Supreme Court: Some Employers Can Refuse To Cover Contraceptives For Religious Reasons

Hobby Lobby wins, but it's unclear just how far this opinion will go.

Birth Control Mandate

As expected, one of the most anticipated decision of the Supreme Court’s October 2013 Term was handed down today. In Burwell v. Hobby Lobby and Conestoga Wood Specialties v. Burwell, the Supreme Court was dealing with the question of whether the religious beliefs of the owners of non-publicly traded, and yet still for-profit, corporation could be ignored in order to enforce a mandate issued by the Dept. of Health and Human Services pursuant to the Affordable Care Act to cover birth control in employee health plans. Although nearly 50 cases had been filed around the country by employers contesting this regulation, the cases as a whole came to be personified by Hobby Lobby, a chair of more than 250 retail stores based around the country that is owned by Oklahoma businessman David Green and members of his family. In their specific case, the Greens argued that the requirement, specifically as it applied to a handful of drugs that they considered abortifaceants, violated their religious belief because it forced them to pay for a procedure they believe to be sinful. The government and those supportive of the mandate argued that Hobby Lobby, which is a legally distinct entity from the Green family, does not have religious rights under either the First Amendment or the Religious Freedom Restoration Act.

Today, the Supreme Court issued a narrow ruling that Hobby Lobby, and other “closely held corporations” like it, did indeed have the right to refuse to comply with the regulation, but it is unclear just how far-reaching this ruling will ultimately end up being:

WASHINGTON — The Supreme Court ruled on Monday that requiring family-owned corporations to pay for insurance coverage for contraception under the Affordable Care Act violated a federal law protecting religious freedom.

The 5-to-4 decision, which applied to two companies owned by Christian families, opened the door to challenges from other corporations to many laws that may be said to violate their religious liberty.

Justice Samuel A. Alito Jr., writing for the court’s five more conservative justices, said a federal religious-freedom law applied to for-profit corporations controlled by religious families. He added that the requirement that the companies provide contraception coverage imposed a substantial burden on the companies’ religious liberty. He said the government could provide the coverage in other ways.

(…)

Justice Ruth Bader Ginsburg, writing for the court’s four-member liberal wing, said the contraception coverage requirement was vital to women’s health and reproductive freedom. Justices Stephen G. Breyer and Elena Kagan joined almost all of the dissent, but they said there was no need to take a position on whether corporations may bring claims under the religious liberty law.

On that point, Justice Ginsburg, joined by Justice Sonia Sotomayor, said the court’s decision “is bound to have untoward effects” in other settings.

“The court’s expansive notion of corporate personhood,” Justice Ginsburg wrote, “invites for-profit entities to seek religion-based exemptions from regulations they deem offensive to their faiths.”

Before going any further, I think it’s important to understand some basic points here.

First of all, the Supreme Court did not rule today that all for-profit corporations may make claims under the Religious Freedom Restoration Act. Instead, it limited its opinion to “closely held corporations,” which are typically defined as corporations where a majority of the shares are owned by five or fewer people (although the number can vary from state to state). Most closely held corporations are small businesses that don’t even have enough employees to fall under the requirement that employers provide coverage to their employees under the PPACA. Some, however, like Hobby Lobby, are larger corporations that still happened to be owned by a small number of people. Other well-known businesses that could potentially be classified as “closely held” include Chick-Fil-A, which is principally owned by Dan Cathy and members of his family. Additionally, although I am not certain of the current ownership structure, Hallmark Cards and all of its subsidiaries were principally owned by Joyce Hall and his family members and descendants and may still qualify as “closely held.” The point is that, this case does not mean that McDonald’s, or Exxon Mobil, or Fedex, are now suddenly vested with religious liberty rights. Indeed, given the fundamentally different ownership and management structures between closely held and publicly held corporations, it would be completely illogical to speak of the “religious liberty” rights of a publicly held corporation.

Second, as I have noted in other discussions of this case, Hobby Lobby, and a company called Conestoga Wood Specialties in a companion case, were claiming that the Religious Freedom Restoration Act, a law that was passed into law by a Democratic Congress and signed into law by President Clinton in response to the Court’s opinion in Employment Division v. Smith, required that they be given an exemption from the law. Reading the language of the statute, one has to admit that they had a strong argument in their favor in that regard and it’s difficult for me to say that the Court was wrong in its interpretation of the law here. Part of what the law requires is that the Court balance the religious claims asserted by the employers with the interests asserted by the government. In this case, the interest in question would be providing increased access to birth control to women. Even if you agree that this is a legitimate and important government interest though, it’s plainly obvious that there are means by which the government could accomplish this goal without requiring employers like the Greens to violate their religious beliefs. The most obvious means, of course, would be some form of direct subsidy to employees but there are other means as well. In addition, the Court found that the mandate in question placed a “substantial burden” on the religious liberties of the Greens and those similarly situated to them. Given this, the balancing test came down clearly in favor of the Greens.

Third, as noted above, the Court did not say that RFRA gives owners of companies like Hobby Lobby the right to refuse a whole host of items typically covered under a health insurance policy just because they might have a religious objection to those procedures. So, this case is not going to lead to Jehovah Witness employers refusing to cover blood transfusions or transplants. The Court also said that the holding should not be seen as meaning that a private employer of any kind could avoid liability for a claim of illegal discrimination based on their religious beliefs. This would seem to be addressed to concerns regarding people trying to use religion to avoid liability under laws banning discrimination against people based on sexual orientation. Obviously, what this decision actually means for future cases will depend on the facts of those cases and the Judges that hear them. However, it’s important to note that, just as it did in the Heller gun control case, the Supreme Court seems to be sending a signal here that its holding is not as broad as some advocates for one side or the other might hope or fear.

Finally, although it’s easy to understand why it is being characterized in this manner by political partisans, it is important to note that the Supreme Court did nothing today that actually impacts the ability of anyone to have access to birth control. You can still go to the pharmacy and buy the pills, you can still get an IUD implanted. All the Court has said is that, in these very limited set of circumstances, the religious objections of employers deserve protection. That is not “taking away birth control,” and I think it’s intellectually dishonest political hackery to characterize it in that manner.

As for the opinion itself, I think the Court got the result right for the most part. In the end, a closely held corporation is really nothing more than a partnership with tax advantages. What ever you might call it, it is still a business that is owned by a small amount of people. If Hobby Lobby were a partnership or sole proprietorship, there would be no question that the Greens would be within their rights to assert a religious objection under the RFRA. Given that, it doesn’t strike me as being all that radical to say that they retain those rights when they enter into a different kind of business form that, ultimately, was chosen so that they could expand the company to the national operation employing thousands of people that it is today. We are still talking ultimately about the individuals who own the company and their rights, which is why this decision would not make any sense if you applied it to a publicly traded corporation owned by tens of thousands of individuals and institutions like Apple, or Exxon Mobil. Additionally, the Court’s determination that the mandate imposed a “substantial burden” on the Greens and others seems correct based on the facts of the case. It is always difficult for a court to judge how sincerely an asserted religious belief actually is, of course, but there’s a general rule that courts ought to be deferential in that regard. Finally, the Court is also correct that there are less restrictive means to accomplish the government interest that is at stake here. I’ve already discussed one such means, the direct subsidy to employees, but another one can be found in the manner in which the Administration attempted to deal with this issue as it applied to strictly religious organizations. Taking all of that into account, it’s difficult for me to say that the Court got this wrong as a matter of law.

As noted above, it’s impossible to say what the legal consequences of a decision like this will ultimately be. To a large degree, that will depend on what kind of cases make it before future courts and the makeup of the judges that hear those cases. At the very least, it is obvious that the pending cases brought by other employers that qualify as “closely held corporations” will all be decided in their favor. Additionally, there are a series of cases ending at various levels in the Federal Court system by religious non-profit organizations that raise objections to the mandate. Lyle Denniston discussed those cases in a SCOTUSBlog post yesterday. I suspect that they too will end up winning their cases. Beyond that, it’s hard to say what Hobby Lobby will mean for the future

Here’s the opinion:

Burwell v. Hobby Lobby by Doug Mataconis

FILED UNDER: Gender Issues, Law and the Courts, Religion, Supreme Court, US Politics, , , , , , , , , , , , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.

Comments

  1. al-Ameda says:

    A 5-4 decision? Completely as expected, 5 of the 9 justices are conservative, Catholic and male – Alito, Roberts, Kennedy, Thomas, Scalia. It surely appears that the Court majority is saying that corporations are people, and that corporations may in fact hold religious beliefs.

    This is yet another reason why a Single Payer Health Insurance system is the sensible path away from this kind of nonsense.

  2. Argon says:

    Agreed – Another reason for single payer – Balance the elimination of employer-provided health care payments with increases in their tax rates.

    Also: I don’t see a clear, logical distinction outlined in the majority decision that distinguishes birth control from additional services that owners might have religious objections against. Seriously. The only thing there is a metaphysical promissory note.

  3. Scott says:

    A couple of things I still don’t understand:

    1) What does closely held mean?

    typically defined as corporations where a majority of the shares are owned by five or fewer people (although the number can vary from state to state

    Does the definition vary from state to state? If so, that means the definition can be politically manipulated.

    2) What was the reasoning to limit this to just the birth control role? Or is this still and opening for lower courts to expand this ruling?

  4. legion says:

    Finally, although it’s easy to understand why it is being characterized in this manner by political partisans, it is important to note that the Supreme Court did nothing today that actually impacts the ability of anyone to have access to birth control.

    Spoken like someone who has never had to rely on welfare to live.

  5. Dave D says:

    Most closely held corporations are small businesses that don’t even have enough employees to fall under the requirement that employers provide coverage to their employees under the PPACA.

    Like Cargill and Koch Industries the biggest two closely held companies in the US with revenues of 138 and 115 Billion in 2013 respectively.

    So, this case is not going to lead to Jehovah Witness employers refusing to cover blood transfusions or transplants.

    Because those anti-choice White Catholic Males held that their own Religious beliefs shared by the owners of Hobby Lobby are more of an onerous burden to liberty, than the beliefs of others that are not shared with them.

  6. James Pearce says:

    Today, the Supreme Court issued a narrow ruling that Hobby Lobby, and other “closely held corporations” like it, did indeed have the right to refuse to comply with the regulation, but it is unclear just how far-reaching this ruling will ultimately end up being:

    No, it’s pretty clear. The Christian right got themselves a bone, but the SC is not prepared to rewrite corporate law or apply this logic to any other scenario but this one. Tells you all you need to know if you think about it.

    Also, you should drop this from your repertoire:

    it is important to note that the Supreme Court did nothing today that actually impacts the ability of anyone to have access to birth control.

    It’s transparently bogus, as “restricting access to birth control” is the entire goal.

    If Mike Bloomberg said that his large soda band doesn’t actually impact the ability of anyone to access large sodas, I have a hard time believing you’d nod along.

  7. legion says:

    And for a slightly less snarky comment, Doug, how do you see this affecting the Corporate Veil? If someone were to win a discrimination suit against Hobby Lobby, wouldn’t this decision pretty much _require_ piercing the veil & holding the “close-held” owners personally liable?

  8. C. Clavin says:

    Hence the terms — “wrongly decided” and “activist judges”.
    The majority relies on junk science to mis-label contraceptive methods as “abortifacients” when they are not.
    By incorporating a business a person frees themselves from obligations and responsibilities for the business. The majority has now decided that that separation only holds when it serves the interest of the person.
    The majority has decided that Corporations are people…only they are people with more rights than you and I. This is the first time that activist judges have granted an individuals rights to a for-profit corporation…and in the process they have decided that the artificial legal entities rights trump those of natural persons. In the 21st century health care should not be a religious question. There is no precedent for a religious exemption under the RFRA when it does harm to a third party.
    The only thing that keeps this atrocious ruling from being over-turned is that there are no more courts.
    The Republican war on women continues apace.

  9. anjin-san says:

    So corporations are people. And they are corporations. They can just toggle back and forth, depending on which condition is more advantageous to them at the moment.

    Question, does this mean that a corporation owned by Muslims can use Sharia as a guide when setting up employee benefits?

  10. rudderpedals says:

    That slippery slope? Yeah, we’re on it.

  11. C. Clavin says:

    @anjin-san:
    No, I don’t think so. The majority chose Christianity as the National Religion.

  12. Mu says:

    The decision is simply not internally consistent. Either the corporation has religious rights that can be violated, then the corporation should be able to refuse anything it likes. Or it has not, and can’t refuse any “standard of care” coverage. Kennedy seems to have tied himself in a knot worse than Roberts on the original Obamacare ruling to come up with this “only contraceptives because my church says so but not anything any other church might come up with” crap.

  13. Jack says:

    @legion: Free birth control has been available through Planned Parenthood since…..Gerald Ford.

  14. Jenos Idanian #13 says:

    I’d suggest a slight tweak to your headline: “Some employers can refuse to cover some contraceptives.”

    Hobby Lobby never objected to contraceptives that was actually “contraception” — as in “preventing conception.” They objected to abortificents — those forms of birth control that acted after conception. That objection is based on the belief that life begins at conception.

    I find myself amused by one woman’s response to the decision:

    Hey feminists, I’ll gladly keep my rosaries off your ovaries once you remove your vagina from my wallet.

  15. Jack says:

    @James Pearce: Apples and Oragnes. This decision does nopt RESTRICT anyone’s access to birth control, it only limits those that are bound by the mandate. They are not BANNING it like Bloomy wants to do with large sodas.

  16. Grewgills says:

    So, this case is not going to lead to Jehovah Witness employers refusing to cover blood transfusions or transplants.

    Under what legal reasoning does it not? Are the Jehovah Witness’s beliefs less closely held? Would paying for the procedures they find sinful be less of a burden on them? Why?

    In the end, a closely held corporation is really nothing more than a partnership with tax advantages. What ever you might call it, it is still a business that is owned by a small amount of people. If Hobby Lobby were a partnership or sole proprietorship, there would be no question that the Greens would be within their rights to assert a religious objection under the RFRA.

    It’s not just tax benefits and you know it. It shields them and their property by creating a separate entity between anyone who would file suit against the business and them. This separate entity doesn’t have religious beliefs in any meaningful sense. That the Supreme Court has decided otherwise is another step down the path to making corporations super citizens with all of the rights of people and few of the responsibilities. Another bad decision by the corporatist court.

  17. C. Clavin says:

    @anjin-san:
    From the ruling…

    This decision concerns only the contraceptive mandate and
    should not be understood to hold that all insurance-coverage man-dates, e.g., for vaccinations or blood transfusions, must necessarily fall if they conflict with an employer’s religious beliefs. Nor does it provide a shield for employers who might cloak illegal discrimination
    as a religious practice.

    So for all those religions that feel strongly about other things besides the contraception mandate…bugger-off.
    When Hobby Lobby decides not to insure single-parent kids, or kids of same-sex parents…then we’ll talk again.

  18. wr says:

    @anjin-san: “Question, does this mean that a corporation owned by Muslims can use Sharia as a guide when setting up employee benefits?”

    Of course not. The five conservative Catholic men made it quite clear that this only applies to religious beliefs they share. All those others are “silly,” and therefore not worth considering.

  19. wr says:

    @Jack: ” Free birth control has been available through Planned Parenthood since…..Gerald Ford.”

    Just one more reason “conservatives” have been targeting PP and forcing their clinics to close.

    Sorry, but your side doesn’t get to spend decades trying to wipe PP off the map, and then use it as a justification for this atrocity of a ruling.

  20. Eric Florack says:

    @Jack: Correct.
    Even absent that, we are talking about on average $9/mo.
    To claim this ruling denies such people birth control is diigenuous at best.

  21. Grewgills says:

    @anjin-san:

    Question, does this mean that a corporation owned by Muslims can use Sharia as a guide when setting up employee benefits?

    Only if the five conservative members of the court remain consistent, care to bet on that?

  22. wr says:

    @Grewgills: “Under what legal reasoning does it not? Are the Jehovah Witness’s beliefs less closely held? Would paying for the procedures they find sinful be less of a burden on them? Why?”

    It’s the same legal reasoning as in Bush v. Gore: “Because we said so.”

  23. Jack says:

    @wr: Conservatives that have a problem with PP do so because they provide abortions, NOT because they provide counseling services, birth control, exams, etc.

    You response still does not negate the fact that FREE BIRTH CONTROL is available to those that need it.

    Your HYPOCRACY knows no bounds.

  24. Dave D says:

    Nor does it provide a shield for employers who might cloak illegal discrimination
    as a religious practice.

    I already saw people arguing that there is a case for female employees to file a Civil Rights Act Title VII violation for gender based discrimination of health services.

  25. PD Shaw says:

    So much for my prediction from yesterday:

    I stand by my earlier prediction that Hobby Lobby wins by more than 5 votes, but certainly could see a severely divided rationales.

    I’d like to take partial credit for two of the liberal justices refusing to agree with the corporate personhood argument, but its still not more than five votes.

  26. grumpy realist says:

    @Jack: It isn’t free, or at least wasn’t when I was using their services.

  27. C. Clavin says:

    There’s a lot of baloney by know-nothings out there about this only affecting a limited number of contraceptives…those the court mis-labels “abortifacients”.
    At issue in this case were indeed four contraceptives which are not abortifacients…but this ruling opens the door for closely held corporations people to drop all contraception coverage.

