Friday, February 25, 2011

Conscience Clauses

Conscience Protections

Last Friday the Obama Administration, through Health and Human Services, eliminated important conscience protection laws that provided healthcare workers with protection from employment discrimination if they chose not to dispense or prescribe for abortion drugs or contraceptives. This sudden change is a dangerous step towards outright religious discrimination in this country, and comes from an administration that fights religious viewpoints and Americans ability to express them at every turn.

I thought a lot about conscience protection clauses since hearing the news. It's a complicated piece of work, and in short I think the courts should enforce religious freedom as defined in the constitution - that government can't legislate religion.

But just to mention the complexity, think of a few examples where religious freedom is NOT protected.

The movie Sergeant York is based on a real-life man who wishes to sit out of World War I because he has read the Bible and found it to say that "killin'" is wrong. After a review of his case, he is told to fight anyway, and he goes on to be a war hero as he uses his sharp shooting skills to save his platoon. One reason that York's case is rejected, I believe, is that thousands - millions even - of other Christians have read the same Bible and still engaged in killin'.

This is a kink in conscience protection clauses. For instance, if York had been a member of a notably pacifist church like the Quakers, would his case have been accepted? His story shows the importance of courts deciding cases rather than laws legislating. If the answer to my last question was "yes," then draft-dodgers could say they had joined the Quaker church. On the other hand, if it is "no" then it opens up the door for Quakers to be drafted into armed service. A court is able to look at individual circumstances and try and judge the heart of the person who is conscientiously objecting.

In the terms of a Health Care worker, would a Protestant refusing to dispense birth control be afforded the same protections as a Catholic? I am not aware of any Protestant churches that have an official stance against birth control. The new law protects mainstream Protestants, most of whom object to abortion but not to birth control. Frankly, the legislation is a major blow to Catholics and Mormons who wish to work in the health care field, as they are the only organized religions I am aware of who have moral objections to birth control.

Another question is the extremity to which the religious views interfere with the job. A muslim who has to pray five times a day may not be able to carry out a job that requires continual alertness, such as being a policeman (remember the scene in Robin Hood where Robin Hood was being attacked while his friend prayed?) or an air traffic controller (although breaks could be scheduled with due replacements during these times) or even a surgeon (I have heard of surgeries taking hours upon hours). But when reasonable, these requests should be accomodated.

When I worked in public accounting, religion was interesting. At training we had Mormons - who cannot work Sunday and Hasidic Jews. The Jews could not work Saturdays, and could not engage in the training that was scheduled for that day. They were accomodated. Both groups - the Mormons and Jews - could not work one day a week in an industry that required 6 - 7 day weeks. I always wondered about it. They were not officially discriminated against, but in a way, they could have been. My teams always chose to work Saturday and take Sunday off. If there was only one Jew on the team, what would have happened? The Jew could have been isolated by his choice to work Sunday instead. Further, during intensely busy times, the firm would have to honor the religious person's need to have a day off, but resentment would be created among the team. Work would not get done. Deadlines may even not get met. There is no way the company could fire these people for their religious beliefs, but I also do not doubt that these traditions put a strain on both the religious people involved as well as their managers.

More hypotheticals: Let's say I was asked to audit a company that performs embryonic stem cell research. Our office actually had a client like this. I would conscientiously sit out. I don't think my firm could punish me for that. On the other hand, if I were to have interviewed with a smaller accounting firm who told me, "We do work with primarily two clients - Planned Parenthood and an embryonic stem cell research lab. The rest of our clients are small. Most people end up on one of the large clients." If I took the job and then insisted on having only the smaller clients, it would be difficult to believe I actually had a religious problem with the clients, and my client preferences would get in the way of my job.

