Contraception, Again…

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It seems a bit odd arguing about contraception in 2012. After all, the matter seemed to have been large resolved some time ago.  While it is tempting to say that Contraception 2012 is a manufactured conflict, there do seem to be some points worth addressing in this context.

One talking point that has been presented by some folks, such as mainstream American media personality Rush Limbaugh, is that insurance coverage of contraception is the same thing as paying someone to have sex.

In the case of people who are prescribed contraceptives because of medical conditions (such as ovarian cysts), this is obviously not the case. In cases in which the person is simply using the contraception as contraception, she is still not being paid to have sex any more than the coverage of Viagra and comparable medicine for men is paying men to have sex. At most, what is being paid for is the means to have sex (Viagra) and the means to avoid getting pregnant (contraception). True, these are connected to sex, but covering either is not the same thing as paying people to have sex.

Another common talking point is that the plan to cover contraception will be “using people’s money” to pay for something they do not approve of.

One obvious reply to this is that for most folks insurance coverage is either paid for by the individual or as part of a benefit package for a job. Either way, the person is earning her coverage. To use an analogy, my insurance covered my quadriceps tendon repair (mostly). This was not using some other people’s money since I pay for my insurance. Likewise, if a woman get contraception covered by her insurance, she is paying for that (either directly or by getting benefits as part of her compensation).

It might be countered that some women get coverage from the state, so tax dollars could go to pay for birth control. Since some folks are against contraception or do not want to pay for it, this should not be done.

The stock reply to this is that our tax dollars are routinely used to pay for things that we might not want to pay for or that we might even oppose. For example, I’d rather not have my tax dollars pay for subsidies to corporations and I certainly don’t want to be paying for other dudes’ Viagra.  This is the way democracy works-provided that the spending is set up through due process, by agreeing to the legitimacy of the state we also give our consent to the spending-even for things we would rather not contribute to.

Naturally, it can be argued that we should not be required to pay for anything we oppose and this has considerable appeal (see Thoreau’s arguments about civil disobedience for an interesting look at this matter). However, if we adopt this principle for contraception, it must also apply across the board. So, for example, folks who are against war can insist that war should not be paid for using tax dollars and so on. It seems likely that for every proposed spending there will be a person who opposes it-thus the state should not spend money on anything. While this would solve the deficit problem, it would seem a rather absurd solution.

A third talking point is that contraception should not be covered because it does not treat a condition. This is most often brought up when defending the coverage of Viagra (which restores a natural function).

The easy reply to this is that some forms of contraception are used to treat medical conditions (such as ovarian cysts). As such, this use should be covered. But, of course, this would not warrant the coverage of contraception as contraception.

One reply worth considering is that the framing of the debate begs the question against women. After all, the claim is that anything that is covered must treat or prevent a harmful condition and this would exclude contraception (except in cases in which a women would be medically harmed by being pregnant). However, this framing tends to be simply assumed rather than being argued for, which is rather unfair to women in this regard. After all, the matter of pregnancy seems to be unique (and limited to women) and hence it seems questionable to insist that it must automatically fall under the framing in question. It can, of course, be argued that it does-but an argument is wanted here to show that is the case.

While some might be tempted to cast pregnancy as the harmful medical  condition that is being prevented by contraception, the idea of casting pregnancy as a harmful medical condition has rather limited appeal. After all, while pregnancy puts considerable strain on the woman, it seems rather difficult to cast it as an illness that needs to be prevented or treated as if it were comparable to measles or cancer.

A more fruitful line of approach is to argue that contraception provides medical control over a woman’s quality of life. That is, it enables her to chose whether to be pregnant or not. Doing this clearly falls under the domain of medicine and women do seem to have a legitimate claim to this right. After all, much of medicine deals with maintaining a desired quality of life and women would seem to have as much right to that as men.

