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Sec. 8. This act does not create a right to abortion.
December 12, 2013 8:58 AM   Subscribe

Michigan's Abortion Insurance Opt-Out Act has been approved by the legislature and will become law unless vetoed. Women in Michigan will now need to purchase a separate rider to cover abortion services even in cases of rape and incest. Abortions will only be covered when the woman's life is in danger.

"Requiring Michigan women to plan ahead for an unplanned pregnancy is not only illogical, it's one of the most misogynistic proposals I have ever seen in the Michigan Legislature." -- Gretchen Whitmer, State Senate Minority Leader
posted by Talez (161 comments total) 21 users marked this as a favorite

 
Holy fucking shit. Women already bear the weight in terms of rape prevention, now we have to deal with this?
posted by troika at 9:03 AM on December 12, 2013 [14 favorites]


Correction: the law cannot be vetoed (which Snyder would if he could; he vetoed the same bill last year), because it was presented to the legislature based on a successful petition from voters. It becomes law automatically.
posted by Holy Zarquon's Singing Fish at 9:06 AM on December 12, 2013 [3 favorites]


Michigan's Abortion Insurance Opt-Out Act has been approved by the legislature and will become law unless vetoed.

Or unless challenged in court, right? C'mon, court challenge!

... except Michigan is the 24th state to pass such a law. Ffffuuuuu....
posted by filthy light thief at 9:07 AM on December 12, 2013


Employers who choose to offer abortion coverage would be required to inform all employees of that decision.

In order to what, give employees who object to such coverage the option to quit? Somehow, I don't think that's the reason. Just guessing.
posted by rtha at 9:08 AM on December 12, 2013 [6 favorites]


Naming it 'Opt-Out' is a lovely (and by that I mean awful) bit of Orwellian doublespeak, considering it's not about anti-abortion women opting out of abortion coverage, but rather all women being forced to opt in if they want to be covered.
posted by Atom Eyes at 9:09 AM on December 12, 2013 [16 favorites]


That's disgusting. I hope there's a court challenge to this headed up to the Supreme Court.
posted by roomthreeseventeen at 9:09 AM on December 12, 2013 [3 favorites]


Michigan is being ridden down to the depths of hell over the past few years.
posted by edheil at 9:14 AM on December 12, 2013 [3 favorites]


What if the fetus's life is in danger?

I'm not being snarky.
posted by sio42 at 9:14 AM on December 12, 2013


~Employers who choose to offer abortion coverage would be required to inform all employees of that decision.
~In order to what, give employees who object to such coverage the option to quit?


I imagine this would alert such employees who could, in turn, encourage anti-abortion protests outside the place of business, shaming the company to the point of changing their minds. Or organize consumer boycotts. The list goes on.
posted by Thorzdad at 9:15 AM on December 12, 2013 [1 favorite]


Whenever these sorts of idiocy pass, I'm always amazed at the number of women who appear to hate themselves. Or, at least, hate other women with remarkable passion.

...which, in the end, refreshes me because it means my dream of subjugating the U.S. beneath my hobnailed boots can actually come to pass. People will, absolutely, vote for their own oppression. Woooo!

Vote for me America, and get ready for the pain train!
posted by aramaic at 9:15 AM on December 12, 2013 [6 favorites]


Naming it 'Opt-Out' is a lovely (and by that I mean awful) bit of Orwellian doublespeak, considering it's not about anti-abortion women opting out of abortion coverage, but rather all women being forced to opt in if they want to be covered.

This is becoming a common tactic and needs a catchy name. Something catchier than 'Force out, shame in'
posted by Slackermagee at 9:17 AM on December 12, 2013


This law was snuck into existence - tiny percentage of voters signed a petition and now we are so screwed. I hope people will remember come election time but given gerrymandering and people's level of apathy I don't know. Good blog post with more about how this was done and Democratic reaction here.
posted by leslies at 9:18 AM on December 12, 2013 [3 favorites]


? How can this jive with the requirements of the ACA?
posted by Gungho at 9:18 AM on December 12, 2013


Correction: the law cannot be vetoed (which Snyder would if he could; he vetoed the same bill last year), because it was presented to the legislature based on a successful petition from voters. It becomes law automatically.

More detail: In Michigan, voter initiatives can be presented to the Legislature as the result of a petition signed by a number of registered voters equal to 8 percent of the votes for Governor at the last general election (Governors are elected in "midterm" years, e.g. 2010, so this number is lower than the voting population). Currently, that's just over 250,000.

The Legislature must vote on the initiative (straight up-or-down vote, no amendments) within 40 session days of the petition being presented to it. If they pass it, it automatically becomes law 90 days after the Legislature adjourns (mid-March, in this case). If they don't pass it or vote on it, it goes to a statewide election at the next general election.

An initiative-based law can be repealed or amended by a 3/4 vote of the Legislature, a similar initiative, or a referendum, which can be put on the statewide ballot via petition signed by a number of registered voters equal to 5 percent of the votes for Governor at the last general election. Currently, that's just over 160,000.
posted by Etrigan at 9:22 AM on December 12, 2013 [6 favorites]


Fucking hell. What assholes.
posted by zarq at 9:23 AM on December 12, 2013 [4 favorites]


How can this jive with the requirements of the ACA?

I think one of the reasons for this (other than the obvious anti-abortion nature) is to force a court showdown with the ACA on this point. Another vector for taking the ACA apart bit by bit.
posted by Thorzdad at 9:24 AM on December 12, 2013 [4 favorites]


Gungho: How can this jive with the requirements of the ACA?

The ability for states to "opt out" of abortion coverage is built into ACA.
During the fractious health care reform fight of 2010, one of the sticking points preventing the bill from moving forward was a controversial amendment proposed by Rep. Bart Stupak, a Michigan Democrat. The so-called Stupak amendment would have forbidden Obamacare plans from covering abortion, instead requiring Americans who wanted this coverage to purchase separate, abortion-only policies. Stupak lost the battle, but he's winning the war.
...
Although Stupak's amendment didn't make it into the Affordable Care Act, a compromise gave states the power to opt out of the federal requirement that health care plans include abortion coverage.
Read more on Mother Jones.
posted by filthy light thief at 9:25 AM on December 12, 2013 [2 favorites]


Also, Sen. Whitmer called it "rape insurance," which I think is perfect. She's already declined a run for Governor next year in favor of Rep. Mark Schauer, but he'd be a fool not to at least ask her to be his Lt.Gov.
posted by Etrigan at 9:27 AM on December 12, 2013 [5 favorites]


It's difficult to remain a civilized nation.
posted by five fresh fish at 9:27 AM on December 12, 2013 [9 favorites]


What if the fetus's life is in danger?

I'm not being snarky.


Covered under OB-GYN/maternity care.
posted by corb at 9:35 AM on December 12, 2013 [1 favorite]


I wish I believed in karma. No, I take that back - I wish karma actually could exist as a real, verifiable force of nature. And I wish it would happen suddenly, like sometime in mid-2014, earth would pass into a part of the universe where one's karma was visited upon them at regular intervals.

I know I'm not perfect, and that day would probably suck for me and most of the rest of the world, but I know some people who would be having a REALLY BAD FUCKING DAY when karma came to town.

Just saying.
posted by Mooski at 9:39 AM on December 12, 2013 [4 favorites]


Here's a report from the Guttmacher Institute on Restricting Insurance Coverage of Abortion [PDF] (as of 2013-12-01).

Their highlights (for those who don't want to or can't load the PDF):
The most restrictive states are Idaho, Kansas, Kentucky, Missouri, Nebraska, North Dakota, Oklahoma, and Rhode Island. (Rhode Island's has been permanently enjoined by court order and the policy is not in effect.) All of these do not allow any private health insurance plans to include abortion at all, except when the mother's life is threatened. Any other coverage must be via a separate rider which, in practice, often isn't available.

This greatly shocked and angered me yesterday when I first saw it, although in retrospect I realized that I'd not really had the expectation that employer health insurance would normally cover abortions that weren't medically necessary. Not that I did or do think that's okay, I think it's an outrage. Just that had I been asked about this point-blank before yesterday, I probably wouldn't have thought such coverage of abortion was normally available.

Regardless, this is just another front in the conservative war against women's reproductive choice.
posted by Ivan Fyodorovich at 9:39 AM on December 12, 2013 [15 favorites]


Also, I'm surprised that these laws have survived court challenges (excluding RI), and that being the case, I'm not hopeful that any new such laws will be struck down.
posted by Ivan Fyodorovich at 9:42 AM on December 12, 2013


Maybe this can be extended so you need to opt in for testicular cancer as well.

Viagra still covered?
posted by umberto at 9:44 AM on December 12, 2013 [1 favorite]


Any legislators suddenly expressing shock are doing so Casablanca-style. They knew what they were voting on, and I'd be very surprised if these exemptions weren't created just to make sure the bill would pass.
posted by corb at 9:46 AM on December 12, 2013


If men got pregnant, abortion would be a sacrament.

Seriously, what in the holy fuck is the constant obsession with abortion? I mean, these guys don't give two shits about the kids after they're born. It's psychotic.
posted by Benny Andajetz at 9:51 AM on December 12, 2013 [37 favorites]


My cynical side says because they're being outbred politically - that they'd all be A-OK with abortion if it could happen only in the urban centers. But abortion in the heartlands means less voters, which means less power.
posted by corb at 10:00 AM on December 12, 2013 [1 favorite]


They would repeal all the Reconstruction amendments in a hot minute if they thought they could get away with it.
posted by elizardbits at 10:00 AM on December 12, 2013 [9 favorites]


Whenever these sorts of idiocy pass, I'm always amazed at the number of women who appear to hate themselves. Or, at least, hate other women with remarkable passion.

There was an article a year or two back from a woman who worked in an abortion clinic and she'd see the same people out protesting them day after day come sneaking in for an abortion. The staff would treat them with respect and care and as soon as it was done, they'd say something like "Well you're still sinners and baby murderers", go out and recover, then come back and be protesting them.
posted by Ghostride The Whip at 10:10 AM on December 12, 2013 [3 favorites]


Some days I almost wish they'd just bring on their theocratic-libertarian Thunderdome world so we can all dispense with being civil and trusting in the system to fix bullshit like this. Getting awful sick of this thing where a minority of fired-up assholes still get to use a broken system and voter apathy as a shield to get away with oppression, after all the times we've gone down this same horrible road before. You can roll out the biggest protests the world has ever seen these days and it won't do anything, your vote doesn't matter if you don't live in the right district, and this game of waiting on the Supreme Court with crossed fingers and a pit in your stomach because given half a chance the court will even further entrench these things is so goddamn tiring.
posted by jason_steakums at 10:11 AM on December 12, 2013 [6 favorites]


What if the fetus's life is in danger?

I'm not being snarky.


Equally not snarky: What do you think happens now? What do you think should be different, if anything?
posted by rtha at 10:13 AM on December 12, 2013 [1 favorite]


How much do the riders cost? The Freep story says the info isn't available.
posted by Ideefixe at 10:15 AM on December 12, 2013


Women in Michigan will now need to purchase a separate rider to cover abortion services even in cases of rape and incest.

Ok. This sucks and is insulting to women.

But, Looking at all the other states that make no such option available, this is better than that.

It being a 'rider' people will look at it with the same scorn they look at extended warranties and sort. The default will be to NOT purchase it.

But please pay for it. Just assume that rather than it being bundled up with everything else, the costs have been taken out of he bundle, and you must purchase separately.

Please don't let some dummy legislators get in the way of something that can be extremely useful.

I consider this to be a beautifully grilled steak, presented on an upturned garbage can lid.
posted by hal_c_on at 10:16 AM on December 12, 2013 [1 favorite]


How much do the riders cost?

