Part 4—Sadly, reporting is hard: So it frequently happens.
Rush Limbaugh’s attack on Sandra Fluke produced storms of outrage in the past week. As frequently happens, this distracted attention from the matters Fluke testified about.
(On February 23, Fluke testified before a group of congressional Democrats. For the text of her testimony, click this. To watch her on C-Span, click here.)
For our money, this distraction was unfortunate, because the original case raised fascinating questions about a major ongoing policy matter. As usual, the reporting has been very weak, to the extent that reporting has happened at all.
But then, what else is new?
We’d love to see this story fleshed out. These are a few of our questions:
Fluke hit the news on February 16, when congressional Democrats tried to have her testify before a full House committee. According to the Washington Post, Chairman Darrell Issa “said that, after a staff review, he had not found Fluke ‘appropriate and qualified’ to testify before his committee.”
That evening, Fluke appeared on the Ed Show, where she described the situation she has confronted at Georgetown:
SCHULTZ (2/16/12): Great to have you with us tonight, Sandra.They say bad cases make bad law. Is that true of congressional testimony? Fluke describes a profoundly troubling set of events. That said, we’re not sure why congressional Dems would have sought this particular testimony.
Now I understand that you already planned your testimony. You were going to cite examples of people who could have benefited from President Obama’s mandate for birth control coverage. Share with us what you would have told that committee today.
FLUKE: That is what I was there to speak to the committee about. That’s why I was so stunned when Chairman Issa made the decision to not allow me to speak on behalf of those women and to say that I was not an appropriate witness, that those women’s stories were not appropriate for this committee. I cannot think of who would be more appropriate for the committee to hear from than the women affected by this policies whose lives were affected.
One of the women I wanted to talk about today is a close friend of mine. She has polycystic ovarian syndrome. And what that means is that she needs to take contraception for medical reason, to prevent cysts from growing on her ovaries and not to prevent pregnancy.
Now that technically means it should be covered on Georgetown student health insurance, which does not cover contraception for prevention of pregnancy. But unfortunately when university administrators and employers and insurance companies get involved in deciding whose health needs are legitimate and whose aren’t, what happens is that women’s health needs take a back seat to that type of ideology. And that’s what happened in her case and we found that that happens in 65 percent of the female students’ cases.
So for her, she was unable—they repeatedly refused her contraception coverage claims and she had verification from her doctor. It didn’t matter. So she had to pay out of pocket about $100 a month for her, month after month after month. And eventually she just couldn’t afford it like many students just cannot afford that kind of a cost.
And she had to stop taking it. I have to tell you, it’s—so what happened is that after a few months of her not taking the prescription, a massive cyst grew on her ovary. And she woke up one night in the middle of the night in excruciating pain and told me it felt like she had been shot.
And I just can’t—I can’t imagine what that felt like for her. What ultimately happened is that she had that ovary surgically removed, she had to have it surgically removed. And as a result of that, she would have problems conceiving a child. But even more, it just hasn’t stopped for her.
Since the surgery she’s experienced symptoms of early menopause, and her doctors are very concerned that at the age of 32, she is entering early menopause, which means that there will be nothing any doctor can do to help her to conceive a child. And it will also put her at risk for increased risk for cancer, heart disease, and osteoporosis.
And that’s where she was this morning when I was attempting to tell her story to the public and to members of Congress, she was at the doctor’s office trying to cope with the symptoms she’s experiencing.
SCHULTZ: Sandra, you know, I know our audience appreciates the story you just told. That was tremendous testimony. And it’s very powerful.
Did a Georgetown student suffer terrible medical consequences when the university (or perhaps an insurance company) violated its own procedures? Fluke seems to describe serious misconduct on someone’s part. But alas! The Washington Post didn’t examine this claim when it did its basic news report about Fluke.
Jenna Johnson’s news report appeared on Sunday, March 4. By then, we were all discussing Rush Limbaugh, not the young woman whose medical disaster Fluke had described. The outrage was general—about Rush! Other folk melted away.
Fluke seemed to describe a serious bit of misconduct—but bad cases do make bad law. Let’s suppose Georgetown (or its insurance company, if it has one) did misbehave in this case. Why would that be the type of testimony congressional Democrats sought?
For ourselves, we aren’t sure—but once Limbaugh calls someone a slut, the excitement overwhelms everything else! Meanwhile, the hometown Post may even engage in reporting as silly as this:
JOHNSON (3/4/12): As a co-president of the Georgetown chapter of Law Students for Reproductive Justice, Fluke and other law students have met through the years with several top Georgetown officials to discuss the student health-care plan.Even that! Students may have to “venture off campus!” As far as half a mile!
"They made very clear to us that they weren't going to do this until the law made them do it," said Lizzy Watson, 23, a second-year law student who is also a member of the group.
Some student groups pass out free condoms on Georgetown's main campus, but purchasing contraceptives of any sort requires venturing off campus, often to a pharmacy about half a mile away.
Other factual disputes have flared, including a dispute about how much contraception actually costs. But go ahead! Try to find reporting about such topics in the Times or the Post. (For Planned Parenthood’s answer, click this.)
Elsewhere, it’s all about the outrage! It’s all about Limbaugh’s remarks.