  28. Grewgills says:

    @Eric Florack:
    That is not the average, that is the lowest price that was found in one community for the cheapest pill. Perhaps if you ever talked to a woman about birth control you would understand that different women have different chemistries and different needs for birth control. Not every pill works for every woman. You need to get out more.

  29. grumpy realist says:

    @Jenos Idanian #13: No, they objected to funding certain medications THEY thought were abortificants. (Doctors differed.)

    Based on this, if I were a closely-held corporation I could refuse all sorts of things, depending on what I claimed to believe.

  30. grumpy realist says:

    P.S. Just wait until a similarly “closely-held corporation” refuses to fund the little blue pill. That’s when we’ll start seeing screaming from the right.

  31. wr says:

    @Jack: “Conservatives that have a problem with PP do so because they provide abortions, NOT because they provide counseling services, birth control, exams, etc. You response still does not negate the fact that FREE BIRTH CONTROL is available to those that need it.”

    Whatever the reason, “conservative” states have shut down PP clinics, so where exactly is the FREE BIRTH CONTROL available? From the empty storefronts left behind? Remember, right wing judges say there’s no burden on a woman if she has to drive 500 miles to get to a clinic, even if she doesn’t have a car.

  32. Jenos Idanian #13 says:

    @Grewgills: Under what legal reasoning does it not? Are the Jehovah Witness’s beliefs less closely held? Would paying for the procedures they find sinful be less of a burden on them? Why?

    I’ll give you a reason that you won’t accept, but is internally consistent.

    In the case of abortificents, a life is being destroyed.

    In the case of a blood transfusion, no life is being destroyed.

    The question of “when does life begin” doesn’t have a clear, scientific answer. There are various definitions tossed around, but the scientific definition of “life” requires four criteria — metabolism, growth, reaction to stimuli, and reproduction. From the instant of fertilization, that is all true of the zygote.

  33. Jenos Idanian #13 says:

    @grumpy realist: No, they objected to funding certain medications THEY thought were abortificants. (Doctors differed.)

    Based on this, if I were a closely-held corporation I could refuse all sorts of things, depending on what I claimed to believe.

    Feel free to make such arguments. But unless you have a well-established history of those beliefs, and those beliefs have a significant number of believers, be prepared to be called out for your bullshit.

    Hobby Lobby’s owners’ beliefs were well-established, and those beliefs have plenty of adherents.

  34. wr says:

    @Jenos Idanian #13: “Feel free to make such arguments. But unless you have a well-established history of those beliefs, and those beliefs have a significant number of believers, be prepared to be called out for your bullshit.”

    Yes. And that significant number is five.

  35. sam says:

    @Doug

    So, this case is not going to lead to Jehovah Witness employers refusing to cover blood transfusions or transplants.

    Yeah, well, Justice Ginsburg begs to differ. (Not that, as a matter of fact, such refusals are in the offing.) And I myself cannot see why a Jehovah Witness or Christian Scientist employer would not be entitled to the same relief as Hobby Lobby. The Court found that Hobby Lobby was exempted from the mandate because the mandated provision of certain birth control modalities sufficiently burdened its religious freedom. I don’t how you can particularize the result in such a way that Hobby Lobby et. al are in and Jehovah’s Witnesses are out. Why is provision of certain kinds of birth control violative of religious conscience whereas provision of certain kinds of medical or surgical procedures are not? What is logical distinction there?

  36. Tillman says:

    @Jenos Idanian #13: They had a well-established history of disliking specific medicines for properties those medicines didn’t have?

  37. Scott says:

    They objected to abortificents — those forms of birth control that acted after conception. That objection is based on the belief that life begins at conception.

    More correctly, they objected to what they say are abortifacients. They are not. So the SC also says, effectively, that religious folks get to define their own science also.

  38. Jenos Idanian #13 says:

    @wr: Yes. And that significant number is five.

    There are more than 69 million Catholics in the United States, and that is a bit more than five.

    And most of them aren’t Catholics like Nancy Pelosi, Joe Biden, the Kennedys, or the rest who define “Catholic” however they wish, but accept the Church’s official doctrine.

  39. al-Ameda says:

    @Jenos Idanian #13:

    Feel free to make such arguments. But unless you have a well-established history of those beliefs, and those beliefs have a significant number of believers, be prepared to be called out for your bullshit.

    In this case all that was needed was 5 conservative Male Catholic justices who were believers. That seemed to be enough to result in a majority opinion to forward the proposition that corporations are in fact “people,” and are analogous to ‘actual’ people who hold private religious beliefs.

  40. sam says:

    @Jenos Idanian #13:

    I’ll give you a reason that you won’t accept, but is internally consistent.

    In the case of abortificents, a life is being destroyed.

    In the case of a blood transfusion, no life is being destroyed

    I’ll tell you why that won’t fly as a legal argument in American courts: It would require a court to take a position on a theological matter. American courts cannot, and most certainly will not do that. The Court took no position on the validity or lack thereof of Hobby Lobby’s religious beliefs.

  41. anjin-san says:

    Hobby Lobby’s owners’ beliefs were well-established, and those beliefs have plenty of adherents.

    So, presto, special rights. I thought “conservatives” were against special rights. Not so, it would seem. Special rights are good, if it is my tribe that is receiving them.

    beliefs were well-established, and those beliefs have plenty of adherents.

    You could just as easily say the same of Islam. And we all know how you respect the beliefs of Muslims.

  42. Jenos Idanian #13 says:

    @Scott: More correctly, they objected to what they say are abortifacients. They are not. So the SC also says, effectively, that religious folks get to define their own science also.

    Fine. Forget the terminology — it’s just semantics. Do the methods prevent conception, the fertilization of an ovum by a sperm cell, or implantation, the embedding of a fertilized ovum (or, if you prefer, zygote) into the uterine wall?

    If one believes that a zygote is alive, then the former is acceptable; the latter is not.

  43. Pinky says:

    @C. Clavin: It’s ironic that you’d use the term “know-nothings” to describe the victorious side here. Historically, the Know-Nothings were anti-Catholic, much like a lot of the comments on this thread from the opposite side.

  44. al-Ameda says:

    @Jenos Idanian #13:

    There are more than 69 million Catholics in the United States, and that is a bit more than five.

    And most of them aren’t Catholics like Nancy Pelosi, Joe Biden, the Kennedys, or the rest who define “Catholic” however they wish, but accept the Church’s official doctrine.

    …. and many of those 69 million Catholics are women who (contrary to the so-called official doctrine of the Church) use artificial birth control. Presumably those millions of women are more “Catholic” than Nancy Pelosi or Joe Biden, right?

  45. Jenos Idanian #13 says:

    @al-Ameda: …. and many of those 69 million Catholics are women who (contrary to the so-called official doctrine of the Church) use artificial birth control. Presumably those millions of women are more “Catholic” than Nancy Pelosi or Joe Biden, right?

    So, you’re arguing that the dissenters — especially the ones who do so secretly– should set the policy of the Church? And since not all Catholics agree with that part of doctrine, the Church has no right to hold that belief? And Catholics who accept that doctrine should have their beliefs trumped by the dissenters?

    Pelosi is an exceptionally appalling case. She regularly asserts that her opinions on Catholic doctrine are superior to those of Bishops and Archbishops. What the hell does one have to do to get excommunicated these days?

  46. al-Ameda says:

    @Jenos Idanian #13:

    Pelosi is an exceptionally appalling case. She regularly asserts that her opinions on Catholic doctrine are superior to those of Bishops and Archbishops. What the hell does one have to do to get excommunicated these days?

    I’d say that about 30 million American women who use artificial birth control are not worried about excommunication.

  47. anjin-san says:

    the policy of the Church

    Hmm. The Pope has made it quite clear that caring for the sick and the poor is a mandate for the church. Funny that conservatives have not rushed to follow his lead.

  48. anjin-san says:

    What the hell does one have to do to get excommunicated these days?

    So much for “judge not, lest ye be judged”…

  49. C. Clavin says:

    @Pinky:
    Actually, if you read what I typed, I was referring to those who mis-interpret the narrowness of the ruling and it’s ultimate effect..

  50. wr says:

    @Jenos Idanian #13: “Forget the terminology — it’s just semantics”

    No, it’s reality. Facts.

    If I say the earth is round and you say it’s flat, our disagreement is not a matter of “semantics.”

  51. wr says:

    @Jenos Idanian #13: “So, you’re arguing that the dissenters — especially the ones who do so secretly– should set the policy of the Church?”

    Um, no. We’re saying that the policy of the Church should not set the policy of the United States, something that you and five old Catholic men on the Supreme Court disagree with.

    But thanks for making your position clear.

  52. bandit says:

    Poor moochers

  53. James Pearce says:

    @Pinky:

    much like a lot of the comments on this thread from the opposite side.

    It’s not “anti-Catholic” to say “I’m not Catholic and I don’t want to abide by Catholic doctrine,” anymore than it’s “pro-Catholic” to say “If you work for me, you will.”

  54. jim m says:

    Seriously folks. If you really think that this is so Eeeeevil then the logical solution is to repeal RFRA or amend obamacare so that RFRA does not apply to it. This is not as much a 1st amendment issue as it is a statutory issue.

    Of course the dems could have done this up front with obamacare, but then that would have required actually reading the law before voting on it and they all lacked the wit to do so. Also, exempting obamacare up front probably would have cost them the dem votes needed to pass the law in the first place.

    So in reality, if you are upset about this outcome the only people to blame are obama, Reid and Pelosi. The SCOTUS only ruled on the law. While I understand that many people believe that the law should be only be enforced when it is ideologically convenient, that is not how a functioning republic works.

  55. anjin-san says:

    @ wr

    it’s just semantics

    A favorite dodge of Jenos’

    I have five bucks that says he has never heard of Hayakawa’s “Language in Thought and Action” and no clue that someone named Alfred Korzybski ever lived.

  56. jim m says:

    @legion: If you are getting health insurance from an employer by definition you are not on welfare. Your comment makes little sense as an employed individual has money to spend on contraception if they need it, and if contraception is going to break the bank I wonder where you think diapers are going to come from. Rain from Heaven?

    And if you are thinking that people on Welfare should have contraception provided for them, there is nothing in this ruling that prevents the federal government from doing just that.

  57. Dave Schuler says:

    @legion:

    The “corporate veil” is a state issue not a federal one.

  58. al-Ameda says:

    @jim m:

    Seriously folks. If you really think that this is so Eeeeevil then the logical solution is to repeal RFRA or amend obamacare so that RFRA does not apply to it. This is not as much a 1st amendment issue as it is a statutory issue.

    How is this a First Amendment Issue? A person who does not want to avail him or herself of a covered insurance benefit that he or she does not believe in is under no obligation to utilize that insurance benefit (e.g. birth control or Viagra).

  59. Pinky says:

    @James Pearce: Do you think that the Five Old White Catholic Men are saying that you have to follow Catholicism? That’d be a bad reading of this decision (to put it mildly). Are you saying that Catholic justices are incapable of impartial legal analysis? That seems to be what most people are implying on this thread when they mention Catholicism. At least that’s how I’m reading their comments. I think it’s fair to consider that anti-Catholic.

  60. anjin-san says:

    @ bandit

    Poor moochers

    Employment based health care coverage is compensation, not charity. It is not a favor that magnanimous job creators are granting to the peasants. What part of that are you not clear on?

  61. jim m says:

    @al-Ameda: Presumably the large number of Catholics who use the pill do not set church doctrine. I must have missed the part where to be a church in the United States your ecclesiastical governance had to be a democracy.

    And religious freedom does not become restricted because there are other believers who believe differently from you. If that were the case then there would be no religious freedom whatsoever.

    As to concerns that this will begin some slippery slope that will mean that JW’s will say that they should not have to pay for blood transfusions etc., that is explicitly outside the boundary of this ruling. It would be interesting to see such a case advance and to find out how the court rules. You might even find that it further restricts the ruling made today.

  62. Scott says:

    @Jenos Idanian #13: From one source:

    http://ncronline.org/blogs/grace-margins/what-abortifacient-and-what-it-isnt

    Rather, the IUD, which is a T-shaped device inserted into the uterus by a medical professional, works by affecting the way in which sperm move. Some IUDs release a synthetic version of the hormone progesterone called progestin, which thickens cervical mucus making more difficult for sperm to enter the uterus. Few sperm are able to reach the fallopian tubes, and those that do reach the site of fertilization are usually incapable of fertilizing an egg.

    The drug Plan B is also artificial progestin and therefore impedes the sperm from entering the uterus in the same way as the IUD. But the drug can also stop the ovaries from releasing an egg. If an egg has already been released, Plan B can slow down the movement of the egg. By slowing down both the egg and the sperm, it prevents fertilization.

  63. jim m says:

    @anjin-san:

    Employment based health care coverage is compensation, not charity. It is not a favor that magnanimous job creators are granting to the peasants.

    Exactly. And as a form of compensation, employees are entitled to choose employers who provide the compensation they want. There is nothing (other than a crappy job market) that prevents one from leaving a job and taking one with better pay (in fact I am in the middle of that process myself right now).

    If this really is such an infringement of liberties let the labor market vote with their feet and refuse to work for such employers. Or is the real offense that people will not choose the way that you want and that is what really bothers you?

  64. rudderpedals says:

    @PD Shaw: It was totally reasonable to expect prudent restraint out of the Court, even at this late date. In spite of today’s divided and divisive rulings I’m optimistic about old dogs learning new tricks and that conscience will tug on the lifetime appointees at some point.

  65. PD Shaw says:

    @sam: “Why is provision of certain kinds of birth control violative of religious conscience whereas provision of certain kinds of medical or surgical procedures are not? What is logical distinction there?”

    Because the analysis used by the Courts is a balancing test, which weighs many factors. It is not a bright line test. Transfusions are medical procedures that are part of treatment. Birth control is a product purchased at a pharmacy, often for non-medical reasons, but certainly also as a precaution where pregnancy is contraindicated. These differences make it easier for government to accommodate the religious exemptions for birth control, that are not practical for blood transfusions. Thus the relative weight is different.

  66. OzarkHillbilly says:

    @al-Ameda:

    It surely appears that the Court majority is saying that corporations are people, and that corporations may in fact hold religious beliefs.

    The clearest argument yet for amending the constitution.

  67. george says:

    @al-Ameda:

    This is yet another reason why a Single Payer Health Insurance system is the sensible path away from this kind of nonsense.

    Yup. I can sympathize with the corporation not wanting to go against their religious beliefs; it shouldn’t even come up, because it should be taken care of a single payer option.

  68. Another Mike says:

    @anjin-san: You caught my interest. Do you have any favorite quotes from the two gentlemen, which might pertain to the above conversation?

  69. Yolo Contendere says:

    @Jenos Idanian #13: Actually, it’s a pretty tiny minority of American Catholics who aren’t using birth control. I used to joke about growing up in a small Catholic family of eight. These days, most families are less than half that. How do you suppose that is happening? It sure isn’t the rhythm method.

    Oh, and fuck you for lecturing anyone on what constitutes a true Catholic.

  70. jim m says:

    @Scott: You have given only partial information regarding IUD’s and Plan B. While you are correct that both act to inhibit sperm locomotion and therefore their ability to fertilize an egg, neither claim to absolutely prevent fertilization.

    Since neither can completely prevent fertilization, both also act to make the uterine lining inhospitable to implantation and embryonic development.

    If the part that you disclosed was universally true and these products were 100% effective at preventing fertilization then Hobby Lobby and others would have no basis for a religious objection.

  71. al-Ameda says:

    Presumably the large number of Catholics who use the pill do not set church doctrine. I must have missed the part where to be a church in the United States your ecclesiastical governance had to be a democracy.

    This ruling suggests that if corporate management desires, it can provide health insurance benefits that are tethered to religious beliefs held by senior management. They can do a church’s bidding.

    I see this as another skirmish in the struggle to further restrict abortion – in that context the majority opinion by 5 conservative male Catholic justices makes perfect sense.

    All of this is why I favor a Single Payer Health Insurance system. Do we want to have a corporations impose religious beliefs (corporations are “people” now) on employees who are utilizing health insurance benefits for themselves and their dependents?

  72. James Pearce says:

    @Pinky:

    Do you think that the Five Old White Catholic Men are saying that you have to follow Catholicism?

    No, of course not. The five conservatives are not all Catholics, for one. And they are not saying I have to follow Catholic doctrine.

    They are, however, saying that women who work for a “closely-held” corporation might have to abide by their boss’s religious beliefs. Although to be truthful, probably not that many since most Christians — yes, even many Catholics– do not believe that birth control is immoral.

  73. Scott says:

    And as a form of compensation, employees are entitled to choose employers who provide the compensation they want.

    Since this case seems to rest on the “substantial burdens” idea, I suppose that burdens on employees don’t count.

  74. Yolo Contendere says:

    it is important to note that the Supreme Court did nothing today that actually impacts the ability of anyone to have access to birth control. You can still go to the pharmacy and buy the pills, you can still get an IUD implanted.

    As long as you can, you know, pay for it. I think it’s intellectually dishonest political hackery to characterize it in that manner. Oh wait, should I have blockquoted that last sentence?

  75. jim m says:

    @al-Ameda: You have to understand that closely held corporations of significant size are rather rare birds. This does not apply to corporations in general and never will.

    I have to wonder that your demand for single payer health care is driven solely by ideological desire. Does quality of care never enter into that consideration or is it entirely a matter of ideology and social justice?

