|
esquilax posted:No issues with the rest of your post but the bolded portion is a poor interpretation that I hear a lot. They can't prevent employees from using "their compensation" on Plan B or any other contraceptive methods, or even an actual abortion. What they are doing is making sure it is not included in the health plan that they offer to the employee. If a company didn't cover Viagra or nose jobs under their health plan, you wouldn't say they are telling their employees how their compensation could be used, would you? Yes?
|
#
?
Mar 27, 2014 19:36
|
|
|
|
| # ? Apr 29, 2024 03:21 |
|
|
I guess that's true, but from what I understand they are trying to get around what the government has determined as the minimum requirements for a company health plan (I am probably phrasing that incorrectly or I may be wrong in which case please correct). Instead of taking the tax hit for refusing they are trying to be entirely except and since the employees are supposed to be getting that as per the government and Hobby Lobby certainly isn't going to give them a pay raise to compensate it feels to me they are having a direct hand in telling them what they should be spending their salaries on. In terms of Hobby Lobby's religious beliefs, is God going to care if they are are indirectly financing abortions through monetary payment or through payment via a health plan? The obvious goal is to make women's healthcare un-affordable to their employees in certain specific areas.
Eggplant Squire fucked around with this message at 19:42 on Mar 27, 2014 |
|
#
?
Mar 27, 2014 19:38
|
|
|
twodot posted:"You want us to cover things we don't want to cover, and if we don't, you will fine/tax us out of existence". In this case, fine/tax us out of existence actually meaning: A $2000 tax for each of their 21,000 employees, representing $42M out of their annual revenue of $2.28B, or 1.8% of revenues. Not insignificant, but probably not putting them out of business. Numbers sourced from wikipedia on their employees/revenue.
|
|
#
?
Mar 27, 2014 19:41
|
|
|
twodot posted:I'm not sure if this was your intention, but I want to note here that Hobby Lobby not providing coverage for certain contraceptives doesn't burden any third parties as far as the law is concerned. The government would be entirely ok if Hobby Lobby didn't provide for those contraceptives while paying the fine/tax, the substantial burden here isn't just "You want us to cover things we don't want to cover", but "You want us to cover things we don't want to cover, and if we don't, you will fine/tax us out of existence". Yeah, I wasn't really talking about Hobby Lobby there, just my general opinion of RFRA.
|
|
#
?
Mar 27, 2014 20:04
|
|
|
I've been reading over this set of posts by Eugene Volokh on the Hobby Lobby case and two things I've gathered (correct me if I'm wrong here: 1. The RFRA likely improves the case for Hobby Lobby (because, the argument goes, Congress could modify or exempt PPACA explicitly from RFRA exemptions and didn't and haven't and they haven't modified RFRA either). 2. In a more perfect world a single-payer system requiring employers to pay a tax into a government health system that provides these contraceptives would have a stronger case on the side of the government (because the uniformity of the tax system as a government interest is enough to override the burden on religious beliefs in the same way religious companies can't object to paying taxes because gays are in the military or pacifists can't object to taxes because they go towards creating weapons). How they decide on the question of the least burdensome method I think will be interesting. Of interest to me but not really in this case is how the question of sincerely held beliefs applies to much larger, non-family owned corporations: does the corporation need to vote to secure that status? Is a majority of shareholders filing suit enough, and what about for a minority of shareholders? For example if a minority of shareholders for Wal-Mart want the company to be exempt from providing coverage for contraceptives they view as abortifacients, and they file suit to press that what would the result be? Mo_Steel fucked around with this message at 20:29 on Mar 27, 2014 |
|
#
?
Mar 27, 2014 20:26
|
|
|
Devor posted:In this case, fine/tax us out of existence actually meaning: edit: Mo_Steel posted:2. In a more perfect world a single-payer system requiring employers to pay a tax into a government health system that provides these contraceptives would have a stronger case on the side of the government (because the uniformity of the tax system as a government interest is enough to override the burden on religious beliefs in the same way religious companies can't object to paying taxes because gays are in the military or pacifists can't object to taxes because they go towards creating weapons). twodot fucked around with this message at 20:32 on Mar 27, 2014 |
|
#
?
Mar 27, 2014 20:27
|
|
|
Implicit in that statement is a moral judgement - if you think that it's morally wrong to exclude ANY medical-related good or service from a health insurance plan then it's perfectly consistent to say that it's wrong to exclude contraception. I think that most people disagree though, and would like to draw a distinction between contraception and nose jobs. Radish posted:I guess that's true, but from what I understand they are trying to get around what the government has determined as the minimum requirements for a company health plan (I am probably phrasing that incorrectly or I may be wrong in which case please correct). Instead of taking the tax hit for refusing they are trying to be entirely except and since the employees are supposed to be getting that as per the government and Hobby Lobby certainly isn't going to give them a pay raise to compensate it feels to me they are having a direct hand in telling them what they should be spending their salaries on. Your phrasing is fine there - they are trying to get around the regulations (because they say the regs violate their religious rights). I take it that from this post that before covering contraceptives became part of the minimum requirements, you think that Hobby Lobby was not telling employees how they should be spending their money? Then after the regulations were released, even though the facts are the exact same, Hobby Lobby is now telling employees how they should be spending their money? If you agree with those and think that the government regulation causes a moral difference, then I think we just have a fundamental disagreement about the moral weight of regulations.
|
|
#
?
