Finding a health maintenance organization that meets one's needs should not be left to chance. But in some cases even these needs is not met, nor even mentioned. State Comptroller H. Carl McCall, who plans to challenge Gov. George Pataki in November, believes the current administration fails to provide women access to important birth control options, including information on contraceptives and abortions.
The issue results from the state's practice of randomly assigning HMOs affiliated with the Catholic church to persons who do not indicate a preference for a particular provider when they turn in their applications. These HMOs refuse to cover such services because sponsoring them runs counter to Catholic doctrine. McCall plans to publish a report today detailing how women in such programs are not adequately informed of their options, and are forced to find an outside provider that covers such services.
Deputy State Health Commissioner Robert Hinckley dodged specific questions concerning McCall's accusations, and assured that New York's health care system "gives women great access to family planning services ... and works" (New York Times, 1/27/02).
Hinckley's definition of "great access" is ignorant of the fact that thousands of young women are not given life-changing health care information. It's not a matter of whether it is right for certain HMOs to refuse to cover operations they are not comfortable with; the problem is that many women who are assigned HMOs sponsored by the church do not even know what their options are.
However, as state actors who are funded by the governor's office, provisions must be made to make sure patients under such plans are aware of the HMOs reservations. McCall is correct for criticizing the current system for making it difficult for women to seek birth control information. Of course, part of McCall's motivations are the elections in November, but this should be expected. As a gubernatorial candidate, his job is to expose the mistakes and inequities of the current administration to his favor, a job he is already doing well by offering solutions.
For instance, McCall suggests changing the way the state randomly assigns individuals to health care plans. The solution is a no-brainer: applicants who express no preference to an HMO should not be assigned to Catholic health care plans if they are young women. Instead, older persons who have no need for family planning services should be funneled into church-based plans. The elderly might also benefit from Catholic providers that offer connections to faith-based programs that are relevant for some individuals close to death.
The state also has to step up and make sure all of its health care applicants are fully aware of the limitations imposed by church-operated HMOs. Any person who chooses one of these plans should be fully informed in writing that they do not cover or provide information on birth control operations and methods.
Otherwise, the state runs the risk of crossing the fine line that separates church and state. Full disclosure of information is the best way of tailoring each person to the health care service they need, without imposing any kind of burden on the right for certain providers to practice their beliefs.
