Health Care and Contraception: Did the Supreme Court Get It Right?

[Brian]

Should religious family-owned companies be required to cover contraceptives under their insurance plans? The high court says no.

I'm curious how you nurses feel about this? Please take a second to vote in our quick poll.

This is a highly political topic, I'd rather not turn this into a hot argumentative subject, so please keep your comments civil :) But please feel free to comment. Thanks

Here is an article on the topic:

Hobby Lobby Ruling Cuts Into Contraceptive Mandate

In a 5-4 decision Monday, the Supreme Court allowed a key exemption to the health law's contraception coverage requirements when it ruled that closely held for-profit businesses could assert a religious objection to the Obama administration's regulations. What does it mean? Here are some questions and answers about the case.What did the court's ruling do?

The court's majority said that the for-profit companies that filed suit-Hobby Lobby Stores, a nationwide chain of 500 arts and crafts stores, and Conestoga Wood Specialties, a maker of custom cabinets-didn't have to offer female employeesall Food and Drug Administration-approved contraceptivesas part of a package of preventive services that must be covered without copays or deductibles under the law. The companies had argued that several types of contraceptivesviolate their owners' religious beliefs. The ruling also covers a Hobby Lobby subsidiary, the Mardel Christian bookstores.

[kanzi monkey]

You are all amazing. What a compelling dialogue. Thank you.

I have a few thoughts/questions:

-what does science mean to you?

-what role do you think science has in shaping the world around you?

-do you feel that there is a disconnect between science and your faith? If so, how do you strategically negotiate this on a day to day basis?

-assuming most of you care for patients and support them through assisting them with medicines and surgeries and teaching--do you feel that your occupation is grounded in science?

-you have seen how the human body is affected by illness, toxins, grief--what are the factors involved here? How to we identify problems, and how do we find the solutions?

-where do we reach to find common ground with other humans in our world? What kinds of things can (or should) everyone agree on? (I'm thinking atomic level here)

Humans are amazing creatures in that they have ideas about who and what they are. And these are vastly different from person to person--in the grand scheme of things I think this is wonderful. However, isn't the most important thing, when delivering medical care to another person, that we remain grounded in science and objectivity? So that this amazing diversity is respected? Because we cannot say that "I'm right and you're wrong" and still be practicing good medicine? Because it is not the time or place, because it is not our business?

Can we agree that we need to use science as a universal language when it comes to health care?

[toomuchbaloney]

It's a little-known or -acknowledged fact (but you can look it up) that, as recently as the 19th century, the Roman Catholic Church did not recognize fetal "personhood" (for lack of a better term) until "quickening,", i.e., the first perceptible (to the mother) fetal movements.

Quickening is not something that is experienced when a fertilized egg passes into the uterus. It is something that happens AFTER the fertilized egg is safely implanted and the zygote has advanced in development. At earliest it is detected by pregnant women in the 3rd month or so. So the catholic church didn't even identify early term contents of pregnancy to be "life". Even in the "church" there has been disagreement on this subject but now many would have us simply bow down and follow the "religious sensibilitites" of a corporate entity. Because corporations are people. People with religion. People with more rights than the lowly women they employ.

[toomuchbaloney]

It is fine...you are stuck on biology. Not everyone can see past that which is visible to the eye.

...and then it is a quick dodge to misogyny and class baiting. Oh well, you can only manage to use the tools you have.

Peace....

My education and degrees are in the sciences.

I am not a person who sets aside science for faith.

I believe that faith exists in harmony with science and when it does not it is a good thing to exercise our free will and discover how our faith has been misplaced or misguided.

You are free to believe how ever you prefer relative to fertilized eggs. Is there some confusion about who the HL ruling will affect? Does it offend you that the ruling will affect the working poor women who are employed in retail? Does it offend you that I mention them specifically? Is there some reason that we should not consider that HL petitioned the court for the "right" to intrude into the personal lives of their FEMALE employees ONLY?

[j0yegan]

It's not birth control. Hobby Lobby gives its employees 16 types of birth control. It's the MORNING-AFTER PILL we're talking about, which shouldn't have even been part of the healthcare act to begin with because it can induce abortion.

