Stupak might reduce abortion insurance coverage, but not accessibility
November 18, 2009
A new study from the George Washington University School of Public Health and Health Services reports that “the Stupak/Pitts Amendment will have an industry-wide effect, eliminating coverage of medically indicated abortions over time for all women, not only those whose coverage is derived through a health insurance exchange.”
In other words, though the immediate impact of the Stupak amendment will be limited to the millions of women initially insured through a new insurance exchange, over time, as the exchanges grow, the insurance industry will scale down their abortion coverage options until they offer none at all.
Do people not understand that abortions will remain legal and available even if this change occurs in the insurance industry? And that third-party payments for abortions have probably driven the prices up? And that if everyone who wanted an abortion were choosing her own provider and paying out of pocket, then the price of the procedure would probably drop? And maybe even it would be cheaper to just pay for an abortion than to buy a policy that covers abortions?
Just sayin’.
unintended consequences: Stupak Amendment & miscarriages edition
November 11, 2009
One of the most interesting things I have read about the Stupak Amendment is this:
Will the Stupak Amendment Affect Insurance Coverage for Miscarriages? I Think So
Sadly, the author experienced a miscarriage recently. In her case, as sometimes happens, the fetus had yet to be expelled. She was put in the difficult position of either waiting for that to occur naturally, or choosing either a chemical abortion or D&C. Each had different risks and costs. The author, like many women who miscarry, chose to undergo the procedure.
Although the fetus is this sort of case is deceased, there is some question (and dispute) as to how the procedure to remove it is typically described medically, or how it is supposed to be documented. It may be described as an abortion. If so, then the Stupak Amendment (which I wrote about earlier this week) would forbid public funding of these procedures even in the case of miscarriage.
It is doubtful that even the most ardent of pro-lifers intended to limit access to post-miscarriage medical care. The mainstream feminists who claim that generous reproductive care, including abortion, is a non-negotiable when it comes to health care reform are using this unintended consequence as evidence that the government should generously fund care but stay the heck out of decisions between a woman and her doctor.
However, that position is not politically viable right now. And, I was taken aback at the naïveté of one commenter who wrote to the OP: “Your eloquent post points out the problems when legislators do not adequately consider complex issues.” The legislators are trying to consider complex issues, but no result will ever be satisfactory to everyone, and there will always be unintended consequences. If they try to write in miscarriage exceptions to Stupak, the pro-life contingency will object that such measures will be used to cover up actual abortions with miscarriage paperwork. Or, women will start trying to induce miscarriages themselves at home, so that the care afterward will be covered by their publicly funded health plans.
There will not be any no strings attached public funding of reproductive health care anytime soon. Whether you are pro-choice or pro-life, take a look at how legislative bodies have always functioned in the past, and take a guess as to whether you will be happy with how they handle bungle this one.
thoughts on NOW and the Stupak Amendment
November 9, 2009
Disclaimer: I haven’t been following the health care stuff too closely, because it is exhausting, but this particular aspect interests me.
The National Organization for Women is very upset because the Stupak Amendment passed and is part of the health care bill that passed the house the other day. According to the NYT, the Amendment “would impose tight restrictions on abortions that could be offered through a new government-run insurance plan and through private insurance that is bought using government subsidies.” According to the LA Times,
The compromise amendment, offered Saturday by Rep. Bart Stupak (D-Mich.), in effect bans abortion coverage by all plans that are purchased using taxpayer dollars. Abortions could still be obtained by policyholders who pay their entire premiums without government assistance or by individuals receiving federal subsidies in the event of rape, incest or danger to the mother’s life.
Since the Amendment was included in the bill that was passed last night, NOW sees this as a “bill that strips millions of women of their existing access to abortion.” More from NOW:
NOW calls on the Senate to pass a health care bill that respects women’s constitutionally protected right to abortion and calls on President Obama to refuse to sign any health care bill that restricts women’s access to affordable, quality reproductive health care.
NOW is so into universal health care, but then they act all surprised and indignant when the political processes which govern the birth of any such scheme return a result which – surprise! – reflects the preferences of the sizable pro-life constituency in this country. Just imagine: If you (or your constituents) thought that abortion was murder and therefore the very antithesis of health care, you would vote to minimize directly or indirectly state-funded abortions, too.
