Tag: birth control

PP, CMP, Videos, Oh my!

Over the last couple of weeks, an organization called the Center for Medical Progress has released a series of undercover videos alleging that Planned Parenthood has been selling parts of aborted fetuses for medical research. Posing as representatives of a medical research company, they have made inquiries about acquiring fetal tissue for research. On the videos, Planned Parenthood representatives discuss how to provide the tissue. They also joke about the procedure and talk about how abortion providers can carry out abortions to spare organs that medical researchers want.

Selling parts of aborted fetuses for profit is illegal. However, asking for compensation for the costs of harvesting those organs is legal. Right now, it appears that Planned Parenthood is in compliance with the law.

Planned Parenthood and the medical companies are countering with allegations that the videos are deceptively edited and several companies have sought a court order to prevent further releases of the videos. Ken White breaks that down here. The short version is that the Center for Medical Progress can not be forced to not show the videos unless they have already waived their first amendment rights by signing non-disclosure agreements. There also appear to be issues with the Center for Medical Progress sting videos taken in California, which is a two-party state. The Center, however, has indicated that they intend to release more videos.

In general, I tend to shy away from the abortion issue. People are too entrenched on the issue. If the Center for Medical Progress has broken the law — either by violating a non-disclosure agreement or taping someone in California without their consent — they should be punished accordingly. And if Planned Parenthood or other organizations have broken the law by selling fetal tissue for profit, they should be punished accordingly. The courts seem well on their way to sorting this out.

The Republicans, however, are using this in yet another effort to defund Planned Parenthood. Planned Parenthood doesn’t get money for abortions. They do, however, get money from grants and from Medicaid for providing birth control and disease screenings to poor women and the Republicans now want to shut that off. I have to say that I’m against this. Planned Parenthood provides abortions. This has never been a secret. Abortion is a nasty business. That has never been a secret either. But their abortion business and their birth control operations are separate and trying to defund the latter because of the behavior of the former is, effectively, trying to ban abortion through the back door.

No, it’s worse. Cutting off Planned Parenthood from federal funds will have no effect on their abortion business. It will simply mean fewer women getting contraception and more women having babies (and having more abortions). It will mean fewer women getting condoms and more women catching diseases. And while you might say “Hey, let them pay for their own birth control!” guess who’s going to have to pick up the bill for those babies and diseases? Unless the Republicans are also willing to shut off Medicaid, WIC, food stamps and everything else … including for children … this is not a move to save the government money. And it is doubly not a move to save money because the Republicans want to divert that money to ineffective faith-based programs that will result in more poor women having babies and getting diseases.

There’s one other aspect of this, though. One I’m hesitant to get into, but one I think is important. The thing is … while I disagree with the Republicans, I understand where they’re coming from.

The pro-choice side has a very long history of trying to run away from the gruesomeness of abortion. They’ve tried to keep protesters from showing signs of aborted fetuses; they’ve tried to block informed consent laws that tell patients how abortion works; they try to pretend that the procedure is no more significant than having a boil lanced.

But this is nonsense. Abortion is a gruesome business. Most medicine is. I had my gallbladder out a few years ago and that was still nasty despite being done through a laparoscope. If you work in medicine for any period of time, you will see things that make your stomach turn. And then you will get inured to it.

If there have been laws broken, that needs to be punished. But there is nothing illegal about providing fetal tissue — at cost — to medical research companies. The alternative is to incinerate the tissue. But there’s also nothing wrong with abortion opponents pointing out that harvesting of fetal cells exists and that abortion providers try to accommodate that demand. This is part of the debate. It is perfectly acceptable to say to pro-choicers, “If you think abortion, should be legal, this is what you think should be legal.” And honest pro-choicers, like Elizabeth Nolan Brown, have accepted that. I accept that (although I oppose most late-term abortion).

The outraged response to this from the Left; the reflexive defensiveness; the attempt to impugn the Center for Medical Progress as “extremists” (which they are) instead of addressing their claims represent a real problem for the pro-choice movement. They don’t like to talk about what abortion entails.

This is not unique to the pro-choice movement. Pro-death-penalty people don’t like to talk about botched executions and the likelihood that the lethal injection combo we use causes excruciating pain. War advocates don’t like to see pictures of dead children. But that doesn’t change the reality of these policies (or their necessity, if you think them necessary).

The pro-choice movement, which I reluctantly agree with, is trying to run away from the reality of what they support. I don’t think they can.

