Another Quiet, Non-Controversial Discussion of Health Care

Over the last week, you may have noticed that I took Rush Limbaugh to task over the whole Sandra Fluke/contraception brouhaha. My attacks, I freely admit, were both political and personal.

Hi, I'm Rush Limbaugh, and my dick isn't anywhere near this big.

I make no apologies for disliking Rush and his abrasive, antagonistic brand of right-wing infotainment. If I did, they would come off as insincere and manufactured as his own apologies to Ms. Fluke. So I'm not going there.

But here's the thing I want to make clear to all my Drunkards, no matter where they stand on the political spectrum: While I think Rush Limbaugh was dead wrong in what he said and why, I don't agree with Sandra Fluke, either.

I wonder what all those colors are between black and white?

Her testimony before Congress on the importance of access to contraception was intelligent, articulate, and correct on many points. But I don't accept her central premise that Georgetown University, or any Catholic institution, or any institution whatsoever, should be compelled by law to provide coverage for birth control. I don't think it should. And at the root of that opinion is my personal understanding of two entities, which may seriously damage any lefty credibility that may be ascribed to me: the U.S. Constitution and the free enterprise system.

I understand. Bear with me.

Let's start with the specific case at hand. Georgetown University is a Catholic university. The health insurance it offers employees and students doesn't cover contraception. The Catholic Church rather famously disapproves of all artificial means of birth control. It's one of my points of disagreement with the religion I was born into, but there's no denying the logic that an institution that forbids its members to use contraception shouldn't have to pay for its members to use it.

Hey, let's quote the First Amendment!

"Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof... ."

Translation: You can't tell people what to believe, and you can't make religions do things that are in violation of their beliefs. Like include birth control in their insurance plans when they teach that using birth control is a sin. Yes, I know - I know from personal experience - that the Pill has other uses besides preventing pregnancy. It doesn't change the fact that if a Catholic institution won't cover a medicine because its primary purpose is contraception, the Constitution says you can't make it.

Nope, not even you, Bill.

That kind of sucks. But a lot of things are bad and wrong and unfair, and you can't just pass laws against them.

Case in point.

The plain fact is, Georgetown University doesn't have to cover birth control in its health insurance. It doesn't have to offer health insurance at all. It's a benefit (from the Latin benefactum, "good deed"). It's true that health insurance is the primary means by which most Americans pay for health care. It's also true that company-sponsored plans are the primary means by which most working Americans buy health insurance. But that's by custom and business design, not by law or right. And a lot of people think that also kind of sucks. I know I do.

Still, the last thing I want to see in America is a legal requirement that all companies (or all those meeting certain requirements, also defined by law) provide health insurance to their employees, not to mention insurance that includes specific types of coverage.

Think about it. For-profit businesses exist to make money. There are a ton of ways to make money in business. You can sell overpriced products, like jewelry or tennis shoes. You can artificially control supply and demand and bribe the government to look the other way, like oil companies. You can hold exclusive rights to your product, like pharmaceutical companies. You can develop cutting-edge, popular technologies, like (although I hate to say it) Apple. And you can invest in employees who will enable your business to do any or all of the above. One of the ways businesses attract and retain the best people is by paying them well and offering great benefits. Not because it's the law, but because it gives them a competitive advantage and lets them make money. Which, if you'll recall the premise of this paragraph, is why for-profit businesses exist.

I majored in business for three whole semesters.
I know what a circle looks like.

If Congress decreed that offering a certain level of health care were mandatory for businesses, I suspect one of three things would happen in companies across the country. Some would decide to follow the exact letter of the law, which in many cases would result in slashing their existing coverage to the legal minimum. Some would move their operations to less-regulated countries, drastically reduce their payrolls (and therefore their insurance obligations), or cut their losses and fold altogether. And some would make a business decision to make a high-level investment in their employees for the sake of growth and productivity. Only one of those outcomes is actually good for Americans, by the way. What do you think your company would do?

Think about it.

Here's the deal: I've worked for companies that offered excellent health insurance plans. I've worked for companies that offered mediocre insurance. And for companies that offered none. In the past I've bought private insurance for my family when it was a better deal than employer coverage. And I've gone without health insurance entirely.  So I've pretty much run the gamut of options.

(Aside: Beloved Spouse's teaching job has always been classified by the state as part-time, no matter what his class load is, so he has no job security, no representation, and no employer-paid insurance. Don't even get me started.)

I'll just quietly seethe.

Would I love to have perpetual access to high-quality, low-cost, employer-subsidized health insurance for me and my family? Of course. And believe me, whenever I've had the luxury of choice, I've based my career decisions partly on the benefit packages being offered by potential employers. Money I don't have to spend on health care is additional money in my pocket.

Which I like.

But do I think there should be federally-mandated insurance coverage, or worse, "universal health care"? No. It's not that I'm against so-called socialized medicine. But even that isn't what people think it is. In Canada, our closest neighbor that provides taxpayer-funded health care to all, there are actually individual programs in each province and territory that provide services rather than a federal program (although they operate under federal law). That's 13 programs servicing 34 million people. Quite a far cry from 50 separate programs taking care of 311 million Americans (not even counting our territories and possessions).

And Canadian health care isn't comprehensive. It typically doesn't include dental, vision, or - ahem - prescription coverage. Many Canadians buy private health insurance to cover those items. And those private plans operate according the laws of supply and demand and the principles of the free enterprise system, just as they do here. No one in Canada seems to think it's a perfect system, but it is at least fair, inclusive, and reasonably efficient. Still, in the Great White North a Sandra Fluke wouldn't even be making the argument that her insurance should cover contraception or anything else that wasn't available to every other person in the country.

I'm no fan of the state of health insurance in America. I think most insurance companies are bloated, overpriced, avaricious, and have far too much clout when it comes to determining how individuals take care of themselves. I think they should be regulated far more effectively than they are. I didn't say there should be more regulation, just more effective. And no, I have no brilliant strategies for achieving that. In theory, we all elect intelligent, impartial representatives to devise those strategies, many of whom should stop pocketing so much damn money from the insurance companies and get to work on that.

But by the same token, as much as I sympathize with Sandra Fluke and all the millions of under-insured, under-served people like her, her opinions are - while valuable - not practical as legislation. The solution is not always to hand the government more power over our corporations and citizens.  And that's coming from someone who has never voted for a Republican presidential candidate in her life.

Oh...and Rush?

The solution is never to call a woman a slut and a prostitute because she exercises her Constitutional right to free speech. Not in my America, you stupid fat blowhard.

God bless my country. And yours too.