It's the Economy, Stupid!

It's totally amazing -- almost everyone on the business channels rails about growth -- we need growth, we're not growing enough, the demographics are tamping down growth, growth is the way out of our fiscal problems, Europe has a growth problem, the global economy is slowing down.  At the same time, the solution being touted from sea to shining sea, from Europe to Alaska, the solution being pushed and pushed and pushed is austerity.  Spend less and somehow we will grow our way out of the problems.  This just doesn't make any sense, unless you are willing to wait years and years for things to equalize.  People need to make money to buy things, people have to buy things for others to make money.  People can't buy things so people quit making things and the economy slows down thereby  reducing growth.  Everyone agrees that long term, we have a financial problem -- health care costs are fast outpacing our ability to pay them.  The single biggest contributor to our long term economic problems are medical costs, both public and private.  Our public system pays out more than it takes in, but it also controls costs better than our private system.  We can cut costs by denying care, by charging people who don't have money more for their care so they can choose between living and medical care, thereby actually raising the costs because the only time they are medically attended to is when there is no choice.  We can continue to ratchet up the cost to employers and employees of employer based health care and we will continue to create a climate where more and more of our wealth goes to the health care system or we can actually try and reduce health care costs, which the new reform act puts a tiny downpayment on.  If you look at the share of the budget, you see where the big ticket items are, but you don't see where the savings can come from.   The ideological war we have gotten into basically cuts domestic discretionary spending every time they cut spending.  The share of government spending that is for something other than medicare, medicaid, defense and the national debt is now down to a miniscule 15% but still we want to cut "government" by which we seem to always mean that 15%.  Government really is getting down to the place where you can drown it in the bathtub just like Grover Norquist wants.  But this is where we invest in America -- this is where the interstate highway system came from, this is where our bridges and water treatment facilities were built, this is where we do basic science research and basic medical research that gives us all those cures and treatments for all those diseases we seek medical care from. 