There doesn't seem to be any cost mandate or other control in the Michigan bill. I would hope that companies would make them available for $1, but that would require them to be composed of functional human beings, so I ain't holding my breath.
posted by Etrigan at 10:19 AM on December 12, 2013


I consider this to be a beautifully grilled steak, presented on an upturned garbage can lid.

The hell?
posted by Celsius1414 at 10:25 AM on December 12, 2013 [9 favorites]


I don't think there's anyone that seriously thought this wouldn't pass once it was before the floor. I'm really hoping for a referendum. Come on, Michigan!
posted by stoneweaver at 10:26 AM on December 12, 2013


More to the point, a hard slap in the face is "better" than a punch, but it would be actually better if the violence wasn't happening at all.

But that would require respecting women, and apparently that's evil.
posted by Celsius1414 at 10:26 AM on December 12, 2013 [1 favorite]


Benny Andajetz: Seriously, what in the holy fuck is the constant obsession with abortion?

You are Pope Francis, and I claim my 5 Pope-Bucks Euros.
posted by filthy light thief at 10:27 AM on December 12, 2013 [1 favorite]


hal_c: I'm looking at the law and it doesn't necessarily guarantee that the riders will even be available for women to purchase, at least from what I'm reading:

Sec. 4. An employer may purchase an optional rider to provide coverage for elective abortion if the employer provides notice to each employee that elective abortion will be included as a rider to his or her health coverage and that the coverage may be used by a covered dependent without notice to the employee.

Sec. 5. This act does not require an insurer, health maintenance organization, health care corporation or employer to provide or offer to provide an optional rider for elective abortion coverage.


Insurance companies don't have to offer them. Employers providing insurance for employees don't have to purchase them.

Even if the riders are available, now women have to purchase additional healthcare insurance because they are women.
posted by inertia at 10:30 AM on December 12, 2013 [9 favorites]


Pure Michigan.
posted by klangklangston at 10:32 AM on December 12, 2013 [13 favorites]


I asked what happens if the fetus' life was in danger because this law has an exception for the mother's life being in danger.

I probably didn't word it well.

What i meant is (and maybe this situation doesn't exist), what happens if there needs to be an abortion because the fetus won't survive or something?

Is that covered under the OBGYN care or would they make the woman carry to term a baby that is just going to die anyways or will be still born?

Is this considered a miscarriage or is that something else?
posted by sio42 at 10:33 AM on December 12, 2013 [1 favorite]


I'd be unsurprised if this passed in a deep red state -- but Michigan? WTH?
posted by bearwife at 10:33 AM on December 12, 2013


So I'm moving to Michigan in a few months and will be jobless, so I'll have time to maybe do something. Anyone know what I can do to be involved in Michigan politics like this?
posted by bibbit at 10:34 AM on December 12, 2013


What i meant is (and maybe this situation doesn't exist), what happens if there needs to be an abortion because the fetus won't survive or something?


I don't think according to the Right that that situation exists. If the baby dies in utero, the D&C would be covered as a miscarriage, I believe.
posted by roomthreeseventeen at 10:36 AM on December 12, 2013


Is that covered under the OBGYN care or would they make the woman carry to term a baby that is just going to die anyways or will be still born?

I believe that you would only be covered once the fetus actually died.

if the employer provides notice to each employee that elective abortion will be included as a rider to his or her health coverage and that the coverage may be used by a covered dependent without notice to the employee.

I think this has a lot to do with things. The people who created this law don't want their kids or wives getting abortions without them having the chance to know about it/change employment.
posted by corb at 10:36 AM on December 12, 2013


would they make the woman carry to term a baby that is just going to die anyways

This very thing - forcing women to carry an unviable fetus to term - was recently proposed in a Southern state iirc but I don't want to google it in case my head explodes from rage.
posted by elizardbits at 10:37 AM on December 12, 2013 [15 favorites]


Lots of work already going on to try to re-take the legislature and repeal a bunch of odious laws. Not surprisingly the Democratic party is the first group working on that. Bibbit if you're moving to the Ann Arbor area memail me and I can connect you with people working now to train and recruit precinct organizers - first step in fighting this stuff.

And yes the law seems to say that a D & C for a fetus that has already died is covered under regular medical coverage but aborting a non-viable fetus that is still alive would have to be through specific abortion coverage.
posted by leslies at 10:38 AM on December 12, 2013


ok it was georgia
posted by elizardbits at 10:41 AM on December 12, 2013 [6 favorites]


I'd be unsurprised if this passed in a deep red state -- but Michigan? WTH?

The Michigan Legislature is deep red, thanks to gerrymandering and Tea Party types cranking safely Republican seats hard to the right. Governor Snyder (who wanted to run as an Independent) is a business-first Republican who has vetoed a lot of the social-conservative stuff (including this very thing when it passed the legislature last year), but the initiative process provides an end run around him.
posted by Etrigan at 10:45 AM on December 12, 2013 [5 favorites]


> If men got pregnant, abortion would be a sacrament.

Repeating myself, because it's such a good line:
If men could get pregnant, abortion clinics would be like Starbucks. There would be two on every block and four in every airport, and the morning after pill would come in different flavors like sea salt and cool ranch.
posted by benito.strauss at 10:47 AM on December 12, 2013 [1 favorite]


Wow. This is insane. Thank you to those who answered my convoluted question.

Unfortunately, now I'm even more angry. You'd have to buy this insurance if you perhaps didn't want to end up in this very unlikely (but still a thing that happens) situation.

Christ.
posted by sio42 at 10:47 AM on December 12, 2013


My cynical side says...abortion in the heartlands means less voters...

There's nothing cynical about it. They're just taking a page from the Catholic church. Birth control = fewer children to maintain the church's numbers.
posted by hwyengr at 10:49 AM on December 12, 2013


"Life gives us many experiences…I’ve had the experience of delivering calves, dead and alive. Delivering pigs, dead or alive. It breaks our hearts to see those animals not make it."

OK well thanks for showing up everyone but I think we're about done here. I'm going to need everyone to go ahead and line up for orderly disposal. We'll be starting with North America but if everyone on the other continents could please start digging graves now, that would be fantastic, thanks so much. I will turn off the lights and make sure everyone's thermostats are off. You can do whatever you want with your possessions but I'm going to need somebody to leave me a gun with at least one bullet in it for when I've processed everyone else. Thanks in advance.
posted by FAMOUS MONSTER at 10:50 AM on December 12, 2013 [13 favorites]


I assume that person making that quote doesn't mean personally delivering from their body.
posted by sio42 at 10:57 AM on December 12, 2013 [1 favorite]


Viagra still covered?

You know this isn't a men vs. women thing, right? Pointless intersex bickering gets us nowhere. Resist the temptation to get sidelined like this, it's not the issue.
posted by unixrat at 10:59 AM on December 12, 2013 [3 favorites]


You know this isn't a men vs. women thing, right?

It actually is, or more precisely, misogyny vs. whatever the opposite of misogyny is.
posted by MisantropicPainforest at 11:03 AM on December 12, 2013 [19 favorites]


Especially since a viciously loud portion of the right appears to think, a la Rush Limbaugh the oily shitstain, that insurance coverage paying for birth control pills is the same as taxpayers paying women to fuck as much as they want.
posted by elizardbits at 11:06 AM on December 12, 2013 [14 favorites]


Benny Andajetz >

Seriously, what in the holy fuck is the constant obsession with abortion? I mean, these guys don't give two shits about the kids after they're born. It's psychotic.

Your question is very much to the point: why, at this particular historical moment, are these initiatives being proposed, passed, and supported by significant constituencies? One immediate technical answer is that gerrymandering has created more ideologically extreme voting blocs that empower radical political actors, and that explanation is a good one, it's empirical and observable and easy to understand.

But what's going on at the level of meaning? What cultural trends exist that could explain why this is happening, why now? I would argue that we're living in a distinctly revanchist socio-historical moment, in which opportunistic coalitions of wealth and institutional power can grab popular/electoral support with legislative measures that essentially promise White people (but more specifically, men) legitimated re-assertion of control over, and mandatory hierachy enforcement in, the lives of women and minorities in exchange for granting powerful economic actors the legal rights and privileges they need to dominate everyone. White men feel like they've lost a lot of ground, that their dominance has been pushed back, and they want revenge. That entails not only re-establishing domination but punishing those responsible for this crime against the natural order that their loss of domination represents. (Incidentally, I think I've written here on Metafilter before about this theory of mine, so I apologize for being redundant.)

To put it another way, White men are basically selling us all out to corporations through electoral politics, and the politicians who broker those deals between voters and corporations also ensure that laws like Stand Your Ground get passed and apply only to White men, that women's human rights get tossed, and so on. It's not entirely the fault of this group, but they're necessary to making it happen. It really is a war, in the Clausewitzian sense of being prosecuted through other means but remaining an aggressive mass mobilization aimed at capturing something that belongs rightly to someone else.

It works for (at least) two different reason. First, because the central idea of enforcing hierarchies is equally applicable to macro-social domination of whole classes by elites and to inter-personal and inter-group domination. Those are all recognizable as part of the same ideology, so its consistent deployment gives coherence at the level of meaning to social actors, and they then feel that it's part of a larger effort in which they're engaged with the powerful. Through the accumulation of money, men believe that they can complete their revanchism. And politicians constantly stoke these fires by appealing shamelessly to the power fantasies of men. The second reason it works now, as opposed to working at some other time, is that several decades of neoliberal ideological foment have resulted in the adoption of profit-oriented market logics which erode the cultural basis of communitarian values. Neoliberal ideology has completely dominated both political parties in the US, so there's no powerful political actors (aside from just a handful of Democrats) who can challenge its fundamental claims about the supremacy of the profit motive above and beyond other values.

So what does this all add up to? Lots of people hurting economically due to deregulation, privatization and regulatory capture, some of whom are also angry enough at their perceived social demotion that they'll support almost any agenda if they think it will win them back the symbolic and empirical domination they believe to be their right.
posted by clockzero at 11:09 AM on December 12, 2013 [28 favorites]


MetaFilter: a beautifully grilled steak, presented on an upturned garbage can lid.
posted by one more dead town's last parade at 11:14 AM on December 12, 2013 [2 favorites]


would they make the woman carry to term a baby that is just going to die anyways

Yes, and it happens all the time.

Quite a lot of "incompatible with life" fetal abnormalities can't be detected early in pregnancy. The standard ultrasound that provides a comprehensive check of fetal anatomy isn't done until 18wks, well past the 12wk cut off for an elective abortion in most states. So, yes, you end up with many cases of women who find that they're carrying a non-viable fetus who will absolutely be stillborn or die shortly after birth and do not have the option of terminating the pregnancy due to laws governing abortion.
posted by sonika at 11:15 AM on December 12, 2013 [12 favorites]


You know this isn't a men vs. women thing, right?

It actually is, or more precisely, misogyny vs. whatever the opposite of misogyny is.


Thirteen female members of the Michigan Legislature voted for rape insurance. There really are people, of every sex and gender, who feel that termination of a viable fetus is something that should be prevented. They don't understand that the vast majority of abortions are because of desperate circumstances, but they don't hate women, and they are the bulk of the anti-abortion movement.
posted by Etrigan at 11:17 AM on December 12, 2013 [6 favorites]


You know this isn't a men vs. women thing, right?

Right, because it all applies to any men who get pregnant as well.
posted by still_wears_a_hat at 12:16 PM on December 12, 2013 [14 favorites]


Thirteen female members of the Michigan Legislature voted for rape insurance.

You don't have to be male to be a misogynist.
posted by troika at 12:18 PM on December 12, 2013 [16 favorites]


You know this isn't a men vs. women thing, right?

It actually feels like a men and women vs. women. I know that a lot of the people supporting this are women.
posted by still_wears_a_hat at 12:23 PM on December 12, 2013 [1 favorite]


This very thing - forcing women to carry an unviable fetus to term - was recently proposed in a Southern state iirc but I don't want to google it in case my head explodes from rage.

