Monday, February 13, 2012

Choosing a Hill To Die On? The Contraception Wars.

Conservative pundits everywhere want to understand something: how can anyone call the Obama administration's revised position on mandated contraception coverage a compromise? Let's start by reviewing the issue in the first place.

Here is a primer on the issue from Politifact.  In two sentences: The administration announced organizations like Catholic hospitals, which are theologically against birth control, would have to provide insurance that covered it at no charge for all employees. The revised position, coming after a firestorm of condemnation from the left and the right, is that 'Okay, the organization won't have to pay--the Insurance company will!' Most observers think that the insurance companies will just pass the cost along to the Catholic organization and so they'll pay for it anyway--just not as explicitly.

Here's some takes on that (from the links above):
Consider these two policies:
A. An employer is required to provide its employees health insurance that covers birth control.

B. An employer is required to provide its employees health insurance. The health insurance company is required to cover birth control.

I can understand someone endorsing both A and B, and I can understand someone rejecting both A and B. But I cannot understand someone rejecting A and embracing B, because they are effectively the same policy. Ultimately, all insurance costs are passed on to the purchaser, so I cannot see how policy B is different in any way from policy A, other than using slightly different words to describe it.
On retrieving my paper copy of the Wall Street Journal this morning, I saw the discouraging headline:
Obama Retreats on Contraception
My first thought was, “Surely the Journal knows better than this. Why would they headline this story as if Obama had, in fact, backed off on the mandate? What are they, USA Today?”
The headline doesn’t reflect reality.
They are right1. It does not.

What Is The Obama Administration Thinking?
What they are thinking is that this is a winning issue and if the Republicans go after this, all guns blazing, they will lose. Why would they think that? Well, I'm going to speculate in a moment but look at this:
Not satisfied with President Obama’s new religious accommodation, Republicans will move forward with legislation by Sen. Roy Blunt (R-MO) that permits any employer to deny birth control coverage in their health insurance plans, Senate Minority Leader Mitch McConnell (R-KY) said Sunday.
The Republicans are doubling down. How can they not? This is a brilliant wedge issue. As I said: the Democratic position is logically flawed. It should be a no-brainer. On the other hand, I think the answer to the pundit's question is staring them right in the face. I'm going to lead with the punch-line here: An ideologically pure stance here is directly at odds with what the majority of the electorate will want. The comparable case is the prosecution and incarceration of women for having an abortion.

Abortion and The Prosecution of Women
If you believe abortion is the murder of a baby--and I hold that whatever one's position on abortion, this is a reasonable stance--then the current most-popular pro-life that doctors should lose their licenses and go to jail--while the mothers do not--is logically inconsistent. If a mother hired a for-real hitman to dispose of her unwanted baby there is no question on either side of the abortion argument she would (and should) go to jail for a long, long time.

Why don't (most) pro-life advocates hold the position that mothers who have abortions should be jailed? There are a lot of arguments for this--that women are the real victims, that an abortion doctor will kill multiple times while the woman usually only kills once, diminished capacity of the victim-mother, and so on. These don't hold up very well and the real reason we don't see a stronger push for jailing mothers who abort is this: going after the women, while logically consistent, is so unpalatable that doing so would gravely risk the whole movement.

If you want to shut down abortion you leave the women alone and go after the doctors. Doctors, in America, are pretty popular--but even so it's better than the specter of trying jail already traumatized young would-be mothers. Most pro-life advocates (from what I can tell on the web) see the logically-consistent approach as a non-starter.2

Given this it is pretty clear to see that there are some logically consistent positions that ideological advocates tend to steer clear of ... even though everyone admits they make sense. Access to contraception, I submit, is one of these.

Contraception  And Women's Health-Care
In this case the ideological position is on the other side: Women's health is both a sizable and politicized issue and contraception is a big part of it. Moreover, it's a popular part of it. Some sources say that 98% of Catholic women in America use contraception against the dictates of the church. If that is the case then a fig-leaf--which is what the Obama compromise is--is all that's required to tamp down their outrage. It's the solution "everybody wants" (save for the Bishops and the GOP candidates).

I think nothing makes this clearer than that the Catholic Health Association which oversees the 600 Catholic hospitals which care for 1 in 5 American patients is "very pleased" with the compromise. Although heavily criticized by the bishops, at least for now, this position represents the real pragmatic stance I suspect most Americans and even most Catholics will share. In other words, as things stand right now? It's the winning hand.

No matter what logic says.

What Do I Think?
I think the big question is not: why are Republicans--across a pretty broad spectrum--doing this (I think the answer is that Rick Santorum is hot right now and running anywhere to the left of him is dangerous) but rather do they think they have a winning hand with this issue? In poker the most dangerous situation for a player doesn't come from holding a weak hand--if all you have is 8-high your options are simple: bluff or fold. If you aren't ready to sustain a bluff you lose the ante and that's it. The most dangerous situation is where you think you are--or are about to be--holding the winning hand and your opposition does too. In that condition you bet the roof if not going "all in."

And then, if/when you're wrong ... you lose everything.

If the Republicans really do think this is a winner and it's not they risk looking out of touch (if not misogynist and theocratic3). I'd love to see what the GOP-strategist numbers crunchers are saying about this--or are they just barreling ahead and taking the risk that this becomes an unforced error that will hurt them in the general?

11-dimensional chess, indeed.

1 The argument that this policy actually does save money because contraception is cheaper than either pregnancy or abortion is not bad but it also isn't especially relevant to the philosophical case against it. Yes, insurance companies might both provide contraception coverage and charge less than before--but in the event that they do, in fact, pass the cost on the Catholic hospital is still paying for it--just indirectly.
2 That is not to say that all the arguments in this space are inconsistent. There are some which envision only jailing socialite mothers who "use abortion as birth-control" but on the whole a great deal of the arguments put forth don't make a lot of sense (such as that if mothers are in legal jeopardy they will not testify against abortion doctors--or that the anguish of abortion is punishment enough) and the cases that do are so nuanced as to be severely splitting hairs (how many socialite mothers are there using abortion as birth-control as opposed to under privileged teenagers?)
3 Consider that the Republicans are not fighting for, for example, the right of insurance to deny blood transfusions to the employees of religious organizations who reject that form of treatment.

No comments:

Post a Comment