A…Misunderstanding…on the Supreme Court

The liberal wing of the Supreme Court is at it again. The three women of the wing are furthering their demand that women generally are entitled to get their contraceptives via OPM, rather than with the women’s own money—apparently, it seems, because these three female Justices think women generally are too helpless to have their own money. These three also are continuing their demand that access to contraceptives must take priority over the religious tenets of the ones they would require to make the provision.

Writing for the dissent to a Supreme Court order advising that Wheaton College, a Christian school in Illinois, need not continue to provide birth control coverage absent filing a form with its insurer asserting its religious objections, Justice Sonia Sotomayor wrote the following:

Those who are bound by our decisions usually believe they can take us at our word. Not so today. After expressly relying on the availability of the religious-nonprofit accommodation [in Hobby Lobby to justify expanding exemptions from contraceptive coverage to closely held commercial businesses], the court now, as the dissent in Hobby Lobby feared it might, retreats from that position.

Of course, the Court’s opinion created no such reliance, as Justice Sotomayor knows full well. The “religious non-profit exemption” was one of a couple of possible alternatives proffered in the Court’s opinion that illustrated less restrictive means of facilitating women’s ability to obtain contraceptives. The Hobby Lobby ruling included this potential alternative in a part of its discussion of the requirement that a government-generated religious burden (or burden of any sort) be applied through the least restrictive means possible:

The least-restrictive-means standard is exceptionally demanding, see City of Boerne…and it is not satisfied here. HHS has not shown that it lacks other means of achieving its desired goal without imposing a substantial burden on the exercise of religion by the objecting parties in these cases. See §§2000bb–1(a), (b)(requiring the Government to “demonstrat[e] that application of [a substantial] burden to the person…is the least restrictive means of furthering [a] compelling governmental interest” (emphasis added)).

The most straightforward way of doing this would be for the Government to assume the cost of providing the four contraceptives at issue to any women who are unable to obtain them under their health-insurance policies due to their employers’ religious objections. This would certainly be less restrictive of the plaintiffs’ religious liberty, and HHS has not shown, see §2000bb–1(b)(2), that this is not a viable alternative.

That the opinion went on at greater length about the “religious non-profit exemption” in no way alters its status as one of at least two hypothetically offered alternatives for satisfying the (hypothetically accepted) government interest in providing contraception free to the user. There plainly is no basis to any claim that filing for a “religious non-profit exemption” is the sole means of being…excused…from providing religiously proscribed contraception.

Another aspect that makes the Wheaton matter interesting here, though, is the question of the form itself that Sotomayor insists that Wheaton should be bound to file in order to get that “religious non-profit exemption.”

As Wheaton correctly notes, it’s not who pays for the provision that’s at issue, it’s that Wheaton would be required to sanction the provision by still being required to have contraception coverage done in their name.

“Wheaton believes that authorizing its [insurance administrator] to provide these drugs in Wheaton’s place makes it complicit in grave moral evil,” the college said in its injunction application filed Sunday with the court. “Wheaton can neither provide the mandated coverage nor execute and deliver” forms that prompt others to do so.

This is clear enough to all but the Progressive who cannot distinguish the pecuniary from the moral.

Status of Obamacare Six Months In

The preliminary results are not promising. And unsurprising.

Among those health-law marketplace enrollees who have seen a doctor or other health-care provider in the first quarter of this year, around 27% have significant health issues such as diabetes, psychiatric conditions, asthma, heart problems or cancer, the data show. That is sharply higher than the rate of 16% for last year’s individual-consumer market over the same time frame, according to the data[.]

It is also more than double the rate among people who held on to their existing individual policies; among those enrollees, the rate was 12%.

This was well understood and predicted from the jump by those (not only on the right) who viewed the matter objectively rather than through the lens of must-pass because it’s the Progressive thing to do.

Look for sharply higher premiums this summer and fall.

An Illustration

…of why government is unsuited to run what are essentially business operations.

Not to keep picking on Obamacare, but this program really is a poster child for why government can’t do this sort of thing. All year long, the Federal government has been trying to revamp its failed ObamaMart, euphemistically known as Healthcare.gov. Here’s the status of that effort.