Mar 27, 2014 20:35
|
|
|
esquilax posted:If a company didn't cover Viagra or nose jobs under their health plan, you wouldn't say they are telling their employees how their compensation could be used, would you? Yes, I would say that. The same as if they paid their employees in Hobby Lobby gift cards instead of money, which would restrict employees' private purchases to the Jesus-approved offerings of Hobby Lobby stores. The government says "No, you can't pay people in gift cards only. You have to pay them in money and it has to be at least this much. If you want to give people gift cards in excess of that, that's fine, but there is a minimum amount of money you must pay them." The government also says "If you want to take advantage of tax deductions and avoid the ACA surcharge, you may also pay your employees in health care as long as it meets these minimum standards. You may go beyond that at your option, but you may not limit their compensation in health care to less than these minimums." Trying to weasel out of that with a religious exemption is exactly as ridiculous as trying to argue they should get to pay workers in scrip so they're not indirectly funding their workers' sinful lifestyles esquilax posted:Implicit in that statement is a moral judgement - if you think that it's morally wrong to exclude ANY medical-related good or service from a health insurance plan then it's perfectly consistent to say that it's wrong to exclude contraception. I think that most people disagree though, and would like to draw a distinction between contraception and nose jobs. Nose jobs aren't an essential health service for women, so the government doesn't mandate them and it's not immoral to deny them. Just like the justification for minimum wage doesn't mean you have to pay your workers $Infinity or you're evil, the justification for health care mandate doesn't mean you have to give them infinite health care either. Frankly, one thing that makes me uncomfortable about your argument (and about the government's defense which concedes the same point) is the assumption that all the money belongs to Hobby Lobby the Glorious Job Creator. I reject that. Compensation belongs to the employee, who receives it in exchange for work they did as a part of the value they created for the company. If Hobby Lobby gives me a paycheck that I cash and spend on Plan B, that's just as much "their money" as if they cut that check directly to the pharmacy. It all comes from the same place, and it's ridiculous that the employer's religion should have a fundamental right to trump the workers' interest. Practically that often happens because the employer has better bargaining power, so his interests tend to win out, religion or no. An employer with a religious objection to nose jobs would likely win that negotiation, but it's because he has superior bargaining power, not because his religion gives him the inalienable right to restrict nose jobs. But here, the government has passed a law saying that workers with an employer health plan have a legal right to contraception coverage. To go on and say that an employer's religious belief should trump laws that protect the workers' interests and that the employer's fairy tales give him a unilateral right to dictate the employee's health care is a terrible imposition on the religious beliefs of workers, not to mention their health and well-being. Remember, employees aren't eligible for subsidies on the exchanges if their employer offers a qualified plan. If Hobby Lobby paid people fully in money rather than partially-money and partially-health-care, then those employees could go buy their own plan that works for them. By simultaneously effectively shutting them out of affordable plans on exchanges yet also refusing to cover essential health services on their own plan, Hobby Lobby is very much using its power as the employer to control their workers' health care choices to the detriment of the worker and that's wrong. No one is forcing the Greens to take Plan B here. All the law does is prevent employers who want to put their employees on a company health plan from denying essential coverage. Edit: esquilax posted:I take it that from this post that before covering contraceptives became part of the minimum requirements, you think that Hobby Lobby was not telling employees how they should be spending their money? Then after the regulations were released, even though the facts are the exact same, Hobby Lobby is now telling employees how they should be spending their money? If you agree with those and think that the government regulation causes a moral difference, then I think we just have a fundamental disagreement about the moral weight of regulations. Hobby Lobby was telling their employees how to spend their money before the ACA, and it was just as immoral then. It just so happened to be legal and employees don't have the market power to effectively resist these tactics. Currently the law doesn't require employers to cover another essential health service: abortion. Abortion can be necessary to save the woman's life or her mental well-being (in cases of rape, for instance), and yes I do think this is employers telling workers how to spend their money because they company has made other health care options unaffordable for them, leaving them no realistic alternative but to submit to the employer's religious beliefs. For a potentially life-saving procedure like abortion, this is cruel, and I have no problem calling employers who do this immoral even though this particular immoral act happens to be legal at the moment. VitalSigns fucked around with this message at 22:51 on Mar 27, 2014 |
|
#
?