I mention this because the protections for health care providers can be seen in a similar way. If a person works for an OBGYN and refuses to dispense birth control (provided that the OBGYN is not a private, pro-life doctor's office), this objection would get in the way of the health care worker performing his job - so much birth control is dispensed in these settings. On the other hand, it is unreasonable of the government to make everyone dispense birth control, even if the person involved works in a family practice setting or hospital, where he can reasonably carry out the rest of his duties without performing this one act.

And that becomes the heart of the matter. What the administration has done is effectively limited the Health Care field to a certain set of religious beliefs, excluding Catholics and Mormons. I already know of Catholics who aspired to be doctors, nurses, or pharmacists but were pushed back because of the connections of the health industry to abortion. Some objected to taking vaccines required to work in hospitals because the vaccines were created using research on aborted babies. Others knew that working in pharmacies would require them to dispense birth control and other abortifaceants, which went against their moral beliefs. And if these aspiring doctors make it to their rotations, even if their eventual field of study is not OBGYN, they still may be asked to work in a Women's Health Clinic or public hospital where their morals will be challenged.

And in my opinion, it goes directly against the Constitution for the Federal Government to deny an entire career field to a group of people because of their religious belief.

Another hypothetical example: A fundamentalist Christian becomes a science teacher. She does not believe in evolution and refuses to teach it. However, she is able to teach most other sciences and a large portion of biology without broaching the subject. Some may say she should not have chosen to go into science. Others may say she should not have chosen to teach. I think that she should be able to do both if they are her passions. Schools can reasonably work around this. She can just not teach it and fill in holes where relevant. She can be assigned Chemistry and Phsyics classes. She can have another teacher substitute (although everyone knows the kids will still be taught evolution). But if it goes against her beliefs to teach it, she should not have to.

In the same way, I think doctors, nurses, and pharmacists should be able to not prescribe or dispense birth control if it goes against their beliefs. They should not be fired if they refuse to prescribe it. They should not be passed over for a job if they refused to dispense it.

What a dangerous precedent to set - the Federal Government mandating which religious beliefs are valid enough to protect and which are not considered legitimate. It is my hope that Congress can overturn the ruling with stricter legislation, or perhaps that the courts will, as I know that many health workers will begin to litigate if they are fired as a result of this act. However, I fear more for the next generation - the health care workers that will not enter the field - that are already not entering the field - because of this blatant religious discrimination by the U.S. Government.

Land of the free, home of the brave. The administration should be ashamed of itself!

Thursday, February 24, 2011

I'm Halfway There

I'm halfway there, and if that counts as compromise, then I am going to call it that.

With the national deficit skyrocketing, the debt going only up, not down, and statistics saying that soon 40% of all federal spending will just be to pay interest on the debt, I am ready for a change. And I think most Americans are. But most aren't ready for what that looks like.

The ever-present debate has two sides - do you lower spending or raise taxes (or both) and which bad option appears good in a recession? I have always, ALWAYS, been anti-spending, whether in a recession or not, whether we had a "balanced budget" or not. But what about raising taxes?

Let's look at the other side. Barack Obama wants to raise taxes. He does - anyone who listens to him talk can tell. First of all, he campaigned on not raising taxes on people making less than $250,000. However, when he had to sign the extension of the Bush tax rates in 2010, suddenly his promise not to raise taxes on the middle class changed into a (now-broken) promise to RAISE taxes on those making more than $250,000 a year.

Now, if he were wanting to raise taxes to help cut the deficit, I would maybe be a little more understanding. But instead we see a habit in this president of outrageous out of control spending. In addition, he has already come out as critical of Republicans in Congress who wish to cut a lot of domestic spending programs (option 1 above). What he says is that these cuts are a drop in the bucket. But so are taxes raised on the upper-class. So if deficit reduction is his goal with the proposed tax increases, he should be willing to work with the spending cuts the Republicans propose - perhaps they can both get their way if they work together.

But I said I'm halfway there. The reason is, while I support deep spending cuts and generally am opposed to any tax increase, I might be willing to see a combination used to help bring down the deficit, if done right.

