Obama administration mandates contraceptive coverage

The Department of Health and Human Services, which is taking on an Orwellian context come to think of it, has just added a new twist to healthcare law.

In the form of more mandates.

Following recommendations by the Institute of Medicine (IOM), the Obama administration announced this morning that insurance plans will be required to cover contraceptives, which include abortion-inducing drugs such as Plan B and Ella, as well as elective sterilizations.

Health and Human Services (HHS) Secretary Secretary Kathleen Sebelius in a news release included the drugs as part of an essential “preventive care” package. “Historic new guidelines that will ensure women receive preventive health services at no additional cost were announced today by the U.S. Department of Health and Human Services,” she said.

The HHS release notes that “contraception methods and contraceptive counseling” are to be covered, while CNN notes that the preventive mandate will include sterilizations.

The mandate comes after a massive, months-long push by abortion giant Planned Parenthood to establish free birth control for American women, a campaign strongly opposed by the U.S. Conference of Catholic Bishops.

Pregnancy is not a disease, they said, and this is not “preventive health”, which Congressman Jeff Fortenberry said on my radio show Friday evening just after the House voted on the debt deal. He’s co-author of the Rights of Conscience Act, even more under threat Monday than it was on Friday.

The spin has been interesting. Early on Monday, the Associated Press carried the story at this link with the headline “Insurers must cover birth control with no copays.” I printed it at the time to use in my show prep materials, so I have the original version. It opened with this:

Health insurance plans must cover birth control as preventive care for women, with no copays, the Obama administration said Monday in a decision with far-reaching implications for health care as well as social mores.

The requirement is part of a broad expansion of coverage for women’s preventive care under President Barack Obama’s health care law.

Etc., etc.

Then that same link took you to a story that morphed into this, headlined “Coverage with no copay extended to health care”. Here’s how it opened:

A half-century after the advent of the pill, the Obama administration on Monday ushered in a change in women’s health care potentially as transformative: coverage of birth control as prevention, with no copays.

Services ranging from breast pumps for new mothers to counseling on domestic violence were also included in the broad expansion of women’s preventive care under President Barack Obama’s health care overhaul.

Since birth control is the most common drug prescribed to women, health plans should make sure it’s readily available, said Health and Human Services Secretary Kathleen Sebelius. “Not doing it would be like not covering flu shots,” she said.

Yes, she really said that. It’s tortured logic (apply critical thinking skills to that one). Or it’s  Orwellian. Whichever is worse.

Now that Obamacare comes to light

Remember when Sen. Nancy Pelosi said they had to sign the healthcare bill to know what was in it? Well it has come to light, and some people are troubled by what it reveals.

Dr. Donalid Condit says it’s a big document loaded with sugar-coated rhetoric covering a bitter pill to swallow.

This ObamaCare prescription  threatens patients, the physicians who care for them, and the common good. The only clear winners are the consultants and lawyers busy trying to decipher this 429-page tome of acronyms and encrypted methodology that will compromise the doctor-patient relationship and is contrary to the principle of subsidiarity.

Very good point.

Medicare beneficiaries will be “assigned” to 5,000 patient-minimum organizations to coordinate their care. While HHS Secretary Kathleen Sebelius talks about improvement in care, the politically poisonous truth is that Medicare is going broke and ACOs are designed to save money. The words “rationing” or “treatment denial” or “withholding care” are not part of her press release, but reading the regulations reveals intentions to “share savings” with those who fulfill, or “penalize” others who fall short of, the administration’s objectives. The administration’s talking points include politically palatable words which emphasize quality improvement and care enhancement when the real objective is cost control by a utilitarian calculus.

Physicians and other health care providers will find themselves in conflict with the traditional ethos of duty to patient within ACOs.

Somebody has to point this out. The moral medicine we have taken for granted, that’s now under new threat.

Ever increasing numbers of doctors are leaving private practice and becoming employed by hospitals, due to a variety of challenges inherent in these uncertain times . The hospitals are the most likely recipient of bundled payments for caring for Medicare patients. Doctors will face agency conflicts between the time honored primary duty to patient, which may conflict with hospital administration, and ACO goals of fiscal savings. Medical care providers will receive incentives for controlling spending, and penalties if they do not. “No one can serve two masters” (Matthew 6:24). Not even physicians.

The physician’s ACO conundrum is illustrated in the language where these regulations proclaim that,  “Providers should be accountable for the cost of care, and be rewarded for reducing unnecessary expenditures and be responsible for excess expenditures.”

This is chilling.

Yet the very next sentence stipulates that, “In reducing excess expenditures, providers should continually improve the quality of care they deliver and must honor their commitment to do no harm to beneficiaries.” (page 14)

Doublespeak? Where is this leading?

The principle of subsidiarity guides policy makers to empower decision making and scarce health care resource allocation at the doctor-patient level. However, the Affordable Care Act moves in the opposite direction.

There is no question that significant – and scarce — health care resources are consumed in the Medicare population toward the end of life. ACOs intend to limit this spending — the government way. The Ethical and Religious Directives by the United States Conference of Catholic Bishops suggest a better path forward…

Laborers need “a new contract”

The U.S. bishops issued their annual Labor Day statement, written by Bishop William Murphy, Chairman of the Committee on Domestic Justice and Human Development. Bottom line: whatever social contract existed with American workers in the past, we need to revisit it now.

With millions unemployed and U.S. workers experiencing tragedies such as mining deaths in West Virginia and the oil rig explosion and subsequent oil spill in the Gulf of Mexico, Americans “must seek to protect the life and dignity of each worker in a renewed and robust economy…”

Robust economy? That’s a tall order. There are unusually difficult times, the bishops conceded.

“America is undergoing a rare economic transformation, shedding jobs and testing safety nets as the nation searches for new ways to govern and grow our economy,” said Bishop Murphy. “Workers need a new ‘social contract.’” Bishop Murphy said that creating new jobs would require new investments, initiative and creativity in the economy. He also drew on the teachings of Pope Benedict XVI, which call for placing the human person at the center of economic life…

“Workers need to have a real voice and effective protections in economic life,” said Bishop Murphy. “The market, the state, and civil society, unions and employers all have roles to play and they must be exercised in creative and fruitful interrelationships. Private action and public policies that strengthen families and reduce poverty are needed. New jobs with just wages and benefits must be created so that all workers can express their dignity through the dignity of work and are able to fulfill God’s call to us all to be co-creators. A new social contract, which begins by honoring work and workers, must be forged that ultimately focuses on the common good of the entire human family.”

New jobs…just wages and benefits….the dignity of work. Good message, bishops. Stay on it.