People who think that women should be forced to do this are monsters.

Perhaps I'm emotional about this because a woman I am close with had to terminate a pregnancy due to the fetus having serious birth defects that made it not able to live outside the womb. Perhaps it is because I'm a human being capable of empathy.

To force women to carry a pregnancy to term of a fetus that is either dead or will be born, suffer, then die, just proves that they do not care about women and they do not care about children. Like I said, monsters.
posted by inertia at 12:27 PM on December 12, 2013 [14 favorites]


Thirteen female members of the Michigan Legislature voted for rape insurance.

The fact that there are women who agree with this does not determine whether it's misogynist. There are women who believe that women shouldn't work or that men should have control, too. It has a lot more to do with a structural social attitude than an individual opinion.

If we look at the big picture, 13 out of 28 women in the legislature means that 46% of the women voted for this. That's compared with 76 out of 119 men, or 63% of the males. So, it seems like overall, there is a clear difference that correlates with gender.
posted by mdn at 12:29 PM on December 12, 2013 [3 favorites]


GRAR. MICHIGAN HOW COULD YOU. I am getting more and more sick of this fricking state.
posted by rebent at 12:39 PM on December 12, 2013


"I'd be unsurprised if this passed in a deep red state -- but Michigan? WTH?"

So, this is one of those things that illustrates something often missed by blue state/red state and views of Michigan from out of state. Outside of Detroit and a few other cities, Michigan is a deeply red state and has been, well, pretty much since the Civil War. You know how I'm always talking about how the rest of the state, especially the Republicans, loathe Detroit and want to destroy it? A big part of that is because Detroit for a long time was enough on its own to essentially carry Michigan for the Dems. This was especially humiliating for the old Gov. John Engler, who promised Bush II the state, but Dems used the open primary to vote for McCain.

Some of that is religious, some of that is the urban/rural divide, but a substantial amount is just straight racism and classism. There's also the fact that Michigan's population is rapidly aging, since a huge number of young people have realized that the future looks pretty shitty and that the best chance we had — Granholm — just wasn't a good enough governor to stop the bleeding. Statewide politics there is often a battle between mediocre and straight evil. I mean, the GOP had a straight-up white supremacist get elected over an Indian dude because, you know, Indians look like terrorists. Seriously, he was endorsed by Stormfront.

(As a side note, for many years the American headquarters of the KKK was in Michigan, in Howell, not too far from where I grew up.)

So now that the GOP has been able to redistrict twice (2000, 2010), they've done a whammy on state Dems, and gerrymandered themselves into extremist, tea party friendly districts. It's fucked up, and has been a big part of the ongoing gutting of my home state.
posted by klangklangston at 12:44 PM on December 12, 2013 [5 favorites]


Pure Michigan.

But it isn't. Michigan is the 24th state to pull shit like this. They aren't the first, and they might be (near?) the last, but they aren't unique in this misogynistic idiocy.
posted by filthy light thief at 12:46 PM on December 12, 2013 [1 favorite]


"Especially since a viciously loud portion of the right appears to think, a la Rush Limbaugh the oily shitstain, that insurance coverage paying for birth control pills is the same as taxpayers paying women to fuck as much as they want."

Which, right, if only. I support paying women to fuck as much as they want, but covering birth control ain't it.
posted by klangklangston at 12:46 PM on December 12, 2013 [3 favorites]


I mean, the GOP had a straight-up white supremacist get elected over an Indian dude because, you know, Indians look like terrorists.

The worst part is that he got beat by a white Democrat in the exact same election.
posted by Etrigan at 12:48 PM on December 12, 2013


But do they cover Viagra cause that shit is important, damn it!
posted by stormpooper at 12:51 PM on December 12, 2013


"But it isn't. Michigan is the 24th state to pull shit like this. They aren't the first, and they might be (near?) the last, but they aren't unique in this misogynistic idiocy."

"Pure Michigan" is the most recent tourism slogan for Michigan, which is almost as idiotic and open to parody as the previous slogan, "Yes, Michigan." So when Michigan fucks up, us mitteneers are often known to respond sardonically with, "Pure Michigan."

A similar common expression is, "Thanks, Detroit," usually uttered when detour signs for I-94 construction lead you to a random vacant lot instead of back to the freeway.
posted by klangklangston at 12:58 PM on December 12, 2013 [5 favorites]


What's good for the Michigoose is good for the Michigander?

*cough*
I'll just see myself out.
posted by The Legit Republic of Blanketsburg at 12:59 PM on December 12, 2013 [2 favorites]


You know this isn't a men vs. women thing, right? Pointless intersex bickering gets us nowhere. Resist the temptation to get sidelined like this, it's not the issue.

So. What is the issue? Sure, an easy pot-shot at viagra might not be the most elevated discourse but I do think it illustrates how a "mens health" issue wouldn't be under attack in the same way. To most people, pointing out how unfair something is typically makes them less likely to support it. (To the Right to Life people, all bets are off...)

But, now I've gotten myself all despondent. What really is the best way to have conversations with people like this? I mean, are people really open to having debate on this issue? Or does our best hope lie in having well funded political machines that are more adept at blocking these things than the Michigan legislature, forget debate entirely? We've lost the battle for hearts and minds, all we can hold onto is the shreds of Roe V. Wade?

On my way to visit my parents in the DC suburbs, I often pass the Planned Parenthood office on K and 16th on a Sunday morning. As you can imagine there is frequently a gaggle of protesters. All I can do is impotently give them the finger from my closed car window as I drive through the intersection. Usually don't need the second cup of coffee on those days.
posted by fontophilic at 1:41 PM on December 12, 2013


"Viagra still covered?

unixrat: You know this isn't a men vs. women thing, right? Pointless intersex bickering gets us nowhere. Resist the temptation to get sidelined like this, it's not the issue.
"

The point is that no aspect of men's sexual health is getting voted off the health insurance island by the state legislature.
posted by desuetude at 2:55 PM on December 12, 2013 [7 favorites]


The point is that no aspect of men's sexual health is getting voted off the health insurance island by the state legislature.

Nor is there any factual future risk of this ever, ever happening at any time.
posted by elizardbits at 3:06 PM on December 12, 2013 [4 favorites]


If men got pregnant, abortion would be a sacrament.

If men could get pregnant, you could get an abortion at the 7-11.
posted by Ray Walston, Luck Dragon at 3:29 PM on December 12, 2013 [1 favorite]


"What really is the best way to have conversations with people like this?"

I find that starting at the source is a good start. As filthy light thief points out, "The ability for states to 'opt out' of abortion coverage is built into ACA."

There you have it. For this to change, you must convince people to modify Obamacare.
posted by Ardiril at 3:37 PM on December 12, 2013 [1 favorite]


I wonder how long it will take for someone to mention the fact that a victim bought "rape insurance" as a reason why we should be sceptical that she was actually assaulted?
posted by jess at 3:41 PM on December 12, 2013 [15 favorites]


I totally understand why rape was chosen to illustrate the outrage. It's certainly a more-than legit hypothetical, given the statistics on rape.

But it frustrates me, too, I worry about shifting the goalposts. This legislation isn't a rape problem to solve, it's a restriction on womens' healthcare and reproductive freedom problem. I worry about precedent.

I worry that attacking this as "rape insurance" reinforces the notion that the legislature should get to judge when a woman's particular reasons/circumstances for choosing an abortion sound "good enough" to deserve health insurance coverage for the procedure.
posted by desuetude at 6:41 PM on December 12, 2013 [5 favorites]


attacking this as "rape insurance"

Another problem with the 'rape insurance' moniker is if this story does ever take off, conservatives can readily point to Bart Stupak, a former House Democrat, as the originator, since it was his amendment that caused this abortion exception to be included in Obamacare.
posted by Ardiril at 6:51 PM on December 12, 2013 [1 favorite]


I wonder how long it will take for someone to mention the fact that a victim bought "rape insurance" as a reason why we should be sceptical that she was actually assaulted?
posted by jess


Oh my god I didn't think this could get worse. But yes. "She was obviously planning to lure him in to her web of lies!"

Another disgusting aspect of this is how a nice idea like "legislation presented by the people can't be vetoed" could be so perverted.
posted by bleep at 7:07 PM on December 12, 2013 [1 favorite]


Sen. Whitmer spoke on Maddow tonight about the law, and her own experience as a rape victim.
posted by tonycpsu at 9:58 PM on December 12, 2013 [2 favorites]


From time to time, I think back to growing up in Michigan, and time being what it is, I momentarily forget about some of the awfulness of it. In my image of Michigan as a child, it seems like a pretty great place to live, and not at all that bad.

Was I just a child, and oblivious? Is this a new thing, or has Michigan always been such a rotten shitty place?
posted by Ghidorah at 10:40 PM on December 12, 2013 [1 favorite]


Where in Michigan did you grow up? Again, Howell was the headquarters of the KKK, and Livonia was the whitest/most segregated city in America, despite being right next to Detroit. And there are plenty of little places that it's better to be from than be in — spots like Milford and Lapeer, or even Flint.
posted by klangklangston at 8:33 AM on December 13, 2013


And Western Michigan has been full of conservative assholes forever.
posted by klangklangston at 8:33 AM on December 13, 2013


My wife and I just moved to Michigan (Ann Arbor, specifically). Was this a mistake? Are we dumb for considering starting a family here?

This seems like a situation where we picked the least bad of the alternatives. Family in WI and OH, wife doesn't want to live in IL, I don't want to live in IN, thus, MI.
posted by zrail at 11:07 AM on December 13, 2013


Michigan is on a downslope, but I don't think it's on the downslope. Progressive groups seem to have been mobilized by all the Tea Party asshattery, but we'll see how 2014 goes.

Plus we have pretty restrictive term limits, so none of the current crop of asshats will be around in a few years.
posted by Etrigan at 11:13 AM on December 13, 2013


Zrail, I grew up mostly in Ann Arbor, and my parents are still there. While I think that their declaration that it's the only place in Michigan worth living is a bit hyperbolic, it's still the best for a lot of things that I value. It's got its flaws — it's been taken with the NIMBY anti-development curse particularly hard, and there's a big denial about class issues, along with the fact that it's pretty damn expensive for what you get (my last trip back, I was reminded that you pay about the same dollars for food there as I do in LA), but it's a pretty nice place. Ypsi is too, and there are parts of Detroit, Grand Rapids and Lansing that would be pretty nice if I had a job that took me there. I'm sure someone around here must be willing to stan for B-ham, Rochester and Farmington 'burbs, but I don't know them well enough.

It does have some of the best public schools in the country, both the Open system and the regular non-magnet schools. They're not all great, but the combo of U-M in town and EMU's teaching college nearby make it a popular destination for top-notch teachers.

And given your constraints, it's pretty much the best of the lot — Indiana is terrible pretty much across the board; I have deep regional prejudices against Ohio that hold up less and less each year (Ohio used to be much more conservative than Michigan, but Ohio has gotten a little better while Michigan has gotten worse), and Wisconsin is on its way to being a wholly-owned subsidiary of Koch Industries.
posted by klangklangston at 1:56 PM on December 13, 2013 [1 favorite]


"but that would require them to be composed of functional human beings,"

Feelings are not an argument.
posted by cuomofied at 2:46 PM on December 13, 2013


"But that would require respecting women, and apparently that's evil."

This meme is getting really tired really fast. Not paying for or subsidizing something women demand we pay for or subsidize is now OMG MISOGYNY! WAR ON WOMEN TEABAGLIKKANS KOCHS WHAT ABOUT TEH CHILDRENZ! every goddamn time. It's time that we be remotely pragmatic and stop caving to emotional terrorism.