  76. Scott says:

    @jim m: Bottomline: The interpretion of scientific data is up to the individual, not scientific community. Another source of mischief. Another slippery slope.

  77. jim m says:

    @Yolo Contendere:

    As long as you can, you know, pay for it. I think it’s intellectually dishonest political hackery to characterize it in that manner

    It is equally intellectually dishonest to imply that ALL forms of contraception are too expensive for people to access without health insurance paying for them. I rather think that few people pay for their Trojans with their Blue Cross plan yet somehow the manufacturer of Trojans stays in business despite no one having insurance to pay for their product. Amazing.

    What it comes down to is that you want the most expensive choices to be covered and you feel entitled to having those provided for you free of charge. I suppose that if you felt that you needed a car that you should be given equal access to a Rolls Royce despite your ability to buy a Ford.

  78. anjin-san says:

    @ jim m

    There is nothing (other than a crappy job market) that prevents one from leaving a job and taking one with better pay

    Well, let’s look past the fact that a crappy job market is what we have, have had for years, and will probably continue to have for the foreseeable future. So for your argument to have much meaning, you have to ignore an awfully large gorilla in the room. Entry level opportunities are not good. Opportunities for lateral and upward job mobility are not good.

    The reality is that most Americans who have a job are clinging to it like a barnacle. People who are offered a job are going to grab it, no questions asked. There is no job smorgasbord where they can choose a job at a company with values that align with their own.

    If you want to pretend that people have a lot of choice here, that’s up to you. I am spending my day in the real world.

  79. C. Clavin says:

    @Scott:
    No…burdens on employees…or others…no longer matter.
    In the past the Court has been clear that accommodations to religious beliefs and observances must not impinge on others.
    This ruling changes that…hence the term — “activist judges”…and now makes it perfectly acceptable for artificial legal entities to impose religious beliefs on natural persons.

  80. SKI says:

    I think it’s intellectually dishonest political hackery to characterize it in that manner.

    And I would suggest that this phrasing is both intellectually dishonest privileged hackery.

    Anything that restricts ability to pay for medical services impacts and restricts access. Only someone willfully blind to reality could suggest otherwise. It is possible that the carve-out for religious organizations could be applied but neither you nor the Court know this.

    Along those lines, birth control is frequently prescribed for medical (i.e., non-contraceptive) reasons. The majority (notably all older conservative catholic males) completely ignore this and there is no discussion on the impact on the employees at all. Their rights are a non-issue to the Court. Contraceptives are a medical issue and employers should have no business deciding what type of care their specific employees get.

    Finally,

    As for the opinion itself, It seems pretty clear to me that the opinion was crafted specifically to apply only to this situation in such a way to get Kennedy to sign on. It is limited to closely-held corporations and used the Administration’s work-around for actually religious organizations to prove that the law wasn’t the least restrictive alternative. They KNOW that they are opening a Pandora’s Box and are seeking to restrict it in advance as much as possible. I hope they are successful but fear they will not be.

  81. C. Clavin says:

    @jim m:

    Does quality of care never enter into that consideration

    We currently pay more for worse health care outcomes than most of the developed world.
    So that’s a losing argument from the get-go.

  82. Yolo Contendere says:

    As for the opinion itself, I think the Court got the result right for the most part. In the end, a closely held corporation is really nothing more than a partnership with tax advantages. What ever you might call it, it is still a business that is owned by a small amount of people. If Hobby Lobby were a partnership or sole proprietorship, there would be no question that the Greens would be within their rights to assert a religious objection under the RFRA. Given that, it doesn’t strike me as being all that radical to say that they retain those rights when they enter into a different kind of business form that, ultimately, was chosen so that they could expand the company to the national operation employing thousands of people that it is today.

    Um, they give up those rights (or should have) for all those other rights they receive with the new business form. Why should they get to have the rights of a partnership/sole proprietorship, as well as the rights of a corporation? Why should they get the tax advantages, as well as all the other advantages, and not have to give up anything in return? Especially when one of the remedies is the government pick up the tab? So they get a competitive advantage the rest of us have to financially cover?

  83. jim m says:

    @anjin-san: If you are unemployed and need a job I will bet that payment for contraception is not even in the top ten of your worries. If you are employed and are unhappy with your employers comp plan then you are at your leisure to find another job.

    I would further say that for people with any one of the following: skills, education, or work ethic, who have a job can easily find another one.

    I too choose to live in the real world. It happens to be one where you don’t get everything you want by ramming your ideology down other people’s throats. The only people in this matter who had no choice are the employers. Employees can always quit, can find alternative means for obtaining contraception (it doesn’t all cost the same as the national debt), or the government could be made to supply this.

  84. al-Ameda says:

    @jim m:

    I have to wonder that your demand for single payer health care is driven solely by ideological desire. Does quality of care never enter into that consideration or is it entirely a matter of ideology and social justice?

    You can stop wondering. I am practical. I’m not sure how coverage of birth control is a matter of social justice? It seems to me to be an issue of a regular healthcare for women.

    We have a health insurance and health care system that is nearly 50% more expensive than that of the next two advanced industrial countries, we consistently have lower health outcomes in many important health indicators, and we end up with 15% of the population as uninsured.

    I generally favor a system similar to that of Switzerland. The government legislates the basic insurance coverage to be provided to Swiss citizens, citizens use their allocation to buy coverage from private insurers, and profit to the insurance providers is limited. Also, citizens may purchase additional insurance (catastrophic coverage) if they so desire.

  85. grewgills says:

    @Jenos Idanian #13:

    So, you’re arguing that the dissenters — especially the ones who do so secretly– should set the policy of the Church? And since not all Catholics agree with that part of doctrine, the Church has no right to hold that belief?

    He was countering your assertion that
    @Jenos Idanian #13:

    There are more than 69 million Catholics in the United States, and that is a bit more than five.

    And most of them aren’t Catholics like Nancy Pelosi, Joe Biden, the Kennedys, or the rest who define “Catholic” however they wish, but accept the Church’s official doctrine.

    by pointing out that many of those 69 million don’t accept that particular church doctrine. Also not that many of those 69 million on the conservative side flout church doctrine on the death penalty, just war doctrine, and a number of other issues.

  86. jim m says:

    @Yolo Contendere: They would give up those rights if they were to sell ownership in the form of stock. Why should people with religious beliefs be barred from forming a corporation? People have been doing so for ages. Now you are going to say that they have retroactively surrendered their rights? That doesn’t exactly seem fair.

    I think you confuse a large public company with the sort of company that is the subject of this law. Lots of small businesses form corporations for tax purposes (Subchapter S corps for example are very popular as a replacement for a sole proprietorship or a partnership). So what you are saying is that because you disagree with them, that certain religious people should lose their rights to form a company unless they deny their religious beliefs even though those religious beliefs have nothing to do with forming a corporation.

    It wasn’t forming the company that is the issue here. It is the protection of the religious belief. That is why I commented previously that this is an issue with RFRA and obamacare. Either could be changed to take care of this issue. But what many seem to want is for the government to arbitrarily change the laws without having to actually pass them

  87. anjin-san says:

    I would further say that for people with any one of the following: skills, education, or work ethic, who have a job can easily find another one.

    You don’t get out much, do you?

  88. grewgills says:

    @jim m:

    As to concerns that this will begin some slippery slope that will mean that JW’s will say that they should not have to pay for blood transfusions etc., that is explicitly outside the boundary of this ruling.

    With exactly no logical or legal reason given as to why that is so.

  89. anjin-san says:

    ramming your ideology down other people’s throats.

    Well, my “ideology” is that people should be allowed to make their own health care decisions, and that the choices they make are none of their employers business. Is this a radical concept?

  90. jim m says:

    @al-Ameda: Birth control is only on rare occasions a matter of healthcare for women. Most of the time it is a matter of personal preference.

    What you advocate is not a single payer system but a highly regulated market. I don’t disagree with that entirely, I do think that our current corrupt bureaucracy is incapable of managing such a system (qv the VA for an example of how well our government works in this area)

  91. anjin-san says:

    I generally favor a system similar to that of Switzerland

    Yes.

    Interesting that the uber-captialist Swiss have a system that is “socialistic” in the eyes of modern conservatives. As is often the case, the Swiss are intelligent, savvy, and sensible.

  92. grewgills says:

    @Pinky:

    Are you saying that Catholic justices are incapable of impartial legal analysis? That seems to be what most people are implying on this thread when they mention Catholicism. At least that’s how I’m reading their comments. I think it’s fair to consider that anti-Catholic.

    I don’t think it is so broad as that. They are saying that these particular 5 conservative Catholic men are allowing their religious belief to trump logical consistency.

  93. jim m says:

    @anjin-san:

    Well, my “ideology” is that people should be allowed to make their own health care decisions, and that the choices they make are none of their employers business. Is this a radical concept?

    Not at all.

    Please tell me how this ruling prevents anyone from doing whatever they want with regard to contraception other than not paying for it? Cannot anyone still do as they please? Have these employers demanded that employees refrain from using certain forms of contraception as a condition of employment? I would be against that if that were the case, but it is not.

    So what you are really saying is that people should be able to make their own decisions in this area AND employers should be forced to pay for that choice no matter what it is. I only disagree with the last part.

  94. legion says:

    @jim m: My point, in response to Doug’s statement, is that when you take something that should otherwise already be taken care of – whether it’s the earned benefit of employer-provided healthcare or the earned benefit of unemployment insurance – adding one extra step or marginal cost – like going to PP to pay a few bucks or paying service charges for getting your benefits on an ATM card – it’s _still_ an unfair cost (whether in money, time, or both) dumped on those least likely to be able to bear it.

  95. sam says:

    @PD Shaw:

    I disagree with your analysis of the difference, PD., as being determinative. Really, the case came down to this: Is there a way for the government to achieve the goal of ACA without burdening Hobby Lobby unduly.? The Court answered yes there is. The government itself could provide the birth control, e.g. That is what is determinative, not the the nature of the treatment but whether there is a less burdensome way (less burdensome to the petitioner) for the government to achieve its objective. In the hypothetical case of the Jehovah Witnesses company, such an employer could argue that the government can provide the transfusions/operations etc. (just as the government can supply, fund, the contraception). It is not that X is easier for the govenment to do and thus company A is exempt. What’s convenient, easy for the government is not determinative. What is determinative is the possibility of the governement achieving its goal without having to burden Company A: Can it do that? And we’re back to my question, Where then is the logical distinction between Hobby Lobby and this hypothetical Jehovah Witness-owned corporation? None that I can see. The government can as easily pay for transfusions and operations as it can for birth control. The cost differences are not dispositive (or, for consistency’s sake, ought not to be) .

    I expect all this to be litigated in the near (like, immediate) future.

  96. C. Clavin says:

    @grewgills:
    This is a blatantly Christian ruling. Other religions don’t count…e.g. Jehovah’s Witnesses and transfusions.
    It’s so narrow that it reminds me of Bush v. Gore.
    Only instead of appointing a Republican to the Presidency it appoints Christianity the National Religion.

  97. Moosebreath says:

    @James Pearce:

    “The five conservatives are not all Catholics, for one.”

    Actually, they are.

  98. legion says:

    @jim m:

    Please tell me how this ruling prevents anyone from doing whatever they want with regard to contraception other than not paying for it?

    You are dodging the issue. Contraception benefits are part of the health benefits their employees contracted for. Hobby Lobby wants to unilaterally get out of that contract, basically, because this one aspect makes them “feel bad”. In the first place, that’s not a valid reason for altering a contract. Secondly, the fact that HL’s own retirement plan invests in contraceptive manufacturers _including the maker of the product they specifically claim “offend” them_ puts the absolute lie to their own arguments.

  99. RWB says:

    @legion:

    Exactly ! This point seems to be ignored, but the potential impact on small business is tremendous!

  100. jim m says:

    @C. Clavin: It is not true that we pay more for worse outcomes. We certainly pay more and that is an issue, but we do get better outcomes.

    The problem is that you are constantly fed a stream of “studies” that claim that the US is a crappy healthcare system. However, once you look at the measurements that are taken you find that they are primarily measures of how socialist the system is. If you look at the recent study that claims that the UK’s NHS is the best system in the world you will find that it measures how equal the access is in terms of payment. When it talks about quality of care it is mostly focused on record keeping and IT development.

    If you look at studies that actually look at the outcomes like the Lancet study in oncology outcomes you find that the US leads in those outcomes.

    You also need to separate what healthcare can do vs what lifestyle dictates. The healthcare system cannot stop people from being obese, or from smoking, or from partaking in any one of dozens of unhealthy lifestyle choices. A lot of studies fail to make such a distinction.

  101. Scott says:

    And as a form of compensation, employees are entitled to choose employers who provide the compensation they want.

    So what you are saying is that because you disagree with them, that certain religious people should lose their rights to form a company unless they deny their religious beliefs even though those religious beliefs have nothing to do with forming a corporation.

    As you wrote earlier, everybody had a choice. They are not losing rights by not forming a corporation, they are exercising their religious rights.

  102. jim m says:

    @legion:

    Contraception benefits are part of the health benefits their employees contracted for.

    WRONG!!!

    If a company was providing health benefits at all before obamacare they were doing so according to their conscience. Now that the obamacare mandate is here the government is trying to force these employers to change their health plans.

    So your claim that these companies are trying to duck out of giving employees something that they were already providing is a lie.

  103. Mustafa says:

    This is most welcomed. I am a Muslim supermarket checker. In the past I have had to handle pork while doing my job. This offends my religious beliefs. Now I can feel free to refuse to checkout such items as my brothers in the UK are able to do.

  104. jim m says:

    @Mustafa: Actually, that is a different issue, but yes employers over a certain size would likely have to make a reasonable accommodation for your religious belief.

  105. anjin-san says:

    If a company was providing health benefits at all before obamacare they were doing so according to their conscience.

    No, they were doing so according to the dictates of the market. You might want to read up a bit on how employer provided health insurance became a commonplace thing in America.

  106. grewgills says:

    @grewgills:

    Also not that many of those 69 million on the conservative side flout church doctrine on the death penalty, just war doctrine, and a number of other issues.

    oops, that not should not have been there

  107. C. Clavin says:

    @jim m:
    You are cherry-picking data from a blogger employed by a right-wing think-tank.
    From the New England Journal of Medicine:

    It is hard to ignore that in 2006, the United States was number 1 in terms of health care spending per capita but ranked 39th for infant mortality, 43rd for adult female mortality, 42nd for adult male mortality, and 36th for life expectancy

  108. Monala says:

    @Eric Florack: No, we are not. Different women, at different stages of their lives, have different needs. Some women have health conditions which are affected by certain types of pills, but not others. Women with erratic schedules (which many lower women working multiple jobs are) often shouldn’t use the pill because to be effective, it should be taken at the same time each day. Women over 40 shouldn’t use hormonal birth control at all–but guess what, they can still get pregnant (and it’s dangerous at that age), so the IUD is often the best solution. (Guess which is one of the key forms of birth control that Hobby Lobby wants banned?)

    Not everyone can use the $9 pills–and most of the alternatives to the $9 pills are far, far more expensive, ranging from $40 to $90/month, or $800 to $1,000 for a one-time implantation of the IUD.

  109. jim m says:

    @anjin-san: My point was that they could choose a plan that did not cover contraception. Yes, of course they were following the dictates of the market, but they weren’t offering the contraception plan. It would seem to me that if they had been providing it previously then any argument of religious objection would be negated.

  110. grewgills says:

    @jim m:

    It is not true that we pay more for worse outcomes. We certainly pay more and that is an issue, but we do get better outcomes.

    We pay (much) more for very similar outcomes by almost all measures (a minority are a bit better or worse).

  111. Monala says:

    @Jenos Idanian #13: I don’t know how you can write with a straight face that no life is being destroyed when it comes to blood transfusions. People rarely get blood transfusions unless they are facing some life or death condition.

  112. jim m says:

    @C. Clavin: I am cherry picking data from a blogger prior to when he was employed by that right wing think tank.

    And it does not make that data invalid. Try confronting the data rather than hiding behind where it comes from.

    And as predicted you throw out the most ideologically driven bullshit examples you can.1) Infant mortality is a political football and is defined differently in nearly every nation. Some nations count infants that die more than a month after birth as still births in their statistics and thus not as infant mortality. Comparing this data country to country is meaningless and a tactic of the ignorant or the dishonest.

    2,3 &4) male and female mortality and life expectancy are skewed my our murder rate. Take out homicide and other fatal injuries and our mortality and life expectancies are not that different from other developed nations. In fact, take out homicide and we are #1 for life expectancy.

    So please explain to me how life expectancy is a matter of health care outcomes when it is so radically effected by non health care issues? Also, is not life expectancy affected by lifestyle decisions like diet, smoking and alcohol intake? How are these the responsibility of the healthcare system?

  113. jim m says:

    @grewgills:

    We pay (much) more for very similar outcomes by almost all measures (a minority are a bit better or worse).

    So explain how it is that when you exclude homicide and fatal injuries that the US has the highest life expectancy of any OECD nation. I suppose it is because of our horrible healthcare system.

    And it is not an issue of how many people are dying of heart disease. The number of people with heart disease is primarily due to lifestyle choices and genetics. The issue is how long to they live once diagnosed. That is why cancer statistics are useful because they actually track their patients over many years where other disciplines do not.

  114. Monala says:

    @jim m:

    If you are unemployed and need a job I will bet that payment for contraception is not even in the top ten of your worries.

