Can we take a step back here? Clearly the HHS mandate that requires the Catholic Church to pay for contraception, sterilization, and abortifacients is an affront to religious liberty. This is being acknowledged from both ends of the political spectrum. At least 92% of the bishops who head a diocese in the United States have spoken out forcefully in opposition to the mandate. They have been joined by leaders of many other religious communities. Even the secular press is presenting this as a religious freedom issue. So how did we get here?
This issue is before us because the Secretary of HHS declared that contraception, sterilization, and the use of abortifacients (morning-after pill) are preventive medicine. This is an error as I argued here. Contraception, sterilization, and abortifacients are elective medical interventions. They are lifestyle choices. Preventive medicine prevents disease and maintains health. Contraception, sterilization, and abortifacients take a perfectly healthy reproductive system and render it sterile. So why did the Secretary of HHS include these elective medical options as mandated preventive care? Because Obamacare says she can.
The real danger of Obamacare is not the specific medical requirements outlined in the bill. The danger is the power this bill ceded to HHS. The Secretary of HHS has the power to set up all kinds of committees and commissions to determine what will be covered care and who will get it. For example, Obamacare will fund the Patient Centered Outcome Research Institute (PCORI) to the tune of $600 million dollars a year to research ways of cutting medical costs. Of course that means the PCORI has to “find” $600 million dollars of “unnecessary” care to justify its existence. Would you trust Blue Cross to do research to determine what is the best medical practice? I wouldn’t. Their financial interest in spending as little as possible on medical care would bias their judgment. The same thing will happen with the PCORI. They are tasked to set best medical practice standards with the ultimate goal of cutting costs. However, the cheapest care is not always the optimal care for the patient. Do you want an organization that is tasked with cutting medical expenses to be responsible for setting therapeutic guidelines?
The fight for religious liberty is the only the first battle of Obamacare. The next battle will be the fight for our eligibility for care. Perhaps the PCORI says we are too old for care. Or the PCORI says we are too disabled to warrant care. Or the PCORI says nutrition and hydration are optional care. If this legislation stands we will soon be fighting for our lives.