Furthermore, it’s unwise for NOW to keep pressing the point that the Amendment keeps women from using “their own money” to access abortion care. It’s not clear whether NOW is counting federal assistance as “their own money” (I think they are). But, even if they’re not, it’s important to remember that this hugely expensive (don’t even try to deny it) plan does lots and lots of things with money that belongs to other people. So while women seeking abortions may be prevented from spending their money in that way, there are tons and tons of taxpayers who are also prevented from spending their money in ways of their choosing. The “their own money” point does not support opposition to this particular bill, it supports opposition to expanding the government’s role in health care in the first place.
Finally, obviously this Bill is not itself an amendment to the constitution and it does not abridge the right to have an abortion. True, it would not in theory respect a right to have an abortion on the government’s tab, and thereby on the tab of pro-choicers, but no such right exists. The Stupak Amendment seems to be the logical extension of the Hyde Amendment, which has long prohibited the funding of abortion using federal Health & Human Services monies. Since now a more expansive health care program is on the table, a more expansive abortion funding policy is needed.
(Of course, I am still ardently pro-choice, and always will be. But nothing regarding positions on the state funding of abortions follows merely from that).
Editing to add: Megan McArdle has some cogents thoughts on this matter in this post: The Health of the Nation
retroactive legitimization of regulation
November 8, 2009
This NYT article caught my eye: New York’s Cabbies Like Credit Cards? Go Figure
New York’s cabbies howled when the city began forcing them to take credit cards. Some even went on strike, calling the requirements a kowtow to tourists and a burden on drivers.
But two years later, the back-of-the-cab swipe has emerged as an unlikely savior for New York’s taxi industry, even as other cities’ fleets struggle to find fares in a deep recession.
Overall ridership and revenue have increased. More and more fares are being paid with credit cards, even for shorter rides. And tips for drivers, usually an early casualty of tough times, are up sharply, double over the pre-plastic days.
Even cabbies are conceding that credit cards are good for business. “It’s better,” said Naveed Shah, 35, a driver for five years, as he gassed up his Ford Crown Victoria recently. “If there was no credit card, people aren’t going to take taxicabs.”
The tone of this article concerns me. The author and the cab drivers themselves seem to have the attitude that the regulations were, on balance, a good thing. That’s because at least some of the taxi drivers admit that they were wrong to resist the regulations, that they boosted business, and that the government really did know best. But that is really besides the point. It is a business owner’s right and responsibility to make business decisions, such as whether to install credit card processing equipment and on what terms. Sometimes business owners make these decisions well, and other times they don’t. The refusal of some cabs to accept payment via credit card violated no one’s right and posed no threat to public health or safety. Thus, no regulation was justified. The cab drivers’ ultimate endorsement of the credit card readers is neither here nor there. It does not retroactively legitimize the regulation.
business-izing higher ed: I’m not scared
November 6, 2009
A few days back, this post about higher ed in the UK appeared over on one of my favorite blogs, Feminist Philosophers. Here’s the big quote: “Business secretary wants students and parents to be treated more like customers in proposals to overhaul higher education.”
The original poster worries that “universities get put under a great deal of pressure to produce a product that can be recognized by the consumer, and that tends to lead to, among other things, massive grade inflation and all that entails, which is a sense that money is just about enough to entitle a student to be called educated.” Other commentors worry about capitalism in general, the commodification of education, taking the spirituality out of educational practices, etc etc.
Maybe my thinking on this matter is too simplistic / idealistic / naive / uninformed by experience working in academia / or something. But I tend to see things this way:
If you are trying to sell something, and people don’t want it, the answer is not to make them buy it, but to sell something else.
People with academic credentials are going to have to get more creative in selling their labor to universities, and perhaps more and more to other entities like non-profits, political groups, private schools, etc. This will not be wholly successful, and some academics will be unemployed. But guess what, that’s already the case, particularly in the humanities where the job markets have been dismal for some time and have lately only been getting worse. The face of academia will change, in some ways we can predict and in other ways we can’t. If a degree really can just be bought outright, it will no longer have much value in tracking who is qualified to work in what field, and the system will change again.
Change will, of course, continue to occur across all sectors of society, and I am consistent in my belief that responsibility falls upon workers to adapt accordingly. Providing support to factory workers or administrative assistants whose skills are no longer relevant only postpones beneficial improvements in technology and productivity at sometimes great cost (I suggest that you read Economics in One Lesson by Henry Hazlitt if you don’t understand why). Producing sound social policy is a balancing act, and other concerns, such as those for the unemployed’s immediate welfare, might sometimes take precedence. But we ought not to speak or act as if maintaining endangered jobs or industries is an unequivocal moral or economic good.