Naturally, it might be countered that I am treating pregnancy as a disease (which would be some major rhetorical points against me). But this is not the case. All I am claiming is that given that pregnancy can be rather challenging for a woman and, of course, a child is a major consumer of resources a women has a legitimate right to use medical means to maintain her desired quality of life-just as a man has a legitimate right to use Viagra and its ilk to maintain his desired quality of life. Just as Viaga is covered as a quality of life drug, so should contraception.

A fourth, somewhat uncommon,  talking point is that contraception is on par with abortion, so covering contraception is covering abortion.

One stock reply is the obvious fact that contraception lowers the number of unwanted pregnancies and this lowers the number of abortions. As such, folks who are worried about abortion would seem to have a good reason to favor covering contraception.

Of course, some folks contend that contraception is like abortion in that it prevents a possible person from becoming an actual person. While this does have some philosophical interest, it would seem to entail that every moment I am not out and about impregnating women, I am engaged in acts comparable to abortion. After all, by not impregnating as many women as possible, I am preventing some possible people from becoming actual people. Put a bit less absurdly, if I am practicing abstinence, then I am effectively engaged in abortion since all those possible people will never become actualized.

It could be countered that this only applies to cases in which I am actually having sex (and presumably that I should only be having sex with a woman I am married to). That is, every time I have sex, there should be a roll of the dice to see whether or not the woman gets pregnant. Presumably if either of use chooses to use any method that lowers the probability of pregnancy, then this would be on par with attempting an abortion.  As such, the only acceptable family planning would be to decide to have sex only when one plans on a pregnancy since intentionally preventing it would be unacceptable. I would be interested in seeing some arguments for this that do not involve an appeal to theology.

 

 

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31 Comments.

  1. This universe has given each of us the exclusive use of the body which we operate. A zygote, embryo, fetus and I must first obtain permission to use the body of a female. The use of contraception is the female, by her right, to deny permission to the zygote, embryo, fetus while granting me permission.

    This universe has also given each of us the power of decision. We are sovereign beings. We may delegate some purpose limited bits of our sovereignty to an agency or government. We make that delegation to create an agency or government to serve all of its membership. In no way do we surrender sovereignty in total.

    Those decisions by which we manage daily life and determine our future are central to the sovereignty that we retain. A person having such decisions made for them by other persons or agencies or government is a child or a slave or a ward of the state. Pregnancy planning, family planning, career planning; all are retained by sovereign individuals.

    This universe cares not if we die singularly by disease or in the millions by disease or war or if species human goes extinct. The value of one life is equal to the value of all life. If the value of one life is diminished, all life is diminished. A female must not be diminished by diminishing, by force of society or law, her quality of life.

  2. I think the ‘not a necessary medical procedure’ is best defended by pointing out that it’s only mere coincidence that contraception has any association with medicine at all. Sure, birth control pills are reasonably advanced chemicals that pharmaceutical companies developed, and by tradition such things are handled by doctors. But in reality, they have about the same connection to health as does toothpaste, suntan lotion, or long underwear on a cold winter’s night. Yes, we DO buy these things to keep us healthy, but society apparently has no problem expecting people to buy them for themselves.
    Severe sunburns, tooth decay, and hypothermia might not be quite as major as pregnancy, but they’re nothing to sneeze at, either. And of course, all of the above are virtually 100% avoidable even without the proper ‘healthcare’ products simply by adjusting one’s behavior.
    Another thing too is, I don’t think we can settle this debate without a frank discussion of the importance of sex. I wouldn’t go so far as to say “Don’t have sex if you don’t want children”, but I personally see no problem with, “Don’t have sex if you can’t afford contraception.” In order to justify the state mandating contraceptive coverage for everybody, it seems to me they have to say that abstaining from sex is some cruel and unusual condition that nobody should have to suffer through if it can be helped, and I’m not buying that for a second.

  3. Do you insure your car against the tyres wearing down? No, because everyone’s tyres wear down according to the use. There would be no point. Virtually everyone has some expenditure on contraceptives in their lifetime depending on their extent of sexual activity. This is an argument that contraceptives should not be covered by insurance.

    The only reason to cover contraception is where low income people who would not otherwise be able to afford it, have their contraceptives paid for by people on higher incomes.