[pmabraham, BSN, RN]

Good day:

"Mature women don't cry-yi-yi- they are demanding that they get what they pay for."

In so far as I know any compensation package is negotiated between the employer and the employee. If a given compensation package doesn't include what a given employee wants to receive, they have a choice to either accept it or move on. In a free country, neither party should be forced especially in the areas against one's conscience.

What I don't understand is why one group feels that it is ok to force another person or group to pay money or provide services against their conscience is a supposed free country.

Thank you.

[HollyLynn14]

Maybe I am alone, but I am sick to death of a woman's lady parts and uterus being front page on the political agenda.

As women, we have a long way to go to equality.

:-/

[MunoRN, RN]

It's not birth control. Hobby Lobby gives its employees 16 types of birth control. It's the MORNING-AFTER PILL we're talking about, which shouldn't have even been part of the healthcare act to begin with because it can induce abortion.

It's not the morning after pill we're talking about, it's all 20 forms of contraception which the supreme court ruled a company can now interfere with coverage of. The supreme court did not agree that these four forms of contraception were abortifacient, likely based on the general scientific and medical consensus, the highlight:

""It is not only factually incorrect, it is downright misleading. These products are not abortifacients," she says. "And their only connection to abortion is that they can prevent the need for one."

Medical Experts Agree: The Morning-After Pill Does Not Prevent Implantation.

[/Quote]

The National Institutes of Health, the Mayo Clinic, and the International Federation of Gynecology and Obstetrics all agree that the morning-after pill does not prevent implantation, the medical beginning of pregnancy. From The Daily Beast:

In federal law and medical terms, pregnancy does not begin with a fertilized egg, but with a fertilized egg that has implanted in the uterus. The contraceptives in question--Plan B, Ella, copper and hormonal IUDs--do not cause abortions as the plaintiffs maintain, because they are not being used to terminate established pregnancies.

[...]

Since the FDA approved Plan B in 1999, repeated studies have shown the drug does not inhibit implantation. After

The New York Times

' Pam Belluck investigated these findings in 2012, the NIH and the Mayo Clinic updated their websites to remove the implantation clause. In Europe, the label for the drug Norlevo, which is identical to Plan B, has already been changed to reflect the most recent research. And the International Federation of Gynecology and Obstetrics and the International Consortium for Emergency Contraception have issued statements saying levonorgestrel-only emergency contraceptives do not stop implantation. [The Daily Beast,

3/22/14

]

NPR: Contraceptives Are Not "The Same As The Abortion Drug." As NPR reported, studies have shown that contraceptives such as the "morning-after pill" do not terminate pregnancy like RU-486, which "isn't considered a contraceptive and isn't covered by the new insurance requirements":

The most heated part of the fight between the Obama administration and religious groups over new rules that require most health plans to cover contraception actually has nothing to do with birth control. It has to do with abortion.

Specifically, do emergency contraceptives interfere with a fertilized egg and cause what some consider to be abortion?

"The Health and Human Services preventive services mandate forces businesses to provide the morning-after and the week-after pills in our health insurance plans," said David Green, founder and CEO of the arts and crafts chain Hobby Lobby, one of the firms suing over the requirements. "These abortion-causing drugs go against our faiths."

The morning-after pill he's referring to is sold under the brand name Plan B. The week-after pill, which actually only works for five days after unprotected sex, is called ella.

Both are classified by the Food and Drug Administration as contraceptives. Neither is the same as the abortion drug RU-486, or Mifeprex. That pill isn't considered a contraceptive and isn't covered by the new insurance requirements.

The constant references to Plan B and ella as abortion-causing pills frustrates Susan Wood, a professor of health policy at George Washington University and a former assistant commissioner for women's health at the FDA.

"It is not only factually incorrect, it is downright misleading. These products are not abortifacients," she says. "And their only connection to abortion is that they can prevent the need for one." [NPR,

2/21/13

]

NY Times: Emergency Contraceptives Work To Prevent Ovulation, Not Implantation. The New York Times explained that emergency contraception works to preempt pregnancy. By delaying ovulation, Plan B stops an egg from being released for fertilization. Some emergency contraceptives may also work to thicken cervical mucus to make it more difficult for sperm to swim. Plan B does not stop implantation after fertilization has occurred. From the Times:

Studies have not established that emergency contraceptive pills prevent fertilized eggs from implanting in the womb, leading scientists say. Rather, the pills delay ovulation, the release of eggs from ovaries that occurs before eggs are fertilized, and some pills also thicken cervical mucus so sperm have trouble swimming.