More questions: How exactly does this case relate to the decision which set off the current dispute? Under terms of Obama’s “accommodation,” will Georgetown have to provide contraception as part of its insurance for students? More broadly, does anyone know, to this very day, how Obama’s accommodation is actually supposed to work? Does anyone know how it would work for Catholic institutions which are self-insured?
We don’t know how to answer those questions. Within our journalistic culture, basic reporting of such matters tends to be inept from the start. But once Rush launches a culture war, everything else is ignored.
We’ve wondered about another aspect of Fluke’s interactions with Georgetown. When she spoke with Schultz, she described a long, frustrating effort to get contraception coverage:
SCHULTZ: I want to know what’s it like—you’re a third-year law student at Georgetown. Are people on campus—are they talking about this story, or has this really hit the attention of women that you interact with professionally in the school setting?According to Fluke, students have been struggling to get this coverage for decades. But according to the student Johnson quoted, Georgetown said it wasn’t going to comply “until the law made them do it.”
FLUKE: Oh, my goodness! Unless you studied at one of these schools, I can’t even explain to you what it is like on campus. We have been following these regulations ever since the Affordable Care Act was passed. And it’s a fight we’ve been having for years, literally decades, students have been struggling for this.
We were struck by the sheer futility of this portrait. Have students really been fighting for decades, trying to get a Catholic university to abandon its view of Catholic doctrine?
There’s nothing wrong with such a fight, of course. Students have every right to wage it.
But we’ll have to admit we wondered a bit about these students. Georgetown is a high-ranking law school. Presumably, its students are very bright—and they plan to be lawyers. (Last night on Fox, Megan Kelly said the starting salary for a Georgetown law grad is $160,000 per year.) In all those decades, did anyone ever try to create a work-around—a solution in which students would get contraception while Georgetown got to maintain its doctrine? How expensive could it be to provide this coverage for the women at Georgetown Law? Did anyone try to create a foundation which would provide this coverage from the outside, with Georgetown maintaining its view of Catholic doctrine?
We’d love to see reporting on that. Instead, the Post reports that law students have to “venture” as far as half a mile in order to buy contraception! This type of reporting tends to obtain once a culture war breaks out. Reporters start plucking the violin strings, helping us bond with the victims.
According to Fluke’s testimony, at least one young woman has been badly injured because of someone’s misconduct. Is that true? And who was at fault? We’ve seen no one who showed any interest in examining this serious claim. But then too, we’ve seen little attempt by major newspapers to explain this issue at all. How would Obama’s “accommodation” work? How would it work if a Catholic institution is self-insured?
Your big newspapers don’t seem to care. And such questions don’t make it to cable, where outrage and fury float boats.
Down through the decades, could enterprising Georgetown law students have found a solution to the problem? Has Obama come up with a workable plan? Are there any win-wins here? Or is this about “breaking the union?”
On this, a quick personal note:
We grew up Catholic ourselves. We emerged with a rather negative view of the Catholic Church. For that reason, we would not have been inclined to enroll at a Catholic university. But if we had enrolled at such a place, we don’t think we would have reacted with shock if we found our Catholic university pursuing Catholic doctrine, however absurd it may seem.
Fluke speaks to such issues in her testimony. Limbaugh made Fluke a victim with his typically stupid conduct. But we’ll suggest a political test for progressives:
Imagine Rush hadn’t interceded. Can you imagine how testimony like this would strike many voters? For ourselves, we’ll guess that many voters would think this might be a bit semi-foolish. We can’t really say they'd be wrong:
FLUKE (2/23/12): In the media lately, some conservative Catholic organizations have been asking, What did we expect when we enrolled in a Catholic school? We can only answer that we expected women to be treated equally, to not have our school create untenable burdens that impede our academic success.Fluke resents the fact that someone disagrees with her view! After all, it’s the 21st century! And she refuses to go somewhere else. Why can't Georgetown just do what she wants?
We expected that our schools would live up to the Jesuit creed of “cura personalis”–to care for the whole person–by meeting all of our medical needs. We expected that when we told our universities of the problem this policy created for us as students, they would help us.
We expected that when 94 percent of students oppose the policy the university would respect our choices regarding insurance students pay for–completely unsubsidized by the university. We did not expect that women would be told in the national media that we should have gone to school elsewhere.
And even if that meant going to a less prestigious university, we refuse to pick between a quality education and our health. And we resent that in the 21st century, anyone think it’s acceptable to ask us to make this choice simply because we are women.
These are subjective judgments, of course. But on balance, that strikes us as semi-foolish. For ourselves, we’re not real high on the Catholic Church. But to our ear, Fluke’s full testimony is full of infantilizing imagery concerning the (presumably) very capable students who chose to attend Georgetown Law. To our ear, the testimony offers a semi-childish view of the way a Catholic institution should respond to those who attend it.
This doesn’t mean that Fluke’s a bad person. It doesn’t even mean that she’s wrong! It does means that her friend might have been spared if someone had solved this problem during those futile decades. If someone found a good-faith solution to a problem everyone has known about for many years.
Is there some way to build “win-win solutions”—to create outcomes where Catholic institutions get to follow their doctrine while their employees and students get contraception? Was there a way to do that at Georgetown in the past? Has Obama’s “accommodation” now accomplished this goal on a larger scale?
Especially after Rush stirs outrage, big newspapers don’t cover such questions.
People! Reporting is hard!