    That is a legitimately debatable point and arguments can be made on both sides.

  4. s. wallerstein (amos)

    First of all, I share Mike’s sentiment of “contraception again”. I thought that access to contraception for all women who want it was a struggle that had been won, once and for all, about 40 years ago, but I was wrong. It’s sad to have to fight the same political battles as my grandparents did, but that’s the way things are.

    Access to contraception should be covered by the insurance policies of all women, be it private or public healthcare insurance. The cost of contraception involves medical supervision, since there are side-effects which only a doctor can deal with. Thus, buying contraception is a bit more complex than buying suntan lotion.

    The benefits of the widespread use of birthcontrol to society are legion and thus, the use of contraception should be fomented by any rational government.

    We have a problem of globalwarming, which is caused by excessive use of fossil fuels. Fewer people means less use of fossil fuels, thus slowing down the rate of global warming and allowing the population to live without such drastic cuts in their energy consumption, as will be necessary if the population continues growing.

    As Mike notes, more use of contraception results in fewer abortions. Not only are abortions ethically controversial (I’m in favor of the right to choose, myself), but also are more expensive and dangerous to the health of the mother than a simple pill.

    There are lots of studies which show that unwanted and unloved children are problem-children. Mothers who did not have access to contraception (and abortion) are much more likely to reject their children than those who freely decided whether they wanted to have children or not.

    Yes, unwanted children can be put up for adoption, but people who adopt generally prefer children of certain ethic or racial groups, and there is no guarantee that all unwanted children will be members of the desired groups. Even if all unwanted children are adopted, there will still be a problem with population growth.

    Finally, contraception permits women to have a full sex life without fear of pregnancy, thus, allowing them to flourish erotically and it seems selfish and petty to deny them the possibility of that flourishing, when it is so cheap and inexpensive to furnish them with contraception.

  5. Julian’s argument is actually fairly illustrative.

    Insurance coverage of a given medical need serves at least one of three purposes.

    One is risk spreading. If something isn’t a risk, but rather a guarantee, insuring against it is stupid from the perspective of risk spreading. You can’t spread a risk that’s guaranteed- you can spread a cost, yes, but not a risk. The closer to a guarantee something is, the less risk spreading value there is in insuring against it.

    Another purpose of insurance coverage is to minimize other risks. For example, fire insurance could hypothetically cover the installation of fire protection, on the grounds that it might be cost effective for fire insurers to cover this at a loss (everyone needs them so the risk isn’t being spread) in order to make more significant profits in reduced fire losses. I have no idea if covering birth control works this way. Some people say it does. I don’t know if they have data. They might.

    And the third purpose of insurance is that it has become our society’s means of permitting purchasers to collectively negotiate with sellers for the purchase of medical care. Under this purpose, covering contraception is as logical as covering anything else.

    I guess the reason I’m going through these is to note that they’re in tension sometimes. There’s no reason why reason 3 needs to be covered by insurance companies, but it is. This multiple purpose system is the source of a lot of confusion, and also problems, in our medical care system.

  6. wallerstein-

    The idea that women are being ‘denied the possibility of sexual flourishing’ because somebody else isn’t paying for their birth control pills strikes me as hyperbole at best. Where does the idea come from that people are being denied something if another person doesn’t provide the means for them- especially if the something in question is really that ‘cheap and inexpensive’?
    The Government does not buy my groceries. They are NOT thereby ‘denying me adequate nutrition’. This goes to your other points as well, as I’d say the benefits of adequate nutrition in a society far exceed even the benefits of contraception…and yet we seem fine with people paying for their own food.
    Julian makes a good point about people who can’t afford contraception for themselves, but this would be very close to 0% of people who are working a job that gives them health insurance benefits. If we’re talking about contraception on an employer-provided insurance plan, we are talking about people that can afford to pay for it themselves almost by definition.

  7. s. wallerstein (amos)

    Ryan:

    First of all, people pay for their healthcare insurance, so the analogy with the government buying you groceries is not so good.

