Mandatory coverage of birth control

I was listening to a debate on mandatory coverage of birth control for religious institutions that employ people of various religions (the Presbyterian science teacher at the Catholic school, the agnostic doctor at the Catholic hospital)

It was my favorite kind of debate.  Every time a new person spoke, they presented a new argument and changed my mind back and forth and back and forth.  I am big on freedom of religion.  I am also a big libertarian.  I also believe in health and choice.  So the arguments really pulled me in all directions.

So here is where I ended up.  It turns out that providing birth control reduces the cost of the insurance because of the high expenses associated with unintended pregnancy.  So the argument that the religious institution has to pay for the birth control turns out not to be the case.  And they don’t provide the birth control, they just have to include it in the insurance.  The women go to a health care provider assigned by the insurer that doesn’t have a problem providing the service.  And of course the employees of the religious institution who do share the belief against birth control have no obligation to use it and since it doesn’t raise costs they aren’t paying for it either.

All it does is require these institutions to add some words to a page that allows their employees who do believe in birth control to have it provided by a medical practitioner who also believes in it paid by an insurance company that also believes in it because it reduces their costs elsewhere.  And an extra benefit is that it reduces the demand for abortion because it reduces unwanted pregnancies.  I think that most religious institution (Catholic, Muslim, Evangelical or whatever) would agree that abortion is “worse” than birth control. So this seems to be a good tradeoff even for the religious institutions.

This combination of arguments is what won me over to support the policy, even though the Libertarian in me doesn’t want to force any private institute to do anything it doesn’t want to do and the freedom of religion advocate in me doesn’t want to force a religious institution to support, even passively, something it doesn’t believe in.

Another ethics question

For comparison, chimps share about 99% of our DNA.  Mice share about 85%.  Pumpkins share about 70%.  There is a lot of junk DNA in our genome that we don’t even need.

So imagine someone is developing a cyborg.  Because of all the electronics, not much human genetic information would be necessary.  They can skip the breathing, circulation, immune system, and more.  But they do include the genes that make the cyborg look, sound, and behave like a real human.  Perhaps it shares 50% of human DNA to achieve this.  Less than a pumpkin.  But by choosing specific genes, it is almost impossible to tell apart the cyborg from a real person. 

Does the cyborg get human rights?  It has less DNA in common with a human than a pumpkin does and we don’t give rights to pumpkins.  But it looks and acts like a human.  What defines a human - actual biology or the perceptual things like appearance and behavior?  What kinds of entities merit individual rights? Responsibilities and obligations?  Do you put the cyborg in jail if it commits a crime?  Or do you put the programmer in jail?  

Just a curiosity for the day.

Is virtual fear torture?

I was reading a book on the future of biotechnology and ethics.  There was a story that brought to mind a slightly different example of my own that I was wondering about.  After 9/11 there was a huge debate about whether waterboarding is torture.  What makes it a serious interrogation technique is that it makes you feel like you are going to drown (die).  If you are confident that the CIA wouldn’t really kill you, I think it loses some of its effectiveness.  Probably still painful (not that I have ever experienced it myself), but not intensely like electroshock or pulling out fingernails.  

So what if instead of waterboarding we invent some kind of electrode insert that makes you think you are going to die?  That's all it does.  It would be totally imaginary and artificial, but the “subject” wouldn’t know that.  Assuming it was really convincing, would that make it as much torture as waterboarding is, even though there is no pain (real or imaginary) – just the fear that you are going to die? 

The end of neoliberalism?

I just read the first two chapters of a book used by one of the econ profs here at Bentley to introduce neoliberalism.  The first chapter distinguishes neoliberalism from the classical liberalism of Adam Smith that lasted until the Great Depression, the pragmatic liberalism of Keynes that lasted between the Great Depression and the economic shocks of the late 70s, and libertarianism in general.  Chapter Two talks about how Reagan and Thatcher  (and to some extent Fraser and Mulroney of Australia and Canada respectively) trumpeted the idea of neoliberalism and initiated it quite effectively.  It also describes how Reagan implemented it through supply side economics while Thatcher implemented it through monetarism.  It also contrasts their neoliberalism from the neoconservatives like Irving Kristol who had a similar economic philosophy but a very different way of looking at the rest of government’s role.  Counter to their political and economic philosophies, neither was able to rein in spending, in Reagan’s case because of the arms race with the Soviets and in Thatcher’s case because of the National Health Service. 

The crash of 2007 seemed to signal the end of the neoliberal era.  The GOP was rejected and Obama and the democrats took over.  The administration presumed a mandate to increase spending (although that was actually started by Bush) to stimulate the economy. They also tried to implement a more centralized, interventionist kind of governance (although this was stymied by GOP senate filibuster and now the GOP majority in the House).  

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I bring this up today because of President Obama’s State of the Union address and his rhetoric on taxation. And the thought that it isn’t either activist government of the progressives or the laissez faire government of the neoliberals that seem to make any difference.  It is the quality of the implementation.  Reagan succeeded at first, which wasn’t too surprising considering how high inflation was, and how hard the Fed under Paul Volcker worked to fight it.  But then foreign policy was his undoing (economically speaking – it was a great result that the Berlin Wall fell). 