Tomorrow: Scott Lemieux’s objection
Bob:
ReplyDeleteI understand where you are coming from but you seem to lack an understanding of law school which utterly nullifies your criticism.
1. That $160,000 salary figure is completely bogus. Law Schools repeatedly lie and selectively disclose employment information. Approximately 40% of Georgetown Law Grads will be unemployed or only marginally employed. Factoring in all graduates, I would estimate that the average starting salary would be $45,000. They will owe, on average $200,000 in high-interest non-dischargeable student loans. Approximately 30% of them will make enough money to be able to repay those loans.
2. This is relevant here because your arugemnt seems to be that they shoudl just attned a different school. This is unrealistic becuase school rankings are EXTREMELY important in determining whether a law graduate gets the six figure job necessary to repay their loans. For perspective: A Harvard Law Gradutate (Top 3 school) has a 95% chance of paying off the loans, A Georgetown Law graduate has a 40% chance (Top 20 school). A George Washington Law graduate has a 20% chance.
3. As a result of the central importance of school rankings and reputation, I can guarantee you that almost no Georgetown law student went to Georgetown because it is a Jesuit University. They went because it was the highest ranked school they could get into (in a geographical location in which they were interested in practicing) and thus gave them the best chance of actually becoming a lawyer and paying off their loans in their lifetime.
Personally, I applied to law schools in 2003. I applied to both Boston College and Georgetown despite being a lifelong atheist.
I never once considered not going to these institutions because they were Jesuit. I did not attend either, but had I done so I would have been shocked to learn that the health insurance provided did not cover any standard care that the Jesuits happen to morally disaprove of.
Georgetown Law Students will each spend $220,000 to attend that school. This is QUADRUPLE what it cost to attend 40 years ago (adjusted for inflation).
This supposedly religiously-principled institution demonstrably lies about the employment outcomes of its students, induces them to attend, and then charges them an exorbitant tuition which in no way reflects the value of the degree conferred nor the quality of Georgetown's services (unless you think Georgetown Law teaches its students 4x better than it did in 1970)
The least Georgetown could do is provide insurance coverage which covers the standard healthcare that anyone would expect to receive when they purchase health insurance.
I agree with this comment. To my ear, Fluke's comments are not "semi-childish" so much as expressing frustration and something of a lack of understanding of the difference between private and public schools. If one is paying tens of thousands of dollars a year to attend a university, one generally expects that university to be responsive to complaints about non-academic issues (such as student health). However, attendance at a private institution is a privilege, not a right; and while it may seem unfair for it to take your money and then refuse to listen to your complaints, at a private institution that power dynamic is reversed. You are paying them to let you into their school, which means you have to live by their rules.
DeleteThe bigger problem here is Georgetown's status as a gatekeeper to a successful career. Not only can they dictate the circumstances and content of your education, you have to swallow it and take it if you want that Georgetown Degree. Ironically, the best way to change that is probably to do what Fluke has done: bring public attention to what this private institution is doing, so future potential Georgetown students can be aware that such things are happening. If it starts affecting their pocketbook, they're more likely to consider changing their stance.
I think it's interesting that Mr. Somersby has so many questions about Ms. Fluke's testimony, but accepted Megan Kelly's "average starting salary of $160,000" at face value, then jumped on that horse and rode it.
DeleteYes, that $160,000/year is highly suspicious, especially if you've been following all the discussion about the many, many law students, even from the "top" law schools, who cannot find jobs and who are now paying far higher tuition for law school than they did just ten years ago. It is very plausible that Georgetown students who land a corporate job start at $160,000, but how many are actually landing such jobs these days? In other words, is this an accurate median figure for all Georgetown's students? (Trusting Megan Kelly on this kind of issue? Amazing.) And how many of those students who do find jobs at $160,000 take them only to pay off the massive debts they've accrued, even though they'd rather practice less lucrative kinds of law? And btw, while a law student is accruing those debts and living hand to mouth, she really may not be able to afford birth control pills. (I know. I had to pay for my daughter's while she was in law school.) But that's okay then. That female student is just more likely to get pregnant, leave law school, and stop crowding men out of the competition for jobs, right?
DeleteSometimes bob somerby, in order to make a minor but fair point about poor news coverage, misses the big picture. More and more often these days. He's all for reading people's positions with an open and generous mind -- unless they're left-liberal-progressive positions that have been less that absolutely perfectly presented either by the figures in the news or by the journalists covering them. Then, ah, the outrage!
Remember, this is the same guy who was all outraged (and should have been) when "During my service in the United States Congress, I took the initiative in creating the Internet" was turned into "I invented the Internet."
DeleteAnd those rather clumsy words were spoken by his dear friend who had DECADES of experience in politics, public office and public speaking when he spoke them.
Now he calls Sandra Fluke's testimony "infantilizing" and "semi-childish"?
He is going to hold Sandra Fluke to a standard of perfection that he wouldn't hold his good buddy Al Gore to?
Mr. Somerby is correct. Basic facts concerning Georgetown's health insurance are way more difficult to find than they should be. For instance, I would like to know if the cost of the operation was covered but the means to avoid surgery wasn't. This would seem to violate the tenents of what we think of as preventive care.
ReplyDeleteThis is a complicated situation and thinking of it in purely political terms yields more heat than light and doesn't seem to move us closer to a solution acceptible to all parties.
