We have in this post to begin crafting a basic health care package (hereafter BHCP).  If we want to do away with the categorical right of conscience, this seems to be our only option.  Let us at least make the attempt. The context of this BHCP is an ideal secular society, one which allows its citizens to live authentically according to their respective worldviews, at least as much as possible.  But if we are dispensing with the right of conscience, we must have our eyes open:  Someone’s worldview is going to be discarded as wrong, harmful, or invalid. Take the nihilists, for example. These are people who believe in nothing, who maintain that everything is ultimately and completely meaningless and void.* Say what you want, this is a worldview which exists, and would be part of our secular society.  Now, what if a nihilist employer (why did he bother starting a business?) wants to say that health insurance is pointless, because life is short and we’re all going to die, anyway? Well, according to the ACA, he has a tax/penalty to pay.  But we’re dealing with a blank slate, and asking what the government ought to do, not what it has done. According to our previous answer, it would be his right not to provide any health insurance.  But we’re starting from the assumption that there is some basic package of health care. And so, we must start by imposing upon the nihilist.  He must provide a BHCP, or pay a price. So much for the nihilists; their complaints amount to nothing anyway.  What’s next? I have to say, I appreciate that my allergy medicines have been covered by our family’s BHCP’s, and I think that is a reasonable thing:  Any condition which can be treated by medication of some kind ought to be available through BHCP’s. But here we are imposing upon the Christian Scientists.  Or, at least a simplistic caricature of them.  Nevertheless, assume they were categorically opposed to medicines. Now we must require both nihilist and Christian Scientist employers to act against their worldviews in order that our BHCP may be universally available. (Isn’t, like, Tom Cruise a Christian Scientist?  I know Jeffrey Tambor is, and as funny as that guy is, he holds to a crazy worldview, no?) Questions for reflection:  How many groups of people would have to be imposed upon before we thought the BHCP went too far?  What about as a percentage of the total population? Let’s get beyond the mundane – a family is in an accident.  The parents die, and the child is in critical condition.  The child survives a life-saving operation, but is in need of blood.  A common, safe way to replenish the blood supply is by transfusion.  Sure, this should probably be included in the BHCP. Not so fast, though:  The father worked for a Jehovah’s witness.  Shall we impose on this employer, too?  Bear in mind, the transfusion will be done either way.  We are only asking if the employer should be forced to pay for it (at least in part). Questions for reflection:  Should expensive treatments and products be preferred for inclusion in the BHCP?  If we’re talking about a car, for example, the insurance policy does not cover oil changes, but it does cover major accidents.  If so, what amount qualifies as expensive? Now, what about preventative treatments?  Nothing is actually wrong yet, but they say an ounce of prevention is worth a pound of cure. This raises the question of birth control, which was linked to the Hobby Lobby case.** It became clear from that case that several stripes of Christians are morally opposed to the HHS mandate.  The mandate, of course, was only enacted because these forms of birth control were presumed to be part of the BHCP.  In our ideal society, should they be? Questions for reflection:  Is pregnancy a disease?  If not, how should we classify it?  If not as a disease, should it be part of a BHCP to prevent it?  If you opposed the HL decision, were you aware of the full argument against birth control/abortifacients?  If so, did you formulate a complete and successful rebuttal?  Who decides which argument prevails? And what about some unorthodox methods of treatment?  I’ll suggest two. A woman believes strongly in the power of prayer, and she believes particularly in the power of a certain mystic’s prayer.  He lives in Nepal. Now, for the mystic’s prayers to work, he must be physically present, and perform a series of rituals which require great concentration, unrivaled devotion, and the most exotic of resources. He requires that his hermitage be transported with him; a modest abode, though cumbersome to move.  He requires a chemical found only in expensive bottles of port, preferably recovered from a shipwreck.  He also requires the fifth leg of 1,003 Brazilian beetles, and a hand-drawn, perfect circle on the floor, within which he will pray. Say what you want, this mystic has a success rate significantly higher than random results would offer, and all other available treatments are experimental.  Now – shall we impose on the materialist^ employer, include this treatment in the BHCP, and insist on the employer’s financial contribution? Questions for discussion:  If you would not include this in the BHCP, why not?  What criterion does it violate?  Why is that a criterion for our BHCP?  Is that an inviolable criterion, or are there other possible instances the BHCP could cover, which might violate your criterion?  What about untested forms of psychoanalysis, or new age therapies? Second – Consider a white supremacist who suffered a debilitating stroke.  He has been in therapy for many months, with very little progress. The doctor believes the symptoms are, to some extent, psychosomatic.  She wants to find a way to snap him out of his feelings of helplessness and frustration.  Now, she is the unfeeling kind, a person who considers all options regardless of stigma. Her solution is to commission a short film made at the local college.  It will, in essence, feature three white men harassing a black woman, leading to a sexual assault of the woman.  The doctor is able to get the film made on the pretense that she is conducting a psychology experiment.  The school agrees, if she will pay a fee of $1,000. Keep in mind, the issue is not whether you think anything like this would ever occur (but don’t be naive).  You must assume it is about to occur, and you are this man’s employer.  Do you want to be on the hook for this treatment?  Would you want to contribute even one dime? Questions for discussion:  What if the treatment works?  What if the doctor and the patient are both completely satisfied with the treatment?  What if, in fact, it leads to the use of other widely stigmatized practices in the treatment of psychosomatic conditions?  Does anything go?  Should we still impose on people who believe racism is wrong, sex crimes are wrong, and all manner of such things are wrong, and expect them to contribute financially to these treatments? This is a serious problem with developing a BHCP – what one considers basic or necessary, another may consider offensive and detrimental.  That we have largely made do with existing health care insurance is an interesting point and worthy of discussion.  But we have moved beyond that point with the recent controversy, and we have one more point to make in the next post.   *It would be difficult to grasp the depths of skepticism and despair present in nihilism.  Impossible, even.  This is why you can depend on the fact that any nihilist you meet is also a hypocrite (not unlike Christians, but we are supposed to admit that upfront). **A common objection to the HL case is that the morning after pill does not actually cause an abortion, because it merely prevents implantation.  This is supposed to be distinguished from an abortifacient. For the purposes of our discussion, it is only necessary to say that someone objected to it, in full knowledge of the facts, even if there remains some confusion about what the drug’s effects are. ^A materialist, of course, is a person who believes all of reality reduces to the physical.  There is no spiritual/supernatural realm, mathematical objects are all useful fictions, logic is a happy accident, and our consciousness…well, let’s not talk about that.