Birth Control And Health Care

If the pandemic has taught Americans anything, it is just how inadequate–and let’s be honest, discriminatory and stupid–our healthcare system is. (Actually, every time I write “healthcare system” I am reminded of the student who was studying to be a hospital administrator, who told me the phrase was inaccurate–“We don’t have a healthcare system. We have a healthcare industry.”)

A few days ago, the Supreme Court handed down an indefensible decision that denied women healthcare if they are unlucky enough to have an employer who has “religious qualms” about allowing their health insurance to include birth control.  Gail Collins provided a perfect analogy:

Let’s pretend there was an order of nuns with a particular devotion to the Sacred Heart of Jesus. So much so that the order had, over the years, decided that any human heart was a holy symbol, and it was immoral to mess with it, even if you were a physician doing cardiac surgery.

Following their consciences, these nuns banned heart-related care from their employees’ health policies. That affected thousands of workers, many of whom did not share their religious convictions. Still, the nuns noted, their insurance coverage was generous. Except for that one thing.

The Court affirmed the right of employers to omit birth control coverage from their group health policies. But that “right” is misleading.  The Obama administration had arranged for the federal government to intervene when religious employers had ethical objections. All the employer had to do was file a form, and they’d be off the hook; the government and the health insurance companies would provide the coverage. The employer wouldn’t need to spend a penny on a sinful women’s health measure.

But that wasn’t good enough. Filing a form would make them complicit. Trump, of course, pandered to the “religious” employers who placed their purported moral purity above the actual health and well-being of their female employees, and the Court acquiesced.

An  estimated 70,000 to 126,000 women will lose their current free contraceptive coverage–and contraception isn’t cheap. As the Times Editorial Board wrote, 

It bears reminding that the cost of birth control can be significant, and that many women rely on it not just to prevent pregnancy but to treat medical issues. Sometimes, the contraceptive method that works best — or the only one a person can tolerate — costs many hundreds of dollars without insurance coverage.

As the Editorial Board also noted,

It’s hard to imagine the conservative justices of this court, especially, allowing employers to claim a moral exemption and require their employees to pay out of pocket for, say, a treatment for Covid-19. That sounds absurd. And yet, when it comes to birth control, such state interference with personal health decisions is considered a legitimate matter for public debate.

The health care industry in this country is the real “American Exceptionalism.”

America could solve conflicts like this one–not to mention racial and economic inequities in access to health care–by emulating other advanced, civilized nations and moving to a single-payer system of health insurance. Not only would such a move eliminate the ability of some Americans to impose their religious convictions on others, not only would it ameliorate a number of racial and economic inequities, not only would it vastly reduce personal stress and the country’s high rate of personal bankruptcies, it would introduce cost-controls to a system that costs far more and delivers far poorer results than others.

How much of our stubborn refusal to provide universal health insurance is due to inertia, to misunderstanding of how markets work or don’t, or a false belief in American superiority–and how much of it is due to a shameful reluctance to extend the social safety net to “others”–minorities and women?


  1. I’ve also read that it’s not a Health CARE Industry so much as it is a Health MAINTENANCE Industry. Well done!

  2. We don’t need the example posed. I assume this means that a Jehovah’s Witness employer can Now deny coverage for blood transfusions.

  3. And Christian Science employers can limit coverage to those practitioners who do approved Christian Science healing.

  4. This cockamamie decision is partly based on the fact that a few (at least three) of the Conservatives on the court are Catholics, so they grew up hearing nuns and priests warn them about abetting others’ sinful acts. It is called “being an occasion of sin.” So even if the Little Sisters of the Poor were to invoke the option the ACA provided, and tell the government that they could not provide access to contraception, they feel that that act would be equivalent to approving something they feel is sinful. This kind of religious mysticism should be a warning to anyone thinking about working for a religious organization. If you are not willing to submit to Medieval rules and regulations, eventually, you will regret taking the job.

  5. One more comment. It is ironic that the Conservatives on the Court, who worship at the altar of the “Original Intent of the Founding Fathers,” would base a decision on (however subliminal) religious teachings, because the Founders’ version of Christianity (Deism) was very “luke warm” compared to theirs, and it is highly unlikely that they would have considered this decision valid.

  6. Isn’t this simply an extension of the Hobby Lobby law allowing employers to control one specific area of health care only for the women in their employ? Do their policies continue to contain coverage for Viagra and other sex aid medications as well as erectile dysfunction supplies? Have they ever connected these two areas of their insured health care coverage? Or is it like the Catholic religion, simply an extension of the male power over women in the work field as well as at home?