This is why health care costs in the U.S. are double and triple per capita than anywhere else in the developed world, why we need a national plan that mandates basic preventive services.
DeleteIn our employer-based system before the Affordable Health Care Act, virtually any employer (unless negotiated through collective bargaining) was pretty much free to negotiate what they would and would not offer in employee group health insurance plans, at co-pays set by the employer.
So we get to the Ford Pinto theory of actuary -- it could be cheaper to pay for a couple of operations for a couple of women than to pay for preventive services for all women.
Then we get to employers offering employees the "cafeteria" plans in which the employee gets to choose how little health insurance they can afford, with so many of them now paying a significant portion of premiums, especially to cover dependents. Works as long as they are young and healthy, then something happens and you find out your insurance plan really amounts to a "cents-off" grocery coupon which pays very little of the health care costs incurred.
This is why the primary cause of bankruptcy in America is medical bills, and has been for quite some time. Then those costs uncollectably by the health care system gets passed along to the rest of us in the form of even higher costs for care, and higher costs for insurance.
If it is indeed true that the hormones necessary to prevent the need for surgery weren't covered but the surgery was there is no other word than perverse to describe that kind of "health" insurance.
DeleteI find it hard to believe that many Americans of all political stripes would disagree with me, too.
But as Mr. Somerby says, facts are hard to come by and reporting basic facts is hard.
Happens all the time. In fact, many years ago, I chose a cheaper PPO plan instead of an HMO for my wife and myself. Then we had our first baby.
DeleteWhen we took the baby in for his first round of vaccinations, we found out that the PPO wouldn't cover them. But the PPO would have paid for the kid to be hospitalized with pertussis, diphtheria, tetanus or rubella.
And in order to get coverage for routine preventive services, such as childhood immunizations, I would have to switch plans and go to the HMO -- at a much higher cost.
This is the way health care works in America. And let's hope we have at least begun to fix it.
But the liberal world does not want a win-win solution. We don't want them to be allowed to follow their doctrine in this secular nation. They can only follow their doctrine in the privacy of their own homes. Once they step across that threshhold the "seperation (sic) of church and state" demands that they abandon their doctrine and be dragged, kicking and screaming, across the bridge to the 21st century.
ReplyDeleteBob, I would sooner believe the anecdote about Sandra Fluke's friend than a third-year law student would volunteer to offer false testimony to Congress.
ReplyDeleteWhere would the story be if Rush hadn't stuck his fat mouth into it?
Most likely it would be in news on the Republican primaries, and how President Obama is breaching the 1st Amendment, and trying to destroy religious freedom in America, and how American women repudiate Republicans, and the GOP better watch out come November.
Which is where it was.
As you say, some of the most important questions have not been asked, or answered.
When the Rush story dies down, as it must, these questions will still be ignored by our media.
Are you serious? Under your hypothetical "win-win" solution, Georgetown's female student population incurs added cost, that is discriminatory. Would you be ok, if Catholic doctorine did not believe in treating sickle cell anemia and African-American students after paying their fair share for a health plan had to pay extra for a sickle cell treatment and management program?
ReplyDeleteYou profess to be for lowering health care costs, but in an example of an inefficient and inequitable delivery system you want to create more cost for the consumer.
How can people be shocked that the Catholic church has sexist views, and is prepared to stand by them?
ReplyDeleteWhy on earth are you surprised this case would be picked? It makes the point that banning contraceptives also applies to women who need them for non-contraceptive reasons (as one of my close friends needs them, I've been well aware of this since the debate began). The consequences in Fluke's friend's case are extreme but I don't think the underlying principle (denying these drugs absolutely for any reason is a Bad Decision)is an outlier.
ReplyDeleteI also wouldn't call the case of Fluke's friend the "outlier" in a "bad case makes bad policy" argument. How common it is, I don't know, but I would hardly think that case was unique. Would you also want to form a national cancer coverage policy on the basis that when you get down to it, only a relatively small portion of the population gets cancer.
DeleteTo me, the "outlier" is the church's rather extreme position that birth control is an intrinsic evil and that nobody should use it. That's a position that's been pretty much rejected, including by Catholic married men and women.
But the church still wants to make national policy out of it.
"Other factual disputes have flared, including a dispute about how much contraception actually costs. But go ahead! Try to find reporting about such topics in the Times or the Post. (For Planned Parenthood’s answer, click this.)"
ReplyDeleteI went to this site and found that there are no Planned Parenthoods outside of Hays, Overland Park, and Wichita in the state of Kansas. The swath of area in Southeastern Kansas that is not covered is equivalent to the entire state of New Jersey. In southwestern Kansas the area not covered is comparable to the entire state of West Virginia.
http://maps.google.com/
"We grew up Catholic ourselves. We emerged with a rather negative view of the Catholic Church. For that reason, we would not have been inclined to enroll at a Catholic university. But if we had enrolled at such a place, we don’t think we would have reacted with shock if we found our Catholic university pursuing Catholic doctrine, however absurd it may seem."
That is nice if you have multiple options, but many people do not have so many(realistic) options, if any. A Catholic hospital is the only one in town or in the surrounding area.
http://www.theagapecenter.com/Hospitals/Kansas.htm#P
Perhaps a Georgetown law student is not the most sympathetic witness (before the Rush comments), but it is very difficult to get someone to talk about the inequality of healthcare in the more rural and poorer areas of our country. If they are ostracized in their community or blackballed at their place of employment their lifes can be ruined. Why are you so dismissive of those with limited options?
