No such thing as free contraception

March 8, 2012 By

At a meeting of a few dozen female writers and editors yesterday, we got talking about civil society and the corrosive nature of politics. An editor I respect a great deal tried to calm things down by reminding us that the political climate isn’t necessarily more hostile than it was in the late 1960s (she told us that she saw targets for sale then wixth President Johnson’s face on them). But, she added, she was appalled by what she called the “deliberate misrepresentation” by the media. She was referring, of course, to the coverage of the HHS mandate requiring religious employers to provide insurance plans that cover abortifacients, sterilization and contraception, even if it violates the doctrines of their church.

This story has not been told. And the story that has been told, of a “war on women” has been filled with misrepresentations.

By way of introducing what I want to talk about, let’s look at something I read on the Wall Street Journal‘s editorial page two days ago in “Bishop Dolan’s Liberty Letter: The Catholic Cardinal describes a chilling visit to the White House“:

The debate over the Obama Administration’s birth control mandate has been ingloriously fact-free, even more than usual. So amid demonstrably false claims about a plot to relegate women to the era of “Mad Men,” if not Salem, Massachusetts circa 1692, Cardinal Timothy Dolan’s letter on religious freedom deserves more readers.

“We have made it clear in no uncertain terms to the government that we are not at peace with its invasive attempt to curtail the religious freedom we cherish as Catholics and Americans,” the archbishop of New York wrote in a public epistle to Catholic bishops last Friday. It’s an eloquent and powerful document, though not one that received much of any media notice. “We did not ask for this fight, but we will not run from it,” he continues.

That this letter didn’t receive media notice is certainly true, even though it is defiant and accuses the White House of nothing less than asserting raw political power to achieve its goals. I mean, it’s juicy and salacious stuff, as far as these things go. But, you see, the media were too busy talking about really important things, like how to spin an unprecedented attack on religious liberty into something about Rush Limbaugh. Literally. And come on, what’s more important, the Constitution or talk radio? What’s more important, the way the White House treats religious liberty advocates or the way Rush Limbaugh treats abortion-rights activists? I think we all know the answer.

And so there was yet another media blackout of religious liberty activists. Today, I read a Religion News Service article headlined “White House insists contraception talks are on track.” Remember, it’s always about contraception, and never about abortifacients, sterilization, doctrine or religious liberty.

The story is a response, using an anonymous White House source, to Dolan’s signed letter. I searched for the original RNS report on the letter. I couldn’t find one. So how is it newsworthy to “reject” Dolan’s letter when Dolan’s letter itself wasn’t considered newsworthy? After four paragraphs of some nasty anonymous comments from the White House that question the motivation and integrity of Catholic bishops, we get this:

The official was responding to statements made by New York Cardinal Timothy Dolan, president of the U.S. Conference of Catholic Bishops, in a March 2 letter to his fellow bishops and in a blog post he wrote about talks between the White House and the bishops.

Facing escalating criticism for the narrow religious exemption in regulations that require employers to offer free contraception coverage to employees, President Obama last month proposed an “accommodation” that would significantly broaden the exemption for faith-based institutions.

The piece paints only those who aren’t giddy over the unwelcome intrusion by the federal government as culture warriors. Which is interesting, considering that, as Dolan said, this is not a fight they asked for. This was something that HHS did to Catholic and other religious institutions and groups.

In any case, I want to highlight the big glaring problem in the above copy: “free contraception coverage.”

As Timothy Carney wrote at the Washington Examiner, again on the editorial pages:

What’s the ObamaCare contraception mandate about? For much of the media and many politicians, it’s about “free contraception.”

Just a very quick sampling: “The rule requires employers to provide free contraception to women” [Washington Post]; “receive free contraception in their health plans” [New York Times]; “free contraception coverage” [< em>Washington Post/Religion News Service]; “cover free contraception” [Daily News], “free contraception coverage,” [Daily News]; “health plans supply free contraceptives..” [Kaiser Health News].

Now, I studied economics in school, and not journalism, so sometimes I forget that really basic economic concepts aren’t actually understood at all by journalists. Here’s Tim’s take:

Insurers are required to pay the cost of all birth-control pills, without copay. As the insurer’s liability increases, the premium for the insurance plan increases. So employees pay higher premiums, as do employers. But because this plan applies to nearly all employers, the employers pass the cost onto employees in the form of lower pay.

So your pills are not “free.” The cost isn’t reduced to zero — it’s instead spread among all your employees, whether they be gay, infertile, male, observant Catholic, post-menopausal, chaste, pregnant, eager to have as many kids as possible, or Shakers.