Planned Parenthood’s War on Women

Over the last few weeks, a number of prominent Republicans have come out in favor of making the birth control pill available over the counter. This action has the support of the American Society of Obstetric and Gynecology. It would almost certainly bring prices down and obviate the need for women to make an expensive visit to the OB/Gyn to get birth control. It wouldn’t end the Culture War, but it would turn down the heat a bit.

There are reasons to be concerned: the “standard” pill isn’t appropriate for everyone and the wrong prescription can create serious health problems (a friend of mine developed a pulmonary embolism because of a bad scrip). But opposition is also coming from an unexpected source: Planned Parenthood.

Planned Parenthood opposes over-the-counter contraception, pushing back against a popular Republican argument being used in many Senate races this year.

The nonprofit’s lobbying arm, which advocates for women’s reproductive health issues, argued that calls for allowing birth control pills to be sold without a prescription are “empty gestures.”

The policy change would “force women to go back to the days when they paid out of pocket for birth control — which can cost upwards of $600 a year,” Planned Parenthood Action Fund wrote on its website.

As has been pointed out, there are stores that sell birth control bills for as little as $10-20 a month. Furthermore, there is no power on Earth that can stop an insurer from covering birth control even if it is over-the-counter. In fact, there’s no reason the birth control mandate can not include reimbursement for OTC birth control (said mandate having been upheld for all but religious organizations and closely-held corporations). Going even further, the contraception mandate was justified by its supporters because some women need very specialized birth control or IUD devices. These would not be available over-the-counter as Planned Parenthood notes in their own statement. Nothing in this would destroy the Obamacare mandate. Nothing in this would stop women from getting birth control. All it would do is change how they get it.

Then there’s this gem:

The statement also noted that no prescription drug manufacturer has applied for their pills to be made available over the counter.

As one of my Twitter followers noted, spot the paradox! We can’t make it available over the counter because no one is asking for permission to sell over the counter this thing they legally can’t sell over the counter.

Of course, I’m sure this has nothing to do with Planned Parenthood themselves being a vendor of reproductive services and prescription birth control. Nothing whatsoever. And I’m sure it has nothing to do with the money they get from the federal government and state governments to provide birth control to poor women. And I’m sure it has nothing to do with their political arm wanting to maintain a “war on women” to raise money and campaign against Republicans. God forbid we should defuse that particular line of crap.

It’s funny. Planned Parenthood is an organization I agree with on a number of issues. But the way they approach the issues fills me with revulsion. They are stewed in Culture War rhetoric and a deep hatred of everything Republican. In this case, it has massively warped their vision. Making birth control available over the counter would do a lot to increase women’s access (especially for those who are uninsured). Planned Parenthood’s position is that they oppose it because REPUBLICANS.

If there’s a War on Women, Planned Parenthood is shooting at their own side.

The Big Shoes Drop

Two 5-4 decisions from SCOTUS today. The first was on forcing non-union employees to pay union dues. The Court decided they can not be forced to. The second was on mandated contraception coverage. The Court ruled narrowly that closely-held corporations can get a religious exemption. But it kept the door open for the government to provide such coverage.

I think the Court ruled correctly in both cases but expect very ugly commentary, especially on Hobby Lobby. There is a huge problem in the Left Wing in understanding the difference between something being a good idea (employer insurance should cover birth control) and something being mandated by law (employer insurance should be forced to cover birth control). So expect lots of commentary about how women’s rights have been set back (all the way to yesterday), how the court was mansplaining, how none of the female justices rules in favor of Hobby Lobby, etc., etc.

Just remember this. At the end of the day, women have no less access to birth control than they did last week. If you really want to make a difference in access to birth control, push the FDA to make it available over the counter. That will do a lot more good than forcing corporations to pay for it.

Update: A very important point from McArdle. The net result of this decision will almost certainly be that Obama will extend the deal he made with religious non-profits — where insurance companies agree to pay for contraception — to closely-held for-profits. And this compromise could have been made years ago.

As I see it, this case should never have made it to the court; the Barack Obama administration should have pre-empted the issue by quietly allowing exemptions for nonprofits and closely held corporations that had clear and deep religious beliefs that existed outside of the desire not to pay for contraception. (Hobby Lobby, for example, is closed on Sundays in observation of the Sabbath, even though this costs them sales; I think we can all agree that the Little Sisters of the Poor have demonstrated a fair amount of commitment to demanding religious principles.)

