By NEMS Daily Journal
OXFORD – All seats are taken as nine justices of the U.S. Supreme Court weigh murky legal theories surrounding Obamacare this week. On a more practical note, workaday Americans have been experiencing an “aha moment” over the requirement that insurance plans pay for birth control prescriptions.
Folks, it’s not that complicated. There are tradeoffs every time we ask government to do something for us.
And here’s a news flash: Taxpayers of all religions have been tapped for the cost of birth control for generations. Taxpayers have also been tapped for the cost of prenatal care, delivery and pretty much 100 percent of the health care of about one of five women in Mississippi and for their children. That’s through Medicaid, the federal-state program for the poor and disabled.
Let’s leave women alone and pick on men to illustrate the process:
* Medicines for men with erectile dysfunction have been paid for by Medicaid since the day the first little blue pill was sold.
* Medicare Part D (for people 65 or older, regardless of income) does not cover this class of medicines, at least specifically.
* Seniors who are “dual eligible,” enrolled in Medicare and Medicaid get their little blue pills for free.
During the recent dust-up over requiring all health plans to include birth control, a certain radio entertainer classified a coed who testified for the benefit as a prostitute. He said she fit the definition because she wanted the public to pay her to frolic with no risk of becoming pregnant. If so, the classification also fits one heck of a lot of grandpas whose frolics are being made possible by a prescription pad, Pfizer Pharmaceuticals and the taxpayers of the Great State of Mississippi.
Now to the core: The birth control coverage requirement is seen as an affront to religion for a simple reason: It is an affront to religion, a direct challenge to any faiths where artificial contraception is seen as sinful. The coed was from a Catholic university. Could government actually force its administrators to support, financially, paying for pills that work against basic church doctrine?
President Barack Obama had to step in. But his solution papered over the issue. Those who don’t want to pay for this coverage may opt out, but the policies will provide the coverage. That’s like to saying you didn’t stop at a sign, but because you meant to stop that’s good enough.
Say there’s a pharmacist who works hard, opens her own store and never misses a Mass. If she refuses to dispense a birth control pills, it would seem that’s her right same as a doughnut store might choose to sell chocolate-filled, but no sprinkles. Not so. The faithful pharmacist would be banned, deemed ineligible for any payments from Medicaid of Medicare, essentially bankrupting her for not toeing the line.
The media terms these clashes between government requirements and what we always thought were core principles of Americanism as unusual or, worse, unexpected. Horsefeathers. Government has to treat everybody alike. When we tell government to pay the fiddler, government calls the dance.
And it can get weird, mostly because once government writes rules, it follows its rules whether they make sense or not.
Let’s go back to Medicaid paying for Viagra.
This was never not discussed or debated. In 1998, the year Viagra was first sold, a letter from the Federal Health Care Financing Administration was written to all state Medicaid offices. It said, in essence, that since Viagra was not in a class of pills excluded by Medicaid, Viagra was covered.
Now Viagra didn’t exist when the list of medicines to be excluded was written. No matter. It was not on the list to be excluded, so it was included.
Fundamentally, America is a wealthy nation, a place where no person should suffer for the lack of medical care. That’s a given. Few disagree.
It would be nice to turn everything over to government and to expect no tradeoffs, that everything would be seamless, efficient. We don’t have that with public-private system in place now, and we won’t have it with Obamacare, either.
The template for the nation, the basic law the Supreme Court is dealing with, was designed to limit government’s reach and powers. With that foundation, expansions desired by the people and their presidents aren’t and can’t be neat, easy and clean.
Charlie Mitchell is a Mississippi journalist. Write to him at Box 1, University, MS 38677, or email firstname.lastname@example.org.