Isn't this bill simply telling people that if you think that one day you might elect to have an abortion you need to cover that in your own insurance? Isn't this along the same line of reasoning of those who said the individual mandate was so necessary because the kid who never anticipates breaking his arm or crashing his car is "abusing" and "milking" the system? That whole "it won't happen to me" talking point that said you need to pay your "fair share" and "pay into the system" because you never know what might happen to you? I mean, I don't "intend" on breaking my phone or my Ipod, but I "insure" them just the same to make sure that if something were to happen that my out of pocket burden would be greatly minimized.

It seems to me that the (arguably faux) outrage is stemming from people having to pay for it themselves instead of forcing men, who don't need the coverage, and pro-lifers, who refuse to carry it, subsidize it for them. The incest/rape thing is admittedly archaic and stupid, but isn't it simply an issue of gender specific reproductive health insurance? Being that it's a procedure that is specific to one gender, it seems only fair that that gender has it's own risk pool and thus their own insurance (and yes, I feel the same way about gender specific diseases, although there's a fair case to be made for lumping all cancers together.)

What am I missing here? Some people don't want to pay for your abortion, a hypothetical one at that, but you're the victim because you have to "pay your fair share" and insure yourself?

Now, if this excluded the option for the rider the outrage would be sufficiently more warranted, but it's not so it isn't.
posted by cuomofied at 2:52 PM on December 13, 2013


Part of my job the last few days has been helping our public opinion & survey research program area unbreak links to old docs that got broken when we upgraded our site. From a 1998 survey on insurance coverage of contraceptives:

Menlo Park, CA – Most Americans support requiring insurers to provide contraceptives as part of prescription coverage, even if premiums rise, according to a new national survey by the Kaiser Family Foundation. The public is also more likely to say contraceptives should be covered by insurers (75%) than Viagra, the new male impotence drug (49%).

[...]

Both women and men (ages 18 and older) say contraceptives should be covered by insurers, though women (81%) are more likely to support such a policy than men (68%). Most (82%) who favor contraceptive coverage say all prescription methods currently on the market - oral contraceptives, IUDs or intra-uterine devices, Norplant implants, diaphragms, the injectable Depo-Provera, and cervical cap - should be paid for.

Link (PDFs of the topline and news release are at the bottom of the page)
posted by rtha at 2:52 PM on December 13, 2013


"It actually is, or more precisely, misogyny vs. whatever the opposite of misogyny is."

Oh FFS, no it isn't. Out of pocket expenditures for a gender specific procedure is inconvenient, but misogyny it is not. You keep diminishing the power of that word when you throw it around every time you don't get your way or have to support ones self.

I have to believe that it will be a fairly minimal monthly cost much like dental insurance, maybe $25-30 a month, if that. It's not like the are tons of women clamoring for abortions as an elective procedure so it's pretty safe to assume that the monthly premium will be negligible.
posted by cuomofied at 3:06 PM on December 13, 2013


Where in Michigan did you grow up?

Kalamazoo, where the kids I thought were my friends had the hilarious idea of putting a swastika on our front door while we were sitting down to shabbat dinner, and the police officer that came refused to document it. His sole contribution was shining a flashlight on the door so I could take it down and wash off the red paintball they'd shot the door with.
posted by Ghidorah at 3:13 PM on December 13, 2013


You keep diminishing the power of that word when you throw it around every time you don't get your way or have to support ones self.

Will you listen to yourself.
posted by heyho at 3:14 PM on December 13, 2013 [2 favorites]


What am I missing here?

one thing you're missing is that not all abortions are to terminate unwanted pregnancies. Some are performed for reasons concerning the health of the mother. Others are performed because the fetus has either died or will die upon or shortly after birth. All of these cases (and others) are ones that we all should be willing to "subsidize".
posted by sineater at 3:15 PM on December 13, 2013


cuomofied: " What am I missing here? Some people don't want to pay for your abortion, a hypothetical one at that, but you're the victim because you have to "pay your fair share" and insure yourself?"

Please list all of the other legal medical procedures that Michigan law mandates a separate opt-in rider for. Yeah, there aren't any.
posted by tonycpsu at 3:18 PM on December 13, 2013 [1 favorite]


"I have to believe that it will be a fairly minimal monthly cost much like dental insurance, maybe $25-30 a month, if that. It's not like the are tons of women clamoring for abortions as an elective procedure so it's pretty safe to assume that the monthly premium will be negligible."

"Hey ladies, pay $25 to $30 a month to make sure when you get raped and pregnant, you don't have to carry that kid to term and then raise it! By the way, this isn't misogyny because reasons!"

Come the fuck on, the rhetoric about "subsidizing" is bullshit, this is a pretty transparent anti-abortion policy and it has no medical basis.

"You keep diminishing the power of that word when you throw it around every time you don't get your way or have to support ones self."

Sorry to do this broseph, but that's exactly what a misogynist would say.
posted by klangklangston at 3:20 PM on December 13, 2013 [8 favorites]


"Kalamazoo, where the kids I thought were my friends had the hilarious idea of putting a swastika on our front door while we were sitting down to shabbat dinner, and the police officer that came refused to document it. His sole contribution was shining a flashlight on the door so I could take it down and wash off the red paintball they'd shot the door with."

See also: West side of the state has had assholes forever. But K-zoo's just a relic of long haul trucking lines anyway, despite being the home of Bell's.
posted by klangklangston at 3:23 PM on December 13, 2013


" Some are performed for reasons concerning the health of the mother. Others are performed because the fetus has either died or will die upon or shortly after birth. All of these cases (and others) are ones that we all should be willing to "subsidize".

I'm certainly not under the impression that it's solely used to terminate unwanted pregnancies, and even concluded that the rape/incest thing is archaic and dumb. As an atheist who was once not, I get the moral dilemma of having people who are adamantly against the procedure not wanting to fund it in any capacity.

But, just as before and as is now, you elected as to whether or not you wanted to be covered for such a thing. Nobody is BANNING the procedure in the event of an expiring fetus or an adverse health risk for the mother, but you would think that to be the case with all the chicken littling that is occurring in the comments here and elsewhere.

Like I've posited before, I imagine the rider will cost little or nothing because you're talking about a large pool for a procedure that isn't used terribly often. And as we get more and more away from individuals being remotely educated or involved in obtaining the coverages they need coupled with a never ending proliferation of rights, this seems to be more of a tantrum because "I DON'T WANNA PAY FOR IT!!"

Well don't, and be stuck with the bill later. It's time the progs start following their own rhetoric and start "paying their fair share".
posted by cuomofied at 3:29 PM on December 13, 2013


"Sorry to do this broseph, but that's exactly what a misogynist would say."


So you're going with the circular logic position that calling out false accusations of misogyny is misogyny, we win , fuck you that's why position?

Well that's quaint. There's clearly no reason engaging you then, because no matter what, you're right.
posted by cuomofied at 3:32 PM on December 13, 2013


cuomofied: " Like I've posited before, I imagine the rider will cost little or nothing because you're talking about a large pool for a procedure that isn't used terribly often. And as we get more and more away from individuals being remotely educated or involved in obtaining the coverages they need coupled with a never ending proliferation of rights, this seems to be more of a tantrum because "I DON'T WANNA PAY FOR IT!!""

Substitute "testicular cancer" for "abortion." Still want to require insurers to force everyone to buy separate coverage for that?
posted by tonycpsu at 3:32 PM on December 13, 2013 [2 favorites]


What am I missing here?

A basic sense of decency?
posted by five fresh fish at 3:36 PM on December 13, 2013 [12 favorites]


"Substitute "testicular cancer" for "abortion." Still want to require insurers to force everyone to buy coverage for that?"


Yes. I stated it earlier in the thread that I hold the position that gender specific diseases be paid by gender specific pools. There can be a compelling case to have "cancer" be an overall pool thing, being as BOTH genders have specific gender related cancers. The same cannot be made for the abortion case.
posted by cuomofied at 3:36 PM on December 13, 2013


Dude, 90 percent of the comments you've made on MetaFilter are about how women are terrible. Yeah, I don't feel like I'm out on a limb here.

"But, just as before and as is now, you elected as to whether or not you wanted to be covered for such a thing. Nobody is BANNING the procedure in the event of an expiring fetus or an adverse health risk for the mother, but you would think that to be the case with all the chicken littling that is occurring in the comments here and elsewhere."

They're making it substantially harder to obtain for no medical or financial reason, and requiring extra bureaucracy just to make women's lives harder. That's bad enough, and it's idiotic to hold that they have to be banning the procedure to be upset.

"Like I've posited before, I imagine the rider will cost little or nothing because you're talking about a large pool for a procedure that isn't used terribly often."

A pool that has just shrunk for no reason. And further, your positing it doesn't make it true.

"And as we get more and more away from individuals being remotely educated or involved in obtaining the coverages they need coupled with a never ending proliferation of rights, this seems to be more of a tantrum because "I DON'T WANNA PAY FOR IT!!""

But they still would be paying for it on either side. Do you know how insurance works, or is this just another screed of yours about some mythical personal responsibility?

"Well don't, and be stuck with the bill later. It's time the progs start following their own rhetoric and start "paying their fair share"."

The hell are you even on about? All insurance is about pooling risk.
posted by klangklangston at 3:36 PM on December 13, 2013 [9 favorites]


"Yes. I stated it earlier in the thread that I hold the position that gender specific diseases be paid by gender specific pools. There can be a compelling case to have "cancer" be an overall pool thing, being as BOTH genders have specific gender related cancers. The same cannot be made for the abortion case."

No, you cannot make a coherent case that "cancer" should go all in one pool while abortion — as distinguished from any other ob/gyn procedure — should not. You are attempting to manipulate categories, and your initial contention of gender pools is also something that's both bad public policy and pretty idiotic when you think it through. Again, insurance pools risk.
posted by klangklangston at 3:38 PM on December 13, 2013 [2 favorites]


cuomofied: " Yes. I stated it earlier in the thread that I hold the position that gender specific diseases be paid by gender specific pools. There can be a compelling case to have "cancer" be an overall pool thing, being as BOTH genders have specific gender related cancers. The same cannot be made for the abortion case."

Why not let the market figure out which things should be pooled and which shouldn't? Insurers know how to do that shit better than lawmakers do. State law in Michigan doesn't micro-manage any other aspects of the actuarial balance of covering various health conditions, why are they insisting on micro-managing this one, and banning insurers from bundling it with their regular coverage, even if they feel that's in their best financial interest?
posted by tonycpsu at 3:39 PM on December 13, 2013 [2 favorites]


A basic sense of decency?

Again, feelings are not an argument.


"Hey ladies, pay $25 to $30 a month to make sure when you get raped and pregnant, you don't have to carry that kid to term and then raise it! By the way, this isn't misogyny because reasons!"


That's called insuring ones self. And you guys pissed and moaned that everyone needed to pay in because they don't know what will happen down to them down the road. Now all of a sudden when it makes you look all sensitive and favorable to the echo chamber you live in, that no longer matters, because feelings.

Do you even know what that word means? You keep throwing it around but you clearly only respond to rudimentary emotional rhetoric - it's like you're one of Pavlov's dogs responding on command.

misogyny: hatred of women

Do tell, how does simply not agreeing with how you see the subject become tantamount to hating women?
posted by cuomofied at 3:41 PM on December 13, 2013


The *only* procedure they are forcing insurers to treat differently is a legal procedure that only women will ever need to get. Your mealy-mouthed bullshit response to the testicular cancer counterexample speaks volumes.
posted by tonycpsu at 3:46 PM on December 13, 2013


klangklangston: "Dude, 90 percent of the comments you've made on MetaFilter are about how women are terrible. Yeah, I don't feel like I'm out on a limb here. "

Holy crap, you're right.
posted by zarq at 3:50 PM on December 13, 2013 [3 favorites]


"Again, feelings are not an argument."

