anyone to pay for coverage for anything is because they are unfairly benefitting from not having to pay for that coverage."

I don't see the unfair benefit that necessitates a government interference mandate.I apologize. I guess you did answer me.

Can you give me an example of an unfair benefit?
Your answer would seem to exclude almost all labor law, correct?

If #2 is correct then I would say that I have answered you. We live in a society and we can and should make laws that benefit society. The law benefits the employer, benefits the employee and thus benefits society. I can't think of a reason not to have the law (outside of the fake religious outrage BS).

It's a rather odd argument to say it's wrong to force someone (employer) to do something in their best interest that also is in the interest of the employee and thus society. You might not like that answer but it is an answer. BTW: If the employer gets increased productivity but doesn't pay for that increased productivity, isn't that an unfair benefit?

Trakar

19th February 2012, 10:45 AM

I apologize. I guess you did answer me.

Can you give me an example of an unfair benefit?

The examples that come to mind most readily, would be situations where company A locates its manufacturing in a remote area and dumps its manufacturing waste into a river, whereas company B pays to properly dispose of its waste. Company A benefits from lowered costs of production and either gains higher market share through selling at a reduced price, or maintains current market share but reaps higher profit margins. In this case government imposes fees (clean-up costs, proper disposal fees, and fines) to establish market balance and most importantly to recoup the public expenses of restoring the dumping ground.

In this case, primarily due to the levels of expense and harm (after all, if proper disposal were trivial in nature and largely irrelevent or insubstantive in cost and harm there wouldn't be any good reason to not use proper disposal methods), government imposition of fees and fines to handle proper disposal and would seem to be reasonable.

Your answer would seem to exclude almost all labor law, correct?

How so? What work related choices and decisions are being restricted or abrogated by not forcing an employer to pay insurance coverage for the non-medically necessary therapy choices made by employees in their personal lives and behaviors? Is it a violation of labor law when a company doesn't pay for insurance coverage for breast augmentation/reduction, the removal of a tatoo obtained on a drunken weekend or any one of numerous other non-medically necessary elective procedures/therapies that an employee might want help paying for?

(...)
It's a rather odd argument to say it's wrong to force someone (employer) to do something in their best interest that also is in the interest of the employee and thus society. You might not like that answer but it is an answer.

In a state where the open-air combustion of non-toxic waste is permitted and pit-incineration is the commonly accepted and used method of handling that waste, but we have a company who prides itself on it's environmental values and has made these values an essential and fundemental quality of its operations and products, and who recycles and re-uses all of its waste at a greater expense than they would incur if they simply followed the common path.

Now, is it appropriate to force this company to encourage its employees about the economic benefits of digging burn pits in their backyards and to buy insurance to cover the costs of pit construction and regular ash removal for those employees who choose to do so?

Skeptic Ginger

19th February 2012, 10:59 AM

unless the physicians were speaking only to some specific instances or conditional settings, they were speaking outside their area of expertise and direct knowledge.I try to be selective using this smilie but it is called for here:
:dl:
Are you seriously claiming the recommendations made by the government's task force on what should be included in preventative care recommendations in the Affordable Care Act were made by people who were unqualified to do so based on your 'expert' opinion?

"ALL" was your word, not mine. I'll let you decide on the proper way you wish to revise your own statements before examining your position further. Yeah, I said all VOLUNTARY BIRTH CONTROL, not all physicians. There's a difference.

RandFan

19th February 2012, 11:01 AM

In this case, primarily due to the levels of expense and harm (after all, if proper disposal were trivial in nature and largely irrelevent or insubstantive in cost and harm there wouldn't be any good reason to not use proper disposal methods), government imposition of fees and fines to handle proper disposal and would seem to be reasonable.So, if an employer benefits from contraception coverage (increased productivity) why should he benefit without paying?

