An Argument For Less Government In Health Care
Secretary of Health and Human Services Kathleen Sebelius has announced that religiously oriented institutions — Catholic ones in particular — are going to have to cover contraception through their health care plans.
Her ruling, unfair as it is toward Catholic institutions and others that want to limit birth control, is a natural outgrowth of the nation's current employer-based health care system. It ought to become both a rallying point for conservatives who favor putting individuals in charge of the health care system and a warning to liberals who want to centralize it under government control.
Under the new regulations, which will take effect for religiously oriented institutions next year, all health care plans except those offered by houses of worship will be required to cover contraception.
Proponents argue that since the federal government mandates health care plans cover a variety of treatments and drugs, there's no good reason why birth control coverage shouldn't be mandatory. On the other hand, it's deeply unjust to force Catholic institutions (even those not involved with worship per se) to violate the church's very clear teachings that ban contraception.
There's every reason to think such problems will grow worse with time. Embryonic stem cell therapies, which many people consider morally suspect, may eventually make it to market. More than a few Americans also bow to pseudo-science cults that discourage vaccination and promote homeopathy and would object to subsidies for those things. In short, problems like those resulting from Sebelius' decision will only grow with time.
This state of affairs could be remedied by increasing personal responsibility for health care by divorcing health benefits from workplaces. Maybe employer-based health care made sense when many workers spent a lifetime with the same company. But it's certainly not a good way to run things in an economy where workers expect to change jobs frequently and many companies, even big ones, tend to have transitory existences.
If employer-provided health plans were taxed as compensation and the government's role limited to some sort of near-universal income and age-related "premium support" — the type of system I'd favor — individuals would be free to follow their own moral compasses in selecting health care plans. With the great majority of employers having nothing to do with health care, none would have to subsidize anything it disagreed with.
Sebelius's decision also should be taken as a warning for those on the Left who want to increase government control over health care. In time, the single-payer system of left-wing dreams could easily become a tool of conservative groups intent on imposing their social vision on everyone.
Although the overwhelming majority of employer health plans already cover birth control and currently no practical government regulation could stop them from doing so, it would be a reasonably simple matter for birth control opponents in charge of the government to impose a regulation that ruled it out of a single-payer system.
The bottom line is this: Sebelius' decision is as disquieting as it was inevitable. As the frontiers of medicine advance, increasing numbers of medical treatments will raise difficult ethical questions that will divide people of good will.
A system that centralizes control over medicine will never be able to answer these questions in a way that recognizes the legitimate interests of all groups in a democratic society. The best solution is to let individuals make their own decisions about health care.
Eli Lehrer is vice president of Washington, D.C., operations for the Heartland Institute and national director of its Center on Finance, Insurance and Real Estate.
[First published in Investors Business Daily.]