    Spoken like a man. Preventing pregnancy–one of the costliest things a woman can go through (not to mention the costs of raising the child afterwards), and one that certainly impacts her ability to acquire and keep employment–is something that will be foremost on the mind of an unemployed woman.

  115. Monala says:

    @jim m: Man, you are full of shit.

    I would further say that for people with any one of the following: skills, education, or work ethic, who have a job can easily find another one.

    So all the stories we’ve seen over the last seven years or so of people with skills, education and work ethic who are now among the long-term unemployed aren’t real?

    Employees can always quit, can find alternative means for obtaining contraception (it doesn’t all cost the same as the national debt), or the government could be made to supply this.

    And employers can stop running a business if they don’t like the rules they have to follow.

  116. James Pearce says:

    @jim m:

    Please tell me how this ruling prevents anyone from doing whatever they want with regard to contraception other than not paying for it?

    Let’s be real for a second: This ruling prevents employees of Hobby Lobby from having contraception covered in their health plans.

    Yes, it’s true they can still get contraception by other means. Yes, it’s true that Hobby Lobby has no ability to prevent its employees from using contraception at all.

    And yes, Hobby Lobby employees are prevented “from doing whatever they want with regard to contraception,” especially if what they want is to get it as part of a comprehensive insurance plan.

  117. sam says:

    @jim m:

    Yes, of course they were following the dictates of the market, but they weren’t offering the contraception plan. It would seem to me that if they had been providing it previously then any argument of religious objection would be negated.

    My understanding re Hobby Lobby was that they were in fact covering the objected-to birth control measures before Obamacare and only became aware that they were doing so after Obamacare was passed.

  118. C. Clavin says:

    @sam:
    They also have millions invested in the pharmaceutical companies that make the contraceptives.
    http://www.motherjones.com/politics/2014/04/hobby-lobby-retirement-plan-invested-emergency-contraception-and-abortion-drug-makers

  119. jim m says:

    @Monala: Aaand the only way you can manage birth control is through a method that costs thousands of dollars? Really? Sorry if I find that it is unreasonable to assume that unemployment means that your lifestyle doesn’t ever change.

    When you can’t pay for things yourself it is fair that your choices are going to be restricted. And once more the answer is that you can have quite a number of contraceptive choices, just not the most expensive once that you covet. What a sheltered life you must lead that you believe that you should never have to sacrifice anything under any circumstances.

    I think another commenter claimed that he “liked to live in the real world”. I would suggest that many here are not doing so if they believe like you do.

  120. jim m says:

    @sam:

    My understanding re Hobby Lobby was that they were in fact covering the objected-to birth control measures before Obamacare and only became aware that they were doing so after Obamacare was passed.

    OK so the question becomes what did they know and when did they know it. If they knew previously and did nothing then they really have no complaint and I cannot see the lower courts allowing this to move forward if that was the case.

  121. James Pearce says:

    @jim m:

    Aaand the only way you can manage birth control is through a method that costs thousands of dollars? Really?

    Is that your professional medical opinion?

    Or just your opinion?

  122. Monala says:

    @jim m: Yes. As I wrote to Eric Florack above, sometimes the only birth control that will work for a particular woman does cost thousands of dollars. Moreover, even women who don’t need something like the IUD can’t necessarily afford birth control if they are unemployed. The Pill requires a prescription. A woman without insurance can’t afford a doctor (and may not have access to a free clinic where she lives). So is your answer to her, just don’t have sex? What if she’s married?

    We’re not talking about someone deciding not to eat out anymore because they’re unemployed. We’re talking about women knowing that they had better not get pregnant right now or their lives are totally screwed. Meanwhile, the resources they need to not get pregnant are harder to come by.

  123. Mu says:

    The reason the US has health outcomes completely unexpected when compared to our expenditures is the enormous amount of money we drop into medicare patients. The US is very similar to spending per person to Europe up to age 65 – then the cost explode. Where the European doctor says “sorry, you’re 85, your heart is at 20%, we won’t do a liver transplant for $1M” the US doctor has guaranteed funding, and happily operates for a 3 months live extension. A typical US senior occurs 50% of his lifetime in the last 6 months of life.
    So the result is that our seniors have great life expectancy past 65, but our average is brought down due to all the people dying young lacking basic healthcare coverage.

  124. C. Clavin says:

    If you haven’t read Ginsberg’s dissent you really should.
    In it she brings up a 1966 case Newman v. Piggie Park Enterprises, Inc. in which the owner of restaurant chain refused to serve black patrons based on his religious beliefs opposing racial integration.
    The SCOTUS ruled against a business and for an individuals rights.
    My…how times have changed.

  125. C. Clavin says:

    @jim m:
    So you are saying that the Carpe Diem guy wasn’t a right-winger beforehe became a right wing blogger?
    And yes…the New England Journal of Medicine is notorious for being ideologically driven.

  126. Pinky says:

    @jim m: Great to see comments on this site that look behind the usual data. Please, please, feel free to drop by any time.

  127. C. Clavin says:

    From VOX…

    “…international evidence certainly suggest that America’s poorest women will be the most-affected by the court ruling. Poverty clearly makes affording contraceptives harder, and even a temporary disruption to a woman’s access can lead to an unplanned pregnancy…”

    http://www.vox.com/2014/6/30/5857904/where-the-pill-is-free

  128. C. Clavin says:

    @Pinky:
    In other words…thanks for agreeing with me…and backing it up with what you admitted was cherry picked data from right wingers just like me.

  129. James Pearce says:

    @Moosebreath:

    Actually, they are.

    And you are right, of course.

    I thought there was one that was Jewish, but nope….

  130. C. Clavin says:

    90% of the corporations in the US are closely held…and because of that they can now impose their religious beliefs on nearly half the US work force…which is fine…if you happen to share their religious beliefs.

  131. Moosebreath says:

    @James Pearce:

    “I thought there was one that was Jewish, but nope”

    No, all 3 Jews dissented here.

  132. C. Clavin says:

    Hobby Lobby does still cover Viagra and Cialis.

  133. C. Clavin says:

    Hobby Lobby does still cover erectile dysfunction prescriptions…because, you know…Christ used the little blue pill.

  134. gVOR08 says:

    @James Pearce: @Moosebreath: They have created a situation where perhaps a token WASP might be be appropriate. You don’t see that very often.

  135. ElizaJane says:

    @Eric Florack:
    My 18-year-old daughter pays $40/month co-pay for her prescribed b/c pills. That’s with insurance. For a young person working 45 hrs/week at a a minimum wage job, as she does, that’s a lot. And without insurance, the pills she needs would be a lot more. She cannot take the cheap ones that the above posters seem eager to advocate.

  136. jim m says:

    @C. Clavin:

    So you are saying that the Carpe Diem guy wasn’t a right-winger beforehe became a right wing blogger?

    I am saying that your disagreement with his point of view does not make a longitudinal study published in one of the most highly esteemed journals in the world, the Lancet, irrelevant. I find your refusal to discuss the data rather telling.

    90% of the corporations in the US are closely held

    Yes, because most sole proprietorships and partnerships are now S corporations. SO you are saying that because people want to adhere to their religious beliefs that they should be put at a competitive disadvantage, be more susceptible to legal liability and suffer negative tax consequences. Wow. You must really hate religious people.

    As for your link to the poorest being the hardest hit. THe poorest don’t have jobs so this is not an issue for them. Is there any argument that you are making which is honest?

  137. jim m says:

    @ElizaJane: If your daughter has a medical condition that requires her to take birth control pills then you have my sympathy. However, if this is merely supporting a lifestyle (i.e. I just don’t want to get pregnant right now) then who the are you to demand that other people pay for your lifestyle out of their pockets?

  138. Pinky says:

    @C. Clavin: Are you disputing the information he provided, or its relevance? Either way, could you back it up? It seems to me like the life expectancy data is more relevant with homicides and/or motor vehicle accidents removed. It also seems like the cancer survival rate would be a decent indicator of the quality of the health care system.

  139. wr says:

    @Pinky: “Are you saying that Catholic justices are incapable of impartial legal analysis?”

    I won’t speak for anyone else here, but I’m saying these five particular Catholic justices frequently privilege their own religious beliefs at the expense of anyone who doesn’t share them. Scalia and Alito are both Catholic reactionaries, and the other three are almost as bad.

    I suspect Justice Sotomayor is Catholic, too, though. You’ll notice no one here objecting to her stand on the issue, because she isn’t trying to force other people to live out her conscience.

    There’s nothing “ant-Catholic” about this, and to claim there is deliberately avoids the real issue. If you have five orthodox Jews or five conservative Muslims on the court deciding legal issues on the basis of their religion, that would be just as bad.

    In this case, however, it’s Catholics. And since they actually came out and said this ruling only applies to this Catholic belief and wouldn’t to those of other religions, it’s pretty clear what they’re trying to accomplish.

  140. stonetools says:

    Third, as noted above, the Court did not say that RFRA gives owners of companies like Hobby Lobby the right to refuse a whole host of items typically covered under a health insurance policy just because they might have a religious objection to those procedures. So, this case is not going to lead to Jehovah Witness employers refusing to cover blood transfusions or transplants. The Court

    After almost 150 posts, I’m waiting for Doug or anyone else to explain to me why the logic of this holding does not extend to Jehovah’s Witnesses and blood transfusions, or Christian Scientists and most modern medical care. I think the simple answer is that the logic indeed extends that far, but the most conservatives are hoping that the issue won’t come up.

    . The Court also said that the holding should not be seen as meaning that a private employer of any kind could avoid liability for a claim of illegal discrimination based on their religious beliefs. This would seem to be addressed to concerns regarding people trying to use religion to avoid liability under laws banning discrimination against people based on sexual orientation

    Again, why? “As a devout Christian, I believe homosexuality to be a sinful abomination proscribed by Leviticus 20:13. As such, I believe it would be an improper burden on my religion to provide them public accommodations.”
    “My religion tells me that blacks are the children of Ham cursed by God so it would be an undue burden on my religion to hire them as employees or to serve them on an equal basis as white people.”
    “I cannot promote women to supervisory positions because as I Timothy 2:12 clearly tells us, ‘I do not permit a woman to teach or to assume authority over a man; she must be quiet.'”

    And so on.

  141. beth says:

    @jim m: So would you deny lung cancer treatment to a smoker? How about not setting the broken leg of a skier because after all, if he hadn’t been pursuing the skiing lifestyle he never would have needed medical treatment. What a bizarre view of the world.

  142. jim m says:

    @C. Clavin: The difference between this ruling and the one that Buzzy Ginsberg cites is that a restaurant is a public accommodation and Blacks are specifically protected against discrimination, whereas people seeking birth control are not. (I say that rather than women because not all women are being discriminated against in this case)

  143. C. Clavin says:

    @jim m:

    I find your refusal to discuss the data rather telling.

    It’s off-topic and I don’t have time to bother with impeaching your ideological beliefs.

    you are saying that because people want to adhere to their religious beliefs that they should be put at a competitive disadvantage, be more susceptible to legal liability and suffer negative tax consequences. Wow. You must really hate religious people.

    No…I’m saying what the SCOTUS has repeatedly and consistently held up until this morning… that accommodations to religious beliefs and observances must not impinge on others.
    Today 5 radical activist judges changed that holding.

  144. beth says:

    @jim m: Oh, okay the nickname shows us that we really shouldn’t take anything you say seriously. Thanks for letting us know that.

  145. jim m says:

    @stonetools:

    I’m waiting for Doug or anyone else to explain to me why the logic of this holding does not extend to Jehovah’s Witnesses and blood transfusions, or Christian Scientists and most modern medical care.

    Because the ruling specifically states so. That’s why.

  146. Tillman says:

    @jim m: And this is the first narrow judicial ruling that made it a point to say it was narrow so it wouldn’t be expanded on in the future.

  147. wr says:

    @anjin-san: “Well, my “ideology” is that people should be allowed to make their own health care decisions, and that the choices they make are none of their employers business. Is this a radical concept?”

    To a libertarian, yes. Because freedom to a libertarian is the freedom of the rich and powerful to fully exert the power of their wealth over the poor and weak. If you stop William Zanzinger from beating Hattie Carrol to death, then you’re interfering with his right to treat his employees in the way he believes right.

    And Hattie is always free to crawl out of the grave and look for a new job.

  148. James Pearce says:

    @jim m: How do you get from here:

    SO you are saying that because people want to adhere to their religious beliefs that they should be put at a competitive disadvantage, be more susceptible to legal liability and suffer negative tax consequences.

    to here?
    Wow. You must really hate religious people.

  149. Pinky says:

    @wr: And what about the violence to innocent men of straw, such as you just committed?

  150. jim m says:

    @C. Clavin:

    I’m saying what the SCOTUS has repeatedly and consistently held up until this morning… that accommodations to religious beliefs and observances must not impinge on others.

    In this case the people being asked to make the accommodation are the business owners and it has been consistently upheld that any infringement of religious expression requires strict scrutiny and the government must do everything it can to avoid infringing on those rights, Justice Kennedy points out that there were several remedies that the government could have used to avoid this: Repealing RFRA, modifying obamacare so that RFRA doesn’t apply, or simply providing contraception for free from the government. That being the case you see that there are other solutions to the problem.

    The link I gave you was in response to your bogus claim that our healthcare system sucks. Rather than address the data from the Lancet, you choose to run away claiming that because “Some right wing blogger” talks about it that therefore it is taboo and irrelevant. That has to be both the most cowardly debate tactic as well as the most dishonest.

  151. Tillman says:

    @James Pearce: Because taxation is hatred? The government taxes us because it hates us, right?

  152. jim m says:

    @James Pearce: I get there because Clavin is saying that giving this exemption to companies is wrong. It can only be wrong because he wishes to deny the benefits of incorporation to those people who he disagrees with. Per my point, most corporations exist to provide specific legal and tax benefits to those forming the corporation. I know personally of several that are essentially sole proprietorships. Why must these people surrender their religious freedom in order to do business on an equal footing with other people?

    That my friend is called religious discrimination.

  153. Tillman says:

    @Pinky: Whose argument did he mischaracterize? “Straw man” means something specific in logic.

    From here, it looks like he posted his opinion on what libertarianism means.

  154. wr says:

    @jim m: “And it does not make that data invalid. Try confronting the data rather than hiding behind where it comes from.”

    In related news, both Dick Cheney and Bill Kristol say we absolutely must re-invade Iraq to keep America safe from annilhation!!

    And it does not make that date invalid just because they said this a decade back and were completely disastrously wrong. You must never never never never never see who it is who is using data to sell his preferred outcomes. You must only read him material with a completely uncritical eye!

  155. jim m says:

    @Tillman:

    this is the first narrow judicial ruling that made it a point to say it was narrow so it wouldn’t be expanded on in the future.

    Is it? I don’t know SCOTUS history that well. I assume you must be a legal historian.

  156. Pinky says:

    @Tillman: Yeah, it was more of a false choice or a slippery slope, saying that either you support the Court’s dissent or you beat poor people to death. (I mean, that was wr’s implication, right?) But then I couldn’t use the “violence against straw man” thing, and the phrasing was just too sweet. (I guess I did the same thing as wr, going for rhetoric over accuracy.)

  157. legion says:

    @jim m:

    If a company was providing health benefits at all before obamacare they were doing so according to their conscience.

    I don’t think you understand what a “contract” is, Jim. The employees were hired with an offer of certain compensation. Health benefits were an explicit part of that package. It’s not something the employer is doing “according to their own conscience” any more than writing paychecks is. It’s what they agreed to do. Now they’re trying to unilaterally alter that contract, just because it makes them “feel bad”. Despite the fact that _investing_ in the companies that make those very contraceptives doesn’t seem to bother them in the slightest. They are lying hypocrites. Period.

  158. wr says:

    @jim m: “Because the ruling specifically states so. That’s why.”

    You might want to read up on the Supreme Court. They are actually not supposed to issue rulings saying “this makes no logical or legal sense, but it’s the way we want it and we’ve got the power, so screw you, suckers.”

  159. stonetools says:

    @Pinky:

    This is contradicted by many other studies. The overwhelming consensus among health care economists is that the US health care system provides worse outcomes than other advanced countries at a higher cost. You can always find ONE guy who disagrees with the consensus, like you can always find ONE climate scientist to dissent from the consensus on global warming or ONE biologist to dissent from the consensus on evolution.
    I might point out that Mr. Roy, despite impressive credentials, is not actually an economist, whereas people like George Packer, who dispute his conclusions, are.

  160. wr says:

    @Tillman: “And this is the first narrow judicial ruling that made it a point to say it was narrow so it wouldn’t be expanded on in the future.”

    Second.

    Bush v. Gore.

  161. jim m says:

    @wr: Wow you really are twisted. The data is the data. If you don’t like it go look up the lancet study yourself, Here is the same study from an NIH site

    It’s a medical study in a prestigious refereed journal. The data shows that the US has better cancer outcomes than anywhere in the EU. Deal with the facts don’t run away and claim that because a conservative brought it up it has no meaning. That is an argument from ideology claiming that ideology is the sole source of truth. While I fully expect you to be that ignorant I hold out hope that some others might not be so.

  162. Pinky says:

    @Tillman: If we’re going to play this game, what do you think of wr’s “in related news”? Straight-up non sequitur, it seems to me, but it’s sort of poisoning the well, too.

