Obama and contraceptive insurance coverage

I don’t usually opine on politics (as opposed to policy) but this episode looks to me like one of the deepest moves I’ve seen since I paid tuition playing high-low seven-card stud, to a guy who called a stone low hand for three rounds and maxed it into my 8-high face cards when he was hit by a king.  Of course it could be a big mistake, escaped with dumb luck; Mark has noted both Obama’s incredible streak of luck as a politician, and Napoleon’s observation that an officer’s reputation for luck is a good reason for rapid promotion.

What it looked like to me was, step one:  laying out a red carpet for Republican base trolls to line up on, singing in unison about the war on religion.  After they got lined up and vocal about it, step two, he genially and calmly revised the policy to meet church hierarchy conditions, otherwise known as picking up a corner of the rug to allow a nice firm grip and handing it to the bishops.   Step three, the bishops [so far appear to have] accepted their victory,  yanking the rug out from under the tinpot theologians yakketing about the original policy, all of whom are now sitting on their rear ends or piled in a heap, trying to figure out why they are looking like clowns again.

The guy who cleaned my clock with his bike had an inept, vaguely clueless manner at the card table.  Perhaps he just got lucky; he did have a very good evening, as I recall. Three or four really good hands he happened to manage in a way that paid off big time.

Author: Michael O'Hare

Professor of Public Policy at the Goldman School of Public Policy, University of California, Berkeley, Michael O'Hare was raised in New York City and trained at Harvard as an architect and structural engineer. Diverted from an honest career designing buildings by the offer of a job in which he could think about anything he wanted to and spend his time with very smart and curious young people, he fell among economists and such like, and continues to benefit from their generosity with on-the-job social science training. He has followed the process and principles of design into "nonphysical environments" such as production processes in organizations, regulation, and information management and published a variety of research in environmental policy, government policy towards the arts, and management, with special interests in energy, facility siting, information and perceptions in public choice and work environments, and policy design. His current research is focused on transportation biofuels and their effects on global land use, food security, and international trade; regulatory policy in the face of scientific uncertainty; and, after a three-decade hiatus, on NIMBY conflicts afflicting high speed rail right-of-way and nuclear waste disposal sites. He is also a regular writer on pedagogy, especially teaching in professional education, and co-edited the "Curriculum and Case Notes" section of the Journal of Policy Analysis and Management. Between faculty appointments at the MIT Department of Urban Studies and Planning and the John F. Kennedy School of Government at Harvard, he was director of policy analysis at the Massachusetts Executive Office of Environmental Affairs. He has had visiting appointments at Università Bocconi in Milan and the National University of Singapore and teaches regularly in the Goldman School's executive (mid-career) programs. At GSPP, O'Hare has taught a studio course in Program and Policy Design, Arts and Cultural Policy, Public Management, the pedagogy course for graduate student instructors, Quantitative Methods, Environmental Policy, and the introduction to public policy for its undergraduate minor, which he supervises. Generally, he considers himself the school's resident expert in any subject in which there is no such thing as real expertise (a recent project concerned the governance and design of California county fairs), but is secure in the distinction of being the only faculty member with a metal lathe in his basement and a 4×5 Ebony view camera. At the moment, he would rather be making something with his hands than writing this blurb.

24 thoughts on “Obama and contraceptive insurance coverage”

  1. Actually, one thing that this episode has proved–well, two things, really–is that Obama is very poor on framing the message, but very good at boxing the opponent in the corner. The solution is masterful in that it removes the objection from everyone except the die-hard crazies who would not accept any resolution short of completely scrapping the requirement for everyone (a la the Rubio bill). But the messaging was pathetic–not only was it not framed as “whose choice”, as JZ pointed out yesterday, but the reality of the situation has been missing completely from the debate. The rule has been in place since 2000 with absolutely no vocal objections from Catholic employers. What’s new is not the required coverage but the removal of copayment. So the only change is a tweak in the policy that makes access to contraceptive completely free. Why this was supposed to have been a big deal is entirely unclear. The proposed resolution actually IS a major policy change in that the coverage responsibility moves from employer (who already had it for over a decade) to insurer (who will just pass the costs to the employer anyway). So the question to Obama people should be, why could you not make this clear to begin with??

    1. Insurance is about spreading risk. Covering contraception is a whole lot cheaper than covering prenatal care, childbirth and the child’s medical care. That, and being able to bishop-slap the busybodies in the pointy hats (most of whose parishioners use birth control, anyway) makes this

    2. Sorry for hitting submit too quickly. This is a win for everyone except the President’s Republican critics (who have been exposed as in thrall to the anti-birth control crown) and the Roman Chickenhawk Church.