How so? What work related choices and decisions are being restricted or abrogated by not forcing an employer to pay insurance coverage for the non-medically necessary therapy choices made by employees in their personal lives and behaviors?I don't claim that. Not even close. I claim that there exists labor laws that force employers to do things that have nothing to do with unfair benefits to them. You seem to be special pleading because of money. Well, it costs money to implement many labor laws. Why should we force employers to implement those laws at a cost if there is no unfair benefit?

Now, is it appropriate to force this company to encourage its employees about the economic benefits of digging burn pits in their backyards and to buy insurance to cover the costs of pit construction and regular ash removal for those employees who choose to do so?If it benefited the company directly in increased productivity, yeah. Of course. Why not? does it benefit the company directly?

Trakar

19th February 2012, 11:32 AM

So, if an employer benefits from contraception coverage (increased productivity) why should he benefit without paying?

productivity increase is a complex measurement and not the only or even most important consideration with regards to Catholic hospitals and their employees. As has been stated by several, (including yourself, I believe, but could be mistaken) we aren't looking at substantively large costs or harms in coverage or lack of this particular coverage, it is primarily a political football that both sides are attempting to use to pump up the emotion levels of their activst bases.

I don't claim that. Not even close. I claim that there exists labor laws that force employers to do things that have nothing to do with unfair benefits to them.

such as? and please, as specifically as possible compare and contrast any of these examples with this mandated employer birth control health insurance coverage issue.

You seem to be special pleading because of money. Well, it costs money to implement many labor laws. Why should we force employers to implement those laws at a cost if there is no unfair benefit?

Again, what examples are you offering up as situations where labor law forces employers to pay costs for practices that do not substantively harm others or unfairly benefit themselves?

If it benefited the company directly in increased productivity, yeah. Of course. Why not? does it benefit the company directly?

Are any minor productivity increases sufficient to offset the damages to the company's culture and branding of green recycling and re-use? If one of the company's primary reasons for operations is to lead the way in recycling and re-use and if they measure their success more by how well they achieve this goal and spread their corporate culture to others rather than by whether or not they are achieving maximum profits, do you find a difference in your assessment of "benefit."

Trakar

19th February 2012, 11:48 AM

I try to be selective using this smilie but it is called for here:
:dl:
Are you seriously claiming the recommendations made by the government's task force on what should be included in preventative care recommendations in the Affordable Care Act were made by people who were unqualified to do so based on your 'expert' opinion?

No, that is your characterization of my remarks. I am saying that blanket, unqualified statements regarding complex issues are generally beyond the accuracy afforded by expertise in any field of knowledge.

Yeah, I said all VOLUNTARY BIRTH CONTROL, not all physicians. There's a difference.

Actually, your words were: "ALL voluntary birth control can be justified as medically necessary"

Which is more than subtly distinct from the revisions you keep making to your terms. This was stated in conjunction with an implication that physicians by and large concur with this assessment, as my statement that you were countering stated that treating physicians should be the primary authority in deciding medical necessity requirements for their patients.

Skeptic Ginger

19th February 2012, 12:46 PM

....
Actually, your words were: "ALL voluntary birth control can be justified as medically necessary"

Which is more than subtly distinct from the revisions you keep making to your terms. This was stated in conjunction with an implication that physicians by and large concur with this assessment, as my statement that you were countering stated that treating physicians should be the primary authority in deciding medical necessity requirements for their patients.You mean the re-statements I keep making to try to get through to you why your reconstruction of my comments is made of straw?

Could it be you finally figured out what your straw man was so now you are claiming I really said something else? :rolleyes:

RandFan

19th February 2012, 01:04 PM

productivity increase is a complex measurement and not the only or even most important consideration with regards to Catholic hospitals and their employees.I've not a clue what "complex" has to do with anything. Studies show it increases productivity.