But that’s not all. If an insurance plan doesn’t cover birth control pills, and an employee wants them, she can purchase generics for $9/month at Target. But what happens if cost is no issue for the user and if the demand has driven up? Avik Roy at The Atlantic writes that it will enrich drug companies at the expense of people who want access to basic contraception:

Under the new mandate, this price incentive disappears. Insurers will be required to pay for any and all oral contraceptives, without charging a co-pay, co-insurance, or a deductible. This “first dollar coverage” of oral contraception kills the incentive to shop based on price.

If history is any guide, this significant change will drive up the price of oral contraception. Today, Tri-Sprintec costs $9 a month. In 2020, don’t be surprised if it costs $30. Drug companies will be able to market “branded” contraceptives at premium prices, knowing that women are free to choose the most expensive, designer product because it will cost them the same as the cheapest generic. Prepare yourself for multi-million-dollar Super Bowl ad campaigns from competing manufacturers…

If you were surprised that PhRMA, the pharmaceutical trade group, backed Obamacare, now you can see why: the HHS contraception mandate alone will be a multi-billion-dollar boondoggle for the pharma industry. If your health insurance plan allowed you to buy a television, of any price, without any cost-sharing on your part, would you buy a 13-inch CRT or a 60-inch flat screen?

This is just one example of how the media are distorting a very important issue surrounding religious liberty. And yes, the distortions and frenzies have been so significant that it’s difficult to keep up with them.

But while the media are giving the appearance that there is one side to this issue and that it’s about “free birth control” for all, I wanted to highlight something I found in a Boston Globe story about a campaign in Massachusetts for the Senate. Sen. Scott Brown, who took Ted Kennedy’s seat a couple of years ago, has been on the other side from his opponents in the race and in the media in this great religious liberty battle. (I might mention that Ted Kennedy himself, a strong defender of conscience protections, might have been on the same side as Brown had he lived.) And even with the deluge of campaigning for this mandate by the media, check this out:

But, if several of the recent polls are correct, Brown may have benefited from his positions on social issues in the last few weeks, such as the one over whether Catholic institutions should be forced to provide contraception in their health care plans for workers.

Well how could that be? Maybe the media should start paying attention to those of us who keep claiming we’re really concerned about this infringement on religious liberty.

Oh, and in the interest of full disclosure, we’ve had a few new entries for my call for any and all stories about religious liberty. They’re not good, they’re not long or substantive, and some are a hot mess, but here they are: Associated Press, New York Daily News, New York Times.

Image via Shutterstock.

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Filed Under: Catholicism, Journalism, Religion
  • Will

    It is not just “health plans”. Politicians have convinced the American public that there IS a Santa Claus, and anything provided by tax money is “free”… or maybe that “the rich” pay for everything.

    When I worked as a tax preparer, I constantly heard demands of “why don’t I get more?” from people who did not understand the meaning of “tax REFUND”, and thought that TheGovernment was GIVING them something. Presumably out of “its own money”.

  • Will

    David Friedman (of THOSE Friedmans) uses a trenchant illustration. Imagine a circle of a hundred people. Another player (“the government”) goes around the circle collecting one cent from each person, and then hands fifty cents to a “lucky” recipient. Repeat this a hundred times. Each participant is convinced that the “recieved” fifty cents, not noticing that he “paid” a dollar for it.

  • R9

    But, you see, the media were too busy talking about really important things, like how to spin an unprecedented attack on religious liberty into something about Rush Limbaugh.

    To call this “an unprecedented attack on religious liberty is” itself spin.

    I get that there is a religious objection which hasn’t been covered all that well. But good coverage will not necessarily portray this as vital freedoms under attack, either. As I pondered earlier it’s debatable if “religious liberty” means “you can opt out of laws you don’t like”.

    Yep it’s against their consciences. Plenty of people end up having to do something against their conscience. Like pay taxes to support something they don’t like. What is special about a religiously-motivated objection?

  • Jeff

    “What is special about a religiously-motivated objection?”

    Well, nothing, other than the fact that this country was founded in large part on religious objection and that its Constitution enshrines the right of conscientious objectors to a religious liberty protecting them from abuse at the hands of the state — nothing but that.

  • Chris Jones

    R9,

    Like pay taxes to support something they don’t like

    We all pay taxes to support things we don’t like, because we don’t all like the same things. But we are not usually forced to use our after-tax money to pay for things we don’t like. That is the difference. We like to think that what is left over after we have paid our taxes is “our own money” and we don’t take kindly to the government (or anyone else) telling us how we must spend it.

    If this were about government funding of contraception, abortifacients, etc., then the Catholic Church (and other religious groups such as my own LCMS) might still oppose it as a matter of policy, but they would not refuse to comply as a matter of conscience. That is because the government has the right to levy taxes and the freedom to spend that money according to its own idea of the common good; but it does not have the right to compel private organisations to spend their own money in violation of conscience and religious precept. That is what the First Amendment means.

