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Discusses Women's Health

I was elated to see the very thoughtful editorial in the January 2 issue of The New England Journal of Medicine. Like many of you, I have relied on the news to get information about the cases being brought to the Supreme Court in which for-profit corporations argue that their “religious rights” are being infringed upon if they are required to provide coverage for contraceptive services to their employees. And I wondered how a for-profit corporation could have religious rights…

In this issue, the entire editorial group of the most prestigious medical journal in the US (and perhaps the world) asked the same question and then give their informed opinion… In the first of the two cases to be argued in March 2014 (Sibelius, the United States Secretary of Health and Human Services versus Hobby Lobby Stores, Inc.) the court is asked to consider whether contraceptive services meet a compelling public health need. The editors as well as the Institute of Medicine proclaim it does. They site the numerous studies that demonstrate that prescribed contraceptive services prevent unintended pregnancies, more than half of which are currently terminated. Although it seems obvious, planned pregnancies give women and their children a better quality of life; younger women have the opportunity to complete school, start careers and establish stable relationships. Ultimately a full panel of contraceptive services saves money for every state and the country. The editors go on to say that “In working with women to prevent unwanted pregnancy, physicians need the full panel of FDA approved contraceptive methods. If that panel is limited by a woman’s inability to pay – if the method deemed optimal for her is unavailable because her health insurance does not cover it – then the religious freedom of her employer will have interfered with the provision of high-quality medical care to her… After all it is the woman, not her employer whose health is at risk.”

A second case that will be brought to the court argues that contraception services insurance should be excluded by health insurance from “religiously concerned” for-profit corporations. The case is titled Conestoga Wood Specialties Corp. versus Sibelius. That corporation “feels” it is unacceptable to provide contraception because of its religious beliefs. The editors of the New England Journal of Medicine point out that this is absurd and give examples to bolster the absurdity. They ask, would it be acceptable if an employer who was opposed to blood transfusions offered employees a health insurance policy that did not cover transfusions, or if they did not believe in vaccination, not cover vaccination, or deny mental health services or cancer chemotherapy? Obviously if the employee does not want to receive covered services she’s free to make that choice for herself. They go on to write that “the arguments of Conestoga puts the religious beliefs of an inanimate corporation ahead of the primary health needs of its employees.”

Their final editorial statement is so eloquent that again I have to quote: “To deny coverage for these vital public health services to women who want them but cannot afford them outside their employer-sponsored insurance would be a personal and public health tragedy.”

I certainly hope the justices of the Supreme Court who will be deciding these cases read the New England Journal of Medicine.

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