Contraception and Insurance --Failure to Consider the Ramifications

I don't understand why the entire discussion of the religious institutions not being allowed to veto contraception coverage in insurance policies for their employees in their secular institutions such as schools, universities, hospitals, and social service organizations, has focused almost solely on contraception as a hot button issue. If constitutional experts were asked, they would point out that if the Catholic Bishops and their Catholic pundit advocates were to reverse this decision, the ramifications for our democracy are significant, the chaos over religious beliefs that will be stirred into the mix of this discussion would be ugly, and, possibly, the employer based health insurance system would have to be ended. If an employer's sincere religious belief  allows them to veto certain coverages in insurance policies they partly pay for as an employee benefit, no matter the belief set of their employees, and even though religious affiliation is unrelated to the employees employment agreement, what provisions might be exempted from these policies?  No one seems to even discuss this.  (remember, we are not talking about churches, or church employees, or institutions which only hire and only serve members who are pledged to the same creed.). Could 7th Day Adventists exempt blood transfusions from their hospital employee's insurance coverage?  Could the Christian Science Monitor exempt all medical treatment not in line with their belief system from policies covering their journalists, editors, building maintenance, IT tech support, most of whom I suspect are not followers of this faith?  Might religious ownership allow  insurance to exempt sterilization from coverage?  What about denying Viagra drugs to unmarried men, since many religions believe fornication is a sin?  How about HIV care when patient is gay.  Doesn't that sanction the  sinful behavior through which the disease was contracted?  I'm sure I could go on and on, just dealing with sins in Christian churches; however, surely exemptions would not be limited to only Christian religions?  Almost all Americans understand that each religion should be treated similarly and neutrally.  What exemptions might Orthodox Jewish organizations demand they exempt from coverage for their diverse staffs.  What about Muslims or Hindus?  Do they have beliefs about medical treatments, not held by most non Muslims, non Hindus?  I'm not familiar with the details of any of these faiths, but I suspect we all might find differences which we don't hold or find odd.  At least some of the tenets that the faithful believe are sacred and fundamental to how they live their lives, but do not have adherents from other faiths or non- believers.  But I see no discussion of these issues and their implications. Most of the institutions covered by these single set of medical minimums, may be owned or even run by people of that particular faith, but almost all of them hire employees without regard to whether they are of that particular faith, and they serve populations which come from many faiths and even non-believers.  They are very similar in their form and function to other such organizations not run by a particular faith.   There are also significant parallels to businesses like stores, restaurants, hotels and the like.  Before the civil rights acts of the 60's, these public places were legally free to turn away people because of their race, gender, ethnic affiliation, religion or whatever personal reason they felt justified.  With those acts and a Supreme Court which upheld those laws, no one need fear the humiliation of legally being turned away from a public accommodation for those reasons.  Today, the vast majority of Americans would never turn back the clock on that progress.  In fact, many cities, counties and states have expanded these protections.  These protections apply to all public places, all places which are open to the general public.  There are no exceptions for religious bigotry or beliefs which may run counter to race mixing or gender equality.  You can have these beliefs because beliefs are protected by the 1st amendment;  but if you serve the public, you must serve them all, over whatever personal beliefs you hold.  Serve one, serve all or get out of the business of serving the public.  The court finally ruled in the sixties that inter-racial marriage could not be banned, whether a religion objected or not.  Religion shouldn't be allowed to impose or force non believers to adhere to their creed.  A minister might not perform the ceremony, but a state license could not be denied.  If the precedent were to be set in this kerfuffle, [i.e. that the state can't regulate what is or is not a necessary medical service contained in a standard insurance policy merely because it is paid in part or in whole by an employer as part of an employees' compensation package, without satisfying religious, non church institution objections]  how far could these employers expand this exception?  In states with legalized gay marriage could they refuse to offer identical spousal benefits?  Could they choose to exclude fertility treatments because this is interfering in God's plan?  Maternity benefits to unmarried women?  Again, are their religious objections we will validate while not upholding those of minority sects or religions in the minority in this country, that many of us might consider odd or flaky.  Even most religions do not want the government making such determinations and would consider such decisions as interfering with religion rather than being as neutral as possible about the validity of any belief.  Again, our heritage says you can believe almost anything you want and call it religion, you just cannot impose it on those who don't agree.   Allowing Catholic Bishops to dictate medical coverage in insurance will open pandora's box.  The unintended consequences for our religious freedoms, and freedom from religion for others is potentially enormous, but the discussion thus far seems only address whether Catholic or other anti-contraception institutions should provide health insurance that every other employer or exchange policy provides.  Just because the premium you pay includes services you don't agree with, doesn't mean you as the employer are providing the service.  You are providing health insurance and that should be it. No one is forcing these doctors, schools, hospitals to actually give out birth control, or condoms or whatever or even prescriptions for them.  The employee will likely go to a provider who does not object and the employer shouldn't even know what insurance services are being used by a particular employee, except for auditing purposes to assure fraud is not taking place and the insurance company is paying for appropriate services outlined in the policy.  For my employer to know every personal and private medical procedure I might use or seek simply because he pays part of my premium is an invasion of my privacy that I don't think most people would expect. Finally, I and many other Americans are forced to pay taxes that go towards a war machine that we totally abhor.  However, most of us do not feel that by paying our taxes, we are supporting this war policy.  We can still strongly object or protest this, but for most of us, we accept that each taxpayer, even if we could avoid prosecution, could withhold taxes in proportion to the expenditure on specific items we oppose.  This insurance issue is quite equivalent.  Separate the concept of providing health insurance from the details of that product.  Leave medical decisions to the patient and doctors, basically unrelated to whom pays a health insurance premium. Or we will rue the day.   Political analysts should expand the discussion to the many, many ramifications of this attempt to roll back this decision, and not just make this issue about contraception.  It is so much larger.