    What is special about a religiously-motivated objection?

    This should be an easy one, R9. What is special about it is that matters of religion are specifically privileged by the First Amendment. It is right there in the Constitution, which (let us remember) is supposed to control and limit what the government can do.

    “No establishment of religion” means more than “no official state Church.” It means “the Church cannot be controlled by the State.” The First Amendment limits what the government can do, not what Churches can do.

  • http://www.twitter.com/beliefbeat Nicole Neroulias

    To call this “an unprecedented attack on religious liberty is” itself spin.

    Good point, R9.

    Also, what exactly are “abortifacients?” And how common is demand for coverage for those, really, versus American women’s use of birth control pills, Mirena, etc.? (Seems like it would be a real distraction, not to mention journalistically inaccurate, to frame this as a debate equally about abortion as it is about access to the pill.) And what would Mollie prefer headlines use for an umbrella term, if not “contraception?”

  • Julia

    Sorry about this necessary length of comment.

    Have any of you visited Colonial Jamestown or Williamsburg?
    The guide will explain that if a resident did not show up for services at the Anglican Church, the resident was fined and if it happened too often the resident was jailed.

    As in England, the parish [Brunton Parish Church in Williamsburg]became a unit of local importance equal in power and practical aspects to other entities such as the courts and even the House of Burgesses.

    Parishes needed to be close enough for travel to church for worship, an obligation everyone was expected to fulfil.

    During the colonial period, all those in public office were required to attend church.

    As the American Revolutionary War began in 1776, the power of both the monarchy and the church as an institution controlled by the government came into question in the colony.

    …. when the new Constitution of the United States and the accompanying Bill of Rights were adopted, the concepts of Separation of Church and State and Freedom of Religion changed the role of Bruton Parish Church in its community.

    An ancestor of mine fled Massachusetts with Roger Williams to found Rhode Island because the official religious establishment did not treat dissenters well. Rhode Island allowed a synogogue and churches which were not allowed in Massachusetts.

    http://en.wikipedia.org/wiki/Colony_of_Rhode_Island_and_Providence_Plantations

    Maryland was founded as a refuge for English Catholics who were having a hard time as recusants in England. That didn’t last and again it became illegal to be Catholic.

    The province began as a proprietary colony of the English Lords Baltimore, who wished to create a haven for English Catholics in the new world at the time of the European wars of religion. Although Maryland was an early pioneer of religious toleration in the English colonies, religious strife among Anglicans, Puritans, Catholics, and Quakers was common in the early years, and Puritan rebels briefly seized control of the province. In the year following the Glorious Revolution, John Coode led a Protestant rebellion that expelled Lord Baltimore from power in Maryland. Coode’s government was unpopular and both William III and Coode himself wished to install a crown-appointed governor. This man ended up being Lionel Copley who governed Maryland until his death in 1694 and was replaced by Francis Nicholson.[1] Power in the colony was restored to the family when Charles Calvert, 5th Baron Baltimore, swore publicly that he was a Protestant.

    http://en.wikipedia.org/wiki/Province_of_Maryland

    This is why the First Amendment was considered necessary to protect religious liberty.

  • Deacon John M. Bresnahan

    There is one side to this government coercion of religious people and groups not being much reported on in the media. It is that it has brought together Protestants–especially Evangelicals– and Catholics who take both their Faith seriously and the First Amendment’s demand that government not trample on religion seriously. But it is being portrayed mostly as the Catholic bishops against everyone else.
    And it isn’t just that the word “contraception” is being used in the media as a spin word to cover over or ignore other very major parts of the religious liberty issue, it is also being used to keep people from connecting the dots about the individual mandate coercion of Obamacare with the coercion of religious enterprises and people. Put the two together and you begin to see–not just individual problems– but the start of a pattern of coercion emanating from Washington. And we have no idea how many more such coercive horrors will pop up as more of the bill in Congress– which was well hidden according to Nancy Pelosi herself–comes into legal effect.

  • Ann

    I knew immediately that the article by Avik Roy at The Atlantic was not consistent with the generic drug push by Pres. Obama and HHS.

    MEDICAL MANAGEMENT PERMITTED

    In providing women’s preventive health services, a plan is allowed to use reasonable medical management techniques to help define the nature of the covered service. For example, a plan may impose patient cost-sharing for use of a brand-name prescription drug when a generic prescription drug, which has been found to be as effective and safe as the brand-name drug, is available.