Mar 27, 2014 22:21
|
|
|
esquilax posted:Implicit in that statement is a moral judgement No there isn't
|
|
#
?
Mar 27, 2014 22:43
|
|
|
VitalSigns posted:Yes, I would say that. The same as if they paid their employees in Hobby Lobby gift cards instead of money, which would restrict employees' private purchases to the Jesus-approved offerings of Hobby Lobby stores. That question was in response to: quote:I think the more important issue is that as a corporation that shields its owners from a lot of legal issues they really have no business telling their employees how their compensation for labor should be used I'm fine with conceding either (1) or (2) depending on how we define the phrase, but not both - if giving someone gift card to Bass Pro Shop in addition to their normal pay counts as "telling someone how to use their compensation" then "telling someone how to use their compensation" isn't necessarily wrong. Therefore if we want to decide that excluding contraception from the plan is wrong, it must be wrong for other reasons than by virtue of being "telling someone how to use their compensation". You've posted many of those other reasons. It this post sounds pedantic and overly specific it's because it is. My last few posts were to rebut a specific argument, and most of your post simply adds new arguments.
|
|
#
?
Mar 27, 2014 23:53
|
|
|
esquilax posted:Which (using your analogy) would imply that giving a gift card to an employee is both "telling an employee how to use their compensation" and morally wrong. I provided the example to show that either (1) restricting a health plan isn't "telling an employee how to use their compensation" making it an incorrect characterization or (2) "telling an employee how to use their compensation" isn't wrong in and of itself, making it a useless argument. If gift cards make up such a large proportion of an employee's salary that they don't have enough left over to afford necessities on their own and have to rely on Bass-Pro-Shop-approved items, then yes it is immoral and exploitative. Scrip and company stores were outlawed for a reason. The immorality consists in the employer using his power to harm the employee. A gift card as a Christmas perk doesn't preclude the employee from buying the things she needs. Paying her largely in gift cards would. You're completely ignoring that fact that by making health care a significant portion of a worker's pay, it makes it unaffordable to buy insurance on the market with her remaining salary. And once again you're ignoring that the immorality mainly consists in the harm that's done to the employee. Denying her a nose job is not a health risk the way denying her contraceptives are, and there's no inconsistency between saying that putting up barriers to contraception is immoral esquilax posted:Therefore if we want to decide that excluding contraception from the plan is wrong, it must be wrong for other reasons than by virtue of being "telling someone how to use their compensation". You've posted many of those other reasons. I'm not arguing this, and I don't think Radish was either. I'm arguing that putting up barriers to workers' contraceptive access is wrong because that's harmful. That employers "really have no business telling their employees how their compensation for labor should be used" is an argument against the employer's claim of a religious exemption. Employers have the practical ability to control what employees do with their compensation obviously (especially in this economy where people are desperate for jobs), but they don't have an inalienable religious right to do so. An employee using her health care coverage that she is paid in exchange for the value she creates for the company is not at all the same thing as forcing the employer to buy birth control. The health care belongs to her, as payment for her work. If the company doesn't like the terms of the payment, they are free to pay their workers in money instead so they can buy their own health care. They shouldn't get to effectively exclude employees from the insurance market and then cry persecution when Congress won't let them deny essential health services to the workers left with no other option. Edit: I get that you don't think Hobby Lobby should win the case. I'm just explaining that an underlying assumption that you (and many people, including the government's advocate) make is that this is Hobby Lobby's money that they're spending and I counter that it's not, that the employee earned it and it belongs to her, and that the government is not forcing Hobby Lobby to spend its money, but merely setting the legal terms of the minimum employment compensation that she is entitled to receive. I'm sure there's probably case law that supports the view that it's Hobby Lobby's money because the courts are pretty terrible at privileging business over labor, but I think it's still worth talking about. VitalSigns fucked around with this message at 01:04 on Mar 28, 2014 |
|
#
?
Mar 28, 2014 00:44
|
|
|
VitalSigns posted:If gift cards make up such a large proportion of an employee's salary that they don't have enough left over to afford necessities on their own and have to rely on Bass-Pro-Shop-approved items, then yes it is immoral and exploitative. Scrip and company stores were outlawed for a reason. The immorality consists in the employer using his power to harm the employee. A gift card as a Christmas perk doesn't preclude the employee from buying the things she needs. Paying her largely in gift cards would. I actually agree with you on the cost point - that there is a compelling interest involved and employee interests are an important factor in what should be done in the case. I'm ignoring the cost point because it's not relevant to the discussion I was having, which was about a specific characterization. VitalSigns posted:I'm not arguing this, I don't think Radish was either VitalSigns posted:Edit: I get that you don't think Hobby Lobby should win the case. I'm just explaining that an underlying assumption that you (and many people, including the government's advocate) make is that this is Hobby Lobby's money that they're spending and I counter that it's not, that the employee earned it and it belongs to her, and that the government is not forcing Hobby Lobby to spend its money, but merely setting the legal terms of the minimum employment compensation that she is entitled to receive. I'm sure there's probably case law that supports the view that it's Hobby Lobby's money because the courts are pretty terrible at privileging business over labor, but I think it's still worth talking about. esquilax fucked around with this message at 01:14 on Mar 28, 2014 |
|
#
?