Instead, the administration chose to pick this fight — and got a definitive ruling that will probably have much broader impacts than quiet exceptions. Nor is this surprising; it was pretty predictable from earlier rulings like Citizens United, in which the court also held that people don’t lose their First Amendment rights simply because they have come together in a group or legally organized that group as a corporation.

Presumably, the administration hates this ruling — but at the same time, it has to love the passion that it has engendered. This is going to be fundraising gold for Democrats for the next two years. In a politics that cares more about symbolism than substance, that too was predictable. And it’s hard to avoid the conclusion that this was the prediction that mattered more. Politics may not be rational, but it still has its own remorseless logic.

Look at Twitter. Look at Facebook. Look at the liberal blogs. They are exploding with rage over a decision that will ultimately have almost no impact on women at all. Women will get contraception coverage; just through a different financial means. So the Obama Administration has riled up their base over next to nothing.

This is how they operate, people. Let’s not act surprised.

Sebelius v. Hobby Lobby

The Supreme Court heard oral arguments yesterday in the case of Sebelius v. Hobby Lobby. This case concerns whether the federal government can force an employer to provide birth control to their employees. Hobby Lobby is claiming it violates their Freedom of Religion and the Religious Freedom Restoration Act to force them to pay for a service they have a moral objection to.

You can read some legal analysis from Mataconis and a series of posts from Stephen Bainbridge. It looks like the Court is leaning in favor of Hobby Lobby, perhaps with a narrow ruling that only addresses this particular issue.

There are two things I wanted to note about this, however.

First, I tend to side with Hobby Lobby on this one. My support has little to do with birth control and everything to do with opposing coverage mandates. Coverage mandates drive up insurance costs and provoke these kind of bitter arguments. It’s bad enough that the government is forcing people to provide or buy insurance. Why must it insist on specifying what the insurance will cover?

The potential for abuse is very high here. What’s to prevent some moonbeam President from mandating coverage for pseudo-scientific gibberish like therapeutic touch or aromatherapy (as indeed, some Senators tried to do and some states actually do)? What’s to prevent a future President from forbidding birth control coverage, especially given the precedent this President has established for ad hoc rewriting of the law? It’s bad enough that employers can control our healthcare. Many employers are now mandating “wellness” programs and the like. Must we let the politicians do it too?

Frankly, I’d prefer the Court strike down coverage mandates in general but they are not going to make such a broad ruling.

But second, this is another reminder that although I side with the Left on a number of culture issues, I am never very happy about the company I keep. The Left Wing, with the sympathetic media in lockstep, has responded to the Hobby Lobby case with a barrage of lies about the case, the law and birth control that is really despicable. They are desperate to pretend that, if Hobby Lobby wins, this means the end of birth control. But it does not:

The New York Times’ Adam Liptak puts it right there in the first sentence: “The Supreme Court on Tuesday will hear arguments in a case that pits religious liberty against women’s rights.” This could not be further from the truth. Women will have the same constitutional rights to acquire and use contraception regardless of whether Hobby Lobby wins or loses. More than that, they’ll have the exact same rights as they had before the contraception mandate was a gleam in Sec. Sebelius’ eye. What women won’t have is the right to force other people to pay for their contraception, but that has never been a right recognized by the Supreme Court.

In the Bizarro World of the newspapers, not paying for someone else’s contraception is the same thing as prohibiting them from purchasing and using them themselves. This is an obviously false equivalence, but one that leftists are bent on telling themselves. No matter how many times you point out that the business owners in these cases aren’t preventing their employees from purchasing and using contraception, a smug leftist will smile and say “but women’s rights, you see,” as if these magic words excuse the lie.

Opponents of Hobby Lobby say that, if the Court decides in their favor, this will allow employers to “impose their morality” on their employees. But there is no such imposition. Hobby Lobby can not stop their employees from buying birth control. They can’t stop them from having sex. They can’t stop them from having gay abortions while smoking pot and watching Girls.

So why is having to pay for your own birth control oppression? Because the Left Wing has convinced itself that healthcare is a right, that health insurance is a right and therefore, if your employer refuses to pay for any healthcare service, they have deprived you of that right.

I find this view absurdly childish. This isn’t heart surgery we’re talking about; this is birth control, which is available for a few hundred bucks a year for most women and can be replaced cheaply with condoms or withdrawal or abstinence. Claiming that you have been “deprived” of birth control because someone else won’t pay for it is no different than claiming you’ve been deprived of electricity because you have to pay your own electric bills (which are, incidentally, usually more expensive than birth control).