    In addition, a plan is allowed to impose cost-sharing (deductibles, copayments, coinsurance) when preventive health services are obtained from an out-of-network provider.

    http://tinyurl.com/7xqydnc

    During the last few years, federal employee health insurance has significantly increased the cost of brand-name drugs while decreasing the cost for generic drugs. The current co-pay under one of the major federal employee health insurance plans (GEHA) for generic birth control pills range from $5 per month at a retail pharmacy to $0 for a 90 day mail-order prescription.

    Patient Protection and Affordable Care Act, Public Law 111–148, contains the authority of the HHS Secretary to “(II) to facilitate generic substitution when a generic covered outpatient drug is available at a lower price”

    http://tinyurl.com/2a86ty7

  • Will

    Julia, that is not consistent with the fact that AFTER the Bill of Rights was adopted, Massachusetts and Connecticut continued to have state-supported churches {http://en.wikipedia.org/wiki/State_religion#United_States_of_America}, and nobody said “Hey! We just prohibited that!”

    Remember the First Amendment says “Congress”, not “all federal state and local authorities”, and “shall make NO LAW” one way or the other on religious establishment. It protected state establishments from federal interference as well as barring national establishments. It is not like, e.g., the clause authorizing Congress to “guarantee to each state a republican form of government”, presumably whether the people of the state want it or not.

  • Chris Jones

    Will,

    What you say is true as far as it goes. But the Fourteenth Amendment has consistently been understood as extending the limitations on government power and actions of the Bill of Rights from the Federal government to the State governments as well.

    Thus you are correct that the state establishments were not touched by the First Amendment at the time; but had they still existed (they did not, IIRC) they would have been abolished by the Fourteenth Amendment.

  • Beate

    Nicole, in the realm of artificial contraceptives, abortifacients prevent implantation but not conception. They do this by altering the endometrium.

  • Ann

    Nicole,

    According to established definitions by the medical community and federal policy, Plan B is not an Abortifacient: A substance that causes pregnancy to end prematurely and causes an abortion.

    http://tinyurl.com/6mkogbf

    The long standing definition of pregnancy by the medical community and federal policy is when a fertilized egg has implanted in the wall of the uterus.

    The primary function of Plan B is to stop ovulation or stop fertilization. There is a small chance that Plan B will stop a fertilized egg from implanting in the wall of the uterus, which has not been proved by medical research. In addition, some/many birth controls pills work in the same manner as Plan B.

    Starting in 1998, the majority of republicans voted for a contraceptive mandate, including Plan B, for Congress/federal employees’ health insurance, including the ones that are currently making the most noise:

    Rick Santorum
    John Boehner,
    Newt Gingrich,
    Eric Cantor,
    Roy Blunt,
    Mitch McConnell,
    Darrell Issa

    Former Arkansas Governor Mike Huckabee – the Arkansas law did not exempt church-affiliated hospitals and universities, did not include a mandate for emergency contraception
    http://tinyurl.com/856auqt

    Former Governor Mitt Romney – mandate included emergency contraception (Plan B)

    Massachusetts State Senator Scott Brown voted for the mandate that included emergency contraception (Plan B)

    Plan B can currently be purchased over the counter without a prescription for women over 17. The current HHS Secretary recently refused to not change the rule to allow those less than 17 to buy Plan B without a prescription.

  • Martha

    “I forget that really basic economic concepts aren’t actually understood at all by journalists”

    Do you really need to have studied economics to realise “There ain’t no such thing as a free lunch”? Or do American journalists get paid such massive amounts they have to cart it home in a wheelbarrow, so naturally they can’t keep track of what was deducted in tax, social insurance contributions, health care plan payments, savings contributions, pension deductions, union subs, etc. etc. etc.?

    People who have to count the pennies in their purse to see if they have enough to buy a litre of milk know about money not growing on trees. Maybe some more journalists should try the experiment of living on the minimum wage for a fortnight or the likes to realise that perks and inducements come from the employer deciding to provide them for a specific job, not from Santa Claus or the Easter Bunny.

  • Martha

    R9, imagine that the government introduced a provision whereby all employees receiving health coverage had to pay a portion of their premium for animal research, because animal research is vitally important for finding new cures.

    Now, if someone said “But I have objections to animal research, can’t I opt out of this plan?” and the state said “No, this is law, everyone has to be covered by a health insurance plan” and then the person said “Okay, so can I switch to this health insurance plan operated by PETA where they don’t pay for animal testing?”

    Then the government comes back and says “Well, actually, that plan will pay for it, because every plan pays a proportion of the premiums gathered into a pot for animal testing grants. But it won’t say that you’re paying for animal testing on your policy, so that should address your concerns, right?”

    In that instance, would you be very surprised if the person who objected to paying for animal testing went to court to see if he could be forced to purchase a plan containing the objectionable provision, rather than one which did not?

