The Obama Administration’s outrageous decision to require any employer providing health insurance to provide coverage for contraception has promoted understandable criticism from those concerned about religious liberty (see here for an example), since groups that are opposed to contraception, principally the Catholic church, will have to either provide a service for their employees which they view as immoral or drop their employee’s coverage.
Of course this outrage is met by the left with their usual cluelessness about liberty. Writing in Huffington Post, June Carbone and Naomi Cahn claim that “It makes no sense to invoke the principle of religious liberty to allow a small group with religious views at odds with the vast majority of the country to impose their views on millions of women who do not agree the them.”
This line of reasoning is completely ridiculous. No one is forcing anyone to work for the Catholic church, so how do the policies of the church “impose” their view on anyone else? It is the Obama Administration that is forcing its views on people. Anyone who wants to buy health insurance is is now forced, by law, to finance the sexual appetites of everyone else. This is freedom?
But the broader issue beyond the narrow case of contraception is the push towards requiring wide-spread preventative health care measures at all. The ACA requires coverage of screenings for various conditions such as hypertension, high cholesterol, cancer, as well as paying for vaccinations and well-baby visits. What is the rationale for these mandates?
The purpose of insurance is to pool risk. We all face risks for disease and injury, so it makes sense to combine resources to provide for the care we might need. Similarly, we don’t use insurance to buy food because there is no uncertainty involved from not eating: we die. Expenditures on universal or wide-spread human needs (like sex) are not something we insurance against. Those who want to force insurance to cover widely-used commodities are really advocating income redistribution—not insurance. One can make the moral case for redistribution, but let’s just not call it insurance reform. Insurance reform is just the cover that leftists use to impose another avenue to redistribute resources.
Of course from a public health perspective, preventative health care can (though not always) make sense. The old adage that an ounce of prevention is worth a pound of cure is still true. [However, just because many diseases can be prevented does not mean that preventative health care is cost-effective: when your doctor tells you to lose weight, for example, do you do it?] Insurance companies know this is true, which is why many plans have very generous benefits for preventative care. It also makes sense for government insurance to provide preventative care. If coverage of contraception is cost-effective (which it likely is), insurers will provide it because it is in their interest to do so. There is no need for rules requiring them to do so.
Whenever government steps in to force employers to do what almost all employers will do anyway is a big warning sign that cost-effectiveness is not the root issue. The issue is one of moral values. In addition to their never-ending quest for indirect income redistribution through the health care system, what they really want to do in this case is condemn the notion that people are accountable for their sexual activity. They want to say that sexual freedom is more valuable than religious freedom. More pointedly, they want to tell the Catholic church that its views are wrong and they need to be changed. They want to curtail the influence of the “small number of men in robes, to quote Carbone and Cahn.
I don’t subscribe to the Catholic view on contraception (and only a precious few Catholics do, either). But it isn’t the business of government to condemn the views of religious minorities or to use public policy to try to punish those with views the majority does not like.