- - Friday, January 4, 2013


The Green family, owners of the craft goods store Hobby Lobby, has taken a courageous stand for religious freedom and for life by defying the Obamacare mandate requiring employers to provide coverage for their employees’ emergency contraceptives, which violate their religious views on abortion. Why is our entire nation not reeling from shock over this administration’s tyrannical action? How shall we characterize a government that would severely punish people for living by their conscience and refusing to participate in an act they — along with millions, perhaps even a majority, of Americans — regard as evil?

The next question is why would conscientious believers support such a government by paying an enormous fine, if they could legally avoid it?

Why don’t they simply stop buying health insurance for their employees? For a company with 13,000 employees, a fine (excuse me, Chief Justice John Roberts, a tax) of $3,000 per employee would cost only $39 million per year, or a little more than $106,000 per day, not $1.3 million per day. If the company spends $10,000 or more per year per employee for insurance, it would save $7,000 each by paying the fine instead. Many employees would probably be delighted to have even part of the difference in their paychecks, although it would be taxable.

The company should also investigate whether the fine-penalty-tax is applied to individuals who are exempt from the mandate. Christian owners ought to encourage their employees to join a Christian cost-sharing ministry that is specifically exempt from Obamacare. Members committed to a Christian lifestyle voluntarily share each others’ burdens, by sending a check, perhaps less than $200 a month, to someone who has incurred a medical bill.

People who refrain from smoking, excess alcohol use, illegal drugs and sex outside of marriage — and who attend regular services of their choice — tend to be healthier. They also find it far more satisfying to send a check to an ailing brother or sister each month than a check — a much larger check — to a multibillion-dollar corporation that profits from denying claims.

There are many ways in which businesses could help workers pay for their medical needs, other than through a greatly overpriced, mandate-loaded, third-party-prepayment product that comes with guaranteed moral hazard.

Employers could inform their employees about ways to find the most cost-effective services or to reduce their bills through prompt direct payment. They should check out healthcarebluebook.com, MediBid.com, surgerycenterok.com, noinsurancesurgery.com and cash-friendly independent practices in their area (some on the “concierge” or retainer model, some not) — to name a few.

Employers could also set up tax-advantaged plans like flexible spending accounts or Section 105 plans. Or they might offer some services on site. They might just give employees a pay raise, or a contribution toward a critical-illness plan. An investment in investigating these possibilities is likely to be much more productive than trying to figure out the byzantine complexity of Obamacare. The government itself doesn’t know how that is supposed to work.

If companies get out of the health benefits business, then their workers will get to experience the oppressiveness of Obamacare first-hand. Compliance with the abortion mandate will be on their conscience. Coping with Medicaid or health exchanges will be their responsibility. The fine-penalty-tax will be on their tax return. How popular will Obamacare be then?

The contraception-abortion mandate needs to be challenged in court for important reasons pertaining to religious freedom. Yet the whole structure of Obamacare and indeed, of the third-party-payment system that lobbied for it, needs to be challenged in the free marketplace.

The Greens believe that emergency contraceptives, including abortion-inducing drugs, are immoral. What about dishonest pricing and monopolistic practices that enable prices twice or even 10 times as high as they could be? What about laws and regulations that burden young workers and benefit the politically powerful? What about the incentive structure that will redistribute care from the elderly, the sick and the disabled to the politically preferred?

Yes, Obamacare seeks to impose its dubious ethics on everyone, but that’s not all. It is riddled with coercion and corruption — and based on bad economics.

Hobby Lobby is starting with the law’s worst feature: the destruction of the most vulnerable patients, the unborn. It’s a good reason to start questioning the whole structure and to find a way to a much better system.

Dr. Jane M. Orient practices internal medicine in Tucson, Ariz., and is executive director of the Association of American Physicians and Surgeons.

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