Matters reproductive have been all over the news lately (with Rush Limbaugh’s idiotic tactical blunder getting the most attention over the past few days).
One item that might have slipped under the casual observer’s radar is this one, in which a team of researchers have developed an artificial womb to which a blastocyst can successfully attach.
The day cannot be terribly far off when we can successfully gestate an infant entirely outside the human body. I wonder what the implications of that will be.
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Atheist sci-fi author (and satirist of theism) James Morrow wrote a novel called Only Begotten Daughter that explored the implications when a baby gestates in an artificial womb. You might enjoy his modern feminist take on the Jesus story. Most of it involves magic and miracles and a trip to hell, but the story’s beginning is reminiscent of this newfangled artificial womb.
In a post just today at VFR, Lawrence Auster argues that liberal/feminist thought understands the current contraception brouhaha as follows:
The logical endpoint of all this, as Aldous Huxley foresaw, is the artificial womb — which will spare women, and even sex itself, from having any special role at all in human reproduction.
Pair that thought up with the eventual perfection of cloning tech, and what have you got?
Too bad Crichton didn’t live long enough to write about the potential dangers of artificial wombs.
Concerning Limbaugh’s remarks: What is “idiotic” is Fluke’s demands for the fruit of someone else’s labor.
I have read a lot of commentary about this issue, and I had yet to hear that contraception ought to be included as a basic element of health insurance because of the absurd notion that “women should be at no more risk of pregnancy and its inconveniences than men are” — until Derbyshire came along. If he wants to argue against the mandate, then he ought to try to refute the case for it, instead of fabricating a straw man.
The case for inclusion starts with the fact that a significant number of women use contraception for reasons having nothing to do with birth control. The Bishops are happy to deny insurance coverage for employees who require birth control pills for cysts, regulating menstruation, or any number of other purely “medical” reasons. They are happy to throw these women under the bus because — gasp! — other female employees might seek contraception because they engage in the appalling sin of being sexually active.
This by itself is sufficient reason to mandate coverage. Women should be covered for gynecological treatments for the same reason that men should be covered for prostate cancer and blacks should be covered for sickle cell anemia. It is not a gender equality issue per se — it is simply a reflection of the fact that not all significant medical issues are distributed evenly, but all should be covered regardless of who is affected.
Derbyshire’s gender equality straw man also ignores the fact that there are fathers involved as well as mothers, and insurance policies which exclude contraception place a burden on both of them.
Implicit in Derbyshire’s concatenation is the notion that while sex is voluntary, prostate cancer is not. His worldview equates contraception with, for example, mandating that health insurers provide obese patients with gym memberships. Hence the question is narrowed to this: if there was a way to provide needed care to women with ovarian cysts but exclude those who make the beast with two backs, would an employer be justified in forcing its views regarding contraception on employees?
There is a strong case to be made for a holistic approach to health care which recognizes that contraception has a role in preventing disease, lowering the abortion rate, and preventing unwanted children from being born. These are all things which are intimately connected with health care, as well as significantly lowering costs to insurers and society at large. This is the thinking behind the recommendation of the Institute of Medicine, which is comprised of doctors and not ideologues or politicians. While a sex-obsessed scold like Rick Santorum would allow the state the power to make these decisions, a true conservative — i.e., one who believes that the state should have limited and clearly defined powers — would have enough respect for the individual to allow them to think on their own.
Regardless of the substantive arguments for and against coverage for contraception, it is certainly a political loser for the right wing. I’ve noticed that sex is a pretty popular activity. Perhaps you have noticed the same thing. There is wide support for including contraception as a basic element of health insurance, including among those who are severely conservative. It’s also an issue which women feel on a very different level than men. I’m guessing that your wife and daughter have much different views on the subject than you do, and they would regard Derbyshire’s silly argument with the hilarity which it deserves.
Free-floating wombs? In that day, not only will men be redundant, but women as well!
Jeffery Hodges
* * *
Peter,
First of all, nobody mentioned John Derbyshire. The person you appear to be railing against is Lawrence Auster.
If the debate focused exclusively on women with actual, diagnosed medical problems for whom the only available treatment is contraceptives, we might be having a different conversation (although many of the most controversial aspects of it would remain). But that it is much more than that is made obvious by the aggressive framing of the demand as a newly discovered “right” to contraception. That it is much more than a purely medical issue — that this is a distinct battlefield in America’s ongoing war of incompatible ideologies (which I would not be surprised to see erupt into actual civil war one of these days) is also made clear by the fact that those indentured to provide this benison are now required, on Imperial whim, to do so absolutely free of charge — without even the co-payment that is customary for other medical services.