    It certainly has nothing to do with religion in the true sense of faith in any sect but the current evangelicals in power and their personal version of Christianity.

  7. It should be noted that none of the aforementioned religious organizations has a problem paying for coverage for Viagra, even for their unmarried male employees.

  8. Here’s a thought: let’s take any matters having to do with reproduction out of the hands of anyone who is incapable of producing a child. That would keep children from making such decisions.
    And men.
    And, for that matter, me — since menopause occurred a few decades ago.

    Let the people who bear the brunt of such decisions make the call and hey, presto! problem solved.

    Silly me. That idea makes far too much sense.

  9. Someone needs to publish a list of companies that do not provide contraceptives as part of birth control so that we can boycott them.

  10. I hear and read about these people and organizations that have strong religious beliefs that can be invoked to deny birth control, etc. Is there a test for this: True-False, Multiple Choice, or essay questions???

    As long as we have employer based health care, the employer in collaboration with the insurance companies can set the rules: What is or what is not covered by insurance, premiums, deductibles, co-pays, or in or out of networks.

    The answer for health care is Universal or Single Payer Health Care. ACA was a small step, that the Reactionary Right Wing is shooting holes into. Corona should expose our wretched health care system, lose your job – Lose your Insurance Coverage.

    It is understandable the Reactionary Right Wing GOP would oppose Single Payer, as it is viewed as an attack on Steroid Capitalism.

    Much less understandable from an ideological standpoint is the fanatic opposition among some Democrats to Single Payer. The corporate Democrats give us this song and dance about fixing ACA, etc. There is no fix to ACA. Single Payer is the only way forward.

  11. As many great posts have stated, religion and hypocrisy go hand in hand. And religious organizations can raise incredible money to spread around to politicians.

    We now have influence and heaven peddlers.

    Our problems are easily solvable if the “systems” were built to serve the people. They weren’t and aren’t. The “systems” were created to serve the Oligarchs — the owners.

    Capitalism is a profit-making scheme. The industries are profit-making schemes.

    The only industry exceptional in the USA is our war industry.

    The reason we cannot change these archaic and broken “systems” is the owners have used their economic clout to buy out the political class who run the “government.”

    The only changes made are scraps tossed to the masses like $1,200 while trillions are looted from our treasury, and when the changes equate to more profits for the owners.

    As long as you see yourself on equal footing with the owners, you’re a sucker. Period.

  12. Sheila, I love the way you tied that together! Especially, using the heart.

    I could go into chapter and verse why these religious organizations ban contraception. The main example used is what happened to Onan when he refused to impregnate his dead brother’s wife to create an heir to the family wealth because his brother, dead brother, was the patriarch of that family. he did have relations with Tamar but because he wanted to usurp his dead brother’s patriarchal leadership, he performed coitus interruptus. Now, it wasn’t because of birth control as many churches claim that Onan was put to death after that, it was because he violated the law, lied, and deceived god! The particular scripture reads that he spilled his semen on the ground.

    It’s the same as misinterpreting the scriptures concerning the curse on Canaan and that the descendants of Canaan were the Black race which is false, the black race in scripture was descended from Put and Kush, Canaan’s Brothers.

    These purposeful misinterpretations and misrepresentations of scripture allows those white European religious leaders to deny and placate their conscience! In other words they can enslave an entire race and it’s okay, they can deny contraception to women and that’s okay, but nuns can sneak around and have abortions. Just like the church falsely agreed that slavery was okay and the slave trade was just another manifestation of Canaan’s curse!

    The hypocrisy is astounding, and for the supreme Court to go along with this ridiculous train of thought is equally astounding.

  13. @Monotonous Languor – It might be less understandable from an ideological standpoint, but not from a financial one. It’s the curse of dependency on deep-pocketed donors i.e. corruption. Isn’t it way past time to abolish corporate run elections?

  14. What if a person pays part of the health care insurance premiums themselves as is frequently the case. Can we pretend that the gender based insurance coverage is paid for by that part of the premium and not the employer paid part?

    In fact, why don’t health care insurance companies just lump all all gender specific coverage under one category, “gender based insurance coverage”, and see how many men change their mind about messing with uterii.

  15. Congratulations to all the well-written and thoughtful comments here! I work with Planned Parenthood at a clinic here and wish I could have every one of our critics sit and just LISTEN to the stories I hear ever week. You (and they) can’t imagine what contraceptives and abortion can mean to a person or a family.