It’s one thing to engage in some consciousness raising to show others why one’s work is valuable. In the case of philosophy, for instance, this might involve efforts to get people to recognize that it is not just mind games and has practical value (hello, business ethics and bioethics!) But that is very different from trying to get the government to prop up one’s way of life using the money of others. Academics have the right to study whatever they wish, but they don’t have a right to be paid by others for it. If people don’t want what you’re selling, and you’re somehow still receiving a paycheck, it’s time to question whether something has gone morally awry.
So, the only fear I have regarding changes to higher ed is a generic one, shared by those who work in many fields, that someday what I have to offer will no longer be in demand. This is an unfortunate yet persistent and ineradicable feature of the human condition. So I say develop your skills in accordance with your best judgments, get whatever experiences you can, and keep your eyes open for opportunity wherever it might exist. This is probably better for your wallet and your soul than lamenting the inexorable march of time and change.
P.S. – None of this is meant to suggest that the kind people over at Feminist Philosophers would support a new tax to pay philosophers, or anything of the sort. In this case, it is actually the government itself which is pushing for the undesired change in education. I’m just sayin’ that often, when people are scared or unsure about the future, they do call upon the government to make it right. And I think there are reasons not to do that.
is cultural libertarianism entailed by political libertarianism?
October 28, 2009
A couple of months ago, I had a debate with a libertarian friend over whether cultural libertarianism is correct/good/necessary/whatever. At the time, I was sure that I was what you would call a “cultural libertarian feminist,” as specified in the Liberal Feminism entry on the Stanford Encyclopedia of Philosophy (a reputable source). Recently, Kerry Howley wrote an interesting piece on cultural libertarianism over at Reason (“Are Property Rights Enough?”), and there have cropped up a variety of responses to it there and elsewhere in the blogosphere. I really wish I had the time right now to wade through all of it, as there is a ton going on. But for now I’ll focus on what I find the most pressing question for people interested in this issue:
Is it somehow inconsistent for a libertarian to care about freedom from government control and coercion but not to care about freedom from socio-cultural control and coercion?
or, to rephrase:
Is cultural libertarianism logically entailed by political libertarianism?
I find this important because it seems as if Kerry says yes: that libertarians who think freedom is just a political matter involving freedom from the state are either just ignoring or implicitly condoning freedom-limiting social structures such as the patriarchy. But cultural libertarian feminism, as I understood it from the SEP article, didn’t seem to be that strong of a position. A claim that political libertarians must care about culture on pains of logical inconsistency is apparently not a necessary feature of cultural libertarian feminism. Read the rest of this entry »
competition is as american as apple pie, except in education
October 23, 2009
Recently, I saw the above video on Facebook. Basically, it illustrates the argument that a public option in health care would compete against private insurers to the benefit of those covered under both kinds of plans. This argument seems like it is supposed to appeal to the market-minded among us, who are into competition amongst businesses. And “competition is as American as apple pie,” quoth MoveOn.org
Now, I’m going to take the liberty of guessing that alot of people who are in favor of the public option also oppose school choice (in my experience, this is true, but feel free to take issue with this assumption in your comments). To the extent that their arguments for the public option are really about competition, their opposing school choice – which promotes competition amongst schools – is inconsistent with their position on health care.
Alternatively, perhaps this just exposes the fact that the proponents of the public option really don’t care about competition much at all, that it was just a strategic argument aimed at pro-business types, and that really they favor something about the state provision of important goods and services, like health care and education.
Thoughts anyone? I’m particularly interested in hearing from people who favor the public option but oppose school choice. Please explain to me your real position on competition, as I am confused. Thanks in advance.
state control of abortion: funding, or failing to provide?
August 21, 2009
I am genuinely confused by this recent Feministe post, Michele Bachmann: radical pro-choice feminist?
The author offers two pieces of information that she seems to believe are contradictory.
1. A quote by Michele Bachmann:
“That’s why people need to continue to go to the town halls, continue to melt the phone lines of their liberal members of Congress, and let them know, under no certain circumstances will I give the government control over my body and my health care decisions.“
2. A video of Michele Bachmann speaking. Basically, she calls for the government to quit funding Planned Parenthood, which provides alot of abortions.