  • http://authenticbioethics.blogspot.com AuthenticBioethics

    Ann, I think it’s a matter of semantics. If Plan B is not technically an abortifacient, that does not mean it doesn’t end a new human life. Words should reflect reality because they are very limited in their power to create it, but we are fond of attempting the latter.

  • http://authenticbioethics.blogspot.com AuthenticBioethics

    Let’s say for the sake of argument that it IS all about contraception. Something I haven’t seen covered in the press — on either side of the issue — is why contraception should be “free” while other vital drugs require copays and coinsurance. Seriously, why shouldn’t drugs for hypertensions, diabetes, high cholesterol, HIV, and cancer all be “free”? Why contraception?

    And if it’s about women’s rights to reproductive products and procedures, wouldn’t even more fundamental rights have all the more claim to being “free”? Why isn’t food free? Or the gas the woman needs to get to the drugstore to buy the contraceptives free? Or the car she needs that uses the gas? Why isn’t electricity free? And computers?

    It’s just something I’m wondering about. I raised the question a few weeks ago on my blog (which no on reads, sigh), but other than that, I haven’t seen many people asking it. It’s not really a “religion ghost” but it is question of journalism.

  • Ann

    AuthenticBioethics,

    While you have a good argument about making all drugs free, there are other reasons to make contraception free. One of Pres. Obama’s frequent statements while campaigning for President was reducing the number of abortion to the maximum extent possible.

    A very large majority of women having abortions are young and poor/low income. There is substantial evidence of women not getting contraceptives due to the cost. While Mollie says a woman without a health insurance plan that birth control pills can purchase generics for $9/month at Target, will the health insurance plan pay for the doctor visit to get a birth control prescription?

    Another issue is the potential damage to the child (physically and mentally) from being born to a young and poor/low income woman, which is supported by considerable research.

    If generic birth control pills can be purchased for $9/month, the argument for “No such thing as free contraception” is substantially reduced. How much does a pregnancy cost a health insurance company or taxpayers when Medicaid pays for the pregnancy cost and ongoing support of the child?

    Cost of Covering Contraceptives through Health Insurance
    http://tinyurl.com/7evoxuz

    Private Insurance Coverage Contraception Cost Effective
    http://tinyurl.com/6r8p3gn

    Why Free Birth Control Will Not Hike the Cost of Your Insurance
    http://tinyurl.com/7vu3xwl

    In addition, health insurance companies profits will increase when millions of customers are added in 2014 when the mandate that employers with 50 or more full time employees must offer health insurance. In the last several years, the number of employers providing health insurance has decreased, especially for the lower paying jobs.

  • http://www.getreligion.org Mollie

    Friends,

    Some of these discussions would be better for the coffeehouse. Remember to keep discussions here about media coverage.

    Best,

    Mollie

  • http://authenticbioethics.blogspot.com AuthenticBioethics

    Ann, so you would agree at least that the lack of media coverage is an issue? I mean about how and why contraception was specifically singled out and how religious exceptions were specifically excluded. You raise other good points about the absence of media coverage for the benefits of free drugs of all kinds to prevent worse medical situations. Blood pressure and cholesterol medications prevent exponentially more costly heart attacks and strokes. Insurance companies, following the president’s logic, should be flocking to cover vital drugs for free to avoid paying for more expensive consequences. But what they really want to do is make money. So, why single out contraception? It smells of politics not health policy, and journalists are not following the scent. That might be a story in itself.

    Another story not being followed up on is the claim that easily accessed contraception means fewer abortions. Doesn’t Planned Parenthood offer free/cheap contraception counseling and products for poor people? Then why are they so busy performing abortions in that group? Sounds like a story to me. Wish someone would tell it.

  • http://blog.beliefnet.com/beliefbeat/2011/02/must-read-new-yorker-investigation-of-church-of-scientology.html Nicole Neroulias

    Where is this Target that’s selling birth control to women for $9/month? (Everyone I know has always had to pay more, except in cases of a student health plan or excellent health insurance coverage.) And what about for the doctor’s appointment, or if you need to try several kinds to get the hormone balance right, etc.? As a journalist, I would need some evidence before continuing to perpetuate this “but it’s already so affordable!” argument…

  • http://www.getreligion.org Mollie

    Nicole,

    In her speech to Democrats, Fluke said birth control costs $3K during law school. A reporter went to the closest Target to Georgetown University and found generic pills sold for $9/month. The nearby CVS sells the pills for $30/month. Every woman I’ve ever known who pays for birth control pills pays $30/month, but apparently you can get them cheaper in some places.

    I find it funny that no newspaper I ever worked for covered birth control pills, either. Unless it was for medical and not avoidance-of-children reasons. And no newspaper I worked for covered more than one visit to the gynecologist per year.