If you are going to argue that the government has a right to mandate “holistic”, preventive healthcare, then there is, despite your sniggering at the very idea, no principled distinction to be made that would exclude mandating a “right” to gym memberships, running shoes, yoga mats, and so on, given the uncontroversial preventive benefits of regular exercise.
From there it is a very short distance to the conclusion that since “society” must bear the costs of health care, then it has a “right” to insist that we all eat approved diets, get a minimum amount of exercise each day, and so on. Given that you have already told us that you consider key clauses of the Constitution to be “infinitely elastic” in their granting of power to the federal government, do you have any problem with Washington mandating that obese people lose weight? (Perhaps an HHS mandate to Weight Watchers to provide memberships free of charge would do the trick.)
The question seems remarkably difficult for folks like Elena Kagan to answer (see here and here).
Finally, don’t be so sure that this issue is a political loser; it has become quite the rallying point for a great many folks in the despisÁ©d heartland.
It has been pointed out often that liberals are authoritarian about everything except issues having to do with sex and reproduction. When it comes to property law, what kind of light bulbs we can use, environmental issues, regulating business and the workplace, redistribution of wealth, hiring practices, racial quotas, college admissions, and practically everything else, they see a potentially unlimited role for state authority; they are perfectly happy to vaporize society itself — to tear down all traditional institutions and established cultural and demographic holdfasts, so as to leave only an atomized collection of deracinated individuals answerable only to themselves and the State. But when it comes to sex (and perhaps drug legalization too, the common thread being unfettered hedonism), liberals are absolute libertarians. “Keep your laws off my uterus!”, cries the feminist Left, while insisting that everyone else pay for their free enjoyment of it.
Again, the real issue is the accelerating pace at which new positive “rights” — the kind of “rights” that entitle a person to goods that others must be indentured to provide — are being discovered.
Nobody even had an inkling that there was a positive “right” to be given contraceptives by other people until just a few months ago; now it is suddenly an essential, inviolable American principle, and any skepticism about it is evidence of a “war against women”.
But I never would have expected you, Peter, to have any other opinion than the one you expressed here; indeed, I was wondering what had taken you so long. We just disagree about these things.
1) Correct: Auster, not Derbyshire. My mistake.
2) There are many things wrong with American health care, and one starting-point to fix the system is the establishment of national standards regarding, among other things, what should be included in a health insurance package. However, I am not comfortable describing these changes in terms of rights. If someone in a coma shows up at an emergency room, he should receive treatment because that is what a decent society would do. This is not tantamount to saying that he has a right to treatment, or that it is tantamount to his right to habeas corpus or free speech.
So I don’t think that a woman has a right to contraception, just as someone with renal failure does not have a right to dialysis. However, there are many things we do as a society which have nothing to do with claimants having rights. We provide food stamps to the hungry despite the fact that they do not have an intrinsic right to be fed, and we provide Social Security to widows with kids despite the fact that there is no intrinsic right to government support. We do this because it is the right thing to do, not because those who require these things have an absolute right to receive them. I realize that others view them as rights, and I part company with them on this point.
3) There is a principled distinction between contraception and providing gym memberships. Pregnancy is sui generis. It causes children to be born. Obesity does not. There are also practical considerations. Providing contraception is much cheaper than pregnancy, abortion, or childbirth. It takes costs out of the system, while gym memberships add costs. Insurers offer preventative care — such as flu shots and vaccines — when a cost benefit analysis favors it. That is clearly the case with contraception, but not with providing Spandex and gym memberships to those who desire them.
4) Government should not mandate that people eat healthy food or compete in Iron Man Triathlons. You have reported that Mayor Bloomberg has enacted regulations about transfats. In my view, if someone wants to eat a baconchilicheeseburger, that’s for him to decide and not the government. There is a wide gulf between reasonable regulations and the nanny state. However, it is perfectly legitimate for insurers to charge fat people more than thin people due to their elevated risks, just as smokers pay more than non-smokers.
5) The kerfuffle about contraception is quite definitely a political loser for the dark side. There are many reasons why Democrats’ fortunes are rising and Republicans’ fortunes are declining, – not least of which is the lack of a credible candidate for President and an unending food fight among those competing for the honor of losing to Obama – and it is easy to elide them. However, the recent polling which shows that independents are fleeing the Republican party is coincident with its strident position on contraception, which is rejected by the great majority of people across the political spectrum. And who despises the heartland? Certainly not Obama. He comes from there.
