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The Birth Control Battle that Needn’t Be

10 Feb

There’s been a bit of an uproar, most prominently by Catholics, over “a new White House policy compelling Catholic institutions to cover contraception in health insurance plans”:

[The] dispute [was] spurred by a late January announcement by the Department of Health and Human Services that all employers, including Catholic hospitals and schools, will be required to offer free access to FDA-approved contraceptives like the birth control pill and Plan B (the so-called morning-after pill) through health insurance plans…  [CNN]

Many are claiming an intrusion on religious freedom, with Pittsburgh’s Bishop David Zubik dramatically stating:

The Obama administration was essentially saying “to hell with you,” particularly to the Catholic community by dismissing our beliefs, our religious freedom and our freedom of conscience.

 

There is obviously a lot to say from each side about this issue. But it really needn’t be an issue at all.

 

The root of this whole row is the fact that, unlike in other countries, the responsibility of providing health care often falls on one’s employer. And when your employer is the Church, or another body that opposes birth control, we can see the complications that arise when asked (or required) to provide controversial services like birth control.

Ask any group of health policy experts whether they would have put in place our employment-based health insurance system, had they had the luxury of designing our health system from scratch, the resounding answer most likely would be “No.” In fact, no other industrialized country has quite this arrangement. It is uniquely American in origin and in modus operandi.

Our employment-based system was not the product of a carefully designed health policy. It was a byproduct of evading wage controls during World War II. [NY Times]

And this issue isn’t the only one with our current health care system:

Most economists are persuaded by theory and evidence that, over the longer run, the contributions employers make toward the fringe benefits of their employees come out of the employees’ take-home pay. Economists think of employers as pickpockets, so to speak, who take a chunk of the employee’s total compensation and buy with it whatever fringe benefits they “give” their employees. That process blinds employees to the inroads that their health care makes into their families’ livelihood.

A second major shortcoming of employment-based health insurance is that it is only temporary. It is tied to a particular job in a particular company, and it is lost with that job. Nowhere else in the industrialized world does a family, already down on its luck over a job loss, also suffer the loss of its health insurance. It happens only in America, under employment-based insurance.

Finally, the group health-insurance premiums employers pay to private insurers are “experience rated” over that employer’s group of employees. This means that the group premium is based on the claims experience – that is, the health history — of just that small group of employees. [NY Times again]

Our nation is obviously in dire need of health care reform for more reasons than this. Unfortunately efforts so far have underwhelming and/or misguided. Ideally this reform would put  affordable health care within reach of all Americans.

The objective of current health reform efforts should not be to abolish the employment-based system to which so many Americans feel attached, brittle and expensive as that system may be. Instead, the aim should be to develop a robust, parallel system of fully portable insurance that individuals or families can purchase on their own, in a properly regulated and organized market, with public subsidies where deemed necessary. As my earlier posts to this blog sought to explain, this can be done in a variety of ways. [NY Times again]

And reform could well be a boon for economic/entrepreneurial growth:

The high costs of health care are:

Hurting U.S. competitiveness. Employers pay more than 50% of the costs of health care, hurting their competitive positions versus competitors from other countries. For example, General Motors’ costs are $1,000 more per car just due to the costs of health insurance.

Hurting job growth. Small companies are the engine for job growth, but because many small employers do not provide health insurance for their employees, employees are often reluctant to leave large firms and the benefits these firms provide. This could be remedied if tax laws were changed to treat employer-purchased health insurance (which today is a non-taxable company expense) the same as giving employees money to purchase their own insurance (which is treated as taxable income for the employee). [snippet from Harvard Business School]

In more detail:

Clearly, health care costs have reached levels that are adversely impacting entrepreneurial activity. One result of the spiraling expenses is the inability of new companies to offer health insurance to their employees. …

A second effect has been to lead many older small firms to reduce health care coverage. … Self-employed people are much less likely than other people to have health insurance. … Small businesses also pay more for health insurance than large companies. …

A third effect of the tremendous rise in health insurance costs over the last decade has been to impose a huge financial burden on new companies. …

Finally, because leaving a job to start a business causes one to give up employer health insurance, the employer-based health insurance system in this country is keeping some people from becoming entrepreneurs. [NY Times, different article]

 

Should health care in the US be properly reformed, this controversy would not be. Employees would be able to get health care some other way. Companies keep money for their business, no longer required to provide services they really shouldn’t have to in the first place (ditto for pensions, I suppose). And thus, the Catholic Church, as an employer, wouldn’t have to worry about indirectly supporting services they oppose, but which many see as essential.

 

More:

Kauffman-RAND Institute for Entrepreneurship Public Policy: Is Employer-Based Health Insurance A Barrier To Entrepreneurship?