And your feelings are? Why is this good public policy? What goal does this accomplish?

"That's called insuring ones self. And you guys pissed and moaned that everyone needed to pay in because they don't know what will happen down to them down the road. Now all of a sudden when it makes you look all sensitive and favorable to the echo chamber you live in, that no longer matters, because feelings."

The fuck are you on about? Everyone is paying in — that's what the insurance is. This would be covered under insurance, except that Michigan is exempting it. They're making women jump through hoops for no reason, which will lead to a lower rate of coverage and detaching it from a broader actuarial pool, which will make it cost more than it would as part of that pool. That's not just "feelings," that's knowing something about how policy works.

"Do you even know what that word means? You keep throwing it around but you clearly only respond to rudimentary emotional rhetoric - it's like you're one of Pavlov's dogs responding on command."

Yeah, it means doing things like singling out women's reproductive freedom to have a higher barrier with no coherent public policy basis. Sorry, broheme, that's how functional misogyny operates.

"Do tell, how does simply not agreeing with how you see the subject become tantamount to hating women?"

Uh, pushing a policy that will cost money and likely lead to negative health impacts for women without any justification isn't just disagreeing — it's punishing women for being women, and that's misogyny. I'm glad you own a dictionary; now you might try comprehension as your next goal.
posted by klangklangston at 3:50 PM on December 13, 2013 [8 favorites]


misogyny: hatred of women

Do tell, how does simply not agreeing with how you see the subject become tantamount to hating women?


Right, you don't *hate* women. You just feel like their medical needs should be placed in a specific ladies-only insurance pool because it's not fair that men should have to pay for things that they will personally never need. Which isn't hatred... It's narrow minded and serves to marginalize women in a very real way by making them pay not only for insurance that *everyone* gets, but then pay out of their own pockets for treatment that only women need that insurance won't cover. Which isn't hating women... It's only fair. If they didn't want to pay extra for health care, they shouldn't have owned such an expensive uterus.
posted by sonika at 3:52 PM on December 13, 2013 [10 favorites]


Why not let the market figure out which things should be pooled and which shouldn't? Insurers know how to do that shit better than lawmakers do. State law in Michigan doesn't micro-manage any other aspects of the actuarial balance of covering various health conditions, why are they insisting on micro-managing this one, and banning insurers from bundling it with their regular coverage, even if they feel that's in their best financial interest?

That's an excellent point. As far as the market deciding, we unfortunately seem to be past that even being allowed. The difference here would seem that it's acknowledging a (admittedly flimsy) religious exemption.
posted by cuomofied at 3:53 PM on December 13, 2013


"Right, you don't *hate* women. You just feel like their medical needs should be placed in a specific ladies-only insurance pool because it's not fair that men should have to pay for things that they will personally never need. "

Well, and it's not even a coherent approach to that, which would lead to advocating for (still dumb, but at least consistent) ala carte pay-ins. But he's fine with paying for all sorts of man stuff he won't need, it's just that ladies don't get the same luxury. But that's not misogyny, oh no! It's just something that will hurt women out of what, blithe idiocy?

"That's an excellent point. As far as the market deciding, we unfortunately seem to be past that even being allowed. The difference here would seem that it's acknowledging a (admittedly flimsy) religious exemption."

Anyone who seriously argues for a market solution to insurance or health care is an absolute moron with no knowledge of how health markets or information functions, and should be put on an ice floe where they can't influence adult public policy.
posted by klangklangston at 3:55 PM on December 13, 2013 [3 favorites]


Do tell, how does simply not agreeing with how you see the subject become tantamount to hating women?

It doesn't. The fact that you keep spouting illogical vitriol about how an unwanted or medically dangerous pregnancy is a woman-only problem is what makes you sound like a misogynist!

Here is a tip: aside from just being a decent human being about things, the fact is that children who are born into households where they are not wanted or not able to be properly looked after is a problem for EVERYONE. Yes, even for dudes.
posted by jess at 3:55 PM on December 13, 2013 [8 favorites]


Right, you don't *hate* women. You just feel like their medical needs should be placed in a specific ladies-only insurance pool because it's not fair that men should have to pay for things that they will personally never need. Which isn't hatred... It's narrow minded and serves to marginalize women in a very real way by making them pay not only for insurance that *everyone* gets, but then pay out of their own pockets for treatment that only women need that insurance won't cover. Which isn't hating women... It's only fair. If they didn't want to pay extra for health care, they shouldn't have owned such an expensive uterus.

Women USE more health care, thus shouldn't they PAY for more health care? It's no wonder some of you are predictably silent about inequalities in car insurance rates considering who benefits from that inequality. It shows a clear level of bias and straight up hackery when you cherry pick when actuarial evidence is relevant.

:Anyone who seriously argues for a market solution to insurance or health care is an absolute moron with no knowledge of how health markets or information functions, and should be put on an ice flow where they can't influence adult public policy.:

Right, because the government getting involved in the first place had nothing to do with the market based system that worked fine. And that market couldn't have ever been perverted by OMG CORPORASHUNZ! and government consistently rigging the game because government is us and we are government.

It's the corporations and the rich who are the enemy. And they have taken control of the government.

The only way for the People to take back government is to give the government more power.

Then with more power it (and us through government because government is us and we are government) will be able to control the corporations that control it.

And if that doesn't work, it was only because we didn't give government enough power.
And if that doesn't work, it was only because we didn't give government enough power.
And if that doesn't work, it was only because we didn't give government enough power.
And if that doesn't work, it was only because we didn't give government enough power.
And if that doesn't work, it was only because we didn't give government enough power.
posted by cuomofied at 4:00 PM on December 13, 2013


You're the one arguing for the government to be given the power to tell insurance companies how to best construct their risk pools, champ. Seems like you might want to do more thinking and less cut-and-pasting.
posted by tonycpsu at 4:03 PM on December 13, 2013


A basic sense of decency?

Again, feelings are not an argument.


I'm not arguing with you. I'm am saying that I have no respect for the opinion you're spewing, nor for you. You don't offer a solution to the problems this society faces; indeed, you are a cause of these problems. You express indecent, ill-informed, harmful opinions and IMO we'd all be much better off without the likes of you shitting-up our world.
posted by five fresh fish at 4:04 PM on December 13, 2013


Right, because the government getting involved in the first place had nothing to do with the market based system that worked fine.

Ha ha ha! You think it was market-based before the big evil government came along with the ACA? HA HA HA HA!!! /collapses

But seriously. You don't seem to know about how insurance pools work (you know, the kind figured out by...insurance companies). Based on your comment history, you really have a weird axe to grind about women/feminism. And you think it's bad for government to be involved in regulating insurance coverage except when they're regulating coverage you think is icky for people you don't like anyway. Neat!
posted by rtha at 4:07 PM on December 13, 2013 [7 favorites]


Women USE more health care, thus shouldn't they PAY for more health care? It's no wonder some of you are predictably silent about inequalities in car insurance rates considering who benefits from that inequality. It shows a clear level of bias and straight up hackery when you cherry pick when actuarial evidence is relevant.

"Some of you?" So, not only are you responding to my comment by dragging in a complete tangent from left nowhere, but you're addressing me based on my gender in a "you folks" kind of way?

I'll respond to the actual substance of any comment you make coherently addressing me as a person. For any "some of you" comments, I'll have to go back into the lady tent and take a poll.

(PS: I'm not only a woman, I'm a pregnant woman. I pay in plenty for my health care and I'm happy to do so. But no, I shouldn't have to shell out *extra* money just because men can't give birth.)
posted by sonika at 4:09 PM on December 13, 2013 [9 favorites]


cuomofied: "Women USE more health care, thus shouldn't they PAY for more health care? "

"Why Making Women Pay More Than Men for Health Insurance Doesn't Make Sense: Take maternity off the table and men aren't any cheaper to insure than women. But Republicans wanted men to pay less anyway."
The argument for gender rating, in the days before the Affordable Care Act, had always been that women cost more to insure. But if we ignore all costs directly associated with pregnancy and childbearing (the logic here being that it takes two parties to create a child and both parties should be willing to pay equally to support that endeavor), men aren't actually any cheaper to insure than women.

"When you get older, men cost more to insure than women," explained Jonathan Gruber, a health economist at Massachusetts Institute of Technology. Later in life, men are more likely to have a variety of conditions including heart attacks, lung cancer, and liver cancer. They're also more likely to smoke, drink, and get in accidents, according to experts.

posted by zarq at 4:09 PM on December 13, 2013 [6 favorites]


"Women USE more health care, thus shouldn't they PAY for more health care? It's no wonder some of you are predictably silent about inequalities in car insurance rates considering who benefits from that inequality. It shows a clear level of bias and straight up hackery when you cherry pick when actuarial evidence is relevant. "

Some of whom? Anyway, the increased costs of insuring women are because women get pregnant, something we have a public interest in supporting. And since auto insurance has a starker risk differential and doesn't involve as potent a public policy objective, it's kind of irrelevant and that it hasn't been mentioned doesn't actually show any hackery or bias.

"Right, because the government getting involved in the first place had nothing to do with the market based system that worked fine. And that market couldn't have ever been perverted by OMG CORPORASHUNZ! and government consistently rigging the game because government is us and we are government."

What the hell are you on about? The first, obvious market failure of insurance is that consumers have no realistic ability to evaluate their costs or risks, the second is that pricing information is opaque, the third is that because of the way that incentives work, there's no ability to reasonably set demand, the fourth is that using a market mechanism for insurance pricing would lead to no one getting covered for expensive, rare things, the fifth obvious failure is that because we don't turn people away at the ER, we end up spending this money anyway.

Seriously, you don't know what the fuck you're talking about, and your copy pasta is less germane than bus stop ramblings of a man shitting into a shoe.
posted by klangklangston at 4:10 PM on December 13, 2013 [2 favorites]


It doesn't. The fact that you keep spouting illogical vitriol about how an unwanted or medically dangerous pregnancy is a woman-only problem is what makes you sound like a misogynist!

Here is a tip: aside from just being a decent human being about things, the fact is that children who are born into households where they are not wanted or not able to be properly looked after is a problem for EVERYONE. Yes, even for dudes.


Where exactly is this abortion ban you speak of? You do know that most children are not wanted in the sense that they were a mistake, right? I thought we were talking about how this is more of an affront to the health of the child or the mother in the event of a medical emergency as opposed to abortion as a form of contraception, or was I mistaken?

Just to be clear, I'm pro-abortion. It's a privacy issue, and the sociopathic right would do well by treating it as such.


"Ha ha ha! You think it was market-based before the big evil government came along with the ACA? HA HA HA HA!!! /collapses"


Your history isn't too good is it? Try WWII setting up the employer based insurance model and then again with Nixon. But hey, good attempt at framing words that were never said and knocking over that straw man with such efficacy.

"Take maternity off the table and men aren't any cheaper to insure than women. But Republicans wanted men to pay less anyway.""

So you're ostensibly saying "ignore factual reality and then I'm right." Classic.
posted by cuomofied at 4:11 PM on December 13, 2013


"(PS: I'm not only a woman, I'm a pregnant woman. I pay in plenty for my health care and I'm happy to do so. But no, I shouldn't have to shell out *extra* money just because men can't give birth.)"

But don't you understand? Men are the norm, and women are deviates that gum up the works! And that's not misogyny, it's just thinking women are less important!
posted by klangklangston at 4:12 PM on December 13, 2013 [11 favorites]


"Where exactly is this abortion ban you speak of?

No one said "ban." Is your trouble that you can't find an adult to explain these comments to you?

"You do know that most children are not wanted in the sense that they were a mistake, right?
Bullshit.

" I thought we were talking about how this is more of an affront to the health of the child or the mother in the event of a medical emergency as opposed to abortion as a form of contraception, or was I mistaken?"

