The recent "Hobby Lobby" Supreme Court decision defended the rights of the owners of a company to refuse to fund a health plan that covered abortifacient "contraceptives." The Hobby Lobby owners argued that such medications violated deeply held religious beliefs. So for now, by a disturbingly close 5-to-4 vote, the Supreme Court has asserted that government has no right to force business owners to violate their conscience-provided that the business is "closely held."
The response of the leaders of both parties demonstrates why medical decision-making and politics are not compatible. It also represents another reason why the federal government should not be involved in health care and why the Affordable Care Act (ACA) deserves to fail.
To illustrate, Republican House Speaker John Boehner said, "Today's decision is a victory for religious freedom and another defeat for an administration that has repeatedly crossed Constitutional lines in pursuit of" big government. He then added, "The President's health care law remains an unworkable mess and a drag on our economy."
Rep. Debbie Wasserman Schultz of Florida, head of the Democratic National Committee, pounced upon the ruling, hoping to frame it as a winning campaign issue for the mid-term elections in November. "It is no surprise that Republicans have sided against women on this issue as they have consistently opposed a woman's right to make her own health care decisions," she said, calling the ruling a "dangerous precedent."
A dangerous precedent? Against women? Really? What about the precedent of the ACA giving unelected bureaucrats the power to dictate what all Americans can be forced to pay for if they buy insurance? And what about the dangerous assumption that if insurance doesn't cover it, you can't have it? And what about the fact that physicians whom patients have come to trust might not be in the network that the employer has chosen?
What about the increased premiums, higher deductibles, jobs and hours cut, and expensive mandated benefits? Isn't this disruption of business and hiring decisions a "dangerous precedent?"
Some are now urging Congress to act. AMA president Robert Wah said the decision "intrudes on the patient-physician relationship and will make it more difficult for many women to make their own personal medical decisions."
It's not personal decisions that are of concern to those following the reasoning of a Washington Post editorial. It's a "balancing test" of personal morality and freedom versus the government view of public health. If the Institute of Medicine, the Food and Drug Administration, and a committee appointed by the Secretary of Health and Human Services decree that a certain treatment promotes public health, then everybody should be forced to pay for it-and possibly even provide it.
Where does that leave the patient-physician relationship?
The Hobby Lobby controversy highlights the flaws inherent in the ACA. The federal government has taken on the role of health care decision making, deciding what gets covered and what does not-and injecting politics into the practice of medicine.
Four Supreme Court justices would have upheld the federal government's authority to destroy a company with a fine of $475 million per year for declining to pay for four of 20 methods of "contraception." The fine for dropping insurance would have "only" been $26 million. This is the price that politicians such as Wasserman Schultz would like to impose on business owners for following their conscience. Whatever you think about those four methods, that's a dangerous precedent for government power.
Some fear that Hobby Lobby, limited though it is, might allow others to go further. Some people, for example, object to contraception in general. And some, the FDA notwithstanding, think that hormonal contraceptives are harmful. Is declining to pay for something an imposition on women's rights? Or is forcing people to support government-dictated benefits a violation of the fundamental Constitutional rights of all Americans?
Hobby Lobby is not waging a "war on women." It is defending a tiny wedge of freedom. Those who oppose this ruling are waging a war on common sense to distract from the wreckage the ACA is creating in American medicine and the economy.