American Journal of Public Health: Insights From Health Care in Germany; NPR: Most Patients Happy With German Health Care

Capitalism vs. the Climate, God vs. Progressivism

8 Feb

One of the most interesting articles I’ve read recently,  “Capitalism vs. the Climate” not only points out some of the potential changes we’d have to make to avert and/or adapt to climate change, but also explains the reason that this “inconvenient truth” is being fought so adamantly by many conservatives, especially of late.

It boils down to this: perhaps climate change theory itself is not necessarily false, but acknowledging its existence would consequently recognize the steps we would have to take and changes we’d have to make to combat it — and most of these steps are anathema to conservatives, contradicting strongly held underlying beliefs and totally upending the status quo:

The [climate change] deniers did not decide that climate change is a left-wing conspiracy by uncovering some covert socialist plot. They arrived at this analysis by taking a hard look at what it would take to lower global emissions as drastically and as rapidly as climate science demands. They have concluded that this can be done only by radically reordering our economic and political systems in ways antithetical to their “free market” belief system. As British blogger and Heartland regular James Delingpole has pointed out, “Modern environmentalism successfully advances many of the causes dear to the left: redistribution of wealth, higher taxes, greater government intervention, regulation.” Heartland’s Bast puts it even more bluntly: For the left, “Climate change is the perfect thing…. It’s the reason why we should do everything [the left] wanted to do anyway.”

Here’s my inconvenient truth: they aren’t wrong. Before I go any further, let me be absolutely clear: as 97 percent of the world’s climate scientists attest, the Heartlanders are completely wrong about the science. The heat-trapping gases released into the atmosphere through the burning of fossil fuels are already causing temperatures to increase. If we are not on a radically different energy path by the end of this decade, we are in for a world of pain.

But when it comes to the real-world consequences of those scientific findings, specifically the kind of deep changes required not just to our energy consumption but to the underlying logic of our economic system, the crowd gathered at the Marriott Hotel may be in considerably less denial than a lot of professional environmentalists, the ones who paint a picture of global warming Armageddon, then assure us that we can avert catastrophe by buying “green” products and creating clever markets in pollution.

So in a way, Chris Horner was right when he told his fellow Heartlanders that climate change isn’t “the issue.” In fact, it isn’t an issue at all. Climate change is a message, one that is telling us that many of our culture’s most cherished ideas are no longer viable. These are profoundly challenging revelations for all of us raised on Enlightenment ideals of progress, unaccustomed to having our ambitions confined by natural boundaries. And this is true for the statist left as well as the neoliberal right.

Here is where the Heartlanders have good reason to be afraid: arriving at these new systems is going to require shredding the free-market ideology that has dominated the global economy for more than three decades … For hard-right ideologues like those gathered at the Heartland conference, the results are nothing short of intellectually cataclysmic.

Or a bit more simply (in this case in particular regarding the absence of any climate change talk in the 2012 presidential campaigns):

Republican candidates are distancing themselves from the issue for ideological reasons. “They believe that addressing climate change will require government action, or even worse, intergovernmental action.” [The World]

This fear has become seemingly extreme; many fear that making even the least offensive change in one’s lifestyle to cope with global warming — or especially being “forced” to make such a change, as in the plan to phase-out incandescent light bulbs in favor of objectively more efficient alternatives — is a drastic over-reach of government control, and that being “denied their right to put any lightbulb in any socket in America is just too much control, a loss of freedom.” Another group of activists has recently begun wailing about a 20-year old, non-binding UN resolution called Agenda 21, which promotes sustainable development, by “…[branding] government action for things like expanding public transportation routes and preserving open space as part of a United Nations-led conspiracy to deny property rights and herd citizens toward cities.”

I think this parallels perfectly with many liberals’ fear of the social changes espoused by Rick Santorum and Michelle Bachman. In their case, the issue is not nature’s threat to us, but God’s.  We’ve screwed up our social structure and are living in ways that “pollute” Christian values in a supposedly “Christian nation”. And instead of rising ocean levels, we may have an angry God to deal with. So they must fight against those pollutants: gays, abortion, sex, whatever. But liberals view this as an equally threatening drastic over-reach of religious intrusion… “just too much control, a loss of freedom.” Implementing all the ideals that people like Rick Santorum and the Catholic Church preach hold dear would require severe and drastic societal changes. (Well, I suppose I meant people like Santorum and institutions like the Church. Unless the Church is technically a corporation, since they’re people anyway)

I think the greatest difference between the practical implications of both sides has to do with this duality:  climate change would presumably affect us all. We wouldn’t have the option to escape its impacts, and they may well be devastating. While religious and social principles surely have a great impact on wider society, people have much greater choice about being following their own personal beliefs. You have the choice to live as piously as you may be inclined, regardless of what others do. Though it may be the most extreme example, the Amish have managed to exemplify this. You have the responsibility to be “in the world but not of the world”, for which you are accountable only to yourself and to God.