Gym membership is cheaper than the consequences of obesity. The reason we don’t subsidize it is that there are many ways to lose weight, and a work out doesn’t help in all cases. We shouldn’t make contraceptives free because they are already quite cheap (they wouldn’t be if they were subsidized), and because there are many ways to not get pregnant.
I’m confused by the talk of BCPs being used to help in health cases, such as ovarian cysts. There is no reason why the medical use of BCP can’t be separated from the contraceptive use. It is similar to Finasteride — it is insured when it is used to treat prostate cancer, but not when it is used to treat male pattern baldness.
Good points, Dom.
Peter, I’m glad, at least, to see you talking sense about “rights” — and you do indeed part company with your comrades by doing so.
You say that government “should not mandate that people eat healthy food or compete in Iron Man Triathlons.” But the vital question is not whether it should, but whether it can.
In previous discussions, you have already conceded effectively unlimited power to the government by your endorsement Obamacare’s individual mandate and your belief in the infinite elasticity of the Commerce and Necessary and Proper clauses. Doesn’t it seem reasonable to think that if a State has both unlimited coercive power and ultimate control of, and responsibility for, the provision of healthcare, it will begin to use its coercive power to force its citizenry to live in healthier ways? Why on earth wouldn’t it?
You write that it is perfectly legitimate for health insurers to charge fat people more, based on the simple fact that they present a greater risk of incurring costs.
Quite right, say I: that’s how insurance works. Insurance is a contractual arrangement in which one party offers to cover expenses should another party undergo some sort of costly misfortune. The insurer calculates the odds that the misfortune will happen, and based on those odds, makes a bet that it won’t.
But if you grant that, then it’s even more absurd to insist that “insurers” must cover people who have already incurred the costly misfortune. But that’s exactly what Obamacare mandates when it insists that insurers can no longer turn down applicants based on pre-existing conditions.
Now, a government with unlimited power can make people do whatever it wants, I suppose, but to call this “insurance” makes a cruel mockery of words and their meanings.
Finally, to imagine that Obama somehow represents America’s heartland is simply beyond satire, so I’ll say no more about that.
Instead of demanding yet another entitlement, why doesn’t the Left just go f*ck itself.
Not without free contraception!
F*cking themselves obviates that restriction.
Malcolm, your concern for the welfare of insurers being forced to accept customers with pre-existing conditions is touching. We can only hope these struggling corporations would be able to manage somehow in the face of such an uneven playing field.
Speaking of struggling, what are Americans with pre-existing conditions supposed to do, exactly, living in a system in which privately held insurance companies are the sole health care providers available?
The “Big” Henry: Sorry, what grade are you in, again? Wondering if maybe there should be an age restriction here, Malcolm – adolescent postings such as these only undermine the legitimacy of your otherwise fine blog.
TBH: Churchgoer’s got a point. You’re a smart guy, but comments like your last are not helpful.
I generally never delete comments, and have been fortunate enough to have attracted very few trolls, but I think I’ll start filtering a little more aggressively.
Intelligent comments, whether supportive, combative, or merely humorous, are welcome. Arid incivility, insults, inanity, and onanism are not.
Churchgoer, my aim is not to snivel on behalf of insurance companies. I only seek clarity here.
As I explained, the business of “insurance” is one thing, and what that business has become as government lays a heavier and heavier hand upon it is another. Words have meanings.
Also, for clarity’s sake: insurers are not the “sole health care providers available”. They do not provide health care; doctors and hospitals do. Insurers pay for health care. Anyone who wants to can obtain any medical services they like, but these services must be paid for.
Of course, if we accept that a “right” exists to have others be indentured to pay for your health services, and we are willing to grant the government unlimited power to coerce private enterprises to do so without regard to any rights or freedoms of their own, then you shall indeed have your healthcare paid for.
1) I do not think that a state with “unlimited coercive power” would “begin to use its coercive power to force its citizenry to live in healthier ways.” In my view, one should presume that while no government or bureaucracy is perfect, that regulations will be enacted and enforced in reasonable ways.
There are many things the government could do with its power, but doesn’t. In medieval England, pickpockets were hanged. There is no constitutional reason why a capital-punishment-loving state like Texas can’t make petty theft a capital offense, but it doesn’t. We differ in that you see government growing uncontrollably in a nature-abhors-a-vacuum fashion, while I am inclined to view most government action as reasonable, benign, and achieving things which are net positives. I don’t think that one should use fear of slippery slopes or a reductio ad absurdum standard in designing government policy.
The contraception mandate is one such example: It expands coverage, enhances national health, and takes costs out of the system. The doctors at the Institute of Medicine made their recommendations entirely on practical considerations, and not whether there was some putative gender equality issue which needed to be rectified. It is an expansion of government power which, in the view of experts, will be one way to fix a dysfunctional health care system.