I attended Georgetown Law 30 years ago. As a man, I wasn't looking to get birth control pills, and frankly I don't even recall the University offering health insurance (I guess they did, but I'm pretty sure I didn't have it).
ReplyDeleteWhat I found particularly striking about Fluke's testimony is that the University doesn't subsidize the premiums at all. Employers typically do (so perhaps the University does subsidize coverage for faculty and staff but not for students). But if the University isn't even paying for the insurance, what's their beef? What business is it of theirs if the insurance plan covers ritual sacrifice (which I think is inconsistent with Catholic doctrine, but I'm not sure). Does their insurance plan cover ritual circumcision for babies of Jewish and Muslim students? I don't think the Church prohibits circumcision, but the Jews believe it is required as a sign of God's covenant with Abraham. St. Paul said circumcision was not necessary for Christians. So isn't paying for it (especially for non-Catholics plainly inconsistent with Catholic doctrine? Of course, the church picks and chooses which doctrines it cares about. For example, some bishops threatened to excommunicate John Kerry for being pro-choice. The Pope has been clear in his position that capital punishment and the Iraq war are immoral, but pols who support (or commit) those sins are still welcome at the altar.
Ask yourself, what is worse, contraceptions, abortions and same-sex marriage, or wars and drone attacks, social and economic policies that enrich some at the expense of others, and capital punishment?
DeleteJesus was clear on this in the Gospels.
The Bishops take another stand, beside the Republican Party.
True. Pope John Paul II was also very clear in his warnings of the dangers and evils of "unbridled capitalism" which places the worker at the service of the economy instead of the other way around and concentrates wealth in the hands of the few.
DeleteAnd birth control is the issue the bishops choose to go to war with the U.S. Government on?
I think her testimony should viewed juxtaposed against the testimony put forth by the Catholic Bishops. To my ear, their testimony is full of infantalizing imagery of an organization that doesn't want to function in the context of a secular society with secular laws and regulations.
ReplyDeleteDoes Ms. Fluke want to have her cake and eat it too? I mean, she wants to go to a top rate law school, which happens to be Catholic, and have it cover contraception. Umm...well, there's a little bit of that. But when it comes to choosing a law school -- or any graduate school -- applicants must consider a variety of factors and I am sure insurance coverage doesn't immediately spring to their minds. Should they expect adequate insurance coverage. I think so.
The Catholic Church, on the other hand, enjoys full protection of the secular society, but it also wants to flout its laws. No one is asking them to provide birth control pills at communion. They are being asked to be responsible employers once they enter that sphere of the society.
In addition to my points in comment 1, i also neglected to mention that Georgetown Law Students are REQUIRED to pay for the insurance provided by Georgetown if they do not have insurance of their own. In other words, these students, not Georgetown, are paying for the insurance. How can Georgetown claim that its religious principle are being violated when the transaction at issue does not really involve Georgetown in any fundamental way?
ReplyDeleteGeorgetown is saying "You MUST pay us money to provide you health insurance or you cannot attend our law school. In return we will provide health insurance which lacks certain basic services and is also more expensive to you as a result. We will do this because those services, which are neither used, paid for or provided by us, violate our religious principles."
This is a point that's almost always never mentioned.
DeleteGeorgetown (and almost everybody else I can think of) requires those covered to pay premiums, often massive ones.
The idea that women are looking for something for nothing is totally inaccurate.
If you're paying for health insurance you want, at the very least, your basic health needs covered.
We require minimum insurance coverage for cars right? In light of that it seems ludicrous to allow health insurers to offer whatever coverage is most profitable for them.
I have been troubled by the claim that contraception would cost $100 a month. I find no reason to believe that and Planned Parenthood suggests otherwise. I would like to know just how factual the story told by Ms. Fluke is. Possibly the person who told here the story was not accurate.
ReplyDeleteYou would have to factor in not only the cost of the prescription pills themselves, but also the costs of routine doctor's visits, since the taking of any prescription drug must be regularly monitored.
DeleteIt would also depend a lot on the precise birth control drug she was prescribed to control her ovarian cysts.
There is no reason to believe that visits to a doctor would not be covered, and this was never mentioned or implied. The issue was the cost of the drugs, which should be clarified. Stories like this need to be clarified and checked, even though we deeply sympathize or empathize.
DeleteA physician I am friends with says the story does not make sense the way it was told, and the physician is completely sympathetic to the patient.
I am completely sympathetic to Ms. Fluke and the patient in question, but on a public matter like this we need to know more. Birth control prescriptions just should not be as expensive as claimed and Georgetown students can afford the prices Planned Parenthood gives us and I know are accurate.
Delete4:39 p.m., if you think those doctor appointments would be routinely covered, then you've been pretty healthy and never had to fight a health insurance company before.
DeleteAnd they deny coverage for all sorts of reasons. Here's an example. My wife gave birth to our second child at 10 p.m. and was admitted to the hospital at midnight. The doctor actually had to fake a "medical reason" to prevent her from being discharged at midnight the next night instead of the following morning, since our health insurance plan only covered her for 24 hours in a hospital.
That's the kind of nonsense that is pervasive in our health insurance system, which is why we needed a national plan with national standards.