    However, if you have problems paying for your groceries, I believe that society should help you buy them.

    We have radically different views of society. For me, society is a community in which we should all support the flourishing of each other; and flourishing includes a decent sex life, without fear of pregnancy.

    Finally, as I said above, contraception means more than just the pills, which must be prescribed by a doctor and whose use should be checked on from time to time by a doctor. Not everyone who is working always can afford to pay for doctors’ visits, so it is important that the insurance of working women covers contraception, which, I repeat, includes the necessary doctor’s visits.

    You (and those of your political position) seem to see society as a collection of individual autonomous consumers, each of who tries to spend as little as possible on everyone else and to maximize his or her savings. I find that both sad and frightening, especially the latter.

  8. Dennis Sceviour

    s. wallerstein,
    “There are lots of studies which show that unwanted and unloved children are problem-children.” Many studies show it is not children are a problem, but often one or sometimes both parents that are the problem.

    “Society…should all support the flourishing of each other; and flourishing includes a decent sex life…” seems too decadent for my tastes. I do not want a sex-life with everyone and anyone.

  9. Dennis Sceviour

    Mike writes, “I would be interested in seeing some arguments for this that do not involve an appeal to theology.”

    The logical arguments in this article could be reduced to an insurance question. The same reasoning could be used about fixing cars, as Julian hinted above. Should the government subsidize car repairs if it creates less pollution or increased road safety?

    People expectations of what government should do are too high. People should be prepared to make their own decisions in life, and to take financial responsibility. If religious beliefs conflict with someone’s opinion on contraception, then one should take the issue up with their church and not with the state (assuming the state is not a theocracy).

    On the other hand, some politicians are prepared to appeal to non-secular voters with promises that threaten to divide a populace. The original American constitution presented several measures to prevent non-secular promises. Sometimes this seems to no avail. The program follows like this:

    The politician makes unconstitutional promises. The politician is elected, and then unconstitutional measures are passed. The Supreme Court overturns the new measures and once again declares liberty. Could this sequence of the repetitive events be reduced to a simpler procedure? I suppose, with the invention of computers, laws are being produced faster than they can be overturned. We need a quick legislative DELETE button on the computer.

  10. wallerstein:

    The analogy will become a lot better once the buying of health insurance is mandated- the Government is defending the position in the Supreme Court as being a form of ‘taxation’ as we speak. In either case, the purchasing of a private insurance policy that everybody is required to purchase, and subsidization by the Government through taxes that everybody is required to pay seems like a small difference to me.

    You say if I have problems paying for my groceries, society should help me pay for them. But contraception is different from food in a variety of respects:

    1.) You don’t need sex to survive or flourish unless you make the second true by definition through introducing the concept of ‘sexual flourishing’.
    2.) You don’t need contraceptives to have sex.
    3.) You don’t need contraceptives to have sex WHILE avoiding pregnancy.
    4.) A wide variety of contraceptive options are already widely available, some of them extremely cheap, such as condoms.

    Those points taken together mean to me that you can’t make a compelling argument for need, even among the poor.

    Also, I’m not sure what the role of ‘regular doctor visits’ has to do with anything. If a person had an insurance plan that covered check-ups, then presumably these sorts of discussions would come up in the check ups. If a person has a plan that DOESN’T cover such things, there’s a million reasons to object to it other than contraceptive concerns.

    Lastly, the idea of a society supporting the flourishing of each other is completely fine with me so long as the society in question has a common idea of what it means to flourish. The United States is not such a society. In fact, it was specifically designed to not be such a society. You should not be expected to finance what I think I need to flourish. The State should not compel you to come around to my idea of flourishing. The idea that a healthy sex life is required to be a flourishing human being is controversial. Taking it for granted to the extent that you’d support the state seizing people’s property to finance it is what seems sad and frightening to me.

