It is not the job of medicine to take responsibility for people who are incapable of responsible adult behavior.

If this is a problem that the government needs to be solving, the correct response is not to make doctors responsible, but rather to appoint guardians to the women who are incapable of taking care of themselves.

Yeah, but I bet my insurance company could already explain exactly why childbirth is covered and injury-prevention gear isn’t.

My point is that insurance companies have already defined all these things. We already have definitions. We already know all these answers. We’re just pretending we don’t because some people want free birth control, and/or want to be able to dispense free birth control.

And why do people want to dispense free birth control? Are they concerned that it is necessary for health? Well, if they are, they’re not being logical, because cheap/free birth control is already widely available. I think it’s pretty clear that the real motives in this dispute have nothing to do with legitimate medical concerns and everything to do with advancing a social agenda, influencing behaviors and perceptions of behaviors.

And, of course, if Catholics have to go secular as a precondition for continuing to render services, then that’s a twofer: it’s both a victory for atheists (who don’t want Catholics to exist on equal terms within society) and it’s also a way for the secular state to get hold of expensive medical equipment without actually having to pay for it (because that stuff is expensive).

No, it really isn’t.

pentamom,

And I am not seriously suggesting pregnancy and childbirth should not be covered by medical insurance. There are two arguments that are frequently made against the contraceptive mandate, and one is that contraceptives should not be covered by medical insurance because (1) contraceptives are not “medicine,” and the other is that “insurance” doesn’t cover routine or foreseeable expenses. But trying to come up with definitions of “medicine” (or “health”) and insurance is very tricky and usually formulating your definitions to exclude something you think should be excluded also eliminates something everyone would agree should be included.

Medical insurance, if modeled after car insurance, wouldn’t pay for much of anything, and certainly not prenatal care and hospital delivery. One could even argue that medical insurance doesn’t pay for elective expenses, and pregnancy is elective.

That’s too broad. By that definition, ski safety equipment would be “not inconsistent with” the definition of medicine. You need something a little more specific — I agree that “necessary to restore or maintain bodily integrity” is a minimum standard, but you need more than that.

Anyway, my point is not that pregnancy/childbirth care should not be deemed medicine, it’s that the word “dangerous” doesn’t apply to a normal childbirth. I’m not supporting David’s reductio here, I’m just asking you to not contribute to the scary modern attitude toward childbearing. “A real risk of death or disability” is not enough to establish “dangerous,” unless you want to call pretty much everything people do “dangerous.”

It is more consistent with appropriate language to call normal childbirth a “safe” process than a “dangerous” one. That does not mean there are no dangers involved, but it casts a false impression on the real nature of pregnancy and childbirth to call it “dangerous.” It ceased to be *generally* dangerous the day doctors started believing that washing their hands between patients actually mattered.

You appear to be undermining your own case.

Your opponents will retort that if pregnancy carries “a very real risk of death or disability” is not its prevention as much “medical care” as vaccination against measles?

Blake,

Then I fail to see why preventing (unwanted) pregnancy doesn’t qualify as medical care, particularly in cases where the potential mother has some kind of health problem that could make a pregnancy dangerous.

“Every minute, at least one woman dies from complications related to pregnancy or childbirth – that means 529 000 women a year. In addition, for every woman who dies in childbirth, around 20 more suffer injury, infection or disease – approximately 10 million women each year.

Five direct complications account for more than 70% of maternal deaths: haemorrhage (25%), infection (15%), unsafe abortion (13%), eclampsia (very high blood pressure leading to seizures – 12%), and obstructed labour (8%). While these are the main causes of maternal death, unavailable, inaccessible, unaffordable, or poor quality care is fundamentally responsible.”

http://www.who.int/features/qa/12/en/index.html

Pregnancy is not a disease – and one could certainly argue that we have “over medicalized” childbirth in the US – but providing medical care reduces a very real risk of death or disability, and that is not inconsistent with a definition of “medicine” that limits “medical care” only to that which is necessary to restore or maintain bodily integrity.

It’s true I view that as a problem, but if you’re suggesting that letting the government micromanage us from Washington is a solution, I call that a case of “out of the frying pan, into the fire”.

Just about anything one can do nowadays to avoid a hospital stay is worth considering.