Sunday, March 1, 2015

Bad Faith - Flawed belief trumps good science in Hobby Lobby Case

This week, all eyes were on the US Supreme Court when it issued a landmark decision in the case of Burwell v. Hobby Lobby. A majority of justices decided that a corporation could not be forced to offer employee health insurance plans that covered contraception services that violated its owner's religious beliefs.

Bad Faith - Flawed belief trumps good science in Hobby Lobby Case

This week, all eyes were on the US Supreme Court when it issued a landmark decision in the case of Burwell v. Hobby Lobby. A majority of justices decided that a corporation could not be forced to offer employee health insurance plans that covered contraception services that violated its owner’s religious beliefs. 

The legal issues at the heart of this decision are sure to be debated for many years. While Justices Alito and Kennedy state in their majority and concurring opinions that the scope of the decision should be read narrowly, many legal experts argue this decision is a fundamental realignment of relationships amongst people, corporations and the government.

A key provision of the Affordable Care Act (aka ObamaCare) mandated that all health plans offer a basket of prevention services designed to lower overall health care spending and improve health outcomes. Independent medical experts convened by the government selected the actual covered healthcare services. These experts decided that preventing unwanted pregnancy was just as useful as diabetes and cancer screening in keeping people healthy. So, all FDA-approved contraception methods made the list.

Unfortunately, not everyone sees it the same way. Some religions oppose most forms of contraception. Others, like the Hobby Lobby’s corporate owners, object to Intrauterine Uterine Devices (IUDs) and morning-after pills (“Plan B” and Ella) because they believe these methods prevent the implantation of a fertilized egg. 

It’s very important to note that the scientific experts say these methods are not abortifacients. Abortion is just not how they work. Instead, they prevent ovulation or block fertilization.

However, the Supreme Court essentially said that the science in this case doesn’t matter. From the majority’s perspective, a strongly and consistently held belief was sufficient to trump science. 

Justice Alito, in his opinion, said, “It is not for the Court to say that the religious beliefs of the plaintiffs are mistaken or unreasonable” (emphasis added). He granted religion a huge loophole. There is no requirement for even internal consistency of the belief.

The religious plaintiffs hold the belief that abortion is a sin. Therefore, anything that is designed to cause abortion is also a sin. They believe IUDs and morning-after pills cause abortions, therefore their use is a sin. Except, the part about their causing abortion isn’t true. The Supreme Court just ruled that it doesn’t matter. 

Imagine applying this new-found legal principle in other ways. God put us on the Earth to tend his creation. God is perfect and he would never let us do anything that would damage his creation. Humans can’t be causing climate change because global warming is part of God’s plan. Therefore, following regulations mandating my power plant lower CO2 emissions would make me deny my faith. In this case, I have to assume the Supreme Court (or at least four of its justices) would have my back—if I truly believed it.

Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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