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janetheactuary

The most interesting thing about the Hobby Lobby discussion is . . .

Last updated on: July 1, 2014 at 7:25 pm   by Jane the Actuary

The most interesting thing about the Hobby Lobby discussion is . . . 2014-07-01T19:25:00-06:00 Jane the Actuary

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No, not that the Democrats are exaggerating the significance of the ruling so that they can push the “War on Women” storyline.  Nor, in contrast, the fact that the ruling is fairly narrow by virtue of the Religious Freedom Restoration Act wording that the government has to use the “the least restrictive means of achieving a compelling governmental interest.”  See Ann Althouse’s write-up, among others, on the topic; she draws a contrast between this and anti-discrimination laws to explain.

Look, I’m not even going to debate the issue of whether contraception is a “preventive treatment” and whether that means pregnancy is a disease, or whether it’s a consumer product.

But everyone’s flipping out:  “OMG, what if the Jehovah’s Witnesses decided it violated their religious principles to cover blood transfusions?  Companies can now do whatever they want as long as they claim it’s in their religion!”  (See here for the becoming-famous Ginsberg line.)

And it occurred to me that this “worst case scenario” is actually fairly instructive.

Imagine if there were a significant number of Jehovah’s Witnesses running companies, or closely-held corporations, and that they believed that if they provided health care coverage to their employees which included blood transfusions, they’d be enabling a sin.  I skimmed the article on the topic in Wikipedia but it’s not clear to me if they view this as something required only of their adherents, like keeping kosher or observing the Sabbath for Jews, or a general moral code applicable to everyone.

But let’s assume its the latter.

It’s still not a problem.  Blood transfusions are a component of medical treatment — after an accident, in the course of surgery, and so on.  It shouldn’t be that difficult to split out the claims value of the blood transfusion component of such surgeries, based on the mountain of data that insurers have available to them.  Then an insurer could design a standard policy which excludes transfusions, and an additional rider which includes them, and there shouldn’t be any risk of anti-selection in the rider-policies because this is true insurance, for serious medical needs, the cost should be relatively minor, and yet everyone working at a JW-employer should have the common sense to know, when the mailing arrives from the insurance company, to select the “blood transfusion” rider.

But imagine a “contraception” rider — it doesn’t work, does it?  Who would choose a contraception rider?  Pretty much only those who know that they’ll be using contraception, and that the contraceptive of their choice is more expensive than average, so that, even with an at-cost policy, they figure they’ll save money.  In other words, there’ll be an immediate death spiral, as the IUD users sign up but not the generic-pill users.

Which all just highlights the problem with contraception being a part of an insurance policy, when it’s a known, predictable, and, for most people a managably-small expense.

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