Saturday, January 25, 2014

Hobby Lobby, Healthcare and Religion

David Green, the founder and CEO of Hobby Lobby Stores, Inc., says in protest of the ACA mandate requiring birth control to be covered by insurance:

“A new government healthcare mandate says that our family business MUST provide what I believe are abortion-causing drugs as part of our health insurance.   Being Christians, we don't pay for drugs that might cause abortions, which means that we don't cover emergency contraception, the morning-after pill or the week-after pill. We believe doing so might end a life after the moment of conception, something that is contrary to our most important beliefs.  It goes against the Biblical principles on which we have run this company since day one.”

Ironically, he quotes James 3:17 in support of his position:  “The wisdom that comes from above is first, pure, then peaceable, gentle, open to reason, full of mercy and good fruit, without uncertainty or insincerity.”

Open to reason?  Full of mercy?  Without uncertainty?  Ok, then let us reason together.

THE RELIGIOUS CONSIDERATIONS

Mr. Green insists that providing health insurance to his employees that covers birth control, which he believes “might end a life after the moment of conception” (and we will address this belief in the next section), violates his religious liberty as a Christian in that it “goes against Biblical principles.”  Which principles are these?

The term “Christian” generally means “a follower of Christ.”  So, what did Christ say about abortion?  Nothing.  However, despite our Founder’s total silence on the issue, anti-choice Christians assert that their position is based on “Biblical principles.”  I have already addressed this assertion in some depth in my previous article, “Is The Bible Pro-Life?”  But, let’s review a few pertinent points. 

First, one might think that this is common knowledge, but just in case it isn’t:  Jesus was a Jew.  Judaism states that a baby is part of its mother until it is halfway born, and begins life as an individual when it takes its first breath – not at the moment of conception.  Because biblically the breath is life, God imparts the soul (which was created before conception) along with the first breath.  But, the status of official “personhood” as such was only awarded to male infants one month after birth.  (It remains unclear to me as to when, or whether, female infants became “persons.”)  While the fetus is valued as a “potential human life,” the Jewish faith does permit abortion for several reasons including the circumstances of the conception (adultery, rape, incest), the age of the woman (under 17 or over 40), and her physical and psychological health, and requires abortion if the mother’s life is in danger.

So, while fundamentalist Christians like Mr. Green believe that life begins at conception and that abortion is murder, their belief has no Biblical basis and would not have been shared by their Jewish Founder.  In addition, this belief is a fairly recent development in modern Christianity, which was only adopted by evangelicals in the early 1980s.  

“without insincerity"

Therefore, Mr. Green’s claim that his objection to birth control coverage by insurance is based on “Christian/Biblical” principles is simply not true.  Be that as it may, let us give him the benefit of the doubt, because he sincerely believes it to be true.  Religious belief is a deeply personal thing, is protected by the Constitution, and cannot legally be subjected to any litmus test for “truth” or even internal consistency.  Mr. Green has a right to his beliefs.

 But, while everyone is entitled to their own religious beliefs, no matter how peculiar, can the same be said about scientific fact?  Let us take a look at the medical facts.

THE MEDICAL SCIENCE

Mr. Green said, “- we don't cover emergency contraception, the morning-after pill or the week-after pill. We believe doing so might end a life after the moment of conception…”  He believes contraceptives might end a life, but do they? 

First, let us address the anti-choice contention that modern science supports their view of a fertilized ovum being a “person” from the moment of conception.  It does not, for the simple reason that science does not concern itself with metaphysical definitions such as “personhood.”

What science can tell us about is the biological mechanics of pregnancy, a subject on which many people apparently are uninformed and/or misinformed.  I have already addressed this at some length in my article, “Biology, Personhood and Human Rights,” and I will not go into great detail here. 

“without uncertainty”  “abortion-causing drugs” ?