Mar 28, 2014 01:05
|
|
|
I'd go a step farther than I think you do and say that there can be no religious right to demand terms that require other people to act according to my own private religious beliefs. I also take the position that merely being involved in a commercial transaction where a third-party receives some sinful thing is not the same as being forced to violate my beliefs. How far does this proximate cause chain go anyway? The Green family never touches or sees the pills right now, their HR department just write a check to the pharmacy, same as a salary check and someone else gets the pills. Is the government forcing me to abort babies because some of my graduate school tuition goes toward the student health center where women can get murder pills? I think it's especially dangerous because the religious conservatives have been pushing to create just such a right. I mean look at Little Sisters. Obama gave them an exemption from the Act, not a single penny of theirs goes to contraceptives, and yet they're claiming that even signing a form acknowledging this fact violates their beliefs because it enables women to get birth control from a totally unrelated party. Conservatives are already trying to pass discrimination laws under the guise of Religious Liberty, and readying their case that Jesus was against unions and the minimum wage, so in VitalSign's dreamworld the court would stop this "tolerate my intolerance" poo poo right here and rule that the government isn't oppressing me when it stops me from oppressing others. But anyway, this has kind of strayed from your original disagreement with Radish, so if you want I'll shut up about my mostly uninformed opinions and let you get back to your discussion with him 
|
|
#
?
Mar 28, 2014 02:03
|
|
|
VitalSigns posted:But anyway, this has kind of strayed from your original disagreement with Radish, so if you want I'll shut up about my mostly uninformed opinions and let you get back to your discussion with him It's cool! I think you guys pretty much had basically the same debate I would have had. My stance is similar that once it becomes a third party compensation (in the form of either money, health care, etc) they are indirectly financing behavior they consider immoral so their argument that one specific type is the one they should be able to dictate the use of seems very faulty. Regardless of how Hobby Lobby operated in the past, they are making health care part of the pay for their employees and that payment should be removed from their moral stances once it leaves their hands. As you say this is another test case to see how far religious conservatives can push the law in their favor at the expense of those they oppress. It seems both of those points have been pretty hashed out and I'm obviously not a lawyer so my legal opinions are pretty worthless.
|
|
#
?
Mar 28, 2014 03:15
|
|
|
I think it would be beneficial for folks debating this to know how PBMs ( pharmaceutical benefits managers ) work. I worked for a PBM for three years. I'm not intentionally making any arguments here. Just effort posting some knowledge. Take it or leave it. Edit ( effort posting on a phone. Apologies for typos ). PBMs are organizations that allow members to purchase Rx drugs at steep discounts. Their clients are insurance companies or employers like hobby lobby - not individual people. Hobby lobby wasn't one of ours but if they are not using a PBM they are morons of the first water. Yes, they are a very large company. But my first assignment on my first month was to import half a million lives from horizon New Jersey. Kaiser had over 30 million lives on record though not all were active. Our volumes vastly outstripped hobby lobby and thus the rates we negotiated with various pharma companies could be from 40% to 90% off depending. Pbm's are finances in two ways. Firstly by an up front annual cost per life. Ours was $10 a year per life with volume discounts for folks like kaiser who brought many lives. Secondly they can dip into the spread. If I negotiate a 53% discount for orthotricyclyn and give you a 52% discount I can pocket the 1%. So volume is everything. The more patients the more drug claims the greater the discounts we can negotiate the more attractive a PBM we are and the more profit from spread. We want to cover *everything* and we want every drug the patient buys to be on the drug plan so that next year when we negotiate discounts we can maintain or increase our discount. We don't care if its necessary or elective. We don't care how much of what's left over the insurer pays. Speaking of which. A claim breaks down into three important numbers. 1 patient out of pocket ( poop ): the amount left after the discount is applied. 2 plan pay (pp): how much of that the insurer pays. 3 true out of pocket ( troop ): the remainder after discount and plan pay that the patient actually pays. So after heart surgery a $1000 drug may be $450 after discount and the pp may be 85% of poop making the troop $67.50. Or after a bout of impotence a guys Viagra might have a 60% discount and the pp is 0% so the patient pays 40%. And this is why Viagra is covered. It isn't about the insurer. The insurer, be it kaiser or hobby lobby, is a third party here. Plan pay was ***** $0 ******. The patient has paid their $10 a year to access our discounts and -by god- they get our discounts. We want them to use our discounts.. Remember. Spread and volume. If they buy their boner pills off plan we don't get spread or volume from the sale. Which is why it pisses us off royally when an insurer -always some Podunk self insuring company- calls up and demands we deny drug claims for specific drugs to their employees with the threat that if we don't they'll drop us as a PBM and find a more accommodating