2) The reason I believe the ACA reforms to be just is that a persistent problem in health care is that the young and healthy opt out of the system, leaving insurers with older people like us, with creaky knees and recalcitrant memories (notwithstanding the fact that after my annual check-up, I was pronounced to be a perfect physical specimen). However, once a healthy but uninsured 25 year old drives his Harley into a telephone pole, taxpayers and providers are left to pay to sew him back together. The ACA reforms solve two problems: the taxpayers and providers are not stuck with the cost of other people’s recklessness, and the pool of insured has low-risk members to balance out the costs of those with pre-existing conditions.
Put yourself behind a John Rawls veil of ignorance and suppose that you are a middle class parent whose child has an expensive and life-threatening ailment. Since you can’t afford his treatment, society has two choices: provide for the child’s care or let him die. Unless you choose the latter option, you then have another two choices: let the government pay for his care or force insurers to do so. Obamacare chooses the latter option but balances the burden on insurers by expanding their customer base with the young and healthy. In my view, that is the least bad option here.
3) While you may find it unimaginable that Obama is emblematic of the heartland, the fact that he has a substantial lead in the big industrial states of the Midwest suggests that those who actually live there feel differently.
Churchgoer: Sorry, are you a man, woman or mouse, again? Wondering if maybe there should be a prominent list of specific topical restrictions here, Malcolm — holier-than-thou postings demand it. Onanism comes in various forms, including the mental, as is well exemplified in this entire thread.
Peter,
1) Your remark here amounts to: give the government all the power it wants, on the assumption that it will never abuse it. This view — which assumes a basic goodness of human nature, and denies the tendency of powerful people and institutions to seek ever more and more power — runs precisely opposite to the wisdom and intentions of the Framers, who had good reason to fear over-reaching central power, and did everything they could explicitly to limit and constrain the reach and grasp of the Federal government. Rather than merely hope or assume that the government would kindly refrain from assuming tyrannous powers, they thought it necessary to ensure that it couldn’t. This pessimistic view of human nature is at the core of conservatism. Expect the worst of people, and you won’t be disappointed; history teaches us that they will reliably deliver. We cast away these safeguards at our peril.
2) See my response to Churchgoer above. Notice also that you seem to imagine that “society” and “government” are synonymous. This is a hallmark of liberal thought that conservatives do not share.
3) We shall see.
1) There are very definite limits on government power: they are in the Bill of Rights, the Fourteenth Amendment, and elsewhere. As for what legislation can be passed, it was the wisdom and intention of the Framers to avoid predicting what sort of laws should or should not be enacted hundreds of years later.
2) Fine, but what do you do about the parent whose kid has cancer?
3) Indeed we shall. Obama will prevail over the scurrilous machinations of his perfidious enemies and will some day be the fifth face on Mount Rushmore.
1) If you open an infinitely accommodating back door by way of the Commerce Clause and the Necessary and Proper Clause, then all those restrictions mean nothing.
2) In the past, the answer was private charity, family support, state and local programs — and of course, having the foresight to obtain health insurance before having children. Somehow we muddled along.
But if you insist that the only acceptable answer now is that the federal government indenture its subjects to provide this service, then let’s at least call it what it is: a “right” to healthcare. And let’s also be clear about the costs, in terms of both liberty and the public fisc, of the government taking over one-sixth of the nation’s economy. Let’s also have no illusions about the effects of socializing healthcare in terms of innovation and quality and access; the current state of these programs in places like Canada and Britain may be instructive.
I won’t sugar-coat it: it is simply an ineliminable fact that there is sorrow and suffering and inequality in this world. What we are debating here is only about what tradeoffs we are willing to make to shift it around.
3) We shall see.
1) Well, no. The Commerce Clause and the Necessary and Proper Clause, regardless of how broadly they are interpreted, do not allow the government to censor Rush Limbaugh, jail people for being Muslims, or deny Dick Cheney the right to plead the Fifth when he is brought to trial for war crimes. OK, just kidding about the last one.
2) In the past, lots of people died because they weren’t covered by the ersatz safety net you describe. In the present, the cost of health care is exponentially higher than it has ever been, making past history somewhat irrelevant. Whether it is “state and local programs” or federal programs which contribute to the safety net is also irrelevant. The issue of what to do with uninsured people having major health problems is at the core of the problem, and you don’t have much of a plan until you can come up with a satisfactory solution.