Hormonal contraceptives all work by preventing ovulation, and where there is no egg, there can be no conception.  With unprotected sex, fertilization can happen anywhere from 30 minutes (if an egg has already been released and is present in the fallopian tube) or up to 5 days later, if sperm survive and ovulation occurs during that time.  The pill prevents fertilization by fooling the body into thinking it is already pregnant, thereby suppressing ovulation on a monthly basis when taken regularly.  Plan B (the “morning after pill”) prevents fertilization by delaying ovulation when taken the next day.  Ella (the “week after pill”) suppresses ovulation if taken up to 5 days after sex, thereby preventing fertilization.  But, contrary to popular belief, these drugs do not prevent implantation of a fertilized ovum!  If the ovary has already released the egg, and sperm are present, the drugs are completely ineffective and the woman can only pray that the odds will be in her favor and it will fail to implant (which happens approximately 60% of the time under normal circumstances without any intervention).  

It should be noted that even if these drugs did prevent implantation of a fertilized ovum – which the latest science says they don’t – this would not constitute “abortion” per se.  Abortion, whether induced or “spontaneous” (i.e. miscarriage) is the termination of a pregnancy, which technically does not occur until implantation, 7 to 10 days after fertilization.  This is what I learned while training for my medical career back in 1992 and remains the standard medical definition of “pregnancy” despite efforts on the part of the anti-choice movement to change the definitions to better suit their agenda.

So, Mr. Green’s concern that hormonal contraceptives cause abortion is not, in fact, an issue.  Nonetheless, his personal religious convictions, however unfounded they may be in scripture and tradition, remain protected by the Constitution.  So where does that leave in terms of public policy?

THE IMPLICATIONS

Mr. Green and those in his camp say that requiring an employer to provide insurance coverage for contraception violates his religious liberty.  But, what about the religious liberty of the employees?  Why is it ok for the employer to impose his own religious beliefs on the employees?  Is it reasonable that their medical care should depend on their employer’s religion?  It’s hard enough to find a decent job these days; will people now be required to seek employment only with employers who share their religion, in order to obtain healthcare coverage?  And why is it the employer’s business what the employee does with his or her own body, outside of the context of their job?  The adult employee is neither the child nor the slave of the employer, and is able to make his or her own moral decisions according to their own religious beliefs or lack thereof.

“full of mercy and good fruit”

Not to mention, the whole can of worms that religious exemptions to ACA would open in terms of various religions and their views on blood transfusions, organ transplants, tissue/bone grafts/ medicines derived from cows or pigs, vaccinations, or medical interventions of ANY kind, which could have a life or death impact on the insured employee  -  but this is a separate issue.  

Interestingly, I don’t remember the coverage of birth control by insurance ever being an issue prior to the Obama presidency.  In the past, back when I was fortunate enough to have health insurance during the many years that I worked for both Christian and non-Christian companies, birth control was always covered like any other medication.  I don’t recall any employer, including the Christian ones, ever paying the slightest bit of attention as to the details of what was covered; they were only concerned about affordability.  No employer ever asked me if I used birth control.  It would have been an embarrassing, indeed unthinkable, invasion of privacy!  Of course, for me it’s a moot point now, because being self-employed, with a preexisting condition, I am unable to obtain any health insurance, thanks to my state governor refusing to cooperate with the ACA plan as a result of pressure by conservatives like Mr. Green.

As a business owner myself,  while I disagree with Mr. Green, I do sympathize with his concerns.  All of the above – the concerns of employers, as well as the needs of citizens, whether they be employed or unemployed – is a good argument as to why healthcare should not be dependent on the whims of our bosses, the insurance companies, or the governors of our states.  The ACA was a big step in the right direction but as written (if indeed anyone knows what it really says, as Congress admitted they didn’t actually read the whole thing) there is too much wiggle room for the working citizen to get screwed without recourse.  Hopefully this failed experiment will put us on the road to universal single-payer coverage like other civilized countries.

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