    Either way, the claim of $3K has not been verified — or vetted in any way — by mainstream media.

    Annual visits to the gynecologist would be covered, presumably.

  • http://www.getreligion.org Mollie

    Ann writes:

    According to established definitions by the medical community and federal policy, Plan B is not an Abortifacient: A substance that causes pregnancy to end prematurely and causes an abortion.

    The first thing to keep in mind is that in religious liberty disputes of this nature, what matters is not how the federal government defines something but how churches do. By way of example, take that recent bioethics paper that received almost no mainstream media coverage, the one that argues in favor of “afterbirth abortion” — calling the killing of an infant who has survived being born an abortion might pass muster with some federal regulations, or abortion-rights advocates but no one would be surprised if traditional Christians kept calling it infanticide.

    Similarly, the situation with redefining conception and pregnancy to take place later than medical science used to state. A run down of how medical dictionaries changed the definition to be more about when the human life implants into the lining of the uterus than when it begins can be found here.

    Again, whether interested parties keep moving the definition further away from the time the new life begins doesn’t really matter to Catholics, Lutherans and others whose doctrine remains the same — taking an unborn human life is against their doctrine.

    That’s why this is such an important religious liberty dispute.

    My pastor led a Bible Class on the topic on Sunday where we went through our Lutheran teachings on the abortifacient qualities of some of what the federal government says employers must provide, regardless of whether they believe it to be the taking of a human life or not.

  • http://www.getreligion.org Mollie

    Again,

    Let’s keep discussion focused on media coverage.

  • Chris Bugbee

    The first line of Mollie’s last post is a model example of framing:

    The first thing to keep in mind is that in religious liberty disputes of this nature, what matters is not how the federal government defines something but how churches do.

    You seem to be saying that traditional Christians get to define the terms and only their view “matters.”

    What is inarguably true regarding doctrine within any particular church or faith community becomes insufficient when it comes to the privileging of that doctrine in the public sphere, which includes so many other points of view. The absolute conflict of multiple religious absolutes is one of the Gordian knots of the 21st century global culture.

    Perhaps the reason why so little of this discussion has focused on journalism is that the originating post’s focus on “media distortions” is much less about journalism per se and much more about a thinly-disguised complaint (itself adroitly framed) that the media is going with the wrong frame. If the media were to adopt the right frame — i.e., “religious liberty”, problem solved!

  • Chris Bugbee

    This seems less about journalism and much more about whose side is prevailing in a public discourse in which the media is only one of many agents..

  • http://www.getreligion.org Mollie

    Chris,

    No, my point is that when you’re writing about whether a church has a conscience objection to a given thing, what matters is the teaching of the church, not whether people outside of the church have a different teaching.

    That’s the same whether you’re Pagan, Catholic or Zoroastrian.

    When you’re writing about a religious group, it’s important to know what the religious group in question is saying.

    If you have leaders in multiple religious groups and religious liberty groups screaming about a threat to religious liberty, you can ignore it or you can cover it.

    The media have chosen to downplay it, at the very least, and I’m just shining a light on that.

    It’s easy to get off track, and I understand that, which is why we encourage all off-topic conversations to head over to the Coffeehouse.

    But there’s more than enough journalism to discuss here.

  • http://www.acupuncturebrooklyn.com Karen

    Insurance companies have made the calculation that birth control coverage costs less in the long run than unplanned pregnancies (regardless of outcome), untreated PCOS, and other related conditions. Not to mention regular gynecolgical

    If contraceptive pills are not covered then costs go up. And who pays for it? All of the rest of us, including those who believe that people ought to use contraception as a morally responsible act after perhaps two children. So the cost of prescription contraception is going to make someone disagree regardless.

  • http://www.getreligion.org Mollie

    Karen,

    Do you have any evidence to back that up? I’ve seen prominent journalists assert it as fact and I’ve heard, of course, Kathleen Sebelius say the same. What’s the cite for this?

  • http://www.getreligion.org Mollie

    I should add that I was speaking with an underwriter recently who said that adding birth control coverage to insurance plans increases the cost of those plans … but that is just anecdotal.

  • Thomas Aquinas

    Karen writes: “If contraceptive pills are not covered then costs go up. And who pays for it? All of the rest of us, including those who believe that people ought to use contraception as a morally responsible act after perhaps two children. So the cost of prescription contraception is going to make someone disagree regardless.”

    That’s really interesting, but completely irrelevant to this case. The issue is whether a business should be required by the government to offer in its insurance plan what the business believes is immoral, though it is relatively cheap for the employee to purchase it out of pocket.