As has been stated by several, (including yourself, I believe, but could be mistaken) we aren't looking at substantively large costs or harms in coverage or lack of this particular coverage, it is primarily a political football that both sides are attempting to use to pump up the emotion levels of their activst bases.
The benefit to women is real and measurable. The Democrats didn't politicize the issue. They simply responded to the ridiculous politicization. They might have shrewdly responded but it's not fair to lay this at their feet. But I don't care. In the end it's a real and measurable benefit and that's what govt does. If it's good for society then we can do those things like all of the other labor laws.

such as? and please, as specifically as possible compare and contrast any of these examples with this mandated employer birth control health insurance coverage issue.
Family medical leave act. (http://www.dol.gov/whd/fmla/) Businesses argue that this is an unfair burden on them to keep a job open and be forced to fill the position with expensive temporary help. That costs money and lost productivity. But here is the question that is still unanswered, why do we force an employer to do anything that isn't the result of an unfair benefit? Do you agree that cost is irrelevant?
Again, what examples are you offering up as situations where labor law forces employers to pay costs for practices that do not substantively harm others or unfairly benefit themselves?A.) Why should we force an employer to do anything that isn't the result of an unfair benefit?

B.) Just about any labor law costs money. Companies often hire people just to make certain that they are in compliance with labor laws. When such a bill is being argued in congress legislators often argue that such regulations cost employers money and lost productivity, right?

Are any minor productivity increases sufficient to offset the damages to the company's culture and branding of green recycling and re-use? If one of the company's primary reasons for operations is to lead the way in recycling and re-use and if they measure their success more by how well they achieve this goal and spread their corporate culture to others rather than by whether or not they are achieving maximum profits, do you find a difference in your assessment of "benefit."If it weren't targeted to a single company then it would be a more compelling example. But no, if the benefit to the company and the employee were as significant as the contraception issue then it would be appropriate. In your hypothetical is there an equivalent benefit to the company? I can't tell from your example. If the benefit is equivalent and direct to the company, yes it is appropriate and no I wouldn't change my assessment.

That said, there doesn't even need to be a benefit to the company. The benefit is what makes it a no brainer. If society deemed it appropriate and govt enacted to make a law then I'm behind it.

Trakar

20th February 2012, 09:47 AM

I've not a clue what "complex" has to do with anything. Studies show it increases productivity. The benefit to women is real and measurable.

Independent studies not from a potentially biased advocacy group have demonstrated this? Can you link to them?

The Democrats didn't politicize the issue. They simply responded to the ridiculous politicization. They might have shrewdly responded but it's not fair to lay this at their feet. But I don't care. In the end it's a real and measurable benefit and that's what govt does.

No, while that may be the goal many hold for government, government tends to do what the majority of voices tell it to do, whether or not such is actually the right or best possible course of action. You may have a lot of faith in the benefit of collective action but there were several good reasons our forefathers didn't set up a pure democracy, and the fact that mob-rule often tends to result in poorly considered, counter-productive and often prejudicial action against the rights of the minority is one I certainly agree with.

If it's good for society then we can do those things like all of the other labor laws.

I still haven't seen support for this perceived similarity between labor laws in general and the forcing of employers to pay for coverage that is not directly related to work place decisions or activities.

Family medical leave act. (http://www.dol.gov/whd/fmla/)

An interesting choice, as this labor concept actually does just the opposite of your proposed birth control mandate. It addresses an actual problem. People in the final stages of prenancy and in the first few months of a new child's life need to spend a lot of time taking care of themselves and that newly born child. Making sure that valued employees maintain their job status through such a situation is more benefit than burden to the organization in most instances, and goes beyond the mere benefit of the immediate and direct action to the parent taking leave and retaining their job status.

Businesses argue that this is an unfair burden on them to keep a job open and be forced to fill the position with expensive temporary help.

cite or reference? Not that I don't see how this might cause difficulties in some small businesses, but as an overall and general business concern? The benefits of retaining experienced, dedicated and loyal employees would seem to more than compensate for any short-term inconveniences caused by FMLA.

That costs money and lost productivity. But here is the question that is still unanswered, why do we force an employer to do anything that isn't the result of an unfair benefit?