Please realize also that there are all kinds of birth control prescriptions, and the prescription that Fluke's friend was given to control ovarian cysts might not be the same one that Planned Parenthood gives out relatively inexpensively, while using their bulk purchasing power to negotiate the price down even further.
I have no reason to believe that Fluke or her friend was lying, but even if they were, birth control is a basic health service even if it is for the purpose of family planning. Why on earth should it be national policy to allow any employer to refuse to cover it for any woman because the Catholic Church considers it sinful?
Georgetown University functions as a secular institution. It intentionally recruits students of all faiths and of no faith. It receives many millions of dollars in taxpayer money through Pell Grants, Stafford Loan subsidies, and also direct grants for all kinds of research. It probably (though I admit I don't know DC law on this) does not pay taxes on its extensive real estate holdings. It receives all sorts of favor from the state because it provides a good that benefits the full breadth of citizens, which is, I'm sure, its stated mission.
ReplyDeleteI work with a group of educational institutions all related to one protestant denomination, who provide the same sort of public good and receive the same sort of public benefits, and all of them take great pains to help provide for both the religious care and the differing consciences of Catholic students, and Jews, Muslims, and many others as well.
Why does the presumed religious liberty of an institution that intentionally recruits and admits all kinds of people trump the individual religious liberty of those very people, its students and employees? In the end I guess know the answer--because the Catholic Church understands its view of moral law to apply to us all whether we agree with it or not. I do understand that, but, hey, I said I'm a protestant.
Bottom line, a big, functionally secular university is not a religious institution in any meaningful sense and it shouldn't get to turn religious teaching into public policy.
Hi Bob, great piece.
ReplyDeleteI do have one quibble. It's not "bad cases" that make bad law, it's "hard cases." So I'm not sure what should be the legal upshot of this case.
But on the broader point of how badly the media covers the actual questions, you're absolutely right. I've been following the story and I have no idea of the answers to the questions you raise.
Presumably, a man attending Georgetown could feel secure that his insurance would cover anything he needs. There's no carve-out for anything that only a male would need and that the Catholic Church disapproves of, because there isn't anything, as far as I know, not even Viagra. To be a female attendee is to know that you pay the same for your coverage as a man and get less, with a bunch of patriarchs looking over your shoulder and judging you at the same time. Why this kind of discrimination in accommodation is tolerated against women, when it wouldn't be against minorities, is amazing to me. It's Jane Crow, instead of Jim Crow.
ReplyDeleteBut to our ear, Fluke’s full testimony is full of infantilizing imagery concerning the (presumably) very capable students who chose to attend Georgetown Law. To our ear, the testimony offers a semi-childish view of the way a Catholic institution should respond to those who attend it.
ReplyDeleteIt was full of infantalizing imagery and a bizarre, blind entitlement the subtext of which is that a Catholic institution should be forced to be secular in each and every way the government decides it should be.
You won't read these truths recognized or acknowledged anywhere else but here, but you will see them defended by "the tribe" on the most absurd grounds imaginable.
The Catholic Church shouldn't have to pay for anything, especially not someone's contraception. Out of pocket, out of mind. It's got enough to deal with because of all those priest pedophilia lawsuits. The bishops can barely afford to keep themselves in those gaily colored robes.
Delete"It was full of infantalizing imagery and a bizarre, blind entitlement the subtext of which is that a Catholic institution should be forced to be secular in each and every way the government decides it should be."
DeletePeople should be entitled to health care when the product foisted on them pretends to be health care. Newsflash: a woman's ovaries are tethered with her overall health.
Or just go about "defending" the rights of institutions to do whatever they please "in the name of the lord" whilst permeating our entire economy.
As alluded to in other comments, does G-town negotiate for a group health plan paid for by the students? One of ours attended BC, also Jesuit, and that was the arrangement. Each student paid about $1100/semester for a group health plan unless they could prove private comparable coverage. The school provides a health facility for cuts and bruises but not much else.
ReplyDeleteDoes the G-town policy cover the cost of AIDS pharmaceuticals? If they do, isn't that a bit inconsistent with doctrine?
The thing that always struck me (also growing up Catholic with a sister Sister and a first cousin Father) the Church has the strongest weapons known to them: eternal damnation, or at best some fairly lengthy spiritual punishment but they have an entire hierarchy seemingly dedicated to temporal extensions of shame, humiliation and, at least in my school days, a predilection for corporal punishment. Isn't the spiritual enough for them?
Why can't the insurance plan they don't pay for include contraception with the Church knowing that anyone who used it risked damnation? Bastards want to get you coming and going.
As a teen-ager, I delivered newspapers. In college, I made money grading math homework. My wife worked 20 hours a week in her last two years of high school, in order to save enough money to go to college. We both took it for granted that we would have summer jobs once we were old enough to work.
ReplyDeleteSandra Fluke is a 30-year old adult. she's a college graduate and a student at an elite law school. ISTM that she can easily find a way to earn enough money to pay for birth control pills. I see no reason why she needs someone else to pay for them.
I agree and urge young people to deliver newspapers, grade math homework and work 40 hours a week during their final years of high school to pay for college. They can pay for a semester or two, then stop and work some more, deliver some more paper, grade homework, perhaps sweep chimneys or clean up parks, then go back and repeat until they're done. Summers too.