  163. Tillman says:

    @Pinky: The phrasing was sweet. 🙂

    @jim m: Technically, aren’t you presuming I’m a legal historian?

    @jim m: How are they surrendering religious freedom? Incorporating in a way that requires them to provide insurance coverage does not impinge on their worship rituals or ability to congregate. Nor does it really force them (by any reasonable definition of the word) to provide the medication they find objectionable since the money to do so is taken out of the salary/wages they would otherwise be giving their employees as compensation.

  164. jim m says:

    @legion: Apparently you don’t work for a living because I have had companies change the health plan several times and usually not to my liking. The contract does not say that the company will always provide exactly the same benefits always and forever. You live in a fantasy land if you think that is the case.

  165. wr says:

    @jim m: ” It can only be wrong because he wishes to deny the benefits of incorporation to those people who he disagrees with”

    Unless what he “wishes” is to allow everyone the benefits of incorporation, but also demand that everyone follow the restrictions imposed by incorporation — including those who claim their precious feelings will be hurt if they have to give their employees health care that includes things they don’t like — except, of course, when they’re investing in the company that makes it.

    I will agree with you on one issue though — the RFRA should never have been passed, and it should be repealed as soon as possible. It’s nothing but pandering to the worst elements of American society.

  166. David M says:

    @jim m:

    Make sure the data you’re referencing doesn’t use survival rates, as they are much less important than mortality rates.

  167. wr says:

    @Tillman: Thank you, sir. I know you don’t always approve of my posts here, but I appreciate your efforts to be an honest broker, commenting on posts themselves individually.

    And I’m going to try to remember that next time you come after me!

  168. jim m says:

    @Tillman: The ruling today and rulings in the past have held that requiring someone to pay for a service that provides something that is against an employers religious view violates their religious rights. That is not new. You don’t have to like it, but in that regard this is quite consistent with decades worth of rulings. The court already held this way with regard to religious organizations. If that reasoning is valid for religious organizations it then remains valid in this case.

  169. Tillman says:

    @wr: …damn it, I was being sarcastic.

    @wr: You have to remember this basic fact: I tend to agree with you 90% of the time, and the remaining 10% is tactics/semantics.

    @Pinky: It’s not quite poisoning the well. I think he’d have to be somehow insulting the reputation of the Lancet to qualify. It’s avoidant of the basic ad hominem Clavin danced around by claiming the guy who linked to the Lancet study worked for a right-wing think tank, but that’s about it. Nothing unusual.

  170. stonetools says:

    @jim m:

    Ipse dixit isn’t actually reasoned argument, you know-or I guess, you don’t know.

    “2+2=5!”

    “No, it doesn’t.’

    “Yes, it does-cause I say so!”

    This is pretty much the Supreme Court’s “reasoning” here.

  171. wr says:

    @jim m: So when The Lancet reported 100,000 Iraqi cvilliians killed by American fire in the early parts of the war, you were out in the street insisting that it had to be true because the Lance was always trustworthy?

    And as someone above already said, you can find someone to write a study to prove that smoking cures cancer, and will have the “data” to prove it. Hell, John Lott’s made a tidy living for himself by presenting “data” about gun violence.

    So yes, it does matter. And when the one study you have ever read in your entire life is countered by innumerable others that say the opposite, pardon me if don’t rush to read it… or take your word.

  172. beth says:

    @stonetools: Haven’t we discussed this already and found that these studies are of people diagnosed and treated for cancer but neglects the thousands in this country who can’t afford healfhcare and are never diagnosed or treated or tracked? I may be misremembering the discussion but I thought the conclusion was that we’ve got great healthcare if you can afford it.

  173. Tillman says:

    @jim m: They are not paying for it since the payment for the objectionable medication comes out of the compensation they’d already be giving their employees.

  174. wr says:

    @Pinky: It’s called an “analogy.” Really, look it up. It’s a great tool in writing.

  175. sam says:

    @jim m:

    However, if this is merely supporting a lifestyle (i.e. I just don’t want to get pregnant right now) then who are you to demand that other people pay for your lifestyle out of their pockets?

    Because vasectomies. No? (Remember, employer paid-for health-care plans are really subsidized, i.e., are a form of tax-free compensation, income. So, you’re paying for his snips. And if you don’t think that’s a lifestyle choice….)

    @Tillman:

    this is the first narrow judicial ruling that made it a point to say it was narrow so it wouldn’t be expanded on in the future.

    Uh, no. Bush v. Gore infamously, or famously, depending on your pew, did it too. This attempt at limiting is different. I’m not sure that Justice Alito’s voiced irritation with Justice Ginsburg’s dissent isn’t in effect merely dicta. Her point was that the Court gave lower courts scant direction in handling religiously-based challenges to, well, really anything at all.

  176. wr says:

    @jim m: “You don’t have to like it, but in that regard this is quite consistent with decades worth of rulings”

    Wait — now you are a Supreme Court historian? Man, you must have done a lot of studying in the seconds since you said you weren’t…

  177. jim m says:

    @David M: You tell a cancer patient that survival is not as important as mortality. I agree that in some instances the differences in mortality are small, but they remain statistically significant. Also as someone who has worked in cancer care, it is very meaningful when you can extend a person’s life by even a year or two. While you may not care about other people’s lives some of us do.

  178. jim m says:

    @sam: Hey, I think that if they cover vasectomies they should cover tubal ligations as well. That would be fair would it not? They are equivalent procedures.

    However, comparing a vasectomy to paying for the pill is not.

  179. wr says:

    @jim m: “While you may not care about other people’s lives some of us do.”

    Sure. As long as they’re not sluts trying to make you pay so they can lead the lifestyle they choose, right?

    And Mr. Tillman: Yes, ad hominem. But come on, his last message was absolutely begging for a pie in the face…

  180. Tillman says:

    @sam: Damn it, people, sarcasm! I know it doesn’t come across in text, but blergh!

  181. David M says:

    @jim m:

    So you don’t understand the difference between survival rates and mortality rates? Or are you just not interested in an honest discussion?

  182. jim m says:

    @beth:

    I thought the conclusion was that we’ve got great healthcare if you can afford it.

    You are quite correct. The problem comes in about how to provide better access. Socializing medicine does not do that well as we see countries like Canada and the UK have extremely long waiting periods for procedures and treatments. These have grave consequences for survival (and mortality. In Canada 80% of colon ca patients are deemed treatable at time of diagnosis. After waiting 3 months to begin chemo half of those are no longer deemed treatable.)

    There may be a way to make insurance more affordable but making it pay for a lot of wellness crap is not the way to do it. Covering healthy dr visits is expensive and preventative care has never been shown to be cost effective. Yes, it can benefit the individual but on the level of the whole population it is not cost effective.

  183. stonetools says:

    Finally, although it’s easy to understand why it is being characterized in this manner by political partisans, it is important to note that the Supreme Court did nothing today that actually impacts the ability of anyone to have access to birth control. You can still go to the pharmacy and buy the pills, you can still get an IUD implanted

    Time to uncork this oldie but goodie from Anatole France:

    The law, in its majestic equality, forbids the rich as well as the poor to sleep under bridges, to beg in the streets, and to steal bread.
    Read more at http://www.brainyquote.com/quotes/quotes/a/anatolefra106266.html#Yyb9gEvLe4rJEJA0.99

    And , apparently, to get access to birth control . If you are a rich employee of Hobby Lobby , you are fine. If you are poor, well according to Doug, too bad.
    Sometimes it’s truly astonishing the lack of empathy well-off , privileged males have for poor women. It’s like they don’t consider them human beings with equal rights.
    About the only good thing about this is that the issue can be solved through voting. Time to vote , women.

  184. aFloridian says:

    To weigh in, I spent a LOT of time reading all the relevant cases and other materials some months back about this case. I’m talking everything relevant since the RFRA was passed. Based on that, and my own legal education, and I am very confident that as a purely legal issue the majority got this decision RIGHT and it was the dissenting justices who were writing as activists, because they object to the majority as a matter of policy and recognize this slippery slope arguments here.

    What I am saying is, I agree with the majority as a matter of law BUT:

    I am not at all confident that this is a correct policy. In fact, while @Jenos Idanian #13 said earlier in this discussion that there was some logical difference between this and a blood transfusion (the blood transfusion does not end a life, or somesuch, which is patently ridiculous, because being denied access to a blood transfusion could leave you dead pretty quickly) I didn’t see the difference. This DOES seem to be a slippery slope. I think the answer might be to look at the RFRA. I have no moral opposition to the contraceptives at issue in this case. Abortion is not a big issue for me. I don’t see it as the genocide of our times. Sorry fellow Republicans. How can you be so concerned about theoretical life while so many already-born flesh-and-blood Americans starve and suffer?

    In sum, I do think the majority made the right decision, but that’s purely as a matter of law. As public policy, it is incredibly worrisome, and does not in any way make me happy or reassured.

  185. Tillman says:

    @aFloridian: Frankly, this is something Congress needs to fix. That’s the bugbear we’re all ignoring.

    We’re ignoring it because the idea that Congress will do anything is sadly amusing.

  186. Grewgills says:

    @jim m:
    Look at the actual numbers in the article you cite. All OECD nations have very similar outcomes, but one spends more to get them.

  187. jim m says:

    @David M: I understand them. I am also saying that while you might think a small difference in mortality is actually thousands of people per year and that does make a difference. The difference between US and UK mortality (if we assume the linked video is correct – and it appears that the other data is correct so I think we can do that) is 6320 lives per year.

    Also, remember that he is giving mortality rates per 100,000 people in the general population. The success of the healthcare is not related to the total population but related to the total number of people with the condition. The numbers look small but what you miss is that in the US the actual rates of cancer are higher than in the UK. So while we have higher mortality part of that s due to the fact that we have more cancer.

    In fact we have 300.2 cancer cases per 100,000 and the UK has 266.9. So given that we are starting from behind the UK and ending up ahead of them suggests that we really are doing something better.

    So who was it that does not understand about the difference between survival and mortality? Who really is looking at the data trying to understand it? And who is just trying to bolster their ideological conclusions?

  188. jim m says:

    @Grewgills: I do not deny that we spend too much for health care. What I would like to see is reducing spending without having to reduce quality.

  189. James Pearce says:

    @jim m:

    Why must these people surrender their religious freedom in order to do business on an equal footing with other people?

    That my friend is called religious discrimination.

    No, my friend, that’s called a bogus argument.

    Hobby Lobby asked the Supreme Court for an exception to how business is done by other people and it was granted. This does not put them on “an equal footing” with other people.

  190. stonetools says:

    Even if you agree that this is a legitimate and important government interest though, it’s plainly obvious that there are means by which the government could accomplish this goal without requiring employers like the Greens to violate their religious beliefs. The most obvious means, of course, would be some form of direct subsidy to employees but there are other means as well.

    All of this sounds like more government social spending to me-which is anathema to the very conservatives celebrating this decision. Is Doug arguing here that his taxes should go up to pay for this subsidy to employees so that the Hobby Lobby owners can enjoy their religious liberty? Somehow I don’t think this is what conservatives have in mind.

  191. jim m says:

    @aFloridian:

    What I am saying is, I agree with the majority as a matter of law BUT:

    I am not at all confident that this is a correct policy.

    That’s fine. WHat I disagree with is those who believe that the law should be interpreted in different ways as policy changes. This is not a good plan for a democracy and is far too open to corruption. I would argue that it paves the way for authoritarianism.

    Public policy is the domain of the Congress and the Presidency. They need to fix it. If we don’t have competent people in DC (and we don’t and that is a bipartisan truth), then we are to blame for that.

  192. george says:

    @jim m:

    You also need to separate what healthcare can do vs what lifestyle dictates. The healthcare system cannot stop people from being obese, or from smoking, or from partaking in any one of dozens of unhealthy lifestyle choices. A lot of studies fail to make such a distinction.

    Actually some public health care systems that have better outcomes than the US (longevity etc) spend significant resources on just those preventative approaches (everything from public education to providing free or subsidized sporting facilities). The distinction doesn’t apply in those cases, because those systems include preventative health in their calculations of how to allocate resources. Lower rates of obesity/smoking etc are already part of the result in those cases.

    In fact, the most efficient healthcare system involves educating people to make healthy choices; its much cheaper to keep people healthy than to try to patch them up after they’re seriously ill. There’s almost no medical disagreement on this; any organization which pretends otherwise is selling you something, as is any organization which thinks obesity etc is separate from healthcare.

  193. James Pearce says:

    @jim m:

    What I would like to see is reducing spending without having to reduce quality.

    An anti-contraception agenda is antithetical to this goal.

  194. jim m says:

    @James Pearce:

    Hobby Lobby asked the Supreme Court for an exception to how business is done by other people and it was granted. This does not put them on “an equal footing” with other people.

    I agree. Based on your argumentation this exception and their refusal to provide this benefit puts them at a competitive disadvantage.

  195. george says:

    @jim m:

    The success of the healthcare is not related to the total population but related to the total number of people with the condition.

    I agree. The greater the percentage of people with the condition, the less successful the healthcare is. Curing them after they get the condition is secondary to avoiding the condition in the first place.

  196. C. Clavin says:

    @jim m:
    This is the very first time a corporation has been treated thusly…so to say SCOTUS has ruled consistently is clearly a mis-statement on your part.

  197. Grewgills says:

    @jim m:

    Yes, because most sole proprietorships and partnerships are now S corporations. SO you are saying that because people want to adhere to their religious beliefs that they should be put at a competitive disadvantage, be more susceptible to legal liability and suffer negative tax consequences. Wow. You must really hate religious people.

    If people want to create a legal entity to stand between them and legal responsibility for what their business does, then they should realize that legal entity is not sentient and so not capable of having religious beliefs.

  198. al-Ameda says:

    @jim m:

    The court already held this way with regard to religious organizations. If that reasoning is valid for religious organizations it then remains valid in this case.

    A corporation is a religious organization?

  199. stonetools says:

    @jim m:

    You are quite correct. The problem comes in about how to provide better access. Socializing medicine does not do that well as we see countries like Canada and the UK have extremely long waiting periods for procedures and treatments. These have grave consequences for survival (and mortality. In Canada 80% of colon ca patients are deemed treatable at time of diagnosis. After waiting 3 months to begin chemo half of those are no longer deemed treatable.)

    Right wing propaganda alert! Note that most Canadians and Brits are happy with their health care and have no interest whatsoever in shifting to a US type free market centered system. . Also too note that most seniors aren’t tearing up their Medicare cards and aren’t demanding a return to a private health insurance based system for seniors-indeed, quite the contrary.
    Finally note that Ms. Libertarianism herself, Ayn Rand, ended up taking Social Security and Medicare benefits.

  200. James Pearce says:

    @jim m:

    “Based on your argumentation this exception and their refusal to provide this benefit puts them at a competitive disadvantage.”

    Um, no.

    You said that not granting the exception would be “religious discrimination.” I think granting them the exception is unnecessary and unwise.

    But then again….I don’t believe in Jesus or John Roberts.

  201. jim m says:

    @george:

    The greater the percentage of people with the condition, the less successful the healthcare is.

    Not true. Healthcare cannot dictate lifestyle choices that predispose people to illness. Unless you are advocating for a government that can dictate, diet, exercise level, ban smoking(including pot) , ban alcohol, and remove all environmental hazards then you cannot blame the healthcare system for the prevalence of disease.

    Oh, and you should also promote a government that restricts child bearing to people who have been genetically screened and cannot pass on any heritable predisposition for disease.

    Once you have done that then you can blame healthcare for all disease because it really will be the result of poor health care. But not before you have done all those things.

  202. jim m says:

    @James Pearce:

    You said that not granting the exception would be “religious discrimination.” I think granting them the exception is unnecessary and unwise.

    Both of those viewpoints are legitimate and can be argued between reasonable people.

  203. jim m says:

    @al-Ameda:

    A corporation is a religious organization?

    No. But a closely held corporation can have a religious viewpoint as we learned today.

  204. jim m says:

    @george: Oh, and as I pointed out earlier in the thread, once you take out homicide and fatal injuries the US has the highest life expectancy of any OECD nation. SO accepting your claim that life expectancy is a direct result of the healthcare system, we have to conclude that the US system is the best in the world because our life expectancy is proof of that fact.

  205. Dave Schuler says:

    Since the majority’s decision is not based on the First Amendment but on the Religious Freedom Restoration Act (which is brief), it might be helpful to read the full text of the law.

    Much of the commentary above is concentrated on what should be the policy where, since we’re talking about a Supreme Court decision, it should be about what is the law?

    In terms of the dissent, I think that Justice Ginsberg’s is unsustainably narrow. Apparently, she believes that since private corporations aren’t specifically mentioned in the legislation, RFRA doesn’t apply to them. I don’t think that’s a reasonable reading but I suppose that intelligent people may differ.

    All this by way of saying that rather than complaining about the Court you should be complaining about the Congress. The appropriate way to vitiate this particular decision is by repealing RFRA.

  206. @al-Ameda: Can you point out in the Constitution, in particular the 1st Amendment, where any distinction is made between individual citizens and private entities/corporations?

    I didn’t think so.

  207. stonetools says:

    @jim m:

    Because one particular measure that the US is ahead on, counting a massive qualification, is the absolute best measure of a heath care system. Look up “cherry-picking” in the dictionary, then get back to us, OK?