competitor to screw over their employees with. And yes calling this a claim is dumb because that puts people in the mind of insurance and makes you think that denying it saves money when what we actually are is a SAMs club and denying claims costs us money. But that's the terminology used in the business so bleh. Crippling our plans for their employees doesn't save them a red cent. It's still $10 per year per life. Just those lives get less for their $10 than everyone else gets. And our administrative overhead is increased because we can't just pass on our discounts to everyone but must instead keep lists of people to screw over. These employers are not content to simply set their pp to $0 like they do for other electives like rogaine etc. They insist on destroying the discounts their employees paid for and are entitled to. Now some more detail on discounts. We didn't negotiate on a drug by drug basis. That would take FOREVER. There isn't enough time in the year. We negotiated with each pharmaceutical company individually and the topics are all brand drugs, all generic drugs, and a few individual drugs that are special/new. So when determining the discount on generics the relevant data point is our total purchase the prior year of every generic that company sells. Doesn't matter what they do. Your grandma's heart medicine and my niece's birth control may both be on the same list. Which means that if my niece isn't allowed to purchase on plan then her purchase doesn't contribute to our volumes which means we can't get as good a discount on your grandma's heart medicine. Forcing people off plan thus hurts everyone else by increasing their costs. Maintenance meds like birth control are more likely to matter than rare one offs since they have high volume/margin and can contribute enough to matter. Still with me? Whew. The issue that the ACA raised is that it requires *cost effective preventatives* to be covered with $0 troop. This means the pp has to be everything left over after the PBM's discount. But hobby lobby isn't simply contesting the pp/troop split. They are trying to take away the bulk purchasing discount too. They are inserting themselves between the patient and the PBM and demanding their employees be charged market rates instead of member rates.
|
|
#
?
Mar 28, 2014 07:45
|
|
|
 Holy poo poo that's worse than I imagined. I mean, I guess I'm not surprised since the fundies are right this moment suing because they don't even want to sign a paper that a woman can use to go get treatment from someone else but goddamn. Goddamnit. So if I understand you right, employers like Hobby Lobby could just refuse to pay any portion of the discounted rate and pay $0 for birth control that way, but instead they spitefully demand you deny the claim and force the worker to forgo the discount her premiums entitle her to and pay market rates instead? Holy poo poo. Thanks for posting. VitalSigns fucked around with this message at 08:27 on Mar 28, 2014 |
|
#
?
Mar 28, 2014 08:23
|
|
|
VitalSigns posted:
The mandate requires that they cover it under the plan AND pay the entire cost, so that wouldn't avoid the legal issue.
|
|
#
?
Mar 28, 2014 13:06
|
|
|
esquilax posted:The mandate requires that they cover it under the plan AND pay the entire cost, so that wouldn't avoid the legal issue. Not the entire cost. Troop must be zero. How troop gets to zero can vary wildly. But at the end of the day PBMs don't deal with individuals ( well ok they do but when they do its something like drug card with only a 10% discount to the patient and huge spread in the PBM pocket as opposed to what corporations get where the vast majority of the discount is passed on ) so if you refuse to cover the drug entirely and force the PBM to deny it you are forcing the patient to pay not just what you aren't paying, but the discount amount too. Basically this all comes down to Medicare. Because the federal gov isn't allowed to negotiate drug rates, sticker prices are inflated to milk the government. Nobody else except the people with no insurance have to pay the bloated sticker prices or anything close to them. But hobby lobby is trying to make their female employees pay the sucker prices too.
|
|
#
?
Mar 28, 2014 15:07
|
|
|
Does Hobby Lobby not have an issue with the companies they deal with in China? China with the one child only rule, where women terminate pregnancies all the time?
|
|
#
?
Mar 28, 2014 15:12
|
|
|
piscesbobbie posted:Does Hobby Lobby not have an issue with the companies they deal with in China? China with the one child only rule, where women terminate pregnancies all the time? Their religious fervor can only be used to improve their profit margins and control lives, not hamstring their own business operation.
|
|
#
?
Mar 28, 2014 15:20
|
|
|
piscesbobbie posted:Does Hobby Lobby not have an issue with the companies they deal with in China? China with the one child only rule, where women terminate pregnancies all the time? People need to stop trying to post "gotchas" because they're all wrong. Hobby Lobby is objecting to paying for contraceptive care directly. It is not, for example, trying to prohibit its employees from taking their pay and spending it on contraceptive care. All of these "gotchas" are trivial for anyone to blow out of the water by looking at the actual facts and make Hobby Lobby's case look much stronger (because it looks like their opponents have to grasp at straws like this). This case comes down to the actual issue: if "religious freedom" should override the government's interest in regulating mandatory contraceptive care and the place where Hobby Lobby's religious freedom ends and the freedoms of their employees begin. You can't get around dealing with that issue, and it's the only issue to deal with.
|
|
#
?