  11. Ryan,

    Your points do have some appeal. After all, I spend a bit of money on running stuff in order to stay healthy and I do not expect my insurer to cover these expenses. Of course, my being fit is of considerable advantage to them since I am thus very likely to avoid many costly conditions that are covered by my insurance. That said, the more the coverage expands, the more the companies need to charge for the coverage so one important point of concern is that of how the cost is to be distributed. If everyone’s rates go up to cover runners’ expenses, then the rest of the folks are subsidizing us-which might seem unfair. Unless, of course, by being healthy we require less medical attention and thus actually save money. Perhaps the same can be argued for contraception. But, as you note, the same argument can extend to sun tan lotion and so on.

    One good reason to include birth control in the coverage is that medical experts in the United States generally seem to agree that it falls under preventative care and thus should be covered.Of course, this view can be challenged.

  12. S.wallerstein,

    Interestingly (or awfully), there are people who argue against contraception precisely because it does allow women to flourish erotically. The general idea seems to be that sex is supposed to be for reproduction rather than anything else. As might be suspected, this is usually based on a specific sort of religious principle that most people (including other religious people)do not share.

    In my view, the idea that sex is just for procreation seems to be an idea that needs to be proven rather than assumed. I would, of course, be convinced by a suitably good argument in its favor (beyond “well, I think that is what God wants”).

  13. Mike,
    The only problem I have with the idea of birth control pills as preventative care is that condoms exist for a tiny fraction of the price, and with nearly the same effectiveness (as far as I’ve heard) when used correctly.

  14. Ryan,
    In most cases the women will be paying for them as part of their insurance (which is often part of their compensation for working). To use an analogy, the fact that my insurance covered my quadriceps tendon repair does not mean that someone else paid for it. It means that the insurance that I pay for covered it-just as it is supposed to do. I don’t get my insurance for free-I pay premiums for it and get decent rates because my employer and union can negotiate for them.

    As far as the women who do get it paid for by the state, it can be seen as a prudent financial move. As was noted by others, birth control is cheaper than the consequences of unintended pregnancies. If a woman cannot afford her birth control and she has a child, then the state will most likely have to step in to assist her and the child. Ideally, of course, we would live in a society in which every person can earn a decent living that would enable them to pay for all the goods and services they legitimately need. Unfortunately, we live in a society in which even people who work hard at honest jobs have trouble making enough money to do so (compare, for example, what you would make on minimum wage in the US to what it costs to live in the US). The economy we created also allows for some folks to do exceptionally well-often at the expense of others. As such, given the system we have it seems the least we can do is to help out the folks who have so much less.

    Naturally, folks who can afford to pay for things do not need help. However, medical costs are such that almost everyone needs help-at least a pooling of risk in the form of insurance coverage.

  15. michael reidyh

    Ryan:
    You’re making sense to this reader. Why now change the procedure whereby people who were working bought their own contraception or not as the case may be? We are being told that the bad Catholic Church is preventing some women employees from having contraception. How? What were those women doing before this. Is this an attempt to make Catholic governing bodies abandon Education and Health or compromise their conscience? Hardly the way to create a society which respects a conscientious position particularly where there is no practical reason for it.

    I am living outside the U.S. so this level of polarisation seem bizarre to me. Perhaps you can enlighten me.

  16. Dennis,

    Actually, suppose that by spending $1 on car repair subsidies we could save $1.50 on taxpayer expenditures (or even just $1.01). Would that not make it worthwhile? After all, if I found out that by spending $5 on a fuel additive I could cut my gasoline bill by $6, it would make sense to do that. Or if an insurance company covered birth control for a woman and avoided having to cover a more expensive birth or abortion payout, that would be sensible for them.

  17. s. wallerstein (amos)

    Ryan:

    First of all, this is a philosophy blog, so I always assume that we are talking about ethical questions in general, not about the United States in particular, even though I do understand that many participants live in the U.S., as does Mike.

    I don’t live there and in fact, where I live, Chile, the public health service distributes contraception to all women who need it. The public health service is financed by payroll deductions and by our taxes. People can, if they wish, opt for private insurance coverage too.