First of all, straight tax increases - increasing the rate of tax charged on a given bracket for instance - chill my bones. The rates don't ever seem to go down, and the numbers just depress you. The more you make, the more you pay, and innovation and hard work are repressed. On the other hand, the tax code is incredibly large because of all the deductions (also known as "loopholes") that are offered.

As an accountant, and having been through Tax Indoctrination Class (also known as Income Tax I) in college, I am less opposed to the complexity of the tax code as I would normally be. Much of what is in the tax code is meant to drive social and economic behavior. As someone who doesn't think government should interfere much in life, I can't say I support the tax code being this way. However, it is "closer" to a free-market system than just implementing demands. For instance, isn't it much better to have the government pay you $1,500 if you install an energy efficient appliance than for them to come knocking on your door and say, "We're here to install your new energy appliance. We'll be done in about four hours."

If we were to raise taxes (while reducing spending) one way would be to simply flat line the tax code. I support a "fair" and a "flat" tax, but what I am saying is simply keep the bracket system we have and erase deductions. Some deductions like mortgage interest payments may be hard to get rid of, but the great thing about getting rid of it is that someone else will have to get rid of something they don't want. When everybody hates the idea, it may be close to being a good compromise. (The only deduction I would not get rid of would be charitable contributions - that is because charity and government overlap in so many areas, if you get rid of this deduction, government may need to step in to take over lost charity revenue, which would be counter productive).

Also I think that everyone should have a share in the tax system. That means, heinous as it sounds, I would raise taxes on the lowest income people. Not much. I think if people paid a minimum of 1% income taxes - no matter how little they made - then they would have a more vested interest in where the government spends its money. Cutting social programs would be easier if everyone involved was saying, "My money goes to WHAT?" As it is, almost half of Americans do not pay any income tax.

Late in 2010 Obama had a team come up with ideas to cut the deficit. In my opinion, their ideas were good, and I would be willing to accept some of the proposed tax increases (they suggested getting rid of some tax deductions as well) if they implemented the proposed spending cuts. But realistically, their ideas were too little, too late. The president is right in one regard - spending cuts make up such a small portion of the deficit. Any real reform has to come from social security and medicare.

I think our generation is ready for that. I have been ready since I was eight. George W. Bush tried to get us ready. But I really do think that when we are paying to support retirees who got us in to this mess and never saved a dime for retirement, and our taxes start to go up to make up for the smaller generation, then we will really start to panick.

The deficit commission had ideas that I think should be implemented, and even more dramatically. Namely, raising the retirement age. Social Security was implemented back when most people died soon after retirement. Now people are healthy and able to work when they are in their late sixties. I think the retirement age should be raised one year every five years. That allows people to actually reach retirement but helps stave off our national debt problem. I think people in my generation understand that they would rather retire as old as 72 than to pay 14% of all their income and never get that money back.

The point is, I'm to the point that I'm willing to compromise and accept a little bit of both: spending cuts and tax increases to help the deficit go down. And if I'm halfway there, that means a lot more people are there because I'm not exactly what you would call a moderate. Also, if I can come up with ways to decrease the deficit, certainly people in Washington can do it.

Wednesday, February 2, 2011

On Reading Decision Points - Medicare Part D

I was working in a pharmacy when Medicare Part D took effect - it was interesting trying to get seniors to sign up and to understand what was going on. My generation's frustration with seniors who refuse to learn how to use the internet came to the surface as I imagined all the grannies and grandpas tying up phone lines while they were explained things that could easily be learned in a quick internet search (my general philosophy is that if I can't find it on the internet, it's not worth doing).

I remember being frustrated with seniors who entered the "donut hole" and then complained about it. They were getting their drugs covered, which was new to them, so they should take what they can get! I get very short-tempered when Medicare and Social Security issues hit the news because I know my generation is paying for it all but will probably never see any benefits of it.