Mar 28, 2014 15:28
|
|
|
VitalSigns posted:
Close ... The mandate requires their pp be high enough to reduce the troop to zero. But they ( hobby lobby ) aren't asking to just pass on their PBM discount without contributing any plan pay. They are asking that claims for things they don't like be denied. That these things not be covered at all. The PBM model is why stupid things like rogaine etc are "covered" even by crappy plans. The coverage is just access to the negotiated discount. So when I got elective LASIK surgery my super expensive eye drops were only $120 instead of around $300 because of my insurer's PBM discount. The savings wasn't coming out of the premiums or costing the insurer anything. If my employer believed glasses were God's Will and insisted that LASIK was defying god and demands that the PBM reject claims for those drops - would not have saved my insurer any money cause that $180 wasn't actually "paid" by the insurer. Them putting that on my statement is a fib to make them look like they are delivering value. If my drops were really covered and not just discounted the pp would have been 80% of the 120 and I would have paid $24. So the most hobby lobby could reasonably demand is to "cover" BC with copayment instead of with no copayment because the plan pay is the only part they actually pay. If they were demanding that then they would be more logically consistent. They are demanding a lot more than that. And since the discounts are so huge in pharma the part they have no right to take away is generally larger than their contribution. Basically they are like a pizza delivery man who thinks keeping kosher means picking the pepperoni you paid the pizza shop for off your pizza. They are an intermediary between the PBM and the patient and they are abusing this position to deny the patient something they paid for. But they are hiding this by rolling the PBM discount and the plan pay into the idea of "coverage" such that they are trying to take away both when - if their arguments weren't theocratic poo poo - the most they would have grounds to take away is the plan pay. Not the discount.
|
|
#
?
Mar 28, 2014 15:32
|
|
|
Let me see if I have this right. The employees through their plan should be able to use the bargained price that the insurance company has access to via a co-pay which would mean that Hobby Lobby does not actually "pay" for their birth control. However Hobby Lobby wants that option TOTALLY removed so that their employees now have to get the open market price which is much higher. Is that close?
|
|
#
?
Mar 28, 2014 15:40
|
|
|
McAlister, thank you for your detailed explanation of how that system works. I appreciate your explanations.
|
|
#
?
Mar 28, 2014 15:42
|
|
|
Radish posted:Let me see if I have this right. The employees through their plan should be able to use the bargained price that the insurance company has access to via a co-pay which would mean that Hobby Lobby does not actually "pay" for their birth control. However Hobby Lobby wants that option TOTALLY removed so that their employees now have to get the open market price which is much higher. No. Hobby Lobby is self-insured and required to cover contraceptive care under the contraceptive mandate so that it costs their employees nothing out of pocket. It is not an option to have employees cover the actual cost via co-pay: what he is describing is a separate issue.
|
|
#
?
Mar 28, 2014 15:45
|
|
|
Of course, the Supreme Court specifically asked them if they'd be okay with the same deal the government gave religious nonprofits or if they'd sue about that too because even acknowledging they object to contraception infringes on their beliefs if such acknowledgment helps a woman obtain Plan B anywhere else and their answer was "Oh uh I don't know we'll see." They wouldn't even agree that the remedy they are trying to claim as an alternative to prove the government has a non-infringing option to achieve the interest at stake under the RFRA is actually non-infringing. It's sophistry. Their legal argument is all about the money, but if you look at the real situation, it's not about money at all and all about the Greens getting to control the women who work for them. I agree that I'd rather the the case decided as you put it because that would protect women from sincerely conscientious employers as well as from bullshitters like Hobby Lobby, but that doesn't make the people pointing out Hobby Lobby's bullshit wrong. VitalSigns fucked around with this message at 15:48 on Mar 28, 2014 |
|
#
?
Mar 28, 2014 15:45
|
|
|
hobbesmaster posted:As I understand it they're only whining about the morning after pill. It works the same as the regular pill and in fact only works if fertilization has not occurred but Hobby Lobby says anything taken after the fact is an abortion according to their religion. Not just the "morning after pill". The claim by current pro-life evangelicals is that all non-barrier methods of contraception work by causing abortions, even IUD and birth control pills.
|
|
#
?
Mar 28, 2014 20:20
|
|
|
Wait, people are actually claiming the regular birth control pill causes abortions? Is anyone actually arguing that in Court? You might as well start calling stairs Satan's Murder Steps at that point.
VitalSigns fucked around with this message at 21:49 on Mar 28, 2014 |
|
#
?