  16. “Civilization will not attain its perfection until the last stone from the last church falls on the last priest.” Emile Zola

    No one is REQUIRED to avail themselves of all coverages in their health care insurance plan; Bible thumpers and those employers making and getting these controlling additions in their plans are simply power plays which are not legal under the Constitution. Neither are they found in Bibles or other religious writings of other religions; they will certainly never find Jesus speaking these demands to be acceptable in his preachings as a Jewish Rabbi.

  17. If there had been a way for conservatives to exclude black and brown people from “Universal Health Coverage”, we’d have it by now.

  18. Alphons @ 9:59 am “It might be less understandable from an ideological standpoint, but not from a financial one. It’s the curse of dependency on deep-pocketed donors i.e. corruption. Isn’t it way past time to abolish corporate run elections?”

    The 1% and the Pacs and SuperPacs have far more influence over who is selected, groomed and elected than, ‘We the People”. There are exceptions.

  19. I read a good article about how in-spite of the gross incompetence and out right lies of the Trump-Pastor Pence Regime, the Trumpet’s will not be shaken in their belief in these despicable creatures.

    The article noted that even though the polls point to a Biden win, it is far from a sure thing. The article mentioned that the 2018 Blue Wave does not mean there will be another here in 2020. The reasoning was The Trumpet was not up for election in 2018. Thus, the hard core Trumpet supporters felt no need to vote in 2018, they are Trumpet followers in lieu of GOP voters.

    The usual suspects of Right Wing Reactionaries, Bible Thumper’s and NRA types will vote in 2020. The Trumpter’s who are bound to the Trumpet over all else will also be voting.

    The gist of the article was the Democratic Party cannot sit on their hands and think 2020 is slam dunk.

  20. I think government is within its rights to make me stop at stop signs and red lights. I do not think government is in its rights to (if I were female) make me (by whatever ruse, e.g., courts via someone else’s religious views) give up my “certain inalienable rights” as described by our revolutionary leaders. “Inalienable” in this context means, inter alia, not only “not for sale,” but not even considered for transfer by any means.

    The answer to fear of clergy and the ballot box is now and has been all along adoption of single payer coverage, as was recognized and adopted by the civilized world decades ago. Insurance companies not only skim 25 to 30 percent of premium off the top for dividends to shareholders and executive compensation which could be applied to coverage, worse, they set the rules for coverage via what we call “campaign contributions” (and ALEC models) to their congressional lackeys. Result (among others)? Medical bankruptcies comprise (at my last count) 41 percent of the total bankruptcies filed. It is not only doctors and hospitals who get stiffed in the process; the bankrupt’s vendors and many others are stiffed as well, but the medical industry doesn’t care since they can fold such losses into higher prices the rest of us pay to maintain or expand its bottom lines, hence a situation where we pay the highest premiums in the world for inferior care and no care at all for millions.

    What to do? The obvious. Adopt single payer coverage. It’s cheaper, better, universal etc., and will end these (I hope) last vestiges of religious control of our “certain inalienable rights.” How our employers may view Bronze Age history and its philosophers is not a stop sign.

  21. How can Trumpers claim American exceptionalism
    …and then admit (with no shame at all) that America IS NOT capable of producing a medical system or an educational system on par service-wise or value-wise with other first world countries?

    Perhaps “exceptionalism” means something different to them. Maybe to them exceptionalism has to do with America’s ability to produce wealthy, greedy, crooked, brutal individuals. Never mind that wealth comes at severe cost to the lives and happiness and health and sanity of the masses, as well as to the planet we suffer on. If so, and I think it is so, it is an “exceptional” value statement in its own right.

  22. Exceptionalism is just a great propaganda piece used for branding. Edward Bernays wrote the book.

    I think Americans want to be exceptional and could be but there is a glass ceiling created by Oligarchs and their inept puppets. Our ability to innovate and produce wealth under sustainable methods is there but we plug those into a corrupted capitalist system and guess what?

    If the systems are bad, you can change people all day long, and guess what?

    Collectively, we could be great. But, who would have to sacrifice?

  23. Todd Smekins, if you know of a church making political donations, or even preaching to support a particular politician, report them to the IRS. They will lose their 501c3 status.

  24. So it follows if you want to send your child to a Catholic School, that school would have access to your medical records to see if you are using contraception. If you are, no Catholic School for you.

