Marie was a young woman who struggled with her weight, starting from a young age. At seven, her mother placed her on her first diet. At fifteen, they took her to an institution to be treated for bulimia. Like all chronic dieters, she suffered from a weight that yoyo-ed. Marie could never be satisfied, for she was bombarded daily with advertisements demanding she live up to our culture’s paradoxical ideal – enjoying food in overabundance, eating out often and cleaning her plate—while maintaining the slimness of models whose own waistlines were trimmed with Photoshop.
That was, until the miracle elixir came— a simple formula syrup that could be consumed with any meal. Researchers found a way to coat microvilli in the small intestine so that food would be fully processed by the body, but not truly digested. It initially was designed for people who had diseases of the intestine, but the real market was much, much bigger.
Soon ads for the Syrup were everywhere! You could eat all the food you wanted, but consume a modicum of the calories. Doctors made different varieties, some that would cover a single meal, some that would last ten years before needing to be replaced, some that would cover you for a lifetime. Health advocates hailed the Syrup as a vital invention for the modern world!
The Presidential administration in power launched new initiatives to distribute the Syrup everywhere – including for free to all school-aged children. Mrs. Obama had experimented with the Let’s Move! initiative, but it simply wasn’t working fast enough. The Syrup was seen as the only way to truly handle the obesity epidemic. With 30% of Americans overweight and another 30% obese, it seemed there was no other option. Marie became their poster child— a model of overcoming obesity through modern medicine!
Soon, insurance companies began covering the Syrup in the hopes of saving money by staving off other more expensive procedures like diabetes treatments. As more and more Americans started taking the Syrup, it became harder and harder for those who didn’t want to take it to refuse. Cultural norms are powerful, and the ability to indulge in any food with none of the consequences was enticing.
Of course, for a small number —about 20%— of imperfect users (those who forgot to take the Syrup and those who didn’t take enough), they still remained obese. And just like all treatments, it wasn’t 100% effective even for perfect users— about 3% would find themselves still obese or even gain weight. But liposuction still existed for those folks.
The only problem remained the cost. Like all medical treatments, there were different costs in different places. Though the Syrup was, by far, one of the cheapest medicines on the market, that didn’t mean much for the poor who could barely put food on the table. Folks with lower-income levels were some of those most impacted by obesity. It was considered public health priority #1 to figure out how to manufacture more affordable Syrup and to distribute it to those who needed it the most. Soon a plan emerged for the federal government to mandate that all insurance providers cover the Syrup, branding it as an essential part of the universal right to health care and oby’s (obese persons’) rights.
There were, alas, some name-sayers. The Catholic Church had consistently opposed the Syrup on the grounds that it encouraged gluttony; a few Christian groups joined them in this opposition. The progressives retorted that gluttony had always existed. The Church wondered how a technological invention only required because of our overindulgence in food could be considered a human right mandated by the federal government. The progressives complained that the Church callously invested in stopping the medicine but had no truly effective plan to help the overweight. But the religious uproar was finally enough that the Obama administration wisely decided to maintain an objection for churches— if there was an ethical religiously-based objection to providing the Syrup, churches and ministries would be exempt from the ruling. (This was deemed acceptable because most of the people working in such organizations would likely hold the same beliefs as those providing the insurance.)
But this wasn’t enough for the religious zealots. Some of them had been fanatical enough to want their ethical beliefs to play out in the workplace; they objected to the secular idea that religion should be removed from all public activity. They’d formed companies motivated by their religious principles and believed their companies—as proper expressions of their religion— should be exempt from the gluttony-promoting requirement to provide the Syrup. As their lawsuits advanced, the circuit courts were split—the 9th and 6th insisted the Syrup mandate must be upheld while the 7th argued the mandate violated religious liberty.
Finally, the case came before the Supreme Court. Lawyers for the government argued that the overwhelming public interest in preventing obesity, the critical value of the Syrup as medicine, and the necessity of eating to our very humanity trumped over the desire of individuals to think consciously about their decisions and avoid taking actions which would unethically promote a culture of wastefulness and indiscriminate consumption. The ruling was split solidly down partisan lines. Though the religious fanatics won this round, Ginsberg, Sotomayor, Kagan, and Breyer stood up for essential oby’s rights. The four justices argued that an employer’s refusal to cover the Syrup would “deny legions of [people] who do not hold their employers’ beliefs access” to this vital medical innovation, the relative cheapness of that innovation notwithstanding. After all, it is no violation of rights to require every person to pay for morally questionable services for others; the real violation of rights comes when you choose to not pay for another person’s syrup. Because to 4/9ths of the Supreme Court and to many in America today, freedom means you demand from others the oil to polish your shackles.