Additionally, while there are hundreds of religions espousing diverging theologies, there is far less diversity in interpreting data related to climate change; either humans have a hand in global warming or we don’t, though to what degree could be arguable. There are, of course, numerous ideas about what exactly we would have to do to deal with climate change or a sinful nation; deciding exactly what measures to take to address the issues we face is always a divisive issue.

And this is not to even mention the idea of separation of church and state. Of course, the exact meaning and implications of that idea could be argued. And conversely, there is the more abstract idea of absolute freedom in matters such as consumer choice that could be argued in the case of restrictive environmental regulations.

Urbanist I am, I of course would support the implementation the “climate agenda” that Klein spells out: Reviving and Reinventing the Public Sphere, Remembering How to Plan, Reining in Corporations, Relocalizing Production, Ending the Cult of Shopping, and Taxing the Rich and Filthy. As Joseph Bast said, combating climate change really is kind of the “perfect thing, the reason why we should do everything [I] wanted to do anyway”, namely revitalizing our towns, cities, and greater public realm in general, and working towards greater social equity. And I would venture to say that many of the goals of such action may well be right in line with religious ideals as well.

And even if you’re not totally convinced about anthropogenic climate change, better safe than sorry, right? Better to force yourself to adapt in advance than to have to deal with the surprise of whatever disaster might occur. I would argue that any short-term impacts to growth and the economy would, in the long-term, be worth it (and perhaps an ever-growing consumer economy, or the jeopardization of our long-term environmental health for short-term profit,  isn’t all that great anyway, topics I may cover at a later date).

Unfortunately, people fear change, and unless our pocketbooks really start getting squeezed — or, in this case, our coastal cities are sunk below rising sea waters, or we witness the Lord’s glorious return from heaven on a chariot of fire — I fear what will happen if the changes needed to combat issues perceived by either side come too late.

Working for free

7 Feb

In the TED talk below, Luis von Ahn explains reCAPTCHA, which he created to kill two birds with one stone and work towards a greater good: in typing these words to verify you’re human, you’re also helping to digitize books (you’ll have to watch the video for the full explanation of how it works).

After re-purposing CAPTCHA so each human-typed response helps digitize books, Luis von Ahn wondered how else to use small contributions by many on the Internet for greater good. At TEDxCMU, he shares how his ambitious new project, Duolingo, will help millions learn a new language while translating the Web quickly and accurately — all for free.

In this case, the basic premise is that by retooling something that people already do, you can get them to do some work for free, saving Google (or whoever is digitizing books) the time and money that would be required to do it themselves.

He expands this same sort of idea, creating Duolingo, an online application that will simultaneously help you learn a language and translate texts for free. This would help make a lot of information available to those that speak other languages, all without requiring a paid translator to do the work.

Meanwhile, CNN has come out with iReport, a social network sort of application that basically gets people to do reporting for them for free, all while they lay off paid staff (all lampooned  by Stephen Colbert here)

Automating processes is nothing new. Someone creates some tool that does a task for a low cost, or even free — everything form stamping envelopes to playing chess. But what does it mean when this free tool runs on people, people who are basically working for free, all to the benefit of, in this case, CNN who no longer needs to pay 50 staff members. Why buy the cow when you can get the milk for free? CNN gets free reporting, and apparently hundreds or thousands of iReporters are motivated to provide it to them, presumably getting some sort of gratification out of doing this work.

I suppose a similar sort of thinking could be applied to blogs and such, as opposed to newspapers. When you can get your information for free online, why bother paying for a newspaper?

  • Is it right to have this work done at no cost, possibly at the expense of paid staff?
  • Why do people put so much time into work they’re not really being compensated for?
  • Should these people demand payment?
  • Are these people strictly being taken advantage of, or is this a sort of grand collaborative effort, where people provide each other with news (or whatever other good or service)?

Divided by undiversity?

23 Jan

From The New Yorker: “The Obama Memos”, by Ryan Lizza:

Congress is polarized largely because Americans live in communities of like-minded people who elect more ideological representatives. Obama’s rhetoric about a nation of common purpose and values no longer fits this country: there really is a red America and a blue America.

  • Do our communities largely lack significant diversity?
  • Is this lack of diversity indeed to blame, at least partially, for our political division and polarization?

Why the low turnout?

2 Jun

What does low voter turnout say about our society? Low political motivation? General laziness? Apathy? Belief the government in generally ineffective? Nothing good to vote for? Can’t vote by iPhone?