Mar 28, 2014 20:42
|
|
|
VitalSigns posted:Wait, people are actually claiming the regular birth control pill causes abortions? Is anyone actually arguing that in Court? You might as well start calling stairs Satan's Murder Steps at that point. They have been claiming that for at least a decade as long as you characterize "fertilized egg fails to implant" as an abortion. evilweasel posted:No. Hobby Lobby is self-insured and required to cover contraceptive care under the contraceptive mandate so that it costs their employees nothing out of pocket. It is not an option to have employees cover the actual cost via co-pay: what he is describing is a separate issue. This entire thing is very confusing.
|
|
#
?
Mar 28, 2014 21:52
|
|
|
VitalSigns posted:Wait, people are actually claiming the regular birth control pill causes abortions? Is anyone actually arguing that in Court? You might as well start calling stairs Satan's Murder Steps at that point. No, the government's position is that it's irrelevant to the legal case even if true, so they've refused to argue about it.
|
|
#
?
Mar 28, 2014 22:14
|
|
|
VitalSigns posted:Wait, people are actually claiming the regular birth control pill causes abortions? Is anyone actually arguing that in Court? You might as well start calling stairs Satan's Murder Steps at that point. Possibly, but not in this case. This case concerns Plan B, Ella, and two types IUD, which the government concedes can work by preventing implantation of a fertilized egg. Thus, by stipulation the scientific/medical veracity of that claim is not an issue in the case. Moreover, even if the government didn't concede that point or if Hobby Lobby didn't want to pay for, say, Depo, it still wouldn't be an issue. What would matter would be whether the plaintiffs sincerely believed that paying for those treatments violate their religion. The government has also conceded their sincerity (barcodes and the Devil strongly suggests these people are serious). What is at issue in the case is 1a) whether Hobby Lobby can raise that religious claim on behalf of its shareholders or 1b) whether Hobby Lobby can exercise religion and thus raise that claim on its own behalf, and 2) if so, how the court should evaluate that claim. Did the RFRA restore the pre-Smith standard by balancing religious liberty with interests of third parties or whether created an entirely new standard that does not consider third party interest.
|
|
#
?
Mar 29, 2014 04:50
|
|
|
Radish posted:Let me see if I have this right. The employees through their plan should be able to use the bargained price that the insurance company has access to via a co-pay which would mean that Hobby Lobby does not actually "pay" for their birth control. However Hobby Lobby wants that option TOTALLY removed so that their employees now have to get the open market price which is much higher. Yes. So if hobby lobby wins what should happen from the PBM side is that BC would go from the covered list to the not-covered list. But all being on the not-covered list means is that when the claim hits the servers the insurers contribution is set to $0 so poop = troop. The PBM would still front load their discounts. Side note: another function of a PBM is making rebates look like discounts. Because of the language that prevents Medicare from negotiating bulk rates you can't actually sell your drugs at a discount or Medicare can say " hey! You sell it to everyone else for $x! That's the market rate! Not the sticker price!" So PBMs facilitate the rebate fiction by paying (sticker - troop) to the pharmacy then collecting the rebate from the pharmaceutical company and the plan pay from the insurer. For the insurance company the rebate functions like a discount. So everywhere I've been saying "discount" the mechanism is actually the PBM frontloading the rebate at time of sale. Anywho. What is likely to happen if they win is that the hobby lobbies of the world will continue their current practice of forcing the PBMs not to submit BC transactions in the roll up report which effectively shreds the patient's rebate check. They are, have been, and seek to continue being, thieves. I haven't seen any indication that the supremes understand how drug purchasing works in the real world so they won't catch this unless someone points it out to them. And I really want someone to do so because PBMs are giant moneyed corporate interests who want to include these transactions on the plans. Certain justices with soft spots for corporate persons would thus have a butt to kiss in this thing that isn't hobby lobby's.
|
|
#
?
Mar 29, 2014 06:01
|
|
|
KernelSlanders posted:Is there some legal basis for this argument or is this simply your opinion of how the case should be decided in some hypothetical legal system other than the one currently in place in the U.S.? I think this statement is inapposite to the Hobby Lobby case, and in fact the Supreme Court has in the past precisely avoided this line of inquiry. Religious freedom is pretty meaningless if the government can determine which of your religious beliefs are correct. One could also argue that it is factually wrong to say one will go to Hell for working on Saturday (as in Sherbert) or that school will corrupt children with worldly influences (as in Yoder). Wasn't that Perry case opinion regarding gay rights and religious supersitions dictating harm for allowing gay people to marry something along these lines, like the religious ones not being able to prove scientific basis for their hoodoo?
|
|
#
?
Mar 29, 2014 06:03
|
|
|
FAUXTON posted:Wasn't that Perry case opinion regarding gay rights and religious supersitions dictating harm for allowing gay people to marry something along these lines, like the religious ones not being able to prove scientific basis for their hoodoo? twodot fucked around with this message at 06:19 on Mar 29, 2014 |
|
#
?