  • ObamaMart still is transitioning to new government contractors to manage basic functions. This transition has been going on since the first of the year. They’re not even stable yet on what companies have been hired to do the work.
  • Some back-end functions, including a system to automate payments to insurers, are running behind schedule—still. These functions were supposed to be fully operational last October 1, at the initial deployment of ObamaMart. The revamp can’t get this right, either.
  • [N]ew versions of some functions still will need to be tested with insurers before open enrollment begins 15 Nov. Actual testing is a new wrinkle. Welcome to be sure, but even though CDS has said that ObamaMart was never seriously tested the first time, apparently CDS still is only testing some parts—spot checking.
  • [The] exchange for small businesses, delayed by technical problems last year…will “launch” without some functions.
  • [T]he system to funnel subsidy payments to plan providers for the benefit of plan purchasers (remember that back end?), originally supposed to be ready for the launch in October, then later set for completion by mid-March, is now scheduled to be fully operational in 2015—well after the enrollment period for purchasing 2015 plans has closed.

These highlights demonstrate a terrible performance, by an entity that has no concept of the cost of money and that has none of the performance incentives that a competitive environment in a free market economy provides.

ER Visits Up with the Advent of Obamacare

Stephanie Armour and Louise Radnofsky pointed this out earlier in the week in The Wall Street Journal.

Among other things, they mentioned

The median ER charge was more than $1,200 for the most frequent outpatient diagnoses in a study of over 8,000 ER visits in 2006-08….

This is right before Obamacare was enacted.

Notice that ER charge. A significant fraction of the deductibles on Obamacare health coverage plans is larger than that—ranging from $2,000 to above $10,000, depending on family size, the specific plan selected, and so on.

Since the ER charge is less than the deductible, even if these ER patients had an Obamacare plan, where is their incentive to see a doctor in his office? He’s still paying those $1,200 out of his pocket. The proud possession of a health plan is irrelevant to that.

It’s Time

…to bring the Veterans Administration within the Department of Defense, to be run by active duty military personnel from mid-level management on up.

I’ve written about the Veterans Administration’s apparently routine failure to perform a number of times.

Now it seems to be killing our veterans through neglect.

Last week, Jeff Miller (R, FL) Chairman of the House Committee on Veterans Affairs, said the panel’s investigators concluded as many as 40 Arizona veteran deaths could be related to VA delays in providing them medical care.

Some veterans say wait times now average 55 days.

It gets worse.

Miller also said panel investigators had evidence that officials at the Phoenix VA Health Care System kept two sets of records to hide lengthy wait times for patients seeking doctor appointments and treatment, the Arizona Republic reported.

Dr Sam Foote, a former VA doctor in the Phoenix system, told Megyn Kelly on “The Kelly File” Thursday night “we believe senior management obviously had knowledge of this.”

Earlier, he told CNN that the alleged secret waiting list was used by senior management to conceal the fact that 1,400 to 1,600 sick veterans were forced to wait months to see a doctor.

It gets even worse. Apparently, the VA also just moves its mismanagers around, rather than terminating them.

Sharon Helman, Director of the Phoenix Veterans Affairs Health Care system [a member of the “senior management” about which Foote talked above], is accused with other management officials of keeping a fake waiting list that made it appear sick veterans were being treated in a timely manner—while hiding the real list that showed up to 1,600 sick veterans were waiting months to see a physician.

And

From July 2007 through the first week of July 2008, at least 22 veterans in the Spokane VA service area committed suicide. During that same time period, however, Spokane VA reported nine suicides and 34 attempted suicides, according to Military.com and other media outlets.

Helman was director of the Spokane facility at the time the number of suicides were being misreported.

Or maybe it’s time to utterly disband the VA altogether, returning all VA personnel other than the doctors and nurses to the private sector. Then build, from the ground up, an entirely different facility whose function would be to take care of our wounded, the families of our fallen, and to help those who separate or retire get on with their lives in their new environment.

This VA is an insult to our soldiers. It’s an insult to our nation.