    Your belief that using contraception is morally responsible is your belief, and you are welcome to it. No Catholic bishop is going to use the state to coerce you not to practice it. But you should extend to the bishop that same tolerance and graciousness that the bishop extends to you. If it would be wrong for him to forbid you from acting inconsistently with what you believe is morally obligatory, it stands to reason that you should do the same in relation to him and the ministries over which he is a shepherd. This is just common decency and civil reciprocity.

  • John Pack Lambert

    The question of whether something is an abortificant for purposes of forcing religious groups to fund its use is not based on medical consensus or federal policy guidelines, but based on the definition of terms for the religion involved.

    If in 1967 Johnson had decided to call what was going on in Vietnam “peace enhancement” and those there “peace enhancers”, it would still have been wrong to send Quakers to prison for not complying with the “Call to Shout Peace”.

  • Aly

    Either way, the claim of $3K has not been verified — or vetted in any way — by mainstream media.

    I agree that the lack of coverage explaining the $3,000 is problematic, but probably for different reasons than a lot of people. The condition Sandra Fluke described, that of a 32-year-old friend with cysts on her ovaries, requires more than one pack of birth control pills per month. I’m not privy to how it was prescribed to treat her medical condition but it is not uncommon for women to need 40+ packs per year in these circumstances.

    The list price (taking breaks at stores like Target or health insurance co-pays out of the equation – the reality for many in low-income, rural settings) for the most popularly-prescribed birth control pills is $65. Multiply that by 46 (allows for five weeks off the pill per year – a common prescription to treat a variety of women’s health issues) and you get to $2,990.

    The Catholic church, by the way, allows for such usage.

    From Humanae Vitae, the Catholic church’s document on the regulation of birth, written by Pope Paul VI:

    Lawful Therapeutic Means

    15. On the other hand, the Church does not consider at all illicit the use of those therapeutic means necessary to cure bodily diseases, even if a foreseeable impediment to procreation should result there from—provided such impediment is not directly intended for any motive whatsoever.

    Where’s the coverage, from anyone, on that part of the issue, with everything spelled out in plain terms?

  • http://www.acupuncturebrooklyn.com Karen

    Mollie,

    Here is one study found by a one minute Google search. Over a period of five years prescription contraception evaluated saved $12,900-$14,100 and prevented 4.1-4.2 pregnancies.

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1615115/pdf/amjph00442-0032.pdf

    A St. Louis study found that half of all pregnancies are unplanned. Only 5% of women use the most effective methods like implants and IUDs and most report that unreimbursed up front costs are the main barrier eventhough long term costs are lower than with the pill.

    None of these studies account for the fact that if women do not visit the gynecologist to get birth control prescriptions, they will skip screening visits for pap smears, breast exams, AIDS screening and STDs. The lack of monitoring likely increases treatment costs in the future.

    The cost of oral contraceptive pills run $9 to $90 per month and it usually takes 3 tries to find one that does not have too many side effects. IUDs and implants cost $600-$1000 up front. In addition are the costs of often multiple doctor’s visits which, as a health care provider, I assure you insurance companies will not cover if the object of the visit is not covered. A doctor’s visit goes for $150-$250 and often higher in my area.

    Public health clinic budgets have been cut to the bone and all 3 Republican candidates are on record as wanting to repeal Title 10 which funds poor women’s health care. And unless things have changed since I was young, all the pills that public clinics have available are the high estrogen types that are cheaper and other effective methods may not be available.

  • http://www.getreligion.org Mollie

    Karen,

    Your claim was “Insurance companies have made the calculation that birth control coverage costs less in the long run than unplanned pregnancies (regardless of outcome), untreated PCOS, and other related conditions. Not to mention regular gynecolgical”

    And then you linked to something that had nothing at all to do with *insurance companies.”

    I don’t think people will disagree that in the short run it’s cheaper to prevent children from being conceived or born than to raise them (although people will definitely disagree in the long term, whether looked at individually or society-wide).

    But do insurance companies *actually* charge less for plans that cover birth control (much less 100% of all birth control costs no matter how much you want to spend)? Here’s why I would be skeptical of that figure and ask for a cite.

    Contra what some suggest, birth control is actually very cheap and able to be obtained fairly simply (although making it over-the-counter would make it even cheaper and even more simple).

    Let’s say you have a plan that does *not* cover birth control costs. Now let’s say you move your company to covering those costs. What woman will keep on paying the bill solely by herself when she could now have those costs spread out by the whole company? And why should she go for the $9/month plan when she can get the designer stuff for $90/month, multiple visits, etc.

    Then your plan went from paying $0/year/person for birth control to as much as well over a thousand bucks a year, plus all the liabilities that go along with it.

    I’m just asking if *insurance companies* actually charge less for these plans. The underwriter I spoke to (I know, just one anecdote), suggested that wasn’t the case.