  25. Dan, how about some of us who don’t go to church begin visiting various church services AND RECORDING THE SERMONS to be used later in our report to the IRS. Just the rumor of people doing that would quell some of the abuse.

  26. Health insurance companies carry a lot of weight lobbying Congress. % of health pool monies go to shareholders & politicians , instead of growing the pool (investing) and lowering policy holder’s premiums and expanding coverage. Insurance done right can do that, but the lust over the pool monies and misuse of it, has resulted in undesirable results. Take healthcare burden off of businesses, have single payer, and the power of negotiation would bring down costs for pts. & hospitals. For profit model in healthcare doesn’t work, and reduces the healing and well being of pts. Business trying to make as much money off of sick people is sickening! These days when jobs are scarce and Covid could cause birth defects, with-holding b/c coverage makes no sense. I understand that Catholics consider abortion as taking of the beginning of human life, but banning pre-conception bc is unreasonable, and will result in more abortions. I’ve heard people say they “don’t want their taxes going to pay for abortions”. I thought Hyde Amendment addressed that? Citizens should be able to practice their religions, but to force others to their religious practices is Un-American. Thanks to Sheila for spurring us to think and being mindful of the complexities of our wonderful country!

  27. To all, the IRS won’t lift a finger, you can take that to the bank, LOL! Even if Trump has to sign an executive order. Only after these knuckleheads are gone, would that happen. Then afterwards, someone has to truly have the stones to go after the criminal element involved in all of this administration’s shenanigans, even if that requires an executive order!

  28. John and all,

    That list is 6 years old. Have written PP to ask for an updated list.

  29. I have heard speculation that part of Roberts’ reasons for upholding the rule of law in the Trump subpoena cases was to forestall the impetus for adding more Justices to the court. If that ruling has that effect, this “healthcare” ruling will probably accelerate the transition to a single-payer plan.

    Please be clear, the “Obamacare website”, was a disaster as was the Obama campaign’s election day app. Single payer makes those seem like fleas on a blue whale. It is going to have to be a slow transition, but this decision is one more step towards making it inevitable.

    Meanwhile, I am announcing the creation of a radical splinter group from the Pastafarians, the Spaghettioes. We believe that Christians, Muslims and Jews are protected by their one god and don’t need health insurance. Others won’t be covered for diabetes, hypertension, high cholesterol, or cancer, because, well just because it is our doctrine. Atheists get full coverage. Contraception and abortion are covered for everyone, including Catholics.

    Now if I can only get someone with a large company to join me and implement these doctrines, that will make an interesting court case.

    JoAnn and Peggy – Medicare and most private healthcare do not cover Viagra or other ED drugs (I don’t have complete, nor necessarily current knowledge). In fact, Cialis, a relative of Viagra, which can be used for ED in high doses is prescribed in low does for BPH (enlarged prostate). It is not covered at any dose. The “sex is sinful” meme affects both sexes, although the impact on women is orders of magnitude more severe.

    Just a side note to twocrows – although experimental parthenogenesis (reproduction from the egg alone) has been performed in mammals, men are usually needed, at least as donors, for human reproduction. Still, I don’t disagree with your premise completely, but if you extend your argument, we would need many different courts, each deciding on issues that affect them, as others would need to be excluded. Argh! I still hate the thought of old Catholic men deciding the fate of a woman’s body and reproduction.

    Leslie – thank you for the idea of the list and John, thank you for the link

  30. Less birth control means more unwanted pregnancies and abortions and more unwanted children and abuse. Stupid, stupid, stupid, and stupid.

    Even into the 1980s and 90s (perhaps later), male dominated employers denied health insurance coverage for birth control pills. It didn’t make sense on the basis of employee health and absenteeism nor on the basis of an employer’s financial bottom line. More children on a family plan meant greater expense in the companies’ health insurance premiums. Sexism, power over women, narrow-mindedness – whatever motivation one wants to assign – it even trumped profits. Discrimination is a money-losing proposition.

  31. One last thought – before we go blaming the “male” world for these terrible things, we need to remember the number of Catholic and fundamentalist women in the anti-abortion movement. I first came across this in the late ’70s. My thesis advisor and his wife were flaming liberals — except — his wife told me that her one issue, to which she was going to devote all of her energy, was stopping abortion. They were good Catholics and she firmly believed that she was preventing “murder”. She wasn’t alone among women.

  32. I’m surprised not one of you mentioned that nuns had to get abortions after priests raped them! Of course, that’s a secret that’s been unleashed! Stop punishing women for men impregnating them.

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