Women can have abortions for any damn reason that they like, it's between them and their doctor.

"So you're ostensibly saying "ignore factual reality and then I'm right." Classic."

So… you're saying that men have no interest in the outcome of pregnancies? That there's no public policy interest in maternal care?

You're the one ignoring factual reality, chief.
posted by klangklangston at 4:15 PM on December 13, 2013


But don't you understand? Men are the norm, and women are deviates that gum up the works! And that's not misogyny, it's just thinking women are less important!

It's the hormones, they make me forget the dominant paradigm wherein pregnancy isn't an ability that women have and men don't - it's a medical condition for which women are penalized and men sit back and claim no responsibility.
posted by sonika at 4:17 PM on December 13, 2013 [9 favorites]


Don't worry, little Offred, Cuomofied will get you back to Gilead!
posted by klangklangston at 4:20 PM on December 13, 2013 [3 favorites]


But don't you understand? Men are the norm, and women are deviates that gum up the works! And that's not misogyny, it's just thinking women are less important!

It's the hormones, they make me forget the dominant paradigm wherein pregnancy isn't an ability that women have and men don't - it's a medical condition for which women are penalized and men sit back and claim no responsibility.


Right, because objecting to one particular health care function is the same as railing against every other part of the health care system that delivers quality maternity care that both men and women alike have a vested interest in. You're the ones extrapolating any other points other than the single issue I'm discussing. So argue with yourself all you like and do whatever it is you need to to lavishly heap praise unto yourself via your own incessant back patting.

How dare I have the temerity to disagree with the collective. Diversity truly is everyone thinking alike.

It's been fun kids. Shift is up. Cheers.
posted by cuomofied at 4:30 PM on December 13, 2013


cuomofied: " So you're ostensibly saying "ignore factual reality and then I'm right." Classic."

No, I'm saying read the article. Which is why I made a big ol' link for it.

There are many reasons listed which explain why a cost imbalance exists, including that men actually use health care more than women for a wider range of problems. The reason costs are higher for women is they use fewer services which tend to be more expensive.

Ignoring the fact that women cannot become pregnant through without male gametes is short-sighted in more ways than one, and setting a precedent for removing male responsibility from the financial obligations that come with pregnancies that they have initiated would be idiotic and no doubt have negative long-term consequences. But more relevantly:

I do not know if you are a parent. I happen to be father to a pair of five year old twins who were born 4 weeks early, and I'd like to share some of that experience with you. I suspect most people don't realize that maternity care and child birth are part of child care, and if a mother and her fetus are not adequately taken care of during pregnancy, a child might be born with medical issues. Issues that can and do cost a hell of a lot of money down the road. Medically-speaking my wife was taken care of quite well during her pregnancy. But my kids were still born four weeks early. The lungs are the last part of a child to develop during gestation, and the majority of that development happens during the last few weeks of pregnancy. So my son (not so much my daughter) was born with asthma.

From a practical perspective one wouldn't think that would be too difficult to treat. But in reality what it has meant is that for the first few years of his life, every single cold and flu and bronchitis he's picked up has gone straight to his lungs. Bronchitis becomes pneumonia. Which means higher healthcare costs. He's been in and out of the hospital. Takes some medication when he's well, and nearly every time he gets sick has to take additional, costly medication to get well again. He's been treated by a couple of specialists for several years now. My wife and I have spent thousands keeping him healthy, and we have insurance! I can only imagine what the cost would be for someone without it.

This isn't going to change, long term. His lungs will always be a weak link.

These are the hidden costs of having a preemie. And they fall to both parents. Not simply his mother. But more importantly, in conversations like this one we all need to recognize that some of the afflictions we develop early childhood are initiated during pregnancy and develop as we do. Adequate health care during pregnancy is preventative care, which could conceivably save thousands to tens of thousands of dollars in treatment down the road. It's not just about the mother. It's also about the child.

That sort of preventative care needs to be as accessible as possible to pregnant women. They shouldn't be priced out of it. They shouldn't be barred from having it. Because that can directly affect the child (or children) they're carrying. Which (if you want to consider it from this perspective) could conceivably become a taxpayer or societal burden down the road.

Sometimes you have to take the long view.
posted by zarq at 4:33 PM on December 13, 2013 [8 favorites]


ZARQ: Thank you for your even handed and thoughtful response. I wish you and your children continued health and can only imagine the incredible amount of strength it takes to raise two newborns at the same time. I think the thing that is (predictably) being misconstrued is that somehow I'm clamoring against prenatal or preventative care, which is just not accurate.

I'm a little l libertarian who belongs no political cults, but there are some issues where I tend to break away from what most people perceive to be static elements of that philosophy. For instance, SCHIP. I don't have an issue with the premise, but what I did and still take issue with is specifically punishing a segment of consumers that has nothing to do with children whatsoever (smokers). Why not pass a small tax to be distributed evenly amongst everyone? Why not tax things related to children such as diapers, formula, clothes, etc and have those who choose to have children "pay it forward"? Why not tax Snickers and Axe body spray? Yet according to the same groupthink individuals I've had to combat today, I "hate children" and "want kids to die" because on a very superficial level, I opposed the legislation. Never mind the fact that the objection was based on the funding mechanism and not the intent, the proles seem to only view intent as a measure for success, empirical data or efficacy be damned.

So now that I have some minor disagreement with the outrage industry, the rhetoric naturally turns into some inane perception that I apparently want to have forced female circumcisions and outright ban women from ever seeing a doctor.

The difficult thing to reconcile here is the religious exemption. You're not going to make everybody happy all of the time and while I disagree with the exclusion of the rape/incest exception, it's reconciled the conflict of interest in terms of funding. It's sad that I even need to point it out, but that's the only thing that's been cut. Everything else is still covered. Preexisting conditions, maternity care, pre and post natal care - those didn't go anywhere, regardless of how much some of the posters would like to pretend like they just passed a law that required each man to build and populate a rape den in their homes.

So yeah, it may not be ideal, but it is what it is, and seeing as the proliferation of rights has now provided free contraceptives as a voter grab bag of appreciation, I don't see a minimal amount of insurance that is literally the definition of catastrophic coverage as being that big of a deal to anyone other than those who like to politicize every little fucking thing that doesn't work in their favor. That's my $0.02, anyways.


Thanks for, you know, being a person. Best wishes to you and your family. Cheers.
posted by cuomofied at 5:01 PM on December 13, 2013


I don't see a minimal amount of insurance that is literally the definition of catastrophic coverage as being that big of a deal to anyone other than those who like to politicize every little fucking thing that doesn't work in their favor.

Like the people who are insisting that having to include full pregnancy coverage -- which, yes, can include abortion in some cases, such as multiple pregnancies or fetal death -- is so unfair, let's make a huge political statement about it and refuse to pay for it.
posted by jeather at 5:09 PM on December 13, 2013 [1 favorite]


[Ok, folks. Some stuff has been deleted, please do not attempt to bait your compatriots, and do not descend into semi-coherent personal attacks. This has been your management PSA for the evening. Thanks. ]
posted by restless_nomad at 5:39 PM on December 13, 2013


"Like the people who are insisting that having to include full pregnancy coverage -- which, yes, can include abortion in some cases, such as multiple pregnancies or fetal death -- is so unfair, let's make a huge political statement about it and refuse to pay for it".

Apparently using the metaphor cherry picking is against the guidelines. Bullocks. I will not go quietly.

Anyways, ignoring context to make a point generally isn't good business.

" You're not going to make everybody happy all of the time and while I disagree with the exclusion of the rape/incest exception, it's reconciled the conflict of interest in terms of funding."

"So yeah, it may not be ideal, but it is what it is, and seeing as the proliferation of rights has now provided free contraceptives as a voter grab bag of appreciation, I don't see a minimal amount of insurance that is literally the definition of catastrophic coverage as being that big of a deal to anyone other than those who like to politicize every little fucking thing that doesn't work in their favor."

Thanks for playing.
posted by cuomofied at 5:49 PM on December 13, 2013


Your history isn't too good is it? Try WWII setting up the employer based insurance model and then again with Nixon. But hey, good attempt at framing words that were never said and knocking over that straw man with such efficacy.

So, this is funny, because I work at the Kaiser Family Foundation. Which is a health policy organization founded by the guy who started the employer-based insurance back in the day. I pretty much get to spend all day reading or at least skimming policy papers about health care and coverage.

I guess I must have missed your point? To me, it read as if you think big government came in and ruined market-based insurance - with the help of the corporations? I think? And together they ruined a market-based system that was never actually around to be ruined? I don't know. Half the shit you say is wrong, a quarter is really kind of offensive, and the rest is really hard to parse. Thank *you* for playing.
posted by rtha at 6:00 PM on December 13, 2013 [12 favorites]


[FYI we are serious.]
posted by jessamyn at 6:08 PM on December 13, 2013


"I guess I must have missed your point? To me, it read as if you think big government came in and ruined market-based insurance - with the help of the corporations? I think? And together they ruined a market-based system that was never actually around to be ruined?"

Well my limited understanding of the health care system prior to the WWII employer based system was that insurance was routinely for catastrophic events and routine and foreseen medical expenses were paid out of pocket, as opposed to now where everything including a single aspirin requires 180 pages of paperwork. Being able to "shop around" for quality and affordability would actually indicate a market based system, no?
posted by cuomofied at 7:15 PM on December 13, 2013


No. Health care is not like a typical commodity. People cannot "shop around." You cannot have health care made cheap in China and shipped to you in North Dakota. More than any commodity, it requires an infrastructure and is deeply geographically based. The predatory inflation of medical costs hasn't been because of a lack of competition due to insurance; it's been because of a lack of competition due to the fact that health care doesn't lend itself to competition. When I slashed my hand open, I went to the hospital down the street because it was there. That's what people do.

That's why Medicare manages to get low costs for everything - because unlike a single person it can force health care providers to compete, and unlike insurance companies it's not interested in inflating prices. As a result, many providers hate Medicare. But if every person had something like Medicare, something that forced competition into the system, then prices would go down across the board.

The only way to make this work is to pool everyone together and use the combined market force to drive competition. That's why, for example, people born with birth marks should be in the same resource pool as people born without birth marks. We shouldn't create separate pools of, say, people with different hair color; that would divide our market power and reduce competition, increasing prices. Even if, for instance, black people tend to suffer from diabetes more often, we need to keep the pools together, even for those procedures, because the market forces work more efficiently that way. Or - I'm just spitballing here - if people happen to have different things between their legs, and there are procedures specific to those different things they have between their legs.
posted by koeselitz at 9:07 PM on December 13, 2013 [6 favorites]


People cannot "shop around." You cannot have health care made cheap in China and shipped to you in North Dakota. More than any commodity, it requires an infrastructure and is deeply geographically based.

Not only this, but how much time do you have to spend shopping around? In an emergency, you quite literally have to take what is available. Level 1 trauma center in NYC might be your preference - but even if you're willing to foot the bill, if you're in a car accident in Wyoming... you'll die before you could get there.

Chronic conditions it's slightly more feasible to shop around, but only barely. You still have time and distance constraints based on your illness and exactly how sick you will be if you put off the treatments you're shopping for. Brand new study in Chicago and you live in Miami? Probably not an option unless you have rather extensive financial resources and an illness that still leaves you functional enough to travel.

The system now sucks from a consumer's point of view. I wanted to get an optional prenatal test done and so I called my insurance company to find out what it bills for - being that it isn't standard, I was fully expecting to pay out of pocket if I chose to have the test, but I very much wanted to know the price BEFORE making that decision. They couldn't tell me. Not that they couldn't tell me if it was covered, they couldn't tell me the price of the test. Flat out refused. How am I supposed to shop around if the only information I get about the price point is AFTER I've received the service? In no way does a functional marketplace operate that way.