If the Democrats are so passionate about birth control, why don’t they create a government program to provide it? I would oppose such a program, but it would likely be constitutional. Of course, they could never get such a program through the legislature. So they have to resort to the back door of forcing other people to pay for it.

Let me be clear. If I ran a business, I would choose insurance that included birth control coverage. I think employers should include it, although bringing birth control into the insurance sphere will likely drive up the cost of it for everyone. But there is a distinction between thinking something should be done and decreeing that it must be done, a distinction that seems lost on the Left Wing.

I would also point out that the “employer imposing their morality” argument only applies in this case. As Bainbridge points out, corporations debate morality all the time — whether to do business with sweat shops, whether to go green, whether to provide daycare, how much maternity leave to provide, whether to divest their funds from nefarious foreign countries.

Large corporations are already faced with choices over whether to pursue social justice, civil rights, and environmental concerns, and with disputes over the interests of majority shareholders, proxy questions, and the like. Corporate law has extensive mechanisms in place for dealing with these scenarios. Religion as one motive among many does not change the landscape.

In fact, religion is already part of that landscape, since state law allows corporations to pursue it among all lawful purposes. There are no practical or theoretical grounds for specifically excluding religion as a permissible basis for corporate decision- making—indeed, it would be a clear violation of the First Amendment to even try. See Emp’t Div., Dep’t of Human Res. of Or. v. Smith, 494 U.S. 872, 877 (1990) (noting that the government cannot ban “acts or abstentions only when they are engaged in for religious reasons”). Yet businesses infrequently choose to pursue religious ends.

As a practical matter, it is hard to demonstrate any interest shown by large, publicly-traded corporations in exercising religion. Market forces tend to push such firms far away from religious controversy. It is no accident that this case and related litigation involve corporations that are closely held.

Is Chick-Fil-A “imposing their religion” by being closed on Sundays? What if Apple announced that they would provide cars to their employees … but only if those cars were electric or hybrid cars. Would the Left Wing start screaming about Apple “imposing their morality” on their employees? What if a university were to ban Apple computers because they don’t like the work conditions in Apple’s factories? There would be some vigorous debate — I would oppose it. But would people think the federal government should step and force the university to use Apples? What distinguishes these moral decisions from a moral decision about what kind of health insurance to provide?

If Hobby Lobby — an ostensibly non-religious organization — were forbidding their employees from obtaining or using birth control pills, I’d be on the side of their opponents. But all they are asking for is to not have to pay for it.

In fact, the Left Wing’s arguments are so disingenuous, I think we are seeing a degree of hysteria. I think they are scared because if the Court strikes this down, it will endanger all coverage mandates. Their ability to dictate every detail of our insurance coverage — to effectively create single payer through mandates and restrictions — will be badly damaged.

But I also think there’s a more concrete motive. The Democrats are pushing this issue and lying about it because, as I pointed yesterday, the polls are not looking good for them. They are worried they are going to lose the election in 2014 and possibly in 2016. And so they are dragging the “War on Women” back out.

Am I too cynical? I don’t think so. This issue has reached a fever pitch at almost the same moment that pundits are projecting a Republican Senate in the fall. The attempts to stuff what is ultimately a business issues into a “War on Women”-shaped hole has almost exactly paralleled the rising unpopularity of Obama and Obamacare. And frankly the Democrats have a long and ugly history of trying to terrify the populace — especially the distaff part of it — with scary stories about how Republicans, if elected, will take away their Medicare, their Social Security, their Obamacare, their birth control, their abortion, their education and their dental fillings if they fall asleep.

So, in the the end, this really isn’t about birth control. If the Democrats really cared about access to birth control, they’d be talking about the solution many libertarians favor — make birth control available over the counter. That would do far more to make birth control available to women than a coverage mandate. No, this about politicizing the hell out of women’s reproductive systems in the hope of holding off electoral defeat.

The Republicans may or not be fighting a “war on women”. But the Democrats are using them as vehicles for their own political gain. I don’t see that that’s any better.

Babies Delaying Babies

Last week, the CDC announced that teen pregnancy rates are the lowest … ever. At least for the seven decades they have been measuring. The fall has erased the surge we had in the late 80’s/early 90’s and the rates are now lower than any time since the 40’s. The rate of teen abortion is way down as well.

