Wednesday, August 3, 2011

Private behavior has a public cost: We all will spend more


Cigarette smokers have taught us that private behavior has a great public cost. Governments have no problem imputing large taxes on smokers and shaming them through tax-supported public service announcements. When it comes to smoking, we get it. But, when it comes to sex, not so much.


“Don’t impose your morals on me,” is the common cry of not just libertines, but all of us. The idea here is that private behavior is private and, as long as it does not affect others, people should be left to their own wills. This worked well when society expected people to exercise personal restraint. It was enough that public consensus kept people in line; few government sanctions were necessary. Healthcare reform, however, is exposing flaws in that argument as it applies today.


The Federal Secretary of Health and Human Services, under the authority granted by the Affordable Care Act of 2010 (ACA), recently issued eight mandates on private health insurance. The Secretary’s order means that in the future, health insurance must pay 100 percent of the cost of preventive care for these eight mandated categories. At least five of these mandates are directly related to sexual promiscuity. We will all pay the cost in higher insurance premiums.

Specifically, the new Federal guidelines require that all Health Insurance policies must cover preventive care for these five behavior-oriented conditions:   
  • Human papillomavirus (HPV) DNA testing for women 30 years and older;
  •  Sexually-transmitted infection counseling;          
  • Human immunodeficiency virus (HIV) screening and counseling;  
  • FDA-approved contraception methods and contraceptive counseling; 
  •  Domestic violence screening and counseling.

Before moving on, read the list again. It is true, of course, that even the most careful, pious person or monogamous married couple could conceivably suffer from one or more of these conditions: but the incidence of such is certainly low enough not to allow a federal official to order preventive healthcare payments for medical tests related to these behaviors.
HPV, STDs, and HIV, for the most part, are diseases resulting from promiscuous sexual behavior. American society has, for the most part, considered medicinal contraception acceptable, although tens of millions reject it on religious grounds. No one that I know of considers domestic violence acceptable behavior; about this, society continues to impose moral and legal strictures.
Physicians are expected to withhold moral judgment while deciding whether to treat an individual. No matter the cause, a hurting or ill person needs medical attention. The man infected with HIV or AIDS should get medical care. The woman suffering from STDs or cervical cancer should get medical care. Despite potential medical, emotional, and psychological dangers, we do not withhold medicinal contraceptives from single or married women who desire to prevent pregnancy. We tolerate cohabitating partners as a price we pay to keep government out of private lives (and we celebrate it in our popular culture). These all come with a price tag, and now, the Secretary has increased it for everyone.
You see, there really is a financial cost to all of us for not embracing the “old” morality, the morality that reserved sexual intimacy for marriage between a man and woman. We have fallen so far from this higher moral standard that today, a Federal official orders that everyone must pay more just to screen for diseases that naturally follow promiscuous behavior.
“We cannot put enough policemen on the street if there is no policeman in the heart,” to paraphrase Alan Keyes, who has sent this on numerous occasions. Public morality flows from private morality, and a lack of it costs all of us.
We do not want government to impose morals on us, but we should not want government to order us to pay for the results of immorality.

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