So, yeah, a $400 billion expansion of a hated entitlement made my blood boil, especially as it was implemented under my favorite president. But after reading his side of the story in Decision Points, I have to give him a little more credit.

One purpose of the program was actually to save money. As he said in his book, at the time Medicare would not cover preventative drugs but would cover expensive surgeries after a problem had occurred. In other words, why not cover the blood pressure medicine to avoid paying for the heart attack. The logic is sound, and if it had saved Medicare money, I would have been all for that.

In addition, many problems I had with the program were the result of Democrat interference and "bipartisan" compromise. I understand that sometimes compromises are needed to get things done in Washington, and that they are a way to keep the minority party represented. However, in my experience compromise means "expensive" as interest add on and on to a bill. I would have preferred that the president pull out of the bill if it ended up costing ANY money instead of saving money in the long run on preventative care.

Still, I am glad that, having read his thought process, I now understand where he was coming from. One of the biggest disappointments coming from this president turned out to have been a reasonable idea after all.

Tuesday, February 1, 2011

On Reading Decision Points - No Child Left Behind

I'm not going to lie, I was never opposed to No Child Left Behind, no matter how many teachers of friends of teachers I heard complain about it. Even when taking some of the qualifying tests myself, I didn't resent the legislation. One reason that I accepted the great "unfunded mandate" was because the "unfunded" part spoke to me more than the "mandate" part. The other reason was that I was recently out of the public school system when it became news and knew first hand its limitations.

Of course, one major limitation in the form of the teachers' unions has become clear to a majority of people in this economy. Teachers constantly demand more funding with less results, when, as a student, it was clear that some teachers just weren't effective but retained their jobs due to strict union rules.

In his book, president Bush reminds his readers of something I never forgot and never understood when No Child Left Behind was criticized. The program was implemented in Texas before it was signed nationally, and it was a huge success. Now, if congress changed some of the ins and outs, that is one thing. Also, any time a larger government like the federal government intervenes in a smaller government, like a city or state, there are bound to be beaurocratic nightmares. That's why I don't generally like government involvement.

Another issue that people brought up with the program, Bush also addresses. It was the idea that teachers spent all their time "teaching to the test." The test was a comprehension exam of the basic skills our children should know before going on to the next grade. So if you teach these skills, then what is the problem?

Frankly, I think that the people who set the standards add a lot of fluff. I know I experienced a lot of nothingness when I went through school. We learned all about endangered pandas and the environment, and yet when we read aloud in groups it was excruciating listening to other kids stumble through basic books.

If students, and therefore teachers, are tested on basic reading and math skills, then that is what students will learn. I don't see a problem with that.

I read about president Obama's new education initiatives and, based on the limited knowledge I have of it, I don't have a problem with it. But I was very disappointed to hear that No Child Left Behind is about to be left behind. In my opinion, it was a well-thought out program that seemed to be working, as long as other kinks in the system were worked through.

On a similar note, in the current education debate I learned something I had not before thought of. The way the education system is set up - in the suburbs - allows high achievers to, well, achieve. But average students do not fly as much. I'm not sure what the solution to the disparity is. I know that in European countries, where education is much better overall, kids are given aptitude tests going into 8th grade or so. That determines where they go to secondary school, which means their curriculum is tailored to their means.

In America we do not do such testing because we don't want to hurt any child's feelings by sending him to a school that doesn't prepare him for college. But at the same time, so many students either drop out or don't to go college when, instead, they could go to a trade school and make a decent living without the debt of college.

A real drawback to this system is that the state determines a child's potential. But at the same time, right now all children are falling behind.

In my suburbian school, I had several GREAT teachers and, although I was not often challenged by my classes, I thoroughly enjoyed the learning process. It pains me to hear of the sad state that the majority of American schools are in, but I know that there are shining star teachers out there who can teach to the level our kids deserve. And I don't think we need to throw tons of money into the system to get these results. I think No Child Left Behind was a great step in the right direction, and I just hope we're not stepping backwards now.