The CDC attributes this to increased use of contraception. This, of course, has provoked the usual outcry from the usual quarters, who are insisting that the real cause of the drop is abstinence education, which somehow propagated backward in time to 1991, when the teen pregnancy rate hit its recent peak. It has also apparently propagated to states that do not have abstinence-only education and have the lowest teen pregnancy rates.

Of course, it’s garbage. Teens who get comprehensive sex education — meaning they are taught about abstinence and birth control — are far more likely to delay sex as well as far more likely to use contraception. The reason, I think, is that when you know that safe sex entails adult actions like buying condoms or pills, it becomes intimidating. It becomes a real complicated thing, not some mysterious fantasy. It’s much easier to have sex when you think Jesus is going to protect you than when you know you yourself have to drag you yourself’s own ass down the to drug store and you yourself have to buy condoms from a smirking clerk.

As I noted before, however, these stubborn facts are unlikely to change the Culture Conservatives’ minds. To them, the important thing is that we tell teens not to have sex; that we wave the moral flag that any pre-martial sex is unacceptable even if said waving means more horny ignorant teens getting knocked up or infected. The principle is what matters, not the result. I see no reason, however, why this moral view should triumph over a clear public health need.

I think it’s likely some other factors are contributing as well. The decline in pregnancy rates has corresponded with the rise in porn, sexting and other online sexual trends. Feminists, having utterly failed to show that porn leads to sexual violence, have recently argued that porn is destroying sexual intimacy. I wonder if they are grazing a truth: if online porn makes it easier or someone to get his jollies risk-free (modulo parents who can read a browser history) until he is mature enough for the real thing.

I also wonder if the last two decades of tightening abortion restrictions have contributed. Parental notification laws and other changes have made abortion a hassle, if nothing else. It is a primary principle of economics that incentives matter. If it’s harder to get an abortion, people are less likely to engage in behavior that may lead to one.

But these are likely minor factors. The big change, according to most research, is that teens are delaying sex and are more likely to use birth control when they do get busy. Both of these are good things and both have been going on for twenty years now. Abstinence-only education is the only thing that’s not helping. Whatever else we’re doing, it’s working.

A Payout to Big Pharma

Let’s repeat this before we start: the current debate is not about birth control. No one wants to abolish birth control, not even Rick Santorum. You think with all the mistresses and hookers the GOP has stashed away, they want to get rid of birth control? No, the debate is about a mandate, plain and simple. It’s about what government can and can not force insurers/employers to do.

But the furor has missed something important. As Avik Roy points out, the birth control mandate isn’t just a vote-buying scheme for women. It’s a huge payout to the Big Pharma companies that supported Obamacare.

Today, oral contraceptives are really cheap. At Wal-Mart, a one-month supply of Sprintec or Tri-Sprintec, manufactured by Barr Laboratories (a unit of Israeli drug giant Teva Pharmaceuticals) costs a grand total of $9.

Under the current system, drug companies have an incentive to compete on price. If you have health insurance that covers birth control today, your insurer is likely to charge you a higher co-pay for expensive, “branded” versions of birth control over cheaper, generic ones. If you don’t have health insurance, and you’re buying the Pill directly from the pharmacy at Wal-Mart, you have even more incentive to shop on price.

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.

The Democrats simply refuse to understand the basic economics of the four ways money is spent. When you can spend somebody else’s money on yourself, you have no incentive to control costs. This is one of the key reasons our healthcare system is such a clusterfuck: the people consuming healthcare are disconnected from the people paying for it. No one has any incentives to control costs. And by promising 100% first-dollar coverage of birth control — no matter how much that birth control costs — the President is laying the groundwork for making this problem far far worse.

And that’s just looking at it from the side of “how much is this going to cost us”. The big story is the payout we are giving to Big Pharma in return for their support of Obamacare — a payout that could amount to billions. When George Bush refused to include price controls in Medicare Part D, he was pilloried for it and derided as an instrument of Big Pharama. But now we have a President giving a far more direct subsidy to pharmaceutical companies and not only is he not criticized for it, he is praised for his progressive insight and vision.

To hell with this Derrick Bell crap. Forget about Bill Ayers and Saul Alinsky. This is what matters. We have entire industries — banking, automotive, energy and pharmaceuticals — that are getting handouts and subsidies from our government. Obama didn’t start this nonsense, but he is making it worse. And this is not the path to prosperity, no matter how much the prospect of free birth control tickles the fancies of radical feminists.