It turns out that the politically charged debate over morning-after pills and abortion, a divisive issue in this election year, is probably rooted in outdated or incorrect scientific guesses about how the pills work. Because they block creation of fertilized eggs, they would not meet abortion opponents' definition of abortion-inducing drugs.

[...]

By 2007, scientific consensus was building that morning-after pills did not block implantation. In one study using fertilized eggs that would have been discarded from fertility clinics, Dr. Gemzell-Danielsson found that adding Plan B in a dish did not prevent them from attaching to cells that line the uterus. [

The New York Times

,

6/5/12

]

[/Quote]

http://mediamatters.org/research/2014/03/24/what-media-should-know-about-hobby-lobby-and-th/198591

[HollyLynn14]

It's not birth control. Hobby Lobby gives its employees 16 types of birth control. It's the MORNING-AFTER PILL we're talking about, which shouldn't have even been part of the healthcare act to begin with because it can induce abortion.

No it cannot.

And even if it could; monophasic pills can be taken as the morning after pill, which is covered.

The IUD can induce a miscarriage, but for women who cannot use OC's, the IUD is a lifesaver.

[HollyLynn14]

Good day:

"Mature women don't cry-yi-yi- they are demanding that they get what they pay for."

In so far as I know any compensation package is negotiated between the employer and the employee. If a given compensation package doesn't include what a given employee wants to receive, they have a choice to either accept it or move on. In a free country, neither party should be forced especially in the areas against one's conscience.

What I don't understand is why one group feels that it is ok to force another person or group to pay money or provide services against their conscience is a supposed free country.

Thank you.

In the 15 years I have worked, not once did I ever get briefed during an interview or prehire what my health insurance covered and what it didn't. Maybe I should move to where you are.

[MunoRN, RN]

Good day:

"Mature women don't cry-yi-yi- they are demanding that they get what they pay for."

In so far as I know any compensation package is negotiated between the employer and the employee. If a given compensation package doesn't include what a given employee wants to receive, they have a choice to either accept it or move on. In a free country, neither party should be forced especially in the areas against one's conscience.

What I don't understand is why one group feels that it is ok to force another person or group to pay money or provide services against their conscience is a supposed free country.

Thank you.

A compensation package is only negotiated for what will be provided beyond the legally required minimum compensation. What you're arguing is that if an employer wants to pay less than minimum wage and the employee doesn't like it then they should just go work elsewhere, which defeats the purpose of a minimum wage. It's probably more accurate to frame that this way; If a company doesn't want to meet it's most basic legal requirements then they need to yield to someone who will.

I think you confuse a free market with market that lacks any protections for employees. The basis of a free market is that a balance is struck between the needs of all sides; employers, employees, customers, public, etc. That occurs in the small scale; in individual employment negotiations, and on the meta scale, by making laws that 'pre-negotiate' things like the lowest possible wage and minimum coverage requirements. There are countries with the type of "free market" you seem to be referring to, they're the kinds of places people are seeking asylum from in droves.

If an employee purchases birth control, they're purchasing that with funds provided by the employer, which by your rationalization would mean they are making their employer pay for their contraception. Should employers be able to control how an employee spends their earned funds?

[imintrouble, BSN, RN]

In the 15 years I have worked, not once did I ever get briefed during an interview or prehire what my health insurance covered and what it didn't. Maybe I should move to where you are.

Of all the things I've read over 50+ pages, I feel compelled to post about this one. Go figure.:)

I haven't job searched for a very long time, but even when I was 18 (a lifetime ago) I ASKED about my benefits package. What I got and what I didn't. In all honesty I didn't ask about specific drugs, but I DID ask about ob/gyn care since that was important to me.

I didn't wait for the prospective employer to tell me, I asked.

[HollyLynn14]

Most employers and HR people I have asked, themselves didn't know or understand.

Imagine that