Supreme Court

This was a terrible, horrible, lousy day, brought to you by our 5-4 Supreme Court decisions in the Hobby Lobby case and Harris v Quinn. My response: Keep your hands off my body…and my union!

The cases in short:

• Hobby Lobby: Agreed a private firm could claim a religious belief on the part of the firm as a basis for denying several kinds of contraception in the company’s health insurance coverage.
• Harris: Determined that some public sector workers could opt out completely of union fees as well as dues, even as they benefit from the union contract.

Off my body: Amanda Marcotte writes about the Hobby Lobby decision at RH Reality Check: “Hobby Lobby is Part of a Greater War on Contraception.” Though there are all those qualifiers to the decision even in my short description above, Marcotte says, “Make no mistake: they are coming for your birth control.” At Salon Elias Isquith offers highlights from Justice Ruth Bader Ginsburg’s “fiery dissent” including, “The exemption sought by Hobby Lobby and Conestoga would…deny legions of women who do not hold their employers’ beliefs access to contraceptive coverage.”

The focus on birth control–nothing else–is just creepy, and it still shocks me when I read people saying “why should we pay for your sex?” Comments on FB and twitter have been flying. Sociologist Jennifer Reich–who just published Reproduction and Society: An Interdisciplinary Reader-–said

Never in my life did I think the Supreme Court would rule in such a blatantly politicized way. Religion only applies to birth control, not other health issues other people might need and that others might resent. Having said that and now reading the decision–and spending all my waking hours thinking about vaccination mandates and personal beliefs–it is also clear the government was mistaken in ever allowing any organizations to exercise a religion-based opt-out. If health is a right, who you work for should never have been the criteria for getting what you need. Such a disheartening morning.

Off my union: Jennifer’s outrage over whose rights are asserted (businesses) and are not asserted (workers) brings me to the Harris decision. The Harris v Quinn case  (as Nick Bunker explains here) “centered on the ability of unions to require workers covered by collective bargaining agreements to pay fees to the union.” The decision, which abrogates those fees, may lead to even more decline than we have already seen in unionization.

Bruce Western and Jake Rosenfeld have shown how the historic decline in unions contributes to the rise in inequality since the 1970s. Public sector unions–I’m a proud member of one–have not declined as much as private sector unions, and this is relevant because the Harris case pertains to public sector unions. Meanwhile, a greater proportion of  women are in public sector unions than private sector unions. CEPR’s Nicole Woo wrote here last week that strong  unions are good for women…and good for families, too. Her column covers her recent paper from the Center for Economic and Policy Research, which highlights just how valuable and important unions are to women. Weak unions are bad for many (and in many ways), but for today I’m thinking about how a decision weakening unions, especially public sector unions, is a blow to women workers.

A really bad day. Not nice at all.

On this historic day, the US Supreme Court’s ruling on health care is being hailed as “a victory for all Americans” – but will all Americans benefit equally from the new health care law signed into law by President Barack Obama? No, not those, like Obama, who are male.

The ACA’s list of “Covered Preventive Services for Adults” includes screenings for only two sexually transmitted infections (STIs): “HIV screening for all adults at higher risk” and “Syphilis screening for all adults at higher risk.” They do include “Sexually Transmitted Infection (STI) prevention counseling for adults at higher risk,” and “Immunization” for the STIs Hepatitis B, Herpes and Human Papillomavirus (HPV). All sexually active boys and men are potentially at risk for contracting a wide range of STIs, including HIV: the interpretation of “higher risk” could keep many from receiving necessary care.

If you scroll down this page, you’ll find the longer list of “Covered Preventive Services for Women” which includes additional sexual and reproductive health care screenings related to breast cancer, cervical cancer, chlamydia, contraception, gonorrhea, plus extra screenings HIV and HPV.  This laudable list is capped off by “Well-woman visits” described as, “preventive care visit annually for adult women to obtain the recommended preventive services that are age and developmentally appropriate….” Why would a man not benefit from these types of services?

A google search for “well-man visits” turns up nothing on U.S. government websites and only one company’s description of their “Well Man Examination” policy: it includes only “Digital rectal exam; and Screening PSA test (age 40 or older).” Younger men could benefit from an examination for testicular cancer, “the most common cancer in American males between the ages of 15 and 34.” None of these tests are mandated under the ACA.

Looking again at government resources, the inequity jarring. In addition to having a website devoted to National Women’s Health Week in May, the U.S. Department of Health and Human Services also sponsors an Office on Women’s Health website.  If you’re on the homepage of the U.S. Department of Health and Human Services and search for “men’s health” you will not find a men’s health website.  However, their Office on Women’s Health website (somewhat ironically) features the U.S. government’s only resource webpage for men’s health, including a link to men’s sexual health. On this page, it focuses more on aging and sexual dysfunction, with only one small link to sexually transmitted infections. This “sexual health” page seems to patronize and condescend to men, doubting their abilities to care about and seek sexual health care:

“Sexual health is a source of concern for many men. Yet some men are not comfortable talking to their doctors about sex.” And, later on, “Remember that problems with sexual health are medical problems, and your doctor can help.”

If you live in King County, WA, then you might be in luck: their Public Health website features a fairly detailed description of “physical examinations for men.”  If you don’t feel comfortable seeking these examinations from your regular doctor, then check out Planned Parenthood: a national organization that provides men’s sexual health exams. While I’m not sure how many U.S. teen boys and men would think of Planned Parenthood clinics as their home base for sexual health care, U.S. health policymakers should look to them for guidance. Depending on the specific PP clinic, their services might include:

• checkups for reproductive or sexual health problems
• colon cancer screening
• erectile dysfunction services, including education, exams, treatment, and referral
• jock itch exam and treatment
• male infertility screening and referral
• premature ejaculation services, including education, exams, treatment, and referral
• routine physical exams
• testicular cancer screenings
• prostate cancer screenings
• urinary tract infections testing and treatment
• vasectomy

U.S. men, where is your outrage? Where are the protests demanding equality in sexual and reproductive health services? Why is there no U.S. Office on Men’s Health? A little digging online unearthed the failed “Men’s Health Act of 2001” which articulated the need for an Office of Men’s Health. If this act is not a priority for today’s politicians, then I encourage you to do your part to raise awareness about the need for accessible, affordable and comprehensive men’s sexual and reproductive health care. All of us — men, women and children — will benefit from better men’s sexual health.