    In any given society, the citizens themselves determine what goods are needed for flourishing.
    Therefore, I can only suggest what goods that I believe are integral to the good life and as a non-participant in the U.S. community, I have very little say in what goods they decide are integral to flourishing.

    You are wrong when you say that in the U.S. there is no common idea of what constitutes flourishing, even though it may only be implicit in your community. For example, the U.S. has an admirable system of interstate highways, paid for by the tax-payers, and it seems to be that behind the decision to construct highways (not all of which lead to points of commercial interest) there is the idea that a good life involves the ability to get from one part of the another of the country with a motor vehicle.

    If you wish, I can give you many more ideas of flourishing which seem to be common to almost everyone in the U.S., but which being so common, may not be even noticed by those who live there, but may be all too clear to an outsider.

    It seems that Chile, with another conception of what a good life is, has chosen to invest more resources and energy in constructing a public health system.

    You seem to believe that taxation, decided upon through democratic processes, is a form of seizing people’s property.

    I don’t agree about that. As a member of society, I pay taxes which support programs which I agree about and programs which I don’t agree about.

    If I lived in the United States, I would certainly try to elect those who are in favor public healthcare programs which finance contraception.

    As for condoms, I agree with you, except that men often refuse to use them or even remove them once the sex act has begun. Isn’t Julian Assange accused of taking off a condom in the middle of a sex act? Correct me if I’m wrong. If that’s true, it’s pretty low.

  18. Dennis Sceviour

    There is a changing meaning of public health care. Traditionally, Public Health are those things that effect everyone – plagues, epidemics, garbage collection, water quality, and sewage management. For the most part, the public expenditure for these things is paid to engineers, not medical doctors. If you want answers to public health care problems, you should be asking engineers, not philosophers (sorry). :eek:

    There have been several interesting arguments that public heath care should include unique personal health care. Public health nurses and clinics do get involved in the delivery of vaccinations, and distribution of condoms to control the spread of sexually transmitted diseases. If we can find a way to afford it, then fine.

    The problem is that the medical profession is against government interference in their business. Forcing physicians to give more and cheaper medicine will accomplish nothing at best. Private medicine is still needed if for no other reason than to maintain an economic balance with the invisible hand that keeps costs under control. I do not want an excessively regulated, overworked and underpaid physician attending to me.

  19. Individuals do pay for their own contraceptives. Some work for it as part of their employment package. The employer attracts workers by sponsoring health care insurance coverage, so those employees accept that as part of their wage or salary. Others, a bit better off, can afford to buy their own health coverage or buy contraceptives separately. No matter how this is accomplished, no one is forcing anyone to violate religious dogma or conscience.

    If the religion businesses were granted exclusion for the secular, non ministerial, non proselytizing enterprises (think McDonald’s) that they operate, it would be the religion businesses that would deny free exercise of religion or conscience of employees who differ in religion or moral conviction. They would be denied the same health care coverage that their cohort would receive through other employers. Hundreds of thousands of secular employees at non ministerial, non proselytizing religion operated businesses would be affected.

  20. Mike,
    I have no problem at all with an insurance company offering contraceptive coverage, and I don’t know how anybody could have a problem with it. They offer it, advertise this feature to draw business. Opens the door for some other insurance company to not offer, and then try to advertise a lower premium or a moral stand that appeals to some conservatives.
    It’s only when it’s mandated – either through Government-funded programs, or private insurance that everybody is required to buy- that my arguments make any sense.

