The Real Stakes in the Contraceptives Fight

I read two good posts from opposite ends of the political spectrum today both making the same point that in important ways the recent congressional Republican tilt against insurance plans offering contraceptives free of charge is just a tiny skirmish in a larger war that really has nothing to do with sex, women, or birth control.

“ObamaCare is a major step toward socialized health care” is the way Roger Pilon puts it, “You can pretend otherwise—the ‘war on women’ rhetoric aims at that—but the coercive elements inherent in any socialized scheme come to the surface when conflicts like the one before us arise.”

Republicans “want employers to be able to offer health insurance that does not cover contraception, sure” is Jonathan Chait’s take, “but that’s a mere way station to the larger goal of denying any health care coverage at all to tens of millions of Americans.”

These are both very good points. If we had a country in which there was broad consensus about the idea that society should collectively pay for basic health care services for everyone, we would then have a series of arguments over what does and does not qualify as the kind of basic health care service that should be covered. But we actually don’t have that kind of consensus. Almost all of the members of Congress who don’t think birth control should count as a covered basic service, don’t actually think anything should qualify—at least as regards the health care needs of people born after the year 1957. It’s interesting that this profound disagreement about the provision of health care services to people born in 1958 or 1985 exists alongside an absolute consensus that people born in 1957 or earlier should enjoy a single-payer health care system. But the fact is that, as regards people born in the past 54 years, an enormous philosophical chasm has opened up about the whole idea of health care provision. The birth control aspect of this has gotten a lot of press because a lot of people find it more accessible than the larger health care picture, but it’s worth seeing the fight in context.