  208. jim m says:

    @stonetools: Hey, if you want me to play by your rules here look at the link I posted about life expectancy. When you eliminate homicide and fatal injury then we have the highest life expectancy. I suppose you feel that homicide is a result of healthcare and therefore you believe I am cherry picking data.

    Also, Cherry picking suggests that you are looking at one data set and just picking the data that you like. There really are not similar fields to oncology that follow their patients long term and where the diseases are both fatal and often unrelated to lifestyle choices (while some cancers certainly are affected by lifestyle choices most are not). Cancer happens to provide a really good assessment of the healthcare system because 1) it requires long term care and 2) it involves many disciplines (the typical cancer patient may require consultations from pathology, cardiology, radiology, surgery, nephrology, epidemiology as well as oncology).

  209. KansasMom says:

    @beth: All of the things you mention are actual lifestyle choices. Sexuality is not. It is as natural as eating and pooping. It’s well documented that people with healthy sex lives are happier, less stressed, and live longer. Birth control, yes jim m, even just so a person can have sex for pleasure and companionship, is health care. Period.

    And I don’t have data and don’t care enough to find it because it’s obvious, but women who control the number of pregnancies that they go through are also healthier and live longer and are under less stress.

  210. wr says:

    @jim m: “But a closely held corporation can have a religious viewpoint as we learned today.”

    What we learned today is that five Catholic men on the Supreme Court believe that the religious views of the owners of certain types of corporations may feel free to impose those views on their employees. That was the decision. Certainly even these five old men aren’t so delusional that they now believe inanimate objects have opinions.

  211. stonetools says:

    All this by way of saying that rather than complaining about the Court you should be complaining about the Congress. The appropriate way to vitiate this particular decision is by repealing RFRA.

    Yeah, that would require changing Congress-massively. I guess the point may be that it’s easier to wait for Scalia to die and have President Hillary Clinton replace him with a liberal judge than to hope for the Democrats to regain the majority in this gerrymandered House.
    Who knows, maybe this decision will prompt women to come out to vote for Democrats in massive numbers this fall? I certainly hope so, but I doubt it.

  212. jim m says:

    @wr: A corporation is not an inanimate object and since many corporations are essentially sole proprietorships claiming that there is a difference between the sole proprietor’s rights and the company’s rights is a distinction without a difference and that is what the SCOTUS held.

  213. jim m says:

    The appropriate way to vitiate this particular decision is by repealing RFRA.

    I have heard it argued that the reason that a clause exempting obamacare from RFRA (which would have been a possibility) was because it would not have carried the dem majority. Repealing RFRA would be too much like touching the third rail for most members of Congress. You’re not even going to get a majority of the democrats to vote in favor of that.

  214. Liberal Capitalist says:

    @sam:

    The Court found that Hobby Lobby was exempted from the mandate because the mandated provision of certain birth control modalities sufficiently burdened its religious freedom. I don’t how you can particularize the result in such a way that Hobby Lobby et. al are in and Jehovah’s Witnesses are out. Why is provision of certain kinds of birth control violative of religious conscience whereas provision of certain kinds of medical or surgical procedures are not? What is logical distinction there?

    Exactly.

    Now, how soon will it be before the “government mandated” Gay / Transsexual / transgender Bisexual rights go under the same knife?

    After all… why provide ANY heath care for “those people”. Now maybe they won’t even have to hire them!

    Or what about those religions that forbid blood transfusions?

    Or, completely reject medical treatment for their belief in the power of prayer?

    What If they believe a man should not work with women? Or if (like Lutherans) believe that women should be deferential to men and work in the home?

    If I am a “closely held” company, there is now no bounds to what I may limit to my employees.

    We are well down the slippery slope.

    Citizens United showed us what can be done with money… this decision will show us what can be done with hate.

  215. wr says:

    @Liberal Capitalist: “Citizens United showed us what can be done with money… this decision will show us what can be done with hate.”

    Unfortunately, I think Citizens United has already done that for us.

    This is just step two, in which the aging white population does its damndest to make sure that they never lose complete power over everyone else, no matter how small its minority grows.

    After all, it worked so well in South Africa…

  216. george says:

    @jim m:

    Oh, and as I pointed out earlier in the thread, once you take out homicide and fatal injuries the US has the highest life expectancy of any OECD nation.

    Well, potentially fatal injuries are often saved at the last second by health care, so I’m not sure about taking them out of the equation – that’s like taking completely failing break parts out of the quality stats for a car.

    Look, I live in Canada now, and was saved by an amazing ambulance and hospital staff after a very bad car crash (other guy ran a red light). A poor health care system (everything from getting there quickly, stabilizing me, getting me to the hospital for immediate treatment, and excellent treatment) and I’d have been a statistic. That experience is one reason I laugh at people who think public health has people dying in the streets; when go I south for a visit I’m always amazed at the number of people who believe what (mainly GOP) spokespeople say about Canadian system – ie that it lets people die without timely treatment. It just isn’t so. I’ve experienced the response to deadly conditions, I’ve talked to many others who’ve done the same. Despite what you’ve probably heard, its very good. Its less good for elective surgery, but I can live (literally) without that.

    I’ve lived in both America and Canada for decades; the only difference I’ve noticed in healthcare is that Canada’s is cheaper. Any differences in outcome, either way, is a few percentage points.

    To be fair, Canadians too think Americans are dying on the streets because they can’t get health care. Maybe that’s inevitable, as people let ideology get in the way of common sense – if you don’t like the ideology of the other system it must be poor, so it must be fatal to get sick or injured under it. Canadians think the American system lets people die untreated. Americans think the Canadian system lets people die untreated.

    Personally I think the best is a mixture of public and private healthcare, like Germany or France, but given a choice between pure public and pure private, I’d go pure public.

    And back to an earlier point – lifestyle is very much part of the Canadian healthcare system mandate. Removing that from the equation is cherry picking; its taking away the benefit of one of their concentrated efforts (yes, it involves legislating things you might not want legislated, but it is effective, and if the citizens don’t mind its a plus, not something to be ignored).

  217. al-Ameda says:

    @jim m:

    But a closely held corporation can have a religious viewpoint as we learned today.

    Yes, corporations are ‘people.’

  218. James Pearce says:

    @Dave Schuler:

    The appropriate way to vitiate this particular decision is by repealing RFRA.

    Too bad we couldn’t just rely on a coherent interpretation of it.

  219. stonetools says:

    @jim m:

    Here is a real economist looking at Avik Roy’s life expectancy argument. He finds that homicides and fatal injuries actually make up a pretty small percentage of all deaths. He then finds fault with the analysis upon which Mr. Roy relies:

    So let’s think this through. What Ohsfeldt and Schneider did was calculate a regression to remove the effects from infant mortality, accidents, assault, etc. from the equation and recalculate the life expectancy (making us first). But there are problems with this:

    Carl Haub, a demographer at the Population Reference Bureau in Washington, D.C., said the method was incomplete. A more-precise analysis would have removed those who died from these causes from overall mortality stats, and then recalculated life expectancy. (For more on how life expectancy is calculated, see this earlier blog post.) “Just because another method is a lot of work, does not mean regression will yield a correct result,” Mr. Haub told me.

    Prof. Ohsfeldt acknowledges that regression was chosen for its relative simplicity for what he called his “little book project.” And he agrees that some deaths that his book attempted to remove from the life-expectancy tables might be dependent on health-care systems.

    OOOPS!

    He concludes:

    Accept it. Even if we look at life expectancy for sub-populations relatively less affected by the reasons people use to try and discredit the metric as a quality measure, we still look pretty bad. Especially when you remember that people in the US over age 65 have much better access to the health care system overall, due to the universality of Medicare. Moreover, even if you argue that the US is more dangerous, then don’t we really need a much better health system to keep us from dying?

    You can’t blame all deaths on the health system, but that doesn’t mean we couldn’t use a much better one.

    So Mr. Roy’s argument isn’t really the haymaker you make it out be . Actual economists-and Mr. Roy is not an economist-debunked the argument back in 2010. It’s essentially one of those right wing zombie arguments that keep coming back again and again, despite being refuted. It was originally made by Betsy McCaughey on the Daily Show. It was refuted then, but Avik Roy slapped a new coat of paint on it and put it out to an eager right wing audience hungry for some shred of rational opposition to Obamacare. Oh well, wrong again, Bob.

  220. anjin-san says:

    @ ElizaJane

    I think I can say, with assurance, that Florack does not give a rat’s ass about your daughter’s health care costs. He is strictly an “I’ve got mine, screw you pal”, kind of guy.

  221. Just 'nutha' ig'rant cracker says:

    @Grewgills: No, he doesn’t need to get out more. All he needs is to keep posting his nonsense so that when guys like you criticize him, he can say to himself “see, they are all out to get me because what I believe is right.”

    @ Eric: I still think you should go back to the more thoughtful stuff that you wrote in the early days of your blog. This stuff is beneath even you.

  222. Eric Florack says:

    @anjin-san: Tell you what, An jin… when you locate a corp that isn’t made up of people, let us know. Meanwhile, stop disregarding their rights.. at least the rights you don’t support.

  223. al-Ameda says:

    @William Teach:

    Can you point out in the Constitution, in particular the 1st Amendment, where any distinction is made between individual citizens and private entities/corporations?
    I didn’t think so.

    Can you point out where in the Constitution the rights of legal entities that are corporations are enumerated, as they are specifically for individuals?

    I didn’t think so.

  224. stonetools says:

    @jim m:

    Cancer happens to provide a really good assessment of the healthcare system because 1) it requires long term care and 2) it involves many disciplines (the typical cancer patient may require consultations from pathology, cardiology, radiology, surgery, nephrology, epidemiology as well as oncology).

    And what about those who cant get that good cancer treatment because they lack health insurance ? That’s when Avik Roy and most conservatives get real quiet and thoughtful. (You yourself have avoided comment about that).
    Here is a study published in the American Journal of Public Heath.

    .

    The study, conducted at Harvard Medical School and Cambridge Health Alliance, found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.

    “The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors, and baseline health,” said lead author Andrew Wilper, M.D., who currently teaches at the University of Washington School of Medicine. “We doctors have many new ways to prevent deaths from hypertension, diabetes, and heart disease — but only if patients can get into our offices and afford their medications.”

    The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking into account education, income, and many other factors, including smoking, drinking, and obesity. It estimated that lack of health insurance causes 44,789 excess deaths annually.

    That’s one of several studies saying that lack of heath insurance leads to more deaths. Experts quibble about the figures, but the consensus is that it’s a significant number

  225. Eric Florack says:

    @anjin-san: a mandate for the church, certainly.
    And that’s why, for example, there are so many catholic hospitals, hospices, etc.
    But he doesn’t say its a mandate for government.

  226. Eric Florack says:

    @wr: No, not ‘BECAUSE WE SAID SO’…. but “the constitution says so. I refer you to the 9th and tenth amendments,

  227. Eric Florack says:

    @stonetools: That makes the assumption that health insurance translates to actual healthcare…. which is a bad assumption under Obamacare

    @wr: No, not ‘BECAUSE WE SAID SO’…. but “the constitution says so. I refer you to the 9th and tenth amendments,

  228. wr says:

    @jim m: “: A corporation is not an inanimate object”

    You’re right — I misspoke. A corporation doesn’t even rise to the level of “object.” It is a legal fiction.

  229. wr says:

    @anjin-san: Although from most of his postings, it sounds more like “I don’t have mine, screw you.”

  230. anjin-san says:

    @ Eric Florack

    Jesus made his thoughts very clear on the subject of compassion and care for the sick and poor. The Pope has reaffirmed this.

    That’s why I am confused when alleged Christians, many of whom seem to hail from the right, take the position that poor people are basically lazy scum that deserve to suffer.

  231. wr says:

    @Eric Florack: “No, not ‘BECAUSE WE SAID SO’…. but “the constitution says so. I refer you to the 9th and tenth amendments,”

    Sorry, but even your boy Scalia ruled out a constitional rationale for this “decision.” It was based solely on RFRA.

  232. anjin-san says:

    @ Florack

    Tell you what, An jin… when you locate a corp that isn’t made up of people

    Wow. That’s stupid, even for you. The army is made of up people, is the army a person? The UC Berkeley Alumni Association is made up of people – is it a person?

    Meanwhile, stop disregarding their rights

    What right of anyone’s have I disregarded? Be specific.

  233. Pinky says:

    @stonetools:

    OOOPS!

    What oops?

  234. An Interested Party says:

    However, if this is merely supporting a lifestyle (i.e. I just don’t want to get pregnant right now) then who the are you to demand that other people pay for your lifestyle out of their pockets?

    Ahh, so men should have to pay for Viagra out of their own pockets…

  235. Kathy Kattenburg says:

    @anjin-san: @Eric Florack:
    “Even absent that, we are talking about on average $9/mo.”

    That is 100% false. God, you’re ignorant. There are at least dozens of different types of contraception and they are not interchangeable. Depending on a woman’s reason for needing to use contraception, and what other health issues she has, and many other factors, the type of birth control method a doctor would prescribe varies greatly in price. You wouldn’t use an IUD if your reason for needing contraception was having PCOS (I’m sure you know what that is, since you’re so knowledgeable about women’s health issues). There are at least half a dozen different kinds of hormonal birth control alone. Some are not advisable to use if you have a family history of breast cancer; some are contraindicated with antibiotics, etc etc. Plus, ALL birth control except for the morning-after pill is prescription-only. So you can’t just walk into CVS and grab the cheapest contraception off the shelf. Do some reading before you pontificate about anything having to do with birth control again.

  236. anjin-san says:

    @ Kathy Kattenburg

    Why are you lumping me in with Florack? Yikes. There goes the neighborhood…

  237. jim m says:

    @stonetools:

    And what about those who cant get that good cancer treatment because they lack health insurance ? … (You yourself have avoided comment about that).

    I haven’t avoided it. Nobody has asked about it. So are you claiming that people on Medicare or Medicaid are not getting good cancer treatment? I actually agree with that if you are because my recollection is that Medicare paid for outdated treatments and did not cover the other treatments (like anti-emetic treatments) that made those outdated drugs more tolerable. But people can get treatment. Years ago when I worked in a bone marrow transplant program we had people whose job it was to find payment for patients. When insurance wasn’t a possibility they worked on charitable sources. We almost never turned anyone away for lack of ability to pay.

    I won’t deny that it doesn’t happen though. But in the US you have options. There are charitable organizations that will help there is the ability to get money from family members etc. The question is how many edge cases are worth disrupting the system for everyone else? Most people can pay. We should be trying to find ways to include the others with the least amount of disruption. Unfortunately, that is not the course that has been taken.

  238. bill says:

    @Jack: they don’t want to hear anything rational today- for some weird reason the gang is all riled up about a virtually meaningless ruling. they take it as an attack on obamacare i think.
    they have fun attacking religious people, they almost don’t see the irony in attacking something that the most religious voting block believes in- and by that i mean “blacks”.

  239. anjin-san says:

    Most people can pay.

    Hmm. I know a guy who’s wife just died of cancer. They both had good jobs and health insurance. Even with insurance and about 75K in generous contributions from friends and neighbors, he is ruined financially due to medical costs. He is 62, too late to start over.

    A decent guy who worked hard and played by the rules. Now he is broken hearted AND broke. It does not say a lot for our system.

  240. Kathy Kattenburg says:

    @anjin-san: I didn’t mean to, an-jin, sorry! I would have taken out your name there if I had noticed it.

  241. steve says:

    “.1) Infant mortality is a political football and is defined differently in nearly every nation.”

    Nope. This has been extremely well studied. The differences are minor. When you look at OECD countries we do not compare favorably and we know that even ascribing the worst possible outcomes to other countries to account for small differences in data collection, we still come out worse. Can provide links if you want.

    2) Cancer outcomes. Dont confuse mortality with survival stats. We might be a bit ahead on some cancers, but not much.

    3) Life expectancy. If you remove fatal accidents, we come out number one. The problem here is that, as most people do not know, you are more likely to die of a fatal accident in a rural area than you are of a homicide or accident in an urban area. Part of the reason for that is that you have access to better medical care in urban areas. (There is a fairly large body of literature on critical access hospitals and the problems they face. Links if you want, though many are behind paywalls. I think I find a few that are reachable when doing research to start a trauma program at our small rural hospital.)

    Steve

  242. beth says:

    @anjin-san: We just went through a 6 month cancer treatment for my spouse. The cost was over $200,000. Insurance covered most of it but the copays,deductibles and loss of wages during treatment took up a huge chunk of our 30 years of savings. But we were the lucky ones. Anyone who blithely tosses off such nonsense as the bs that payment is almost always available simply has no idea what fhey are talking about. There are thousands of people not getting medical treatment because they just can’t afford it.

  243. jim m says:

    @steve: As I point out comparing mortality rates is not simple as that tends to ignore that actual rates of disease, which in the case of cancer are markedly higher in the US than in Europe. People having cancer is not a function of the health system so comparing mortality rates without adjusting for the differing rates of occurrence is meaningless.

    Comparing access to our rural areas to the rural areas of a country like the UK or Belgium is silly. But regardless, most homicides never make it to the hospital. Most fatal injuries are dead before they get there too and that is not a function of living in a rural area. Most homicides are in major cities as are fatal accidents, which tend to be MVA’s and construction. So it is entirely reasonable to omit those from a comparison to other countries, so long as we omit those from the other country data as well.