  21. wallerstein- well, my point can be generalized, I wasn’t just talking about the United States. If there’s some country in which almost everybody is an atheist and everybody wants the Government to pay for their contraception and they all pay in, then yeah, I don’t give a crap- I don’t live there and it doesn’t seem like anybody’s rights are being violated.
    My point is, that’s the kind of set up you need in order to make ‘The Government takes your money to foster everybody’s flourishing’ a viable set up. You have OTHER countries, like the U.S. for example, that are specifically billed as making room for multiple definitions of human flourishing. In places like that, the question of who’s version of flourishing gets subsidized becomes more complex. That’s a point that should be equally in(coherent) no matter where you happen to live.
    Yes, in any given society, people determine what it means to flourish. The U.S., perhaps unlike Chile, however, is not and was never intended to be one society. We’re effectively a bunch of societies protected by one military. You hit the nail on the head when you say that you as a Chilean have very little to say about what the U.S. decides is necessary for human flourishing. This is true. But similarly, an Oklahoman has very little to say about what a Californian says is necessary for human flourishing. Or at least, that’s the concept the country was founded under.
    That’s not to say there are no common or nearly-common themes of American sentiment- you cite the highways, and those are a symbol of an American tradition of freedom and independence. It’s an “American Spirit” thing to drive around in your own car instead of riding a train here and there.
    However, when there is a conflict in what Americans see as flourishing, there ought to be no attempt to resolve that conflict by the State. When there is consensus, fine. When there is not, let Mainers be Mainers and Floridians be Floridians.
    Taxation is absolutely a seizing of property. Stop paying your taxes and see what happens. You may do it willingly, but the Government asking for money and your neighbor asking for money can never be equivalent situations because of what the Government can do if you say no.
    Sometimes men take off condoms in the middle of a sex act, and sometimes women lie and say they are on the pill when they really aren’t. Such duplicity is an argument for maybe only having sex with people you know and trust, not for a Government program.

  22. A poll perform by Thompson Reuters in May 2011 pointed that 77% of respondents believed that private medical insurance should cover the costs, while 74% said they believe government-sponsored insurance should cover the pill as well. Therefore in the US there seems to be a significant majority that believes that contraception should be covered by Medical insurance.
    True, the rights, opinion and will of the minority should be considered in any decision. However, medical insurance seems to work in a very different form.

    Insurance profits from managing risk; you pay an affordable fee to have the right to be covered if an event happens. Bussiness managing risk are an integral part of our economy. But medical insurance is very different than the rest because it deals with human health.

    In the US you can not drive if you do not carry car insurance. Yes, an insurance that protects the damages you can cause by an accident is MANDATORY to drive. So then, why haven’t we heard a lot of protest about this norm by the state? Very simple, if you do not have insurance, you just are not allow do to drive; there is nothing so critical that has been lost.

    If you apply a parallel reasoning – if you do not have insurance, you do not have a right to health or in cases to live-, you can see the significant amount of ethical conflict that creates to a society.

    Example: John decided not to have medical insurance. He was young healthy, and could use the money elsewhere. Unfortunately, he got into an accident, and was drove to the emergency room. He needed treatment inmediately and without it he will die. What do you do? Do you let him die?

    This can be applied to any medical condition from urgency to non urgent. Do you deny medical attention to a person in need?

    Is it ethical for the society to let him die? If you answer yes, you can argue that medical insurance should not be mandatory. If you answer no, you must argue that medical insurance must be mandatory

  23. Peter,

    People were asked if somebody else should pay for something for them, and a majority said yes. Ok?

  24. Also, the reason why auto insurance is mandatory is because most of the time when you have an accident, you are destroying somebody ELSE’s property.

  25. Ryan;

    It appears to me that you have very little understanding of the insurance business. People pay a fee to be covered for the possibility of some event. Nobody is paying for other people expense’s; example: John lives in a flood risk area and he buys house insurance; my friend Tim lives in an earthquake area and he buys the same house insurance. There was a terrible earthquake this year, Is John paying for someone else’s expenses? Yes, but he accepted that by buying the insurance policy. That is at the heart of the insurance business.

    Yes, the car insurance policy is to protect someone else’s property. But is not a person without insurance damaging the insured person if services are provided? In the previous case, Tim does not have house insurance, and the insurance company for x reasons pays for the house and passes the cost to John. John is actually paying for Tim’s house and his insurance premiun will go up. Isn’t this a way of “destroying” John’s property? Becuase the higher charges are passing undue burden of his finances.