Mar 29, 2014 06:17
|
|
|
evilweasel posted:No. Hobby Lobby is self-insured and required to cover contraceptive care under the contraceptive mandate so that it costs their employees nothing out of pocket. It is not an option to have employees cover the actual cost via co-pay: what he is describing is a separate issue. She. And it is an option if they win because all them winning should entitled them to do is to set their plan pay to zero. That would mean *they* aren't paying a red cent. They have no reasonable grounds to say their religion prevents the third party PBM from including the employees purchase at the third party pharmacy in the roll up report to the third party pharmaceutical company and then frontloading the negotiated rebate to the patient as effectively a discount. This transaction, literally, doesn't involve them in any way beyond the possibility of them providing plan pay to reduce the parent's troop. They could stop using a PBM if they don't like it. Course that would make their drug prices across the board skyrocket as they don't have the kind of volume we do which would be akin to paying the fine they don't want to pay.
|
|
#
?
Mar 29, 2014 06:21
|
|
|
twodot posted:At the district level, sort of. Judge Walker ruled the ban has no rational basis (or alternatively that religious belief doesn't provide a rational basis for legislation, which is well established). However, the requirement that legislation or state constitutions be rational (not based on religious reasoning), is distinct from deciding whether or not a particular religious belief is supported by evidence (edit: Nothing Walker said implies that religious beliefs like "Gay sex is a sin" are factually incorrect). After that, the courts were just saying that the plaintiffs didn't have standing to appeal the district court. So what you're saying is that despite the finding that religion is no rational basis for legislation, you're maintaining that it's OK to use religion as a basis to carve out exclusions in law for private companies because they really believe something strongly?
|
|
#
?
Mar 29, 2014 06:24
|
|
|
FAUXTON posted:So what you're saying is that despite the finding that religion is no rational basis for legislation, you're maintaining that it's OK to use religion as a basis to carve out exclusions in law for private companies because they really believe something strongly? McAlister posted:They have no reasonable grounds to say their religion prevents the third party PBM from including the employees purchase at the third party pharmacy in the roll up report to the third party pharmaceutical company and then frontloading the negotiated rebate to the patient as effectively a discount.
|
|
#
?
Mar 29, 2014 06:32
|
|
|
McAlister posted:She. I'm not getting it. Are you saying that the discounts (incl rebates) entirely offset the cost of those drugs? Or are you saying that the discounts can be allocated to those drugs specifically so that they are paying $0 in an accounting sense, so that they are only losing out on $26 million in discounts instead of paying $26 million? Or are you saying that the PBM would be taking on the cost burden for the drugs? It probably wouldn't matter to the legal issue, as they more than likely have a religious opposition to it being on the plan at all, regardless of the cost. It also doesn't solve the legal issue because it's not just drugs - IUDs also make their list and I'm 90% sure those are medical devices and would be covered through medical benefits and not a PBM.
|
|
#
?
Mar 29, 2014 09:28
|
|
|
I was cruising the Wiki on the Hobby Lobby case and ran across this gem:quote:The United States Supreme Court ruled in Employment Division v. Smith (1990) that a person may not defy neutral laws of general applicability[a] even as an expression of religious belief. "To permit this," wrote Justice Scalia, "would make the professed doctrines of religious belief superior to the law of the land, and in effect to permit every citizen to become a law unto himself." He wrote that generally applicable laws do not have to meet the standard of strict scrutiny, because such a requirement would create "a private right to ignore generally applicable laws". Strict scrutiny would require a law to be the least restrictive means of furthering a compelling government interest. The US Congress responded by passing the RFRA, requiring strict scrutiny when a neutral law of general applicability "substantially burden[s] a person’s[b] exercise of religion".[1] The Supreme Court upheld the constitutionality of the RFRA as applied to federal statutes in Gonzales v. O Centro Espirita in 2006. What Scalia's describing is exactly what RFRA did and what Hobby Lobby says they should be able to do. And I guess posters in the thread are saying Scalia's now favoring the other side of this coin (or maybe that's because these are good Christians and Smith was a peyote-smokin' Indian). So my question is how doesn't Hobby Lobby win if the court has to apply strict scrutiny RFRA-style? Do they have to apply it?
|
|
#
?
Mar 29, 2014 17:20
|
|
This poster loves police brutality, but only when its against minorities!
|
|
| # ? Apr 29, 2024 03:21 |
|
|
twodot posted:Are you asserting you are familiar with the Green's religious beliefs enough to know this is definitely not prohibited by their religion, or something else? Since they aren't stopping their employees from using their paychecks to buy contraceptives, I think it's a safe guess that the Green's only care what they do and not what others do.
|
|
#
?
Mar 29, 2014 18:09
|
|