  244. jim m says:

    @anjin-san: Most can pay. Did I claim all? Nope. Does one anecdotal tragedy mean that we should change everything for everyone? Nope. Yes it sucks and yes there should be a way to help people avoid this sort of problem. One way would be to have insurance do what it was originally intended: save people from catastrophic losses due to medical bills, and not do what we keep wanting it to: pay for every wellness check up, every nick and cut and bruise.

    You can have one or the other but not both. Our society has chosen the latter and your friend is suffering the consequences of that choice.

  245. jim m says:

    @beth: Nothing that anyone is suggesting is going to recover your lost wages. There are precious few plans that will pay that. Most LT disability plans only cover 60-80% of your income. But that is not a health insurance issue per se and blaming the health care industry for that problem is not going to solve it either.

  246. wr says:

    @bill: “they take it as an attack on obamacare i think.”

    Again, I can’t speak for anyone else, but personally I take it as an attack on my religious freedom, on the constitution, and of the values that lie at the heart of the USA. We are not 16th century Spain, and I do not choose to be ruled by the Catholic Church. Or any church, for that matter.

  247. wr says:

    @jim m: “You can have one or the other but not both. Our society has chosen the latter and your friend is suffering the consequences of that choice.”

    Gosh, just about every other industrialized nation has figured out how to “do both.”

    It’s not because we can’t, it’s because our government has been seized — or bought — by people who believe the sole function of the nation-state is to shovel as much of the GDP to its richest citizens as possible.

    You, I suspect, call this “freedom!”

  248. jim m says:

    @wr: You do understand that Hobby Lobby is not owned by Catholics? So this ruling was not of Catholics for Catholics. This was for people with a religious conscience.

    What astonishes me is that leftists think that not having something paid for is equivalent to not being allowed to do it at all. And at the same time they think that allowing someone else to exercise their religion somehow violates their (nonexistent) rights to be free from exposure to religious ideas.

    Funny how tolerance seems to be a one way street.

  249. KansasMom says:

    @jim m: An adult without children doesn’t qualify for Medicaid in Kansas. And since Kansas refused Medicaid expansion I promise you there are poor Kansans not receiving cancer treatment, hell they aren’t even being diagnosed, right this minute. They are too poor to qualify for a subsidy and our governor is an asshole. Your mortality rate is directly related to whether or not you governor is an asshole and you are working poor who has an employer that doesn’t provide insurance.

  250. jim m says:

    @wr: They have figred out how to do both by not doing a whole lot of actually treating people.

    In Toronto the Hospital for Sick Children does bone marrow transplants for kids with leukemia. Years ago I spoke with their transplant team and they lamented the fact that after June they were unable to do any more transplant because they had already reached their budgeted treatments. If your child needed a transplant your only choice was to wait until the next year and hope that they were still alive and healthy enough to get treated.

    In Quebec a man sued the health system for violating his constitutional right to access to health care. The Supreme court in Quebec famously ruled the “Access to a waiting list is not access to healthcare”.

    These systems ration healthcare through waiting lists. So no, they don’t get both in these systems. Not even remotely.

  251. jim m says:

    @KansasMom: I have not claimed that there were no gaps. I have said that turning the entire nation into the VA is not the solution. I also believe that the actual quality of care given is top notch. That is not a problem with Healthcare, it is a problem with paying for it. We should separate delivery from paying for it so we can retain the high quality delivery systems and improve access for people who need it.

  252. anjin-san says:

    Does one anecdotal tragedy mean that we should change everything for everyone?

    This is not “one tragedy” it is on ongoing nightmare for millions of people. Ask Beth. Hard working are being wiped out by illness while the CEO’s of health insurance companies are shopping for their fifth home.

  253. anjin-san says:

    @ jim m

    I have said that turning the entire nation into the VA is not the solution.

    Well, since no one is proposing that, you have nothing to worry about.

    Do you understand what “single payer” means? Apparently not. There are plenty of folks here who can explain it to you, feel free to ask.

  254. anjin-san says:

    @ Jim m

    your only choice was to wait until the next year and hope that they were still alive

    Really? There are no other hospitals in Canada?

    I’m going to suggest that you are simply making shit up.

  255. anjin-san says:

    @ Jim m

    This was for people with a religious conscience.

    I have a religious conscience. Kindly do not presume to speak for me.

  256. wr says:

    @jim m: “So this ruling was not of Catholics for Catholics. This was for people with a religious conscience.”

    If and only if that “religious conscience” objects to certain types of contraception. The five conservative Catholics who made this decision specifically ruled out other types of religious conscience, for instance, that of Seventh Day Adventists. They are priveleging their own religious beliefs above those of any who have different ones, essentially installing conservative Catholicism and certain sects of souther baptism as our state religion.

  257. wr says:

    @jim m: “And at the same time they think that allowing someone else to exercise their religion somehow violates their (nonexistent) rights to be free from exposure to religious ideas”

    Sure, sure, liberals bad, waaah. Heard it all before.

    But for this liberal there is a line between “allowing someone else to exercise their religion” and “allowing someone to force me to live by the rules of their religion, whether or not they bother to follow them.”

    You apparently can’t see the difference.

  258. jim m says:

    @anjin-san: Are you aware that children’s hospitals are actually rather rare things? Bone Marrow transplant programs are even rarer. I am not making things up. It really does happen. Most people are not going to pick up their family and travel cross country to see if they can get treatment. Even if they are willing to do so they cannot afford it and the likelihood is that they will get the same answer.

    You can deny the truth that socialized medicine rations healthcare based on budgetary realities, but it doesn’t change the fact that it is. I have seen that reality in Canada, the UK, Germany and France first hand.

  259. wr says:

    @jim m: “Funny how tolerance seems to be a one way street.”

    Well, I’ll give you this — you held out a lot longer than most “conservatives” before falling back on right wing self-pity. But I guess we all knew it had to come sooner or later. Ultimately, it’s the only possible defense of a morally indefensible ideology — “Mommy, liberals are being mean to me!”

  260. wr says:

    @jim m: ” They have figred out how to do both by not doing a whole lot of actually treating people.”

    Oh, I take it back. Right wing self-pity and flat out lies.

    I’ve spent time in Canada. I know a lot of Canadians. Tell you what, you go up north and you propose to swap their system for ours.

    (Hint: Read up on how to remove tar and feathers…)

  261. jim m says:

    @wr:

    there is a line between “allowing someone else to exercise their religion” and “allowing someone to force me to live by the rules of their religion, whether or not they bother to follow them.”

    I am still waiting for someone to explain how saying that I am not going to pay for what you want to do is prohibiting you from doing it. Care to make an attempt at that? Please explain how anyone is prohibited from obtaining contraception. Explain how an employer is going to stop their employees from using contraception.

    Waiting… Not getting many responses on that other than “it is so expensive to get what I want”. Cry me a river. There are lots of things that I want that I cannot afford. That doesn’t mean that I should have the right to force my employer to provide them.

    Unless medically necessary there is no reason to force anyone to provide this.

    I hear a lot of BS about how your rights are being infringed upon, yet I cannot see any evidence that any rights are being infringed upon. I see lots of evidence that people feel entitled to lots of free stuff.

  262. jim m says:

    @wr: Morally indefensible? Tell me how morally defensible asking people to pay for your lifestyle is. Don’t go crying about how your rights are being infringed upon until you can demonstrate how this ruling allows employers to regulate the private lives of their employees and prohibit them from using contraception and pay for it themselves.

    Oh, I see, it is really about getting a free ride to pay for your lifestyle Where does that appear in the Constitution? You seem to confuse civil rights with a free ride. They aren’t the same thing.

    And it is not self pity. I just point out to you that your ideas are simply falsely branded. When you demand tolerance what you really demand is having your way and not being exposed to other ideas.

    If you really believed in tolerance you would try to find a comon ground and try to find a way for people to preserve their religious views and also accommodate other people’s desire for access to contraception. But that was never what you wanted. All you wanted was to get your way. Tolerance is not about getting your way. it is about accepting the fact that you cannot always have your way and not getting all cranked about it.

  263. wr says:

    @jim m: “You can deny the truth that socialized medicine rations healthcare based on budgetary realities, but it doesn’t change the fact that it is. I have seen that reality in Canada, the UK, Germany and France first hand.”

    And apparently missed that reality right here. Tell me, what happens to a kid with two minimum wage earning parents who needs a bone marrow treatment in Kansas? Oh, wait, you already solved that for us — he can appeal to his friends to chip in for him! Maybe if they all pool their minimum wages, they can help out! Or they can do what Mitt Romney suggested — get a loan from Mom and Dad. Because everyone has a mom or dad who’s rich, right? Or maybe Mom and Dad can beg at freeway entrances.

    But you’re right about one thing. If the child of a billionaire in this country needs a bone marrow transplant, that kid is going to get it in his choice of flavors. We have the best health care in the world for really rich people. If you’re not rich, and if you live in a state with a psychopathic governor, well, you die.

    But unlike your case in Canada, that’s just an anecdote, right?

    Every system rations care. We choose to ration it so that the super-rich can have whatever they want, and the poor are free to die in the street. I believe there are better ways – including the Canadian and British and French systems.

    \

  264. KansasMom says:

    @jim m: The VA is highly rated by the participants. Just like Medicare. And Medicaid. Sucks there are no share holders to pay off though.

  265. Kathy Kattenburg says:

    @jim m: Contraception IS medically necessary for the millions if women who use it, Jim. So you just gave us the retort to your own invalid point.

  266. wr says:

    @jim m: “Tell me how morally defensible asking people to pay for your lifestyle is”

    We’re actually talking about employees’ compensation packages, which Hobby Lobby just cut because of their deep moral sense. Maybe you think that employees are all moochers stealing from their bosses, but most people would find that a ludicrous notion.

    “Oh, I see, it is really about getting a free ride to pay for your lifestyl”

    So the employees don’t work? They’re just getting handouts from those lovely people who own the company?

    Or are you just another Republican who loathes people who actually work for a living and worships the useless speculators?

    Either way, I hope that when you’re out looking for a new job, as you said you were, you explain to your prospective employers that you don’t think you should be paid for any work you do, as that would be getting a free ride.

  267. jim m says:

    @KansasMom: I know of no one that wants to rely upon the VA for anything serious. My father uses it for his hearing aids and is very satisfied. But when it comes to his heart condition he avoids it like the plague. I suggest asking all the dead people who were waiting for treatment what they think. Oh yeah, you can’t.

  268. wr says:

    @jim m: “When you demand tolerance what you really demand is having your way and not being exposed to other ideas.”

    Is that the new Republican phrase for slashing an employee’s benefits package — “exposing them to other ideas”?

    I’ve heard these brilliant ideas, by the way. They decide that all science is wrong and they are right, because that’s what they choose to believe. Truly I am impoverished by not studying them further.

  269. wr says:

    @jim m: “If you really believed in tolerance you would try to find a comon ground and try to find a way for people to preserve their religious views and also accommodate other people’s desire for access to contraception.”

    Well, here’s some common ground. Since these fine religious people never had a problem with their employees’ insurance package covering contraception until it had the “Obamacare” label stuck on it, and since they apparently have no problem owning shares in the companies that make these drugs, and since they have no problem dealing with the Chinese government despite its history of forced abortions, I’m going to say they can preserve their religious views by taking their noses out of the way other people live their lives.

  270. al-Ameda says:

    @jim m:

    and the one that Buzzy Ginsberg

    I believe her name is “Ruth.”

  271. wr says:

    @jim m: ” My father uses it for his hearing aids and is very satisfied. But when it comes to his heart condition he avoids it like the plague.”

    Well, at least you’re above arguing via anecdote, unlike all those mean liberals you chided for doing that.

  272. beth says:

    @jim m: So I guess that explains the clamoring in those countries to switch to the U.S. system of health insurance….oh, wait.,, nevermind.

  273. Eric Florack says:

    @Grewgills: actually, no.
    That was the nationwide WAL Mart Pharmacy price.

  274. jim m says:

    @wr:

    Maybe you think that employees are all moochers stealing from their bosses, but most people would find that a ludicrous notion.

    No i don’t think that, but then I also do not have the illusion that health plans are immutable and never change. I have had employers change health plans almost annually and never to my advantage. Did I like it? Nope. Did it contribute to my leaving? Yep.

    So the employees don’t work? They’re just getting handouts from those lovely people who own the company?

    Employees work. But what we are talking about here is whether or not you have a constitutional right to contraception. You don’t. It really isn’t any more complex than that. Nor do you have a constitutional right to healthcare. It isn’t in there and the court has never construed one. Furthermore, the refusal of an employer to provide a benefit does not amount to them stopping you from accessing it. No one has yet to show how Hobby Lobby employees are prevented by their employers from getting contraception on their own. I have asked and asked and not one of you has taken up that challenge.

    Or are you just another Republican who loathes people who actually work for a living and worships the useless speculators?

    No. I actually work for a living. I loathe freeloaders who refuse to take responsibility for their own lives and expect everything to be handed to them on a platter. I haven’t had everything handed to me and I think people demanding this sort of thing are childish and ignorant.

  275. jim m says:

    @beth: I have worked in hospitals were we had VIP wards for people flying in to receive treatments, so yes people really are clamoring to come to the US for treatment.

    I will simply note that Fidel Castro did not use that vaunted healthcare system in Cuba, he fled to Spain for his therapy.

    People really do flock to the US for healthcare. If you have never worked in a university hospital you might not have noticed but I have and I have worked with many university hospitals and the reality is that they all receive a significant number of people who travel from all over the globe to receive treatment in the US.

  276. jim m says:

    @wr: If they really did not know that their plan covered contraception beforehand I can accept their current position. But I agree with you that if they knew about it before they should have no right to refuse to pay for it now.

  277. Eric Florack says:

    @anjin-san: If you think its none of the employers business, why deman employers pay for it?

  278. beth says:

    @jim m: Yes, rich people. Rich foreign people can get great care here, just like rich Americans can. It doesn’t solve the problem if you’re not rich. I would think the 99% in the rest of those countries like their health care system just fine and don’t want to have anything to do with the U.S. style system. You absolutely cannot compare the care the 1% get to the care the 99% gets. It’s a completely ridiculous argument.

    And there’s also a very growing industry of American medical tourists who have to go overseas to get operations they can’t afford here.

  279. Kathy Kattenburg says:
  280. wr says:

    @jim m: “I haven’t had everything handed to me and I think people demanding this sort of thing are childish and ignorant.”

    Oh, we know. You built it all yourself, never relied on another person, never took a benefit from any government, and you’re building a house in Galt’s Gulch as we speak. We all tremble in awe.

  281. jim m says:

    @Kathy Kattenburg:

    I take it you’ve never heard of Griswold v. Connecticut.

    Yes, where the SCOTUS ruled that a person has a right to privacy and that the state could not outlaw contraception. That has no relation to this case as nothing in this case prevents people from using contraception of any kind.

    There is a difference between having someone pay for your contraception and having someone prevent you from ever using contraception.

  282. wr says:

    @jim m: “If they really did not know that their plan covered contraception beforehand I can accept their current position”

    Right, This is a huge issue of religious conscience to them, so important they’ve got to fight it to the Supreme Court, because forcing them to pay for their employees contraception is straight from the pit of hell. It’s just not important enough to them that they ever bother to ask their insurance agent if it was covered.

    I’m really convinced.

  283. jim m says:

    @beth:

    I would think the 99% in the rest of those countries like their health care system just fine and don’t want to have anything to do with the U.S. style system.

    Actually, surveys of Americans show that the overwhelming majority of Americans were satisfied with their healthcare. Most of the concern has always been for other people, for the uninsured. People who have insurance have always surveyed as satisfied with their plans. It does not surprise me that people elsewhere are satisfied with their health system as the majority of people do not really call on it for much, if anything.

  284. jim m says:

    @wr: If you can prove that they knew about it beforehand I will agree with you.

    However, for other employers who were not providing this coverage beforehand I believe that they should still have this right.

  285. beth says:

    @jim m:

    People who have insurance

    Until they lost their job, or got denied for a heart operation because they had acne as a teenager, or had their policy cancelled because they spelled their middle name wrong on the application. Do you even live in this country? How can you possibly be so out of touch?

  286. KansasMom says:

    @jim m: What do you mean by lifestyle? Having sex is not a lifestyle. It is normal human behavior. Are you a robot? Do you not crave contact? Sex is not some icky thing only to done with an intent to conceive. It’s fun, it’s rewarding, it’s healthy. You kinda freak me out, I’m envisioning Crazy Eyes

  287. Andre Kenji says:

    I live in Brazil, that has a GDP per capita that´s more than half of the GDP per capita in Mississippi and West Virginia, the two poorest American states. I know LOTS of low income people, including people with chronic diseases. I don´t know anyone that was forced to sell or to savage their savings accounts to pay medical bills.

  288. Kathy Kattenburg says:

    @jim m: Right. Only not being able to afford it. And since it is a constitutional right, not being able to afford it is a problem.

  289. george says:

    @jim m:

    You’re right, Canadians are dying on the streets for lack of medical treatment. That’s why I died in the car accident I described.

    Its just that we’re reborn a number of times, so our overall life expectancy is about the same (actually longer) than the US one. Seriously, why do you think not even the Conservative Party in Canada wants to talk about getting rid of the public option? Because Canadians are secretly suicidal and want a health care system which can’t help them when their life is a risk? The reason only 5% of the Canadian population wants to get rid of the public option is because it works very well for critical cases. It doesn’t do so well for optional surgery, so many (including myself) would like a private option as well, such as in Germany or France.