I am uncomfortable describing health care as a right, because then you have to explain the provenance of that right, which lands you in quicksand. However, whether people should have health care because it is a right or because it is something which a decent society does is a distinction without a difference. As a member of the Church of What Works, I want to know what sort of health care is the most rational and humane way to allocate the resources we wish to provide for it. While I would propose something different from Obamacare, I find it to be far superior to the status quo and well worth enacting.
1) There is already a constitutional tension arising regarding the Free Exercise Clause and the contraception mandate. (Though I’m sure you’ll disagree.) I don’t think you or anyone else knows how deep the rabbit-hole goes. Anyway, notwithstanding the examples you gave, the degree of government coercion permitted by an “infinitely elastic” interpretation of the Commerce Clause and Necessary and Proper Clause is worrisome enough — as indicated by the fact that even a Supreme Court justice was unwilling to state with certainty that the powers granted by the Commerce clause were insufficient to support a mandate that we all eat broccoli.
2) Well, in my view, “rights” are just whatever people decide they are. If the government mandates that all people are entitled to have their health-care services paid for by others, then that’s a newly enshrined “right”, it seems to me. (If it swims like a duck, quacks like a duck…) And if it’s a distinction without a difference, then why cavil over the distinction?
As I said above: it is simply an ineliminable fact that there is sorrow and suffering and inequality in this world. What we are debating here is only about what tradeoffs we are willing to make to shift it around. The question is: to what extent are we willing to beggar a once-prosperous nation, and cast away its essential liberties, in an attempt to eliminate, or at least level, all of life’s vicissitudes?
I’ll add: in no way am I denying that healthcare is a difficult practical and ethical problem. But if you are a member of the Church of What Works, it should be clear by now that Obamacare, with its likely unconstitutionality, its granting of limitless and unspecified executive powers, and with states and other entities lining up to apply for (and being granted) exemptions — and with more than half the population calling for its repeal — is not What Works.
In short, it stands in violation of the most basic principle of health care: first, do no harm.
Henry,
No, I certainly won’t propose any topical restrictions. I simply ask that commenters make civil and intelligent postings that advance the discussion.
“Why doesn’t the Left just go f*ck itself?” is not such a comment.
Fair enough. What about your response to that comment, “Not without free contraception!”, which, to me, sounds like a jocular endorsement of my comment?
In the interest of brevity (and so I can actually get some work done today), I will bypass the dubious assertions and premises in your statement to answer your question thusly:
We ought to take the resources we currently devote to health care and reallocate them in the most efficacious and humane manner possible. This includes such things as taking some of the money spent on prolonging a dying man’s life for an additional month and reallocating it to things like vaccines and pre- and post-natal care (which is not in Obamacare) and making freeloaders pay for their coverage (which is).
The benchmark is the status quo: would any changes improve the national health, is there an incremental cost to those changes, and if so, are they worth it? Unless one believes that the status quo is the desired state of health care, then the question becomes how we can improve things at the same expense level or at an acceptable increase in those expenses. In my view, Obamacare is not perfect, but is far superior to what we have now.
Henry,
A fair point. I should keep in mind Richard Strauss’s advice to aspiring conductors:
So: if you will refrain from such comments henceforward, I will refrain from endorsing them.
You drive a hard bargain, Malcolm, but I accept that deal.
Peter, I agree that “the question becomes how we can improve things at the same expense level or at an acceptable increase in those expenses.”
But costs come in various forms. And with that in mind, I emphatically do NOT agree that Obamacare is “far superior to what we have now”.
But, but, but Malcolm!
If you’re gonna start screening on the basis of intelligent, clarifying commentary – where the heck am I supposed to leave comments?
JK,
Self-deprecating remarks are one of the basic ingredients of traditional Jewish humor. But one should be more circumspect in a forum such as this, because there is no telling who (or what) is lurking in the shadows, with fragile sensibilities and holier-than-thou admonitions at the ready.
As far as I’m concerned, you needn’t worry about any imagined inferiority with respect to the commentary here (no disrespect intended to anyone in particular).
“But, but, but Malcolm!” JK ejaculated.
I hope I do not offend our gracious host by informing his readership that when he was a teenager, Malcolm thought it was hilarious – I mean, absolutely hilarious – when the word “ejaculated” was used in the sense of “blurted out.”
I have absolutely no recollection of that whatsoever, Peter. A scurrilous fabrication.
Or perhaps it came up during your intercourse with some other party.
JK, you have a special dispensation. Carry on as usual.
Peter?
Reckon the fellow ejaculating here knows whereof he speaks from personal experience?
http://www.thesmokinggun.com/documents/crime/rush-limbaughs-dominican-stag-party
Malcolm, perhaps this will jog your memory: do you remember your friend E. Jack U. Tate?