(In the end I was able to speak with the billing department at the company that provides the test. Which wasn't a big deal other than I had to know who made the test and how often do you know which 3rd party is running your lab work? A lot more grunt work than I've put into any other purchase short of buying a car.)
posted by sonika at 9:42 PM on December 13, 2013 [4 favorites]


How am I supposed to shop around if the only information I get about the price point is AFTER I've received the service?

You can't even get it then. My son had to go to the ER for croup a year or so ago, and I was watching our insurance company's claims website like a hawk for the bills to come through, since we were going to have to pull money out of the 401(k) to pay it. One big chunk came in from the hospital, and another big chunk came in from the physician's group, and i figured that was it, but then ANOTHER smaller chunk came in, and then another -- and finally I called the hospital and asked if there were any charges still outstanding, and the billing person said "There's really no way to know. Everyone works with different billing groups, there could still be charges outstanding. Just pay them as they come in." So not only could I find out how much it was going to cost beforehand, I couldn't even find out after -- I was just expected to keep coughing up hundreds or thousands of dollars every time they sent me a bill. It's been more than a year so I think we're probably in the clear, but there truly is no way to know if we are or not. And "not going to the ER" wasn't an option -- he was dying, he stopped breathing in the car on the way there.
posted by KathrynT at 11:21 PM on December 13, 2013 [4 favorites]


A few more things:

cuomofied: “Right, because the government getting involved in the first place had nothing to do with the market based system that worked fine. And that market couldn't have ever been perverted by OMG CORPORASHUNZ! and government consistently rigging the game because government is us and we are government.”

rtha: “Ha ha ha! You think it was market-based before the big evil government came along with the ACA? HA HA HA HA!!! /collapses”

cuomofied: “Your history isn't too good is it? Try WWII setting up the employer based insurance model and then again with Nixon. But hey, good attempt at framing words that were never said and knocking over that straw man with such efficacy.”

Well, let's talk about history, shall we? Here is a pretty intelligent, clear-eyed take on health care from 1947, reported from annual conference of the American Medical Association. You may be surprised to find that things have changed less than we tend to imagine:
A past-president of the National Association of Manufacturers made a skillful speech; there is hardly any need to tell you what he said: it is summarized when his former office is named... The past-president of manufacturers had a progressive mind, as he freely confessed, and so he realized that organized medicine must find some way of enabling people with small incomes to procure adequate medical care for themselves - to procure the kind of care for which the convention was repeatedly congratulating itself. He had applied hard thought to the problem, especially in relation to "politicians and reformers." And he had reached a conclusion: that we would be wise to adopt "the voluntary plans for hospital and health insurance" that the AMA recommends.

That was what he was brought to Atlantic City to say. And in the course of his inaugural address the new president of the American Medical Association found occasion to say it again. They were talking about a fearful bugaboo, a national health program, and they were voicing the party line of the present actual rulers of the AMA...

The ultimate and minimum is this: There must be no federally controlled health program; the program whose coming is seen to be inevitable must be based on states rights. There must be no national imposition of medical standards apart from those which organized medicine itself imposes... organized medicine insists on complete, unsupervised control of any health program that may evolve; and it requires that any plan to interfere with the fee-for-service system as little as possible, not at all wherever there is any way to maintain the system.

This stand, of course, is so unrealistic that it suggests the need of psychiatric scrutiny... The greatest desideratum of any health program, the practice of preventative rather than remedial medicine, is impossible for most of the population without some kind of compulsory insurance. And finally without compulsory insurance there is no way of providing complete medical service, except by the group practice which organized medicine disapproves, or by setting the prices of "voluntary" programs so high that they will be out of the reach of ordinary people.
This is from an essay by Bernard Devoto called "Doctors Along The Boardwalk." It's worth reading the whole thing (look, I scanned all 18 pages for you, read it, it's fun and informative) but the general point here is pretty clear, I think: Employer-based "voluntary" insurance was emphatically not a "progressive" idea pushed by the New Dealers and the big-government Dems and all that. Employer-based insurance was a scheme concocted by the industry to retain control and make money.

Moving up to current events:

“In an emergency, you quite literally have to take what is available. Level 1 trauma center in NYC might be your preference - but even if you're willing to foot the bill, if you're in a car accident in Wyoming... you'll die before you could get there.”

Indeed. There's a term for this in economics, actually: inelastic demand.

Here is a very good overview of this subject that I think everybody should watch:

"Why Are American Health Care Costs So High?"
posted by koeselitz at 11:22 PM on December 13, 2013 [5 favorites]


After being spanked around the block and back again by people better informed and far more intelligent than himself, the craven libertarian can only wish that his ass were covered by public health insurance.
posted by five fresh fish at 8:11 AM on December 14, 2013 [1 favorite]


Insurance companies don't have to offer them. Employers providing insurance for employees don't have to purchase them.

Even if the riders are available, now women have to purchase additional healthcare insurance because they are women.



OH...so they're not actually riders...its just a loophole that allows employers to disregard the law.

Has ANYTHING good ever come out of this shitty state?
posted by hal_c_on at 10:00 AM on December 14, 2013


The 23 states that had already restricted abortions from insurance long before Michigan got around to it.

http://www.nwlc.org/resource/state-bans-insurance-coverage-abortion-endanger-women%E2%80%99s-health-and-take-health-benefits-awa
posted by Ardiril at 10:09 AM on December 14, 2013


Will add to the "entertainment" -we're in the process of buying insurance since our crappy existing policy doesn't meet the ACA requirements. We have a dependent daughter who doesn't live in Michigan (college student) but we'll still have to find a rider for her as well as for me and I'll be willing to bet that Blue Cross doesn't have pricing worked out for that yet - will post when we find out. I will be surprised if it's as inexpensive as cuomofied thinks but of course one doesn't dare self insure since what happens if you need an abortion and have complications? Probably not covered by regular insurance. Another nice complication - thank you Michigan republicans.

I read the bill by the way and regular insurance will cover a D & C if one's fetus has died but not an abortion if it's going to die - one has to continue the pregnancy until fetal death has occurred. It does allow coverage for ectopic pregnancies and for pregnancies which will kill a mother but not ones that will lead to bad health outcomes less than death. This kind of slice and dice coverage has all sorts of nasty ramifications beyond the simple disgustingness which is clear on the face of it.
posted by leslies at 10:12 AM on December 14, 2013


"When I slashed my hand open, I went to the hospital down the street because it was there. That's what people do."

This is a catastrophic example and would not lend itself to the question of "shopping around" that I asked, unless you truly believe that people run to the emergency room for absolutely everything. There are multiple clinics in almost any given area, so the idea that there's only one place to go for a check up or to see a podiatrist or a pediatrician is a false one unless were dealing with an extreme rural example.

In fact, this is happening now, and it is working.

"Employer-based insurance was a scheme concocted by the industry to retain control and make money."

Thanks for the boat load of links! I don't disagree with this point at all. I have been saying all along that that is the beginning of the end of the health care system in the US.
posted by cuomofied at 10:34 AM on December 14, 2013


This is a catastrophic example and would not lend itself to the question of "shopping around" that I asked,

Given that a lot of people's health care expenses happen in catastrophic circumstances, that's a pretty big problem then, isn't it?

Even in the case of "shopping around" -- I needed a sinus and temporal bone CT, which had to be done in two separate scans because of a different slice density. I asked the billing department how much they would cost, as this was in January and I hadn't hit my deductible, and she looked it up and said "$250." I winced, but this was to diagnose a pretty serious health problem, so we budgeted the $500 and I scheduled my scans.

Well, guess what! They billed me $1700 each! I said "WAIT WAIT WAIT y'all said $250!" and they said "Yeah, that's not a quote, just an estimation, that'll be $3400 please." And that was just that. What on earth should I have done differently there?
posted by KathrynT at 10:41 AM on December 14, 2013 [8 favorites]


There are multiple clinics in almost any given area, so the idea that there's only one place to go for a check up or to see a podiatrist or a pediatrician is a false one unless were dealing with an extreme rural example

Pricing is not transparent, either to the patient or even to the clerk you're calling to ask about prices. Try calling around to different facilities local to you to ask about a minor, non-emergency surgical procedure - not only will prices be all over the map, but as in KathrynT's example, what they tell you beforehand will likely be extremely different (and surprise, way more!) once the surgery is done. Is the low price you get quoted at facility A low because they're a high-volume and efficient place? Or are they going to hit you afterwards with a bunch of other charges? Is the expensive place expensive because they really have the best doctors and staff and equipment, or are they expensive because people believe they're getting better treatment and so hey, that's what the market will bear? It can't be a new idea to you that people will (irrationally, because people) pay more because they believe something is better if it costs more - and this isn't about wine or a hotel room, but your damn health. Most people don't want to go to a cut-rate place if they can possibly avoid it. You are free to think that's dumb, but pretending like that attitude doesn't exist is silly. And a single regular person is not in any position to negotiate, or to bring the market to its knees by saying "You cost too much, I ain't gonna buy."

See also this recent NYT piece about the cost of stitches.
posted by rtha at 11:37 AM on December 14, 2013 [2 favorites]


And a single regular person is not in any position to negotiate, or to bring the market to its knees by saying "You cost too much, I ain't gonna buy."

Well one person, no, but as a whole, yes, so long as we quit buying into the notion that we can't do anything about it and that the government should be allowed a monopoly over the entire industry. Then you get no accountability, no response to you or your complaints because fuck you that's why.

Also, as I had posted above, market choices can lead to a forced deflationary effect in costs to the consumer:

"As patients are demanding price-matching, some hospitals relent.

'Hospitals are having to match our prices because patients are printing their prices and holding that in one hand and holding a ticket to Oklahoma City in the other hand and asking that hospital to step up,' Dr. Smith said. 'So we’re actually causing a deflationary effect on pricing all over the United States.'"


I don't see how continually doing business as usual is expected to get us any other results.
posted by cuomofied at 11:59 AM on December 14, 2013


And sorry, my html is lacking. I'm trying by best to follow protocol in terms of layout.
posted by cuomofied at 11:59 AM on December 14, 2013


cuomofied: "This is a catastrophic example and would not lend itself to the question of "shopping around" that I asked, unless you truly believe that people run to the emergency room for absolutely everything. There are multiple clinics in almost any given area, so the idea that there's only one place to go for a check up or to see a podiatrist or a pediatrician is a false one unless were dealing with an extreme rural example."

Without looking it up, try to name five doctors within a reasonable distance from you who all accept your medical insurance who are openly competing for your business. The system is designed to minimize competition. That's because it was designed by the free market, which abhors itself and abhors competition. Every free market actor would happily eliminate every other if it had the chance - and this has happened often in history, particularly in medicine.

"Thanks for the boat load of links! I don't disagree with this point at all. I have been saying all along that that is the beginning of the end of the health care system in the US."

That wasn't my point. We agree on that, yes, but what I am pointing out is that the current system is the purest form of "market-based" medical system possible. It was engineered from the start to make as much money as possible for providers by preserving "insurance" as a "voluntary" scheme. It is bare market force at work.

It's a very good demonstration of why simple market forces don't work with medical care. There is no natural competition in the system.

"Well one person, no, but as a whole, yes, so long as we quit buying into the notion that we can't do anything about it and that the government should be allowed a monopoly over the entire industry."

We are not talking about a government monopoly on health care. Nobody supports that idea. That's the hackneyed caricature that libertarians tend to draw of national health systems, but it's not how they work.

Providers always remain independent. In the UK, for example, and in Israel, health care providers are independent. They are part of a free market that is forced by the buying power of the nation to compete for contracts. That is why national health systems tend to be cheaper - because competition drives down prices. Israel has a neat system where you choose your health provider from a short list of those who've gotten approved by the government, and competition takes place on the consumer level; the the government negotiates prices for those blocks of consumers. But whether it's done that way or the government does all negotiation on its end, we're still talking about a purer and more functional form of "free market" than the simple commodity-like system libertarians tend to imagine.