    Yes, there are cases in Canada which fall through the cracks. As in the US. Having lived in both for decades, the only difference is the cost. And the Canadian system is cheaper by every stat I’ve seen.

    I’m not suggesting you come to Canada and get into a near fatal car accident to see the health care system here in action, but I suspect you might change your opinion on how well it works if you did so. You might still prefer the American system, but at least you wouldn’t be talking nonsense about the Canadian system.

  290. KansasMom says:

    @jim m: I’ll talk to my step-dad about it this weekend. But my little anecdote can’t compare with decades of statistics. I like math.

  291. anjin-san says:

    There is a difference between having someone pay for your contraception and having someone prevent you from ever using contraception.

    No one is asking employers to “pay for contraception” – health insurance is compensation, not a gift. It is earned by the employee. Do you let your employer tell you what you can spend your paycheck on?

    If you have to make crap up to support your argument, you are making a lousy argument.

  292. beth says:

    @anjin-san: That’s what’s always been so weird to me. Whenever I took any medication, be it an antibiotic or birth control or whatever, I never once thanked my employer for paying for it. It was covered under my insurance, which was part of my compensation (and which I paid a portion of also). Do you suppose this guy writes his employer a thank you note every time he goes to the doctor?

  293. anjin-san says:

    surveys of Americans show that the overwhelming majority of Americans were satisfied with their healthcare.

    Got links? Also, we need to understand the difference between “healthcare” and “health insurance.” I’ve alway been pretty happy with my healthcare. I live in a high wealth area, lots of good doctors and hospitals.

    Health insurance? That’s another story? I’ve had to go to war simply to get things that are covered paid for. I’ve been told that my out of pocket for a surgery would cost one thing, had the surgery, then been billed quite a bit more than the agreed upon price. When I took issue with that I was told “you don’t want to pay? Fine. We will ruin your credit rating.” Being over billed (never under) happened all the time. I’ve had people in hospital billing departments tell me flat out lies.

    Finally got fed up and switched to Kaiser. 90% of the problems went away.

  294. anjin-san says:

    @ Florack

    If you think its none of the employers business, why deman employers pay for it?

    Like I told the other guy:

    A. Health insurance is Compensation, not a present. It’s earned. It belongs to the employee. Employers are not “paying for” an employee’s health insurance, any more than my clients are paying for my mortgage.
    B. Again, why is this any of the employers business? Does an employer get to tell an employee how his paycheck is spent?

  295. EddieInCA says:

    Strictly anecdotally….

    My wife… who doesn’t really follow politics… signed up today to volunteer for Allison Grimes, Kay Hagan, Wendy Davis, and Michelle Nunn. All four of them. Today.

    We live in California. That’s how pissed off she is.

    And she’s not alone.

    I’m thinking this decision might end up being positive for the GOP like Prop. 187 was for them in California.

  296. anjin-san says:

    @ jim m

    Tell me how morally defensible asking people to pay for your lifestyle is.

    This is beyond stupid.

    If we employ your reasoning, why should employment based health care cover and health consequences from smoking, drinking, eating meat an fast food, drinking soda pop, playing sports, swimming, hiking… well, you get the idea, don’t you? These are all lifestyle choices, after all.

    And, as another commentator pointed out, having sex is not a “lifestyle choice”,

  297. anjin-san says:

    @ EddieInCA

    Glad she is getting more involved. Women should be pissed off.

  298. Scott O says:

    @jim m:

    So explain how it is that when you exclude homicide and fatal injuries that the US has the highest life expectancy of any OECD nation. I suppose it is because of our horrible healthcare system.

    Others have addressed this already but I can see an obvious reason to question that study. I do understand that people dying in their 20s from murder or accidents will have a big impact on average life expectancy. If the US has a higher percentage of such occurrences then it would be fair to take that into account when using life expectancy as a measure of the quality of a health care system.

    That said, let’s look at some of the numbers in the article you linked to. Including fatal injuries, Japan 78.7, Iceland 78, US 75.3. Without fatal injuries, Japan 76, Iceland 75, US 76.9. We’re #1! Because fatal injuries in Japan and Iceland increase their life expectancy and fatal injuries in the US decrease our life expectancy. Does that make any sense to you?

    The article sort of addresses this:

    “UPDATE: A number of mathematically astute readers have asked why some countries have increased average life expectancies once you take out fatal injuries. I asked Robert Ohsfeldt about this, who responded that the adjustment factor was based on fatal injury rates relative to the average. Hence, the adjusted numbers shouldn’t be seen as hard numerical estimates of life expectancy, but rather as a way of understanding the true relative ranking of the various countries on life expectancy excluding fatal injuries.”

    I think he meant decreased, not increased. I haven’t read the 33 page pdf . Maybe they’ve got a good explanation of how the came up with these numbers but I’ve got to say that it smacks of statical massage. As the old saying goes, figures don’t lie but liars sure can figure. Not saying that’s definitely the case here, just that I’m skeptical.

    One more point. Legitimate arguments can be made as to how well the quality of our health care system compares to others. I don’t think the differences are large. But we spend much more. That alone seems to me to be a good reason adapt what has worked well in other countries.

  299. Scott O says:

    @Scott O:
    Correction: Without fatal injuries, Japan 76, Iceland 75 76.1, US 76.9.

  300. anjin-san says:

    @ jim m

    Are you aware that children’s hospitals are actually rather rare things

    Are you aware that hospitals that are not children’s hospitals actually do treat children? Apparently not.

  301. Matt says:
  302. C. Clavin says:

    @KansasMom:
    No… For Republicans sex is only about pro-creation.
    Anything beyond missionary for the purposes of having a child is a dirty lifestyle choice.

  303. C. Clavin says:

    An illustrated guide to personhood in America.
    https://mobile.twitter.com/bakerbk/status/483642132750553090

  304. Grewgills says:

    @jim m:

    I know of no one that wants to rely upon the VA for anything serious.

    My father, my uncle, my hanai uncles all rely on the VA for all of their major healthcare and all of them have been getting excellent care and are satisfied with the care they have gotten. All of them are in their 60s and older, so have had more than a few incidents that needed taking care of. I know enough people in the system to know that claims that it is crap everywhere are crap.

  305. Grewgills says:

    @Eric Florack:
    You do realize that the lowest priced generic doesn’t work for millions of women? When we first moved here on our savings with no job and no insurance my wife got her birth control from planned parenthood and the cheapest thing they had available that would work for her was $40/month. Fortunately we had saved enough that that was an option and within a couple months we were both employed and my employer covered us. A lot of people aren’t so lucky.
    Why are you so invested in expanding the personhood of a legal fiction used for business transactions?

  306. Grewgills says:

    @jim m:

    But what we are talking about here is whether or not you have a constitutional right to contraception. You don’t. It really isn’t any more complex than that. Nor do you have a constitutional right to healthcare.

    Actually no, that is not what we are talking about. The ACA required the contraceptive coverage and Hobby Lobby argued that the RFRA superseded that. The Hobby Lobby decision didn’t rest on constitutional issues, it rested on legislative issues. As much as you might wish it was, this is not a 1st amendment case.

    No. I actually work for a living. I loathe freeloaders who refuse to take responsibility for their own lives and expect everything to be handed to them on a platter. I haven’t had everything handed to me and I think people demanding this sort of thing are childish and ignorant.

    Anyone who has grown up and been educated in this society or any Western democracy and thinks they haven’t had anything handed to them is childish and ignorant.

  307. bill says:

    @wr: it’s a bit of an over-reaction i think- nobody is forcing anyone to work at hl let alone go through the torture of having to pay for contraception (which is cheap anyway). it’s not like a huge expense is being placed on anyone despite the “free stuff” mentality of some people. all this squawking about a minor issue, it’s like gun control & bergdahl all rolled up into one event.

    @EddieInCA: she should see which way the wind is blowing before getting all soppy with wendy davis- her views change daily and she’s just a speedbump now.

  308. C. Clavin says:

    @bill:
    First…not all contraception is cheap. Especially some of the things used for reasons other than contraception.
    Second…this ruling applies to 90% of the companies in this country, and over half the work-force. So it’s not about HL alone.
    So based on those facts I can only assume you will change your opinion…as it is based on mis-information.
    Right…..

  309. C. Clavin says:

    @Grewgills:
    I can only assume, based on his comment…

    No. I actually work for a living. I loathe freeloaders who refuse to take responsibility for their own lives and expect everything to be handed to them on a platter. I haven’t had everything handed to me and I think people demanding this sort of thing are childish and ignorant.

    …that he is going to wave his health care subsidy, his housing subsidy, SS, and Medicare.

  310. Rafer Janders says:

    @C. Clavin:

    No, no, he EARNED those things. He’s not like those other freeloaders….

  311. stonetools says:

    About jim m’s “lifestyle choice” crack, does he understand that married women use contraception and have sex with their husbands beyond the need for procreation? And that their husbands actually prefer that?
    I guess those married women are sluts asking Jim m to subsidize their oversexed lifestyle too.

  312. beth says:

    This tweet from one of the leading voices on the right tells the truth – it’s always been about the sex, it has nothing to do with women’s health.

    Erick Erickson ✔ @EWErickson
    Follow
    My religion trumps your “right” to employer subsidized consequence free sex.
    11:02 AM – 30 Jun 2014

  313. Rafer Janders says:

    @beth:

    “Employer-subsidized”? It is possible for these people to get it into their heads that health insurance is COMPENSATION FOR LABOR PERFORMED, and thus no more “employer-subsidized” than a cash paycheck? Unless, you think, that I’m also eating employer-subsidized food and wearing employer-subsidized clothes and attending employer-subsidized concerts etc. etc…..

  314. al-Ameda says:

    @Andre Kenji:

    I live in Brazil, that has a GDP per capita that´s more than half of the GDP per capita in Mississippi and West Virginia, the two poorest American states. I know LOTS of low income people, including people with chronic diseases. I don´t know anyone that was forced to sell or to savage their savings accounts to pay medical bills.

    Are you implying that Brazil doesn’t want to change their health insurance system to a market-based system that is many times more expensive and results in 15% of the population uninsured? What’s wrong with Brazil?

  315. Pinky says:

    @jim m:

    There is a difference between having someone pay for your contraception and having someone prevent you from ever using contraception.

    Ding ding ding ding ding! There’s a line in The Once and Future King, “everything not forbidden is compulsory”. It’s one of the rules in the society of the ants. A thing can’t be in the gray area, it’s got to be federally-guaranteed or banned.

  316. Rafer Janders says:

    @Pinky:

    Except that employer-mandated health insurance is NOT “having someone pay for your contraception.” YOU pay for your contraception via the labor you perform for compensation.

    If I work at a job and utilize my health benefits for contraception, that’s no more my employer “paying for my contraception” than it would be my employer “paying for my whiskey” if I go to a bar and pay with cash from my paycheck. All the employer is paying for is the employee’s LABOR — the compensation for that labor, once performed, is hers.

  317. C. Clavin says:

    @Pinky:
    There’s a difference between having someone impose their religious beliefs on you and America.

  318. Pylon says:

    Jim, Jim, Jim. No one waits 3 months for chemo in Canada. You get diagnosed with a treatable cancer, you start that day.

    There is no budgeted amount for specific medical procedures at any hospital. Let alone bone marrow transplants. That’s not how medical budgets work. And guess what? There are plenty of children’s hospitals, and guess what? Even non-children’s hospitals can do bone marrow transplants.

    When you want to make shit up, know your audience.

  319. Eric Florack says:
  320. george says:

    @Pylon:

    Jim, Jim, Jim. No one waits 3 months for chemo in Canada. You get diagnosed with a treatable cancer, you start that day.

    I suspect he’s simply not going to believe you. He’s like some of my relatives in the US who don’t believe I didn’t have to wait for days in a hospital hallway before being treated after a severe auto accident – the GOP story that Canadians are dying in the streets for lack of medical care trumps any and all evidence to the contrary, and the few cases that fall between the cracks (as also happens in the US) are taken as the norm. The belief seems to be that Canadians enjoy dying in accidents and from disease, and so cling to public health despite the corpses piling up on our streets.

    Though I will add that Canadians have the same misconception about the US, that people are dying in large numbers without seeing medical care. How either opinion passes the common sense test eludes me.

    My experience, and the stats, show that the differences in outcome are a few percentage points one way or another, but that the Canadian systems costs far less.

  321. Pinky says:

    @Rafer Janders: Doesn’t the fact that the employer is required to pay for it enter into it? Or the fact that up until a few years ago he wasn’t? Or, for that matter, isn’t the whole point of the ACA (at least on the private side) to specify that payments are made in the form of specific types of health care? Those things would seem to put health care in a slightly different category than cash payments. The fact is, companies were not given the option of giving cash to their employees, or giving them coupons usable for health care or whiskey (I think that was your example). Employees weren’t given the option of asking for cash or coupons.

    As a matter of law, if you say you’re sick of your wife and I give you $500, that’s ambiguous, even if you use it to go buy a gun. If you say you’re sick of your wife and I give you a gun, that’s unambiguous. I mean, it’s foreseeable that if your employer pays for your insurance which covers contraception, then you could buy contraception with it, right? It’s to some extent – we can argue about the extent, but it’s to some extent – analogous to the company being required to purchase contraception. I can’t imagine you’re arguing otherwise. Are you? Maybe I’m missing something.

  322. C. Clavin says:

    @Eric Florack:
    The three biggest lies you link to are all based on mis-interpretations and mis-information…lies.
    I was admonished above for attacking a comment based on the source alone.
    But when you see some of these sites…like the Newsbusters site you link to…you can automatically just assume it’s based on total BS.
    Past record generally means something.

  323. Tillman says:

    Before this thread goes into the dustbin of the archives, I realize I never answered something profoundly important.

    @jim m:

    Is it? I don’t know SCOTUS history that well. I assume you must be a legal historian.

    You don’t have to be a legal historian to recognize that narrow rulings in the vein of the Hobby Lobby decision regularly open the doors for further cases using the same, supposedly-limited-to-this-one-instance logic that later go on to expand the original ruling’s domain.

    Lawrence v. Texas explicitly said in its majority opinion:

    The present case does not involve minors. It does not involve persons who might be injured or coerced or who are situated in relationships where consent might not easily be refused. It does not involve public conduct or prostitution. It does not involve whether the government must give formal recognition to any relationship that homosexual persons seek to enter.

    However, the same reasoning Kennedy used in Lawrence was applied when they decided United States v. Windsor ten years later when he spoke of moral and sexual choices made by couples. Lawrence, by making sodomy laws unconstitutional, opened the legal doors for a suit such as Windsor agitating for equal status as citizens to even take place.

    We’ve seen gay marriage quickly flip from a radical idea in early 2000 to fast becoming a reality in the present day. A narrow ruling that relies on this-time-only logic will not be contained to the situation it was crafted for. Lower courts will use the logic in their decisions, as they did with Lawrence and Windsor, and open the floodgates further for greater corporate religious rights.

  324. Rick DeMent says:

    @Jenos Idanian #13:

    Feel free to make such arguments. But unless you have a well-established history of those beliefs, and those beliefs have a significant number of believers, be prepared to be called out for your bullshit.

    Really … tell me what Christian Religion holds you accountable to madtes by the government. Also tell me how sincere their beliefs are given the fact that the have and continue to invest in market funds that have contraceptive manufacturers as part of their portfolio? I really wish the government would have went farther down this road. What faith are they specifically, and what in their creed would have said that by complying with a government run health care bill would they be held accountable by God for how their employees used that benefit.

  325. C. Clavin says:

    @Rick DeMent:

    and continue to invest in market funds that have contraceptive manufacturers as part of their portfolio?

    Also…a huge amount of the stock on their shelves is labeled “Made in China”.
    China…where there have been more than 300 million abortions in the last 40 years.
    China…where labor rights violations, rock-bottom wages, grueling hours in prison-like conditions and extreme poverty are standard operating procedure.
    Apparently the Christ these so-called Christians believe in has nothing to do with the one in the bible…the one who railed against those working in Chinese factories and having abortions because of Government mandated family planning.
    The owners of HL are raging hypocrites…and for the SCOTUS to take their arguments at face value is a travesty of justice.

  326. Monala says:

    @Pinky: Doesn’t the fact that the employee pays for their own health insurance enter into it? I haven’t heard that Hobby Lobby offers Cadillac plan insurance–something that few employers offer in the U.S. anyway, and almost certainly no minimum-wage retailers (correct me if anyone knows otherwise). Which means that it’s likely that HL employees are paying at least a portion of their premiums, and probably co-payments and deductibles, out of their own wages. So we have, from the perspective of the employee, their compensation (insurance is a form of compensation), paid often in large part by their wages (in the form of premiums, deductibles and co-payments), for their healthcare. Why does the employer get to trump all that?

  327. Monala says:

    @Pinky:
    The fact is, companies were not given the option of giving cash to their employees

    Sure they were. Companies don’t have to offer insurance–they can settle for paying the fine. Was it Trader Joe’s that decided that it was cheaper to drop their health plan, pay the fine and give their employees cash to buy insurance on the exchanges?

  328. anjin-san says:

    @ Manala

    Why does the employer get to trump all that?

    Because Hobby Lobby is now a special, protected class – something conservatives claim they despise. But I guess that changes depending on what side of the fence you occupy.