    You’re link doesn’t even address how insurance companies handle this, just how 15 different contraceptive methods compare against each other in terms of economic value.

    Anyway, the point of all this is that *journalists* should explain if or where they’re getting their contention that birth control/abortifacient/sterilization coverage is cheaper for insurance companies than coverage without it.

    And let’s work to keep our comments focused on media coverage.

  • http://www.getreligion.org Mollie

    Comments on this thread should deal with media coverage.

    Not your personal beliefs on how awesome/evil contraception is or your personal beliefs on how awesome/evil Catholics are, etc.

    I’ve had to delete a couple of comments for attacks on others or just being unrelated to journalism issues.

  • http://www.getreligion.org Mollie

    After multiple warnings, I’m being stricter in enforcing this.

    I don’t know how to say it any more simply than I am: Your comments should be focused on media coverage.

    If they’re about anything *other* than media coverage, feel free to make them in any other part of the internet, including our coffeehouse.

    Thanks.

  • Ann

    Mollie,

    I provided information and links in #9 that women can be charged a co-pay for not using generic birth control pills. The claims of selecting “designer stuff” is without merit.

  • Will

    So… if these hormone drugs are (routinely?) prescribed for “other” medical conditions, and Catholic doctrine sees nothing wrong with that…. why does all the coverage and government statements consistently call them “birth control pills” or “contraceptives”?

  • http://catherineguiles.com Cathy G.

    A journalist I know pointed out to me that everyone – Rush Limbaugh, Archbishop Dolan, you, me, your mom – already covers other people’s birth control with their tax dollars: It’s called Tricare, the health insurance for members of the military and their families.
    I’d love to see someone in the media highlight that!

  • Chris Jones

    Will

    why does all the coverage and government statements consistently call them “birth control pills” or “contraceptives”?

    Because the only controversy is over who pays for them when they are prescribed and dispensed as contraceptives. When they are used for a bona fide medical condition, there is no religious liberty implication and therefore there is no controversy.

    You can use a condom to make a water balloon, too; but you wouldn’t introduce that into a discussion on birth control. The use of “the Pill” for purposes other than birth control is no more relevant to the discussion than that.

  • Will

    If there is no controversy over bona fide medical uses, such as PCO, WHY DID SANDRA FLUKE BRING IT UP?

  • http://www.getreligion.org Mollie

    Will,

    That’s not relevant to a discussion here except insofar as it relates to journalism.

    Did you see a media report that relates to that? One that handled it well or not well?

  • Chris Jones

    WHY DID SANDRA FLUKE BRING IT UP?

    No need to shout.

    She brought it up to obfuscate and confuse the issue, the better to attach the Church. That is how political rhetoric works.

  • Will

    I thought I had seen it above as a rationalization for the “$3000 a year” claim. (Unless you already spiked that comment.) SOMEONE wants us to think there is controversy.

  • Will

    All right, I see it quoted from Fluke’s testimony in a comment on http://www.getreligion.org/2012/03/debating-access-to-religious-liberty/, presumably from media reportage.

    So, is there controversy about these “bona fide medical uses” or not. Clearly she wants us to think there is, and I am annoyed at being told that there is and there isn’t.

  • Ann

    Cost-sharing for “brand names” directly from HHS, August 1, 2011

    New health plans will need to include these services without cost sharing for insurance policies with plan years beginning on or after August 1, 2012. The rules governing coverage of preventive services which allow plans to use reasonable medical management to help define the nature of the covered service apply to women’s preventive services. Plans will retain the flexibility to control costs and promote efficient delivery of care by, for example, continuing to charge cost-sharing for branded drugs if a generic version is available and is just as effective and safe for the patient to use.

    http://tinyurl.com/3hjgssm

    My health insurance requires a letter from a doctor that contains scientific evidence, not just a doctor’s opinion, before it will cover name brands.

  • Aly

    Mollie is correct that this is not the place to debate the controversy, but rather the coverage. The issue I was raising – lack of real explanation of one legitimate health concern related to the Sandra Fluke testimony – was meant, I suppose, to take both “sides” of the argument to task, both those in the MSM who only talk about birth control for birth control’s sake, and those in specialized publications that paint this solely as a religious freedom issue.
    There’s another story in the testimony that no one is covering; birth control pills used for therapeutic purposes may not violate religious freedom but insurance providers can and do use that as an argument for not covering those 40+/year prescriptions.
    Why is this part of the story being so largely ignored in the coverage? The simple answer is probably laziness and bias. Shocking, I know. The more complicated answer, I suspect, has something to do with controversy driving web clicks. There’s no controversy if there is agreed-upon middle ground.