This is the thing about functional capitalism that people always miss: actors in the free market despise it and will attempt to destroy it at the first possible instance. That's what happened with health care in the 1940s - the free market managed to step in and eliminate competition in order to secure profits to themselves. The same thing happens inevitably in every industry.

Government regulation is needed to preserve (and in some cases even create) markets where free competition is actually possible. That's the point of a national health care system - not to make doctors the employees of the state (that never happens) but to force them to compete by removing the enormous monopoly-generating power that the peculiarities of medicine create.
posted by koeselitz at 12:55 PM on December 14, 2013 [6 favorites]


There are multiple clinics in almost any given area, so the idea that there's only one place to go for a check up or to see a podiatrist or a pediatrician is a false one unless were dealing with an extreme rural example.

Did you not listen *at all* to those of us providing examples of trying to do exactly this and not being able to due to willful lack of reliable information by insurance companies and billing departments?
posted by sonika at 1:10 PM on December 14, 2013 [4 favorites]


At this point Blue Cross's response upon being asked about abortion riders in Michigan was "what??? Really?? We'll have to get back to you." Just to make this more complex.

And no - clearly cuomofied hasn't listened to anyone whose knowledge doesn't match his opinion - why let data interfere with a firmly held notion? In terms of abortion providers one is generally lucky to find one option so I cannot imagine anyone in that crisis situation price shopping.
posted by leslies at 1:27 PM on December 14, 2013 [6 favorites]


"The system is designed to minimize competition. That's because it was designed by the free market, which abhors itself and abhors competition. Every free market actor would happily eliminate every other if it had the chance - and this has happened often in history, particularly in medicine."

That is so far from reality that it's near impossible to even take you seriously. Do you not see the blatant fact that the more government has gotten involved the less competition there is? It couldn't possibly be that business has used government to enact regulation that in turn keeps them them as dominant players in the market, right? You do realize that with the ACA we have even fewer options than before because of - you guessed it - more regulation and intervention? Large corporations such as the insurance companies are the ones that favor regulation because it becomes cost prohibitive for new market participants and allows them to retain their market share. Monopolies cannot exist without government first getting involved. Ever. Once that occurs it is not a free market but rather collusion by big business and government. The ACA does nothing to decrease the already oppressive hand of the insurance industry, structuring health care competition in a way which will be profitable only for the monopolies which it seeks to create while strengthening existing ones.

So no, government regulation ISN'T needed to preserve (and in some cases even create) markets where free competition is actually possible, rather it's needed to keep these unnecessary, inflationary 3rd party monstrosities forever entrenched in the business of our health care.

But hey, it's certainly a clever attempt at projection, you using the consequences of government intervention and framing it as though it were the result of the icky free market and their icky profits.

"That's what happened with health care in the 1940s - the free market managed to step in and eliminate competition in order to secure profits to themselves. The same thing happens inevitably in every industry."


And what mechanism did they use? What instrument gave them an ally who has a monopoly on force and violence? That couldn't have possibly been done by lobbying and having laws enacted that are favorable to your industry and in particular your own business, could it? Cost controls on labor are not a free market. Mandates on how you can buy coverage and from whom and what boundaries you must remain in is not a free market. Limiting choices via legislation is not a free market. These are, in fact, the antithesis of a free market and anathema to true competition. As for there being no natural competition, it's been removed and regulated out of existence.


It's like a really perverted form of Stockholm Syndrome with statists. You keep turning to the ones who made the problems to be the ones to deliver you from them. It's maddening.

"That is why national health systems tend to be cheaper"

National health systems are cheaper because they tend to cap labor expenses and and purchase in volume, along with those nations seeming to have representatives who aren't completely corrupted to the core, unlike our wonderful public servants who amend health legislation to prevent bartering on volume purchases at the behest of the insurance lobby and big pharma. That's why nobody can get a handle on the drug benefit projections with things like Medicaid Part D, for example; nobody in Congress has the stones to demand a volume discount because their funding immediately dries up.


Did you not listen *at all* to those of us providing examples of trying to do exactly this and not being able to due to willful lack of reliable information by insurance companies and billing departments?

Do you not listen *at all* to the fact that we need to demand these things as consumers? I get that we have unreliable information now. No dispute. That needs to change. It's like saying "Well, we aren't ON the moon, so we probably shouldn't try to get there". It's a defeatist mindset from the get go.

I can guarantee you that the further we embed the government into the market, the less our ability to seek redress will be. The market *has* to respond to consumer dissatisfaction, especially in the times we live in now. Little Suzie homemaker could get riled up and post a negative review of a company or facility and have it spread like wildfire, directly taking money out of that market participants pockets unless the grievance is addressed. Even then, depending on how bad the actions of a business the damage may already be done and that market share will go to other entities. A perfect example was with Abercrombie and Fitch having to directly respond to negative criticism of it's sizing. Another example of this would be Amanda Billyrock and her pissing match with PureVPN. Somebody won that battle and I'll give you a hint: it wasn't the business.

Government does not allow for this type of reactive response to demand because, unlike corporations or business, you can't defund them. When there is nowhere to turn for other options for that service we as consumers are fucked.

I certainly don't have all the answers, but I simply disagree with handing it over to the same sociopaths who destroyed the system in the first place.

Countdown to liquor day, as well as my shift, has come to an end. Til next round. Cheers.
posted by cuomofied at 8:10 PM on December 14, 2013


Do you not listen *at all* to the fact that we need to demand these things as consumers? I get that we have unreliable information now. No dispute. That needs to change. It's like saying "Well, we aren't ON the moon, so we probably shouldn't try to get there". It's a defeatist mindset from the get go.

I did say that this is bullshit and doesn't work from the point of view of the consumer (as did others), but it's obviously easier for you to just gloss over other people's responses in order to carry on your own monologue than it is to employ actual reading comprehension.
posted by sonika at 8:37 PM on December 14, 2013 [3 favorites]


I've seen this: "People cannot "shop around." You cannot have health care made cheap in China and shipped to you in North Dakota. More than any commodity, it requires an infrastructure and is deeply geographically based.

Not only this, but how much time do you have to spend shopping around? In an emergency, you quite literally have to take what is available. Level 1 trauma center in NYC might be your preference - but even if you're willing to fo
ot the bill, if you're in a car accident in Wyoming... you'll die before you could get there.

Chronic conditions it's slightly more feasible to shop around, but only barely. You still have time and distance constraints based on your illness and exactly how sick you will be if you put off the treatments you're shopping for. Brand new study in Chicago and you live in Miami? Probably not an option unless you have rather extensive financial resources and an illness that still leaves you functional enough to travel.

The system now sucks from a consumer's point of view. I wanted to get an optional prenatal test done and so I called my insurance company to find out what it bills for - being that it isn't standard, I was fully expecting to pay out of pocket if I chose to have the test, but I very much wanted to know the price BEFORE making that decision. They couldn't tell me. Not that they couldn't tell me if it was covered, they couldn't tell me the price of the test. Flat out refused. How am I supposed to shop around if the only information I get about the price point is AFTER I've received the service? In no way does a functional marketplace operate that way.

(In the end I was able to speak with the billing department at the company that provides the test. Which wasn't a big deal other than I had to know who made the test and how often do you know which 3rd party is running your lab work? A lot more grunt work than I've put into any other purchase short of buying a car.)"


And this: "There are multiple clinics in almost any given area, so the idea that there's only one place to go for a check up or to see a podiatrist or a pediatrician is a false one unless were dealing with an extreme rural example.

Did you not listen *at all* to those of us providing examples of trying to do exactly this and not being able to due to willful lack of reliable information by insurance companies and billing departments?"

So you argued a point, then somehow agreed with it by pointing out you disagreed with it, and then are mad because I addressed what appeared to be a grievance. Establish what you want, if you even know what that is, and I'll be happy to address it. But it appears that you're now flailing about because we agree? Not sure what your endgame is here.
posted by cuomofied at 8:47 PM on December 14, 2013


But it appears that you're now flailing about because we agree? Not sure what your endgame is here.

My endgame is that you keep commenting in a way that suggests that you have not actually read what anyone has written. Yes, we agree about consumers being ill served by insurance as it stands - which you didn't notice until it was pointed out to you, but could have deduced much sooner had you actually read the substance of previous comments rather than immediately casting everyone else in thread as your adversaries.
posted by sonika at 5:51 AM on December 15, 2013 [3 favorites]


The hell are you even on about? All insurance is about pooling risk

All insurance is not about pooling risk in the same way that people are asking health insurance to be about pooling risk. For example - your car insurance goes up if you've had an accident, because they judge you're more likely to have another one and they'll have to pay out more. It goes down if you're a woman, older, or married, because they assume these groups are more responsible and less likely to have accidents. Your life insurance goes up if you have certain medical conditions, and goes down if you seem in general good heath. Health insurance also used to do this to some extent - people cost more or less to insure - or would be refused service - based on their age and medical history.

But people didn't like the fact that an insurance managed their risk by adjusting prices in this way for health, so the "no change for pre-existing conditions" stuff came along. But it is worth noting that is a very new change, and has not historically been how they've done business.
posted by corb at 6:20 AM on December 15, 2013


Pricing is not transparent, either to the patient or even to the clerk you're calling to ask about prices. Try calling around to different facilities local to you to ask about a minor, non-emergency surgical procedure - not only will prices be all over the map, but as in KathrynT's example, what they tell you beforehand will likely be extremely different (and surprise, way more!) once the surgery is done.

This, however, is a real problem, and I think people should be required to give you their pricing chart up front, and be required to hold to it, just like any other contract. If there's any haggling to be done, it should take place pre-procedure, rather than after. People should not be surprised by what they have to pay - but this applies for all health insurance, not just abortion coverage.

I am, though, a little confused about abortion coverage in the first place. I've never had an abortion, but I've thrown in money to help pay for other people's abortions, and from what I recall, they live in the $500 range. It seems like the sums that are being tossed around here - like $25 monthly - are far too high - as women are unlikely to have multiple abortions close together, and within 2 years they'd have paid for one abortion. If anyone has more recent data on abortion pricing though I'd appreciate the correction.
posted by corb at 6:32 AM on December 15, 2013


corb: "But people didn't like the fact that an insurance managed their risk by adjusting prices in this way for health, so the "no change for pre-existing conditions" stuff came along. But it is worth noting that is a very new change, and has not historically been how they've done business."

It's how they've done business for a vast majority of the insured population. Less than 4% of Americans got their coverage through the individual market in 2012, with over 48% getting it through employer plans that do not exclude or increase prices based on pre-existing conditions. When you factor in the rest of the insured population in that graph (people insured through government programs, including your beloved Tricare), more than 95% of Americans today have insurance coverage that can't exclude or surcharge them based on pre-existing conditions.

corb: "the sums that are being tossed around here - like $25 monthly - are far too high"

cuomofied pulled that number directly out of his ass. The actual incidence and cost of abortion coverage would make it a rounding error for most plans, which is why the insurers have no problem bundling it unless Big Government gets in the way.
posted by tonycpsu at 8:27 AM on December 15, 2013 [1 favorite]


cuomofied: "Monopolies cannot exist without government first getting involved. Ever."

Historically, this is false. For example, silver peaked in price in the 1980s and then crashed on Silver Thursday because the Hunt family created a worldwide silver monopoly by pouring their entire fortune into buying up all the world's supplies of commodified silver. In the 1830s, the Rocky Mountain Fur Company monopolized the beaver pelt trade in the western US several times. There are other examples, but it's clear that monopolies don't only happen because of government action.
posted by koeselitz at 10:59 AM on December 15, 2013 [4 favorites]


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