I still don't see where we are forcing an employer to pay for something that isn't the result of an unfair substantive benefit with FLMA or other Labor laws. There is no mandate in FMLA for the employer to hire replacement staff or to do much of anything other than allow up to 12 weeks of unpaid leave due to personal or family medical issues without allowing the employee to return to their job at the end of that period.

Do you agree that cost is irrelevant?

Not at all. I would agree that cost may not be the only, or even the major issue, but cost is always a consideration when it comes to business issues.

A.) Why should we force an employer to do anything that isn't the result of an unfair benefit?

I can't help but notice that you seem to have permanently wandered away from the originally stated "why should we force an employer to *pay* for anything" statement that goes more directly to the heart of our original discussion.

In general, I don't see that we do force employers to pay for issues that aren't related to unfair benefits. There are certainly discrimination and prejudice issues in which some employers may be forced to take actions they'd rather not take, but this is different from what we are talking about and doesn't force the employer to pay for something unrelated to his business operations, counter to the organizational culture, and purely applicable to private personal decisions and choices made by an individual in their away from work lives.

B.) Just about any labor law costs money.

You don't see the difference between, for instance, safety and access expenses used to improve and secure the workplace environment while enhancing the value of the property, and being forced to pay a third party for the non-business related choices employees make in their bedrooms.

I thought the whole idea was to get government out of America's bedrooms not have government drag employers into the bedroom with them.

Companies often hire people just to make certain that they are in compliance with labor laws. When such a bill is being argued in congress legislators often argue that such regulations cost employers money and lost productivity, right?

Have you listened to the idiocy that often tries to pass itself off as reasoned and supported argument in the halls of congress? In the short term, virtually any change from the way business is currently being run is going to cost some money, the question is are there offsetting longer term benefits for the business or is the legislation long term regressive in its impacts and results.

If it weren't targeted to a single company then it would be a more compelling example.

The example holds if extended to entire industries but then you begin to add in the complicating factors of legal bias and discrimination against the business practices that favor majority non-green companies over minority green companies and it takes the argument to a different level than merely forcing an employer to pay to institute a program that has nothing to do with its business operations but is long-term detrimental to its organizational culture, its branding, and thus its profittability/viability.

But no, if the benefit to the company and the employee were as significant as the contraception issue then it would be appropriate. In your hypothetical is there an equivalent benefit to the company?

No clear long-term benefit is yet established (beyond reasonable contention) to BC coverage. There are studies from some sources which seem to indicate there may be some benefit, but I haven't examined these studies in the depth required to establish that they are both substantive and applicable to the specific topic in question while demonstrating objectivity in their analyses and findings. I am still looking for any independent objective study of the issue particularly with regards to private healthcare organizations, but I will look in more depth at the Guttmacher study to see how it addresses and treats the full spectrum of cost and benefit issues or whether it is a very narrowly focussed study designed to fulfill its advocacy and promotion agendae.

I can't tell from your example. If the benefit is equivalent and direct to the company, yes it is appropriate and no I wouldn't change my assessment.

any short term benefit to the company is offset in the broader and longterm detriments to the company, its organizational culture/goals and its brand. I would argue the same is true with regards to forcing Catholic affliated hospitals to pay for BC coverage for its employees. (of course the point is moot - as Obama has enacted changes which do not force the Catholic affiliated employer to pay for this coverage).

That said, there doesn't even need to be a benefit to the company. The benefit is what makes it a no brainer. If society deemed it appropriate and govt enacted to make a law then I'm behind it.

I don't generally go along with the crowd on public policy issues, even when they are headed in the same direction I am. I have little respect or trust in the "average" capacity for complex consideration or decision making. That said, and since the Obama administration actually seems to have come to a resolution that, at the least, acknowledges my perspective and does not force employers to pay for this coverage, there is actually very little left to say. Given that government has enacted a policy that doesn't require employers to pay for BC coverage, I welcome your support for that position.