Thoughts about Sebelius address Georgetown graduates

In a few hours, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius will address a keynote speech to graduates at Georgetown University.  This is a controversial appearance.  One provision of the health of the Health Reform (i.e., the ACA) mandates that employer cover contraception coverage.  Although Georgetown University has agreed to provide these benefits, other religious institutions (e.g., Catholic hospitals) argue that this mandate impinges on their religious freedom.

Should the government mandate coverage of contraception?  Today, the Healthcare Economist provides multiple views.

Those who support the contraception coverage mandate.  Why should your job determine your health benefits?  Shouldn’t all individuals have access to a minimum level of healthcare regardless of their employer.  Although Catholic hospitals have argued that mandating contraception coverage impinges on their religious freedom, but not covering contraception the religious views of the employer are hoisted on their employees.

Those who do not support the contraception coverage mandate.  Why should the government tell employers what services to cover?  Even more importantly, why should the government tell employers to covers services against which the employer has religious objections.  Of course, it may seem ‘unfair’ that employees who want to use contraception do not receive coverage.  However, these employees are free to work for other firms.  Further, these employees are not barred from purchasing the contraception.

The policy wonk.  This argument can also be seen as a part of a larger debate about mandated benefits.  Mandated benefits may improve outcomes by facilitating access to care. Further, it may help consumers compare health plans since all plans would be required to offer a minimum benefit level.  The key drawback of having a minimum benefits package is the expense.  Covering more service is expensive. It is not only expensive to provide the services, but is also administratively expensive.  For instance, if the government mandates coverage for cancer treatment, a plan must specify which specific types cancer drugs and procedures are covered.  Over time, provider special interest interest group will lobby to have their (profitable) services included in the mandated benefits package.  Thus, although mandated benefits may improve access to care in the short-run, in the long-run it will be difficult to maintain a mandated benefit package that does not lead to significant increased growth rates in health care costs.


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