  26. Unless Tim has the magical ability to cause earthquakes, I really don’t see how your analogy works. If I cause a car accident, and I ruin your car, and I have neither cash nor insurance, there is no way for you to get compensation from me for your destroyed vehicle. That’s why it’s compulsory to have car insurance. It has nothing to do with everybody sharing the burden for everybody else’s accidents. That’s just you reading Obama’s (unconstitutional) justification for forcing people to buy health insurance backwards onto another situation.

  27. Incidentally, the above is why only *collision* insurance is mandatory.

  28. Ryan;

    When I participate on this blog, I have no interest in reading Obama’s opinion, or any one else’s ( mandatory insurance was first proposed by the republican party). This is a philosophy site. I was just using a simple example to analyze the insurance businees and the ethical ramifications from it. I was just stating facts as I see them.

    If Tim does not pay insurance and uses its benefits it is comitting fraud (ethical and legal violation). A fraud none of the people paying for insurance are compensated for. How would John get reimbursed for the money he paid for Tim’s house?

    In my opinion, the analogy stands because in both cases there is economic danmage to a third party, and compendsation for the damage has to be assured. The logic of mandatory insurance is to assure compensation to the damaged party; a compansation that clearly does not occur when someone is using insurance benefits he did not pay for.

    Again, even though everyone has its own political preference, this is not a political site but a philosophical site. I do not participate in this site to argue Obama, Rommey, etc. I come here to argue ethics, law, the role of the state from a philosophical point of view.

  29. With specific respect to the current US debate over obliging Religious related bodies to provide insurance cover for contraception, my view is that the laws/constitution of the USA apply to it, and it is either legal or it is not. In political terms I think Obama is making a tactical mistake, since it will probably upset more voters than it pleases (those it pleases probably already vote democrat, those that don’t are typically potential switch voters I suspect). But that is not what I wish to write about – it’s politics and law, outside of my expertise, and not philosophy really.

    What I would like to point out for discussion is the question of contraception’s impact on society, has it been entirely a positive one (as is the secular assumption that is rarely reflected on) or could it also have negative impacts, e.g., in allowing the physical expression of sexuality without the possible consequences of pregnancy, or sexually transmitted disease. My view is that both have beneficial and detrimental social consequences. I don’t propose to go further into that point right here, I just want to ask those that read it to reflect on it, since it is usually dismissed as having no negative social aspects, and I believe it probably has – and this can be discussed outside of a religious context. For those that can not see the negative aspects I really believe they need to stretch their imagination.

    The other point I would wish to make is that there are many ways to differentiate contraception, in particular those that prevent conception and those that terminate a zygote, an early abortion. The ethics of contraception are more severe/difficult to resolve in the latter case.

    I have heard/read of Singer’s utilitarian approach to abortion. That on balance of the rights of the zygote/embryo/fetus/child can be weighed by a utility function against the rights of the mother (and rarely mentioned/factored father). The result being that you make arbitrary (sometimes with some medical speculation as to consciousness of pain onset) weight assignments and come up with a timing when abortions are OK and when they are not. Recently there has been an argument that this utility function methodology can be extended to the early days/weeks of a birthed child, since the effective difference between a fetus and a birthed child is very small in the early days of life. In other words some “ethicists” consider an argument for infanticide. What this shows to me is the poverty of the utility approach.

    See… http://www.newstatesman.com/blogs/nelson-jones/2012/03/birth-abortion-infanticide

    For one, whilst I might be positive to contraception to prevent disease, or for the management of the likelihood of impregnation (as it can be argued even the Catholic Church recognizes to a degree, i.e., the use of “natural methods” for fertility control and the recent “understandings” for the case of preventing STD). But, abortion still is a more serious ethical issue, that for me amongst many others, religious and non-religious, poses ethical dilemmas that are not resolvable by a utilitarian ethics approach.

  30. The case against birth control (I would like to point out that I am personally not against birth control in all circumstances, I am for it to prevent STD’s and manage prudently the number of children in marriage to a reasonable number and spacing):

    http://www.bbc.co.uk/ethics/contraception/against_1.shtml

  31. Articles. « Loftier Musings - pingback on April 10, 2012 at 8:57 pm

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