Now, I understand how this is a weird picture if you add a further piece of information:
3. Michele Bachmann is quite radically pro-choice (and that is why she wants Planned Parenthood defunded)
But in the absence of 3, there is no contradiction, and so I don’t really understand the shock value of the original post as presented.
I guess it comes down to this:
If you oppose state control of health care (and thereby abortion), and you think that “control” consists in, or is promoted by, many-strings-attached state funding, then definitely retracting federal funding from Planned Parenthood is the right thing to do.
But I can only assume from the post that the Feministe author thinks that state control of health care amounts to the state refusing to help provide those services promoting reproductive choice for women – i.e., abortion. (Remember, the Bachmann speech wasn’t about outlawing abortion, even if she actually wants to, but merely about defunding it).
Which seems like a better way of understanding “state control of health care/abortion” to you? Or am I totally missing something here?
Edited to add: A very similar story also appeared over at Feministing. Someone, please explain this to me? I don’t get it.
my least favorite facebook group: “cancel student loan debt to stimulate the economy”
August 16, 2009
I found out about this little movement through its Facebook group, “Cancel Student Loan Debt to Stimulate the Economy.” Basically, a guy named Robert Applebaum hatched an attractive-to-some but crazy plan to have the government bail out those carrying college debt by paying off their loans. This would, allegedly, cause all those formerly oppressed by student loan debt to feel renewed consumer confidence and start spending again and, well, you know the rest.
I could say alot about why this plan is bad on economic grounds. But, I’m not primarily an economist, I’m primarily an ethicist (in training), and so I want to say two things about what is morally wrong with this scheme.
First of all, the proposed bailout is deeply discriminatory. It’s full of language like this:
“Instead of funneling billions, if not trillions of additional dollars to banks, financial institutions, insurance companies and other institutions of greed that are responsible for the current economic crisis, why not allow educated, hardworking, middle-class Americans to get something in return? After all, they’re our tax dollars too!”
Now, keep in mind that the reason Applebaum thinks that college grads in debt are good bailout candidates is because they would spend their new disposable income and stimulate the economy with it, while rich people who get bailed out might not (saving or investing it instead). But this does not by itself suggest that “educated, hardworking, middle-class Americans” are the ones who should get the stimulus money. On the contrary, since non-college-grads learn less on average than college grads but are often similarly hardworking, they are equally as good as candidates to receive stimulus money that needs to be promptly spent. In fact, the very reason alot of these people didn’t go to college is because it costs alot of money and they couldn’t afford it. What better way to equalize these unfair life circumstances than to bail out the hardworking non-college-grads? I suspect that the reason that version of the proposal doesn’t have a Facebook group and a website is because those who are not college educated have less of a presence in social media. That doesn’t make them any less morally eligible to be bailed out, however. To whatever extent you think that college grads who are in debt are entitled make a moral claim for bailout money, non-college-grads are equally entitled to make such a claim, if not more. For Applebaum to prefer bailing out the college grads in the absence of a morally relevant difference between the two groups reveals that the proposal is about fulfilling special interest group demands at the expense of others, and not really about fixing the economy at all. Read the rest of this entry »
feminism, abortion and universal health care
August 14, 2009
So, I’ve been warming up on this blog for a while now, so I figure it’s time to start linking to other blogs that I read. Today’s subject is a post over at Feministe, “one of the oldest feminist blogs designed by and run by women from the ground up.”
Just as background, let me say that I am both pro-choice and a feminist (in some sense, but that is a topic for another time). But, I am against universal health care, for complicated reasons including, but not limited to, that health care is a need and not a right, that it would stifle medical innovation, that it would violate doctors’ right to contract freely, that it would not be able to control costs, and that it is morally worse for the government to engage in care rationing than for a private insurance company one has voluntarily hired to do so (but, this too is a topic for another time).
On to the Feministe article. It’s on the topic of some other work by Chris Korzen about abortion and health care reform. To be honest, I haven’t been following the news on health care reform in the legislature too well, because my gag reflex is a little weak. Even so, it is apparent that the position taken in the Feministe article is philosophically shallow. It is a great example of why I can’t get on board with many mainstream feminists regarding reproductive issues, even though I am pro-choice. Here are the highlights: Read the rest of this entry »
