Our Stupid Debate on National Healthcare

I’ve held off writing anything about the whole contraceptives/Sandra Fluke/Rush Limbaugh mess because it’s a classic example of an important political debate turning trivial, stupid, and misogynistic. At the top level, we have the ongoing debate about how to reform the healthcare industry in this country. The current big and controversial plan is the Affordable Care Act, which is either going to save or destroy our medical industry, depending on what you believe.

The first step down toward stupidity is that under the Affordable Care Act every health insurance plan is supposed to include a lot of things that don’t belong under an insurance plan. As a general rule, it’s a bad idea to buy insurance that pays for things you can afford to pay for directly. Insurance is supposed to be a mechanism that protects you against disasters. This is why your car insurance protects you against the risk of major car repairs due to a crash, but not the risk of replacing worn-out tires or changing dirty oil. It’s also why it’s foolish to want health insurance to cover routine office visits and inexpensive medications. It’s cheaper to pay directly.

So why do health insurance plans cover these things? Two reasons, one good, the other bad. The good reason is that some of these things actually reduce your overall healthcare costs, so it’s to your insurance company’s advantage to cover you completely. This is efficient and good for everybody. The bad reason is that your medical expenses are not deductible from your taxes (unless they’re huge) but your employers are allowed to deduct the cost of buying you medical insurance from their taxes. Essentially, you are funnelling payments for your routine medical care through your employer to avoid paying income tax. It’s a complicated and wasteful response to tax policy.

The first step down toward trivia is the discussion over the requirement that all health insurance plans should provide contraceptive pills for women. If this was any other medication, it would hardly be worth discussing. In any serious attempt to reform healthcare, the criteria by which drugs are included in the formulary requirements for the standard insurance plans should be spelled out and applied to all medications. There shouldn’t be any need for Congress to decide these things on a pill-by-pill basis.

That’s where the Catholic Church enters the fray with their insistence that contraception is immoral, and that they shouldn’t have to pay for something they consider immoral. I don’t understand the Chuch’s position on contraception. I’ve heard explanations, but they always make it sound like the Catholic Church thinks that (1) people shouldn’t have sex for any reason other than to have a child, and (2) the way to stop them from doing that is to force them to have unwanted children if they do. Both of those points sound stupid to me, but I was raised as a Protestant, so I might be biased.

This all leads to a confrontation over whether or not religious freedom means the Church should receive special accomodations as a religious institution so that it can sidestep the requirement to fund contraception. Given that I’ve heard that contraception is one of those things which insurance companies like to include for free because it reduces their long-term costs, the Church may actually be paying more for the privilege of refusing to provided birth control to women, which seems stupid and more than a little misogynistic.

Then we get Sandra Fluke’s testimony before congress. It was largely a typical and unremarkable litany of the the difficulties women face from having to pay for birth control. I don’t think there’s any doubt that women’s lives would be better if they received free birth control, just as their lives would also be better if they received free iPads. But the money for either of those things has to come from someone, and I’m sure those other people’s lives would be better if they were allowed to keep the money. There’s an argument to be made here, but Fluke’s testimony was little more than a plea to be given someone else’s money. There was nothing unusual about this, as asking to be given someone else’s money accounts for a large fraction of the reasons people talk to members of Congress.

Then, for some reason. Rush Limbaugh got involved, which did nothing to reduce the stupidity of the discussion and really cranked up the meanness. He did some radio bits where he tried to portray Sandra Fluke as a “slut” and a “prostitute” who wanted to be “paid to have sex.”

For some reason I don’t quite understand, out of all the outrageous things that Limbaugh says, this one really upset people, to the point that they are organizing boycotts against his sponsors. My co-blogger Ken tells me it’s because Limbaugh didn’t just call her names, he really laid into her during a lengthy series of degrading tirades.

Maybe. I haven’t heard Rush Limbaugh’s show for any length of time since 1994, but I distinctly remember he used to go into a lengthy series of tirades about everything — although mostly, it seemed, about what other people were saying about him — and I somehow doubt this was any different. Just bad luck on Rush’s part, I guess.

Some of Rush’s defenders responded by reminding everyone the Bill Maher called Sarah Palin some bad words. And thus the debate on national healthcare has degenerated into an argument over which side has meaner talk show personalities.

And then, as I was writing this, I found out that Gloria Allred is trying to encourage a Florida State Attorney to press criminal defamation charges against Rush Limbaugh for “falsely and maliciously imputing to her a want of chastity” because “his reference to Ms. Fluke as a ‘slut’ and ‘prostitute’ were baseless and false.” I think somebody needs to explain to Ms. Allred that there is a hell of a lot of territory between “slut” and “chaste.”