DeleteAt 30 years old Sandra Fluke could take on multiple jobs to pay for her medicine. The friend she was testifying too, when she got out of the hospital. No one should pay for anything except the person herself or himself. The same with war. A few more delivery routes and we can afford a bomber or two. Freedom isn't free.
Beat that chest, Tarzan.
DeleteDave does kind of read like "I walked five miles to school barefoot through the snow uphill both ways, and if it was good enough for me, it's good enough for everyone."
DeleteWell, BS.
Wait a minute, I thought from the previous posts that the students paid for the insurance, not the school. So the school isn't being forced to compromise its highly moral and principled stand against contraception.
DeleteAlso, you'd have to sell a lot of papers and do a lot of tutoring to pay the tuition at Georgetown Law School.
DinC is an entitled idiot in his 60's who has absolutely no idea how easy he had it. When he and his wife went to college, Ivy League Schools cost approximately $10K a year, adjusted for inflation.
DeleteStudents all over the country are doing exactly what DinC and his wife did. The only difference is that they are graduating with crippling debt and no job prospects, rather than debt free with job prospects.
DinC should be uttelry ashamed of himsefl.
Well, Bob, some stories legitimately have side issues of relevance, but you seem to really be quibbling here.
ReplyDeleteIt's absurd to think that when a man brutalizes a woman over some belief she holds and/or words she spoke that the press would significantly focus on the woman's words/beliefs.
Limbaugh's outrageous conduct is THE story. You're like the judge wondering why no one's bringing up the victim's tight jeans in the rape.
What's disappointing to me is that Bob seems to be doing to Sandra Fluke what he accused the mainstream press of doing to Al Gore 12 years ago.
DeleteHe's parsing every single word, until he bends it into something he wants it to say, and if it isn't 100 percent accurate, then it's 100 percent wrong.
So why not do the same with the testimony of Bishop Lori, who sat on Issa's first, all-male panel? Quite simple. It didn't resonate with the public like Sandra Fluke's powerful testimony.
And that is why Rush Limbaugh, in his usual fashion, had to go straight to the ad hominem, attacking Sandra Fluke in very personal, very vile terms. For three days, until his advertisers began bailing out, and only then did he issue his non-apology apology.
And yes, a powerful media voice for more than 20 years being brought to his knees by the testimony of a single "nobody" 30-year-old law student IS the story.
Bob, you really need to a refresher course on what constitutes church "doctrine," particularly in the area of artificial birth control, which has all sorts of nuances.
ReplyDeleteFirst off, the church is not just the hierarchy. It is also the people. Have a theologian tell you about "sensus fidelium." That says that in order to be authentic, a church teaching not only has to be handed down from on high, it must also be accepted and practiced by the people to be authentic.
Then we get to the concept of the well-informed, individual conscience. Suppose, for example, that a Catholic woman has been told that a pregnancy would cause her and her baby severe health issues, even to the point of death, she has prayed hard about it, and has concluded that the best thing she could do was practice artificial birth control, not only for her sake, but the sake of her baby, and the sake of her husband who would be a widower. I doubt that any bishop, except the most intransigent, would condemn her to eternal damnation rather than to leave the ultimate judgment of her decision to a loving and merciful God.
Third, there is the concept of "remote cooperation" -- the farther removed from the decision, the less culpability. For example, a government mandate to provide birth control in all health insurance plans would be "remote cooperation" should the government force the church to do it in its health insurance plans. It is not the church making the decision to provide birth control. It is the government's decision to provide it and a woman's decision to access it.
And that is not even what Obama is asking. He has offered to broaden the conscience exemption to include ALL Catholic institutions, including Georgetown University, as long as women like Sandra Fluke have free access to birth control medications like all other American women will have.
The big, broader question you have failed to ask is should the government assist any religion in enforcing teachings that it has been unable to enforce itself? And that is exactly what the church is asking for now.
"Even that! Students may have to “venture off campus!” As far as half a mile!"
ReplyDeleteIt's great to see Mr. Somerby so generous with other people's time and money, but if he had done the ground work which he so often urges on others (before *they* opine), he would know that the contraception mandate is only one of dozens (actually, hundreds) in Obamacare, and all for the purpose of achieving what he claims passionately to want -- rational health care, for everyone, regardless of what state he or she may live in, or who the employer is.
And yet any one of the those mandates -- indeed, many -- can and will offend some constituency which doesn't care to pay for them, from the obvious example (Viagra) to the already deeply politicized (childhood immunizations).
Without knowing Mr. Somerby's medical history, it's impossible to find an example relevant to him, but if he cares to volunteer the information, we could explore the matter to determine just how generous he is, in giving up rights to pacify offended minorities, whether those minorities object based on the supernatural or not.
"Did a Georgetown student suffer terrible medical consequences when the university (or perhaps an insurance company) violated its own procedures? Fluke seems to describe serious misconduct on someone’s part. But alas! The Washington Post didn’t examine this claim when it did its basic news report about Fluke."
ReplyDeleteWhat strikes me is that, on some level, it doesn't matter if there was misconduct by the insurance company, or sloppy work by someone in the doctor's office (maybe someone didn't fill out paperwork properly by the insurance company's lights), or if Georgetown had made special arrangements with the insurance carrier(s) it contracts with not to include birth control coverage, or if those carriers don't normally include birth control coverage anyway. None of this really matters for the case at hand, and that may be why journalists haven't investigated these questions. (Or if my third scenario matters somewhat to the issue of religious freedom that Issa and the bishops are raising, no need to cover that issue re Fluke, since there are other opportunities for pursuing that issue, and Fluke herself was trying to evade it by focusing on someone who needed birth control for an ovarian cyst condition, not birth control per se.)