With Obama, I think he had the right idea in stimulus, at least for that time, and it worked a little bit.  But it skyrocketed the deficit much more than is justified by the weak growth we got out of it.  He spent the money increasing consumption rather than investment.  So the money got spent, stimulating the economy, but then was gone (much of it to China for electronics and apparel).  

It is too bad that politics and extreme wings of both parties seem to screw us up every time.  It seems like we are always so close to doing things right.  We get Presidents with visionary ideas and good motives.  But then politics gets in the way.  Or perhaps extremist ignorance and confirmation bias.  If a little of a policy seems to work, then more must be better. 

In my idealistic vision, I imagine a Constitutional Convention just like we had back when we converted the Articles of Confederation into the US Constitution.  The realist in me knows that it would be quickly hijacked by lobbies, special interests, and extremists.  But I just imagine some new Thomas Jeffersons, James Madisons, Alexander Hamiltons, emerging from the grassroots (or netroots) and transforming Washington into a working government again and trampolining the US back to a “light unto the nations” that it has historically been.

Affirmative v negative rights

There were two cases I heard on the radio today that are fantastic examples of the conflict between affirmative and negative rights.  The first story was about the Internet.  According to the Bill of Rights, we have the right to access the media available to communicate within our freedom of speech.  What that means is not that we get free broadband, but it means that the government has the goal to provide universal access (hence the tax we pay on our phone bills) and that a common carrier (like AT&T), even though it is private, cannot deny you service if you have the money to pay.  This is the negative right.  No one has the right to deny you the access (the negative part), but you don’t have the affirmative right to demand it either.  So we have an affirmative right to free speech, but a negative right to Internet access.

Then there are some rights that are related to government restrictions.  In a public place, the government does not have the right to prevent you from saying something.  But in a private place, the owner does.  They can kick you out of the premises if you insist on speaking about a particular topic.  Google is collecting all kinds of data about you when you navigate the Internet but the government cannot do the same.  The Supreme Court is deciding whether the government can subpoena those records and if you have the right to know when they do.

The second story was about a proposed law in Concord, MA whereby restaurants (as private property) can refuse to serve anyone for any reason, including those protected by the Civil Rights laws (race, religion, gender, etc.).  This seems to violate the Civil Rights laws.  What qualities are affirmative rights and what are not?  The show’s hosts and callers were clueless about the law (what else is new with talk radio).  They didn’t see the difference between denying someone service for being black/female/gay and denying them service for being sloppy, smelly or some other attribute that isn’t protected by law.  Even on private property, you have a partial negative right to service to any business serving the public (like a restaurant) – they can’t deny you service for being in a legally protected class, but they can deny you service for anything else they want (like being a jackass, or wearing an ugly purple shirt).  And for some safety and health laws, they have to deny you service (smoking, no shoes, etc). 

Health care is a muddled example.  An emergency room has to serve anyone who comes in.  It isn’t just protected classes that have the positive right, but so does everyone else. They can bill you later, but if you can’t pay it becomes complicated.  But either way, they can’t deny you service up front based on your ability to pay.  So do you have the positive right to emergency room care?  Sort of.  Until we come to a solid and explicit conclusion on this, we will never solve our health care problem.  It is really the basis of whether Obamacare’s individual mandate is Constitutional or not.  The only way the mandate can be unconstitutional is if we let ERs deny service to unprotected classes (i.e. people who can’t pay and don’t have insurance).  But if we have the right to ER treatment, we have to allow the individual mandate.  You can’t have both the right to ER care even if you can’t pay and have the right not to get insurance to pay for it.  That just encourages freeloading.

Then the other muddled part is whether a religious institution or individual can deny a service that violates their religious beliefs.  The controversial one is abortion, but what about birth control (hospitals that will refuse to let your primary doctor give you advice on it, or drugstores that won't give you the morning after pill even if you have a prescription)?  Or can Scientologist parents refuse treatment for their minor children because of their religious beliefs (regardless of what the kid thinks)?  We can make these decisions on pure ideological grounds (freedom of religion or a right to health care) or we can decide based on practical considerations (how easy is it to just go somewhere else for treatment or to buy the item).  If one Walgreens doesn’t sell condoms to minors, I can go to another one or to a CVS.  But if I am at the only hospital covered by my insurance, can they deny me a procedure that my insurance covers?  If not, I have no other options.

Then another good one is whether prisons are legally required to provide Kosher or vegetarian meals to prisoners that need them.  Obviously, the person isn’t in the prison by choice, so they can't just go somewhere else.  But a lot of prisons are privately owned and managed so they aren't governed as strictly as government agencies are.  Religion is a protected class, so do prisons have to serve you a Kosher meal on Kosher plates prepared in a Kosher kitchen?  That could be expensive.  Hotels often go to a nearby Kosher takeout and give you a disposable Styrofoam box and plastic cutlery.  Do prisons do the same?  And what about vegetarian?  This is not a protected class.  So there is no legal obligation for the prison to give you a vegetarian meal.  How about lactose intolerance or allergies?  Those aren’t protected classes, so does the prison have the right to deny you a nut-free eating environment if you are allergic to nuts?  I wonder if you could get paroled just because you are costing the prison too much money to give you a Kosher and vegan meal in a nut-free and gluten-free room.