    3. is that Obama is very poor on framing the message, but very good at boxing the opponent in the corner.

      I also think that the message should have been framed differently for the independent voters. Obama is playing politics for the American people as well (not just rich people inside the beltway and elsewhere). If you want motivated independent voters to turn out for you (or against the clown show) you may want to explain what you just did. To me it is simply too easy for the GOP to spin this. I’m willing to be wrong but the messaging was insufficient in my view.

        1. Yes, I caught it last night on PBS, much too wordy. It was clear there was no Press Advisory sent to the major networks because a hash was made of the “analysis” and there was no consistent statement of what the intent was, nor a statement about what the “accomodation” was, nothing. The GOP doesn’t pass gas without a memo explaining the decibels and intent and how the noise should be described. If they want to smack down the culture wars and silence the culture warriors then they should make it clear what they did.

    4. Does covering contraception actually cost anything?

      How many months of birth control pills does the cost of one pregnancy and childbirth pay for? How about something like a premature birth or other problem?

      1. The consensus seems to be that covering contraception saves money. I recall one person claiming a study said it saved something like three dollars for every dollar spent, but if they even linked the study in question I certainly don’t recall it.

        Of course, some of this will depend on demographics. The people most likely to have good insurance coverage – middle class people – are most likely to pay for their own birth control if their insurer doesn’t, making it a win-win for the insurance company’s bottom line even though as much if not more is thereby spent on health care (more because the insurers often negotiate prescription prices down). The people most likely to forego contraception they desire and to incur greater health care expenses are the more vulnerable people – those pushing mops at a Catholic Church operated hospital, school, or food bank for example.

      2. For what it’s worth, the cost of a single, complication-free delivery (for you and the baby combined) starts somewhere north of $10k. C-sections, complications, twin births, etc. add to that.

        Note that this is for the delivery alone and does not include pre- or postnatal care.

        For comparison, that’s some three decades worth of oral contraceptives (assuming you use generics, brand name stuff is a bit more expensive).

        I’ve also sometimes wondered how many uninsured women have an abortion annually even though they’d love to have children, simply because they cannot afford to pay for a delivery (a first trimester abortion generally costs a few hundred dollars, often less than the copay for a delivery even if you are insured).

        1. I’ve also sometimes wondered how many uninsured women have an abortion annually even though they’d love to have children, simply because they cannot afford to pay for a delivery (a first trimester abortion generally costs a few hundred dollars, often less than the copay for a delivery even if you are insured).

          When I ask pro-lifers about signing up on a list to take the unwanted child, they are all on board.

          When I ask them to carry all the costs of their belief that they can forceg the mother to carry the zygote to term, I get all kinds of sputtering and harrumphing.

          So I think we all know the answer, and there is more than a grain of truth to the italicized.

  2. Shadowfox, because the simple approach doesn’t have the option of letting out the string on the religious radicals?

  3. A London friend now retired from the City told me that the favoured style is still to come across as a nice bumbling amateur. It’s extremely effective if you aren’t. Americans favour confidence and bombast; disastrous if the hat has no cattle.

  4. Ugh, Michael…hate to say this, but it would appear that guy also had a “stone cold low hand” for the first 3 rounds also. Either I’m missing something, or you left something out.

    1. exactly. but he did a good job helping me believe he was failing to improve high hole cards with disappointing low draws and wasn’t even playing against me.

  5. That may work for hyper-aware political blog junkies, but unfortunately hasn’t and isn’t going to translate into the traditional media or the mainstream thought production. Translation: it looks like Obama blinked under hard right pressure again.

    Cranky

    1. To whom? It’s not much in the way of data, but I’m seeing a lot of anecdotes of exactly the opposite happening.

      1. and the bishops seem to be responding as if obama pissed on their feet and told them it was raining. it’s hard to call it a cave to right-wing pressure if the right acts as if you’re hurting their feelings.

        1. Yes, and if he openly, obviously punked them, he’d be called out for ‘partisanship’ and ‘extremism.’ Instead, he looks like the Great Compromiser, gets the results of a grand master, and lets the reactionary right fall on their own extremist sword.

    2. Not to women. Obama got you your birth control for free vs. Romney want you to pay for it (and Santorum wants you not to have birth control). Which do you think women prefer?

      It amazes me how the MSM has so many men talking about this issue. And so many of them just have no clue.

      1. If you can’t trust a theoretically bipartisan panel of old rich white male Catholic pundits (cf Mark Shields) when they defend the position of a bunch of powerful old white male celibate Bishops regarding contraception, whom can you trust?

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