What matters is that the birth control mandate in the Affordable Health Care Act is vindicated no matter what the explanation is for the case Fluke describes. Why should ANY woman or ANY doctor have to go through hoops (and the more hoops, the more opportunities for honest bureaucratic screw-ups, not to mention "misconduct") simply to get the kind of prescription benefit (and coverage for office visits associated with receiving/monitoring prescriptions) that men and women routinely get for a million other things? Certainly outrageous for the case Fluke describes. But more generally, birth control is a MAJOR health issue for women -- and, not incidentally, for men, who benefit when the women in their lives have fewer pregnancies that are unwanted or ill-timed from the men's point of view, not just the women's. And men also benefit from the good reproductive health of women with whom they want to have children. (Here that, bishops?)
And people who can't imagine how time-consuming and exhausting it can be to deal with medical insurance providers -- especially when you're sick (and btw, ovarian cysts are very, very painful -- acute pain), well, they've just been lucky. The sheer lunacy of the catch-22's insurance providers put you in when they are given half a chance, the long menus and then holds on telephones, till you finally reach somebody who then transfers your call to someone else, who gives you a different explanation than the person you talked to a week ago.
Fluke's complaint about having to go off campus to buy birth control pills is odd. Even if the pills were covered by insurance, the drug store that sells them wouldn't be any closer to the campus.
ReplyDeleteI recall being shocked and envious when I visited my daughter's dormatory around 25 years ago. Not only was the dorm co-ed, but there were boxes of free condoms out in the hall. If Sandra Fluke's undergraduate dorm had a similar setup, it's no wonder that she expects contraceptives to be not only free but right at hand.
"If Sandra Fluke's undergraduate dorm had a similar setup, it's no wonder that she expects contraceptives to be not only free but right at hand."
DeleteFluke indicated no such expectation, according to anything reported by Mr. Somerby (or anyone else, as far as I know). But his post does rather leave the impression that Ms. Fluke is a silly enough person to indeed be outraged by a need to walk 5 or 10 minutes each way in order to get a birth-control prescription filled.
Mr. Somerby quotes a WaPo story in which the reporter, Jenna Johnson, first paraphrases and quotes a member of the Georgetown chapter of Law Students for Reproductive Justice, which Ms. Fluke co-chairs. Then, in the next paragraph of the Post story Mr. Somerby is quoting, Johnson (not Fluke, nor any member of the organization she co-chairs), says, "Some student groups pass out free condoms on Georgetown's main campus, but purchasing contraceptives of any sort requires venturing off campus, often to a pharmacy about half a mile away." Having finished quoting from the Post story, Mr. Somerby exclaims, "Even that! Students may have to “venture off campus!” As far as half a mile!"
Mr. Somerby's snark here is directed at the Post reporter, Ms. Johnson, not at Ms. Fluke, whom he has not reported to have made any comment about the distance to pharmacies. But, David in Cal, I don't blame you for being confused. Later in his post, after lamenting the absence of attempts by law students over the years to remedy the problems about birth-control coverage at Georgetown (or is he lamenting that reporters don't tell us more about such attempts? not entirely clear), Mr. Somerby says, "But to our ear, Fluke’s full testimony is full of infantilizing imagery concerning the (presumably) very capable students who chose to attend Georgetown Law. To our ear, the testimony offers a semi-childish view of the way a Catholic institution should respond to those who attend it."
Thus, two people receive Mr. Somberby's vividly worded criticism and condescension, Ms. Johnson, the Post reporter, and Ms. Fluke, which fact may make it easier to conflate his criticism of the WaPo reporter and of Ms. Fluke, as you seem to have done. Rush Limbaugh, btw, receives no criticism from Mr. Somerby, who instead characterizes people's outraged attention to Mr. Limbaugh's (possibly libelous) remarks as a "distraction."
Just to note that condoms are made readily available, and for free, at many colleges and universities these days (a practice instituted primarily with undergraduates in mind). Often, the college/university health center provides them. (I assume Georgetown's does not and that student groups there have taken it upon themselves to do so.) Condoms are strongly recommended for use even when the female partner is using birth control pills, an IUD, or another form of birth control, and for use by males having sex with one another, because of sexually transmitted diseases. (Of course, people in "committed relationships" make decisions about condoms re STD's on a different basis from people having "more casual" sex.) Condoms may legally be dispensed by various groups on campus because they do not require a prescription from a doctor; birth control pills and several other common forms of birth control (e.g. IUD) do require a prescription and can only be dispensed by a licensed pharmacist or a physician.
DeletePersonally, I think it's excellent policy to make condoms readily available to everyone -- and a distance of a half-mile to the nearest pharmacy (if this is indeed the closest place to get condoms if you're living on the Georgetown campus) makes it especially important for the Georgetown student groups to make them available, as long as the Georgetown health service isn't going to. Ms. Johnson rather confusingly inserts her observations about condoms and the nearest pharmacy into her story, but at least the issue of distance to the nearest pharmacy is probably relevant to the subject of condoms that she has raised.
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