A few other aspects of Mr. Limbaugh’s apology got my attention. In the course of apologizing for his disgusting rant against Ms. Fluke, Mr. Limbaugh continued to assert his political position on the current debate about the employer mandate to cover oral contraceptives. Several of his points are worth exploring.
First, in his apology Mr. Limbaugh said that “American citizens should [not] pay for these social activities.” (I’ve previously explained that the term “social activities” appears to be a reference to sexual intercourse.) With his wording that “American citizens” should not be paying for oral contraceptives, Mr. Limbaugh seems to imply that the debate is whether the government is going to be footing the bill. However, the current debate is not about whether Medicare or Medicaid will cover such prescriptions. Further, the single payer approach to solving our health insurance mess was never seriously on the table during the Obama era debate of potential reforms. So, to the extent Mr. Limbaugh is trying to make it sound like the current debate is about the government (i.e., “American citizens”) paying for these prescriptions, that is misleading. (Parenthetically, as a tax lawyer, I should point out that the government is not funded merely by the income taxes of “American citizens.” For example, resident aliens also must pay income taxes to the federal government.)
Instead of being a debate about what the government will fund, the current issue is what employers are required to provide for their employees. In our country, the reality is that employees have very little bargaining power. Unionism is not strong. And without some type of collective action, employers generally hold disproportionate power over employment terms. Employment at will is the norm. With the exception of certain executives and entertainers, employment contracts are rarely something, over which rank and file employees have much negotiating power. Consequently, government mandates are the only realistic option to help make sure that employees are not overly exploited in certain contexts. That is why we have minimum wage laws, as well as occupational safety and health regulations. Without them, employees could be paid unconscionably low wages and enticed to risk their health to work in unsafe conditions.
As I’ll explore more in a subsequent post, oral contraceptives are a type of medication. They are an important tool in providing women with medical care. For this reason, it is important that they be covered by employer health plans. Women’s health should not be put at risk because of an employer’s (questionable) objection to that type of medication. It is for this reason that the Obama administration intervened. Again, the issue is not what taxpayers will fund. The issue is preventing employers from refusing to cover important medications when they provide health insurance. The point is that there should be a basic standard of care, upon which we can all depend, regardless of who our employer is.
I also note that in his apology Mr. Limbaugh rhetorically asked about “personal responsibility and accountability.” He seemed to be suggesting with that language that the cost to engage in “recreational activities” like sexual intercourse should be covered exclusively by those engaging in such activities. Again, this is not an issue of taxpayer funding, it is about establishing a floor of coverage in employer provided health insurance coverage.
And it is worth noting that in most employment settings, employees do pay for their health insurance. Indeed, most of us pay significant premiums for such benefits. The point of the employer mandate in question is to ensure that when employees pay their premiums, they are getting the coverage they need and are not being sold a plan with significant holes. In that sense, this is a consumer protection concern.
I am also intrigued by Mr. Limbaugh’s reference to “personal responsibility” in this context for other reasons. For years I have heard fiscal conservatives rail against people having children that “they can’t afford.” I have lost count how many times I’ve heard such fiscal conservatives assert that the poor shouldn’t have children at all because they don’t have the resources to care for them. Such fiscal conservatives emphasize “personal responsibility” in their arguments. The suggestion seems to be that if you are not financially stable you should be celibate (even if married), always use birth control or have a medical abortion if you become pregnant. Those options don’t all necessarily sit well with social conservatives, including many Christ followers.
As a result of fiscal conservatives’ criticism of people having children they “can’t afford,” it is interesting to hear Mr. Limbaugh talk about “personal responsibility” in the context of employer mandates to cover oral contraceptives. In the next post, I’ll explore in greater depth the health reasons women take oral contraceptives, but for now it seems to be the widely accepted assumption that women taking them are simply trying to avoid pregnancy. If one accepts that assumption, it stands to reason that some of those women may be using oral contraceptives because they “can’t afford” to care for (more) children. Such women would appear to be doing what fiscal conservatives value, i.e., taking personal responsibility to prevent pregnancy. It then seems hypocritical to undermine such women’s efforts and to allow employers to make oral contraceptives prohibitively expensive because they are not included in employee medical plans.
Then some children were brought to Him so that He might lay His hands on them and pray; and the disciples rebuked them.