The title of this article is “Jawboning by HHS Doesn’t Scare Insurers,” but maybe they should be scared.

A survey of more than 1,000 OB-GYNs who work in religious hospitals finds that more than one-third report they’ve had a conflict regarding religion-based policy and patient care. At Catholic hospitals, the figure was 52 percent.

Full Julie Rovner piece worth reading.

Can I do that? I would like to be able to. But the IRS won’t let me.

In another case a part-time worker has the opposite problem. She offers to take a cut in pay if we will allow her to join the NCPA health plan. I would like to be able to do that too. Ah, but the IRS won’t let me do that either.

When I say the IRS won’t let me, that’s not technically correct. It won’t stop me from doing these things; it will just impose draconian penalties if I do. Allowing even one employee to choose between taxable wages and non-taxed fringe benefits could enable the IRS to constructively treat our entire health plan as a taxable benefit and it could then tax every employee’s health insurance the same way it taxes wages. (For most of our employees, that would be a 25% tax; for some it would be a 45% tax.)

These problems affect men just as much as they affect women, of course. But the problems mainly arise because the most important economic and sociological change of the past half century (the entry of women into the labor market) is completely at odds with a tax law written years ago by men who thought that full-time male workers with stay-at-home wives is the way life would be lived.

I am woman, hear me roar 

There are other features of the tax law that are also relics of bygone assumptions. As a result, the highest tax rates in our economy are paid by women wage earners. In fact, women earning only modest incomes can pay taxes at rates that are twice those paid by such billionaires as Warren Buffet and Bill Gates. Consider that:

• When a woman leaves the home and enters the labor market, she will be taxed at her husband’s tax rate, even if she earns only the minimum wage. When all taxes and all costs are considered (including the cost of child care and other services she was previously providing as a homemaker), a woman in a middle-income household working a full-time minimum wage job can expect to keep only about 32 cents out of each dollar she earns.
• If the woman’s husband dies prematurely, Social Security will provide a modest benefit as long as she stays home and takes care of children; but if she works, the combined effect of direct taxes plus loss of benefits will create a marginal tax rate of 75 percent — leaving her with only 25 cents out of each extra dollar she earns.
• Once the widow’s children are grown, Social Security benefits will cease and she will be on her own to fend for herself; but if she previously responded to the system’s anti-work incentives, by remaining out of the labor market, she will now have to enter the market without job skills.
• If the woman receives government assistance, she will confront a newly reformed system that is supposed to encourage work; however, when explicit taxes are combined with loss of benefits, her marginal tax rate will be about 72 percent — leaving her with only 28 cents out of each dollar of wage income.
• When the woman reaches the retirement age she will once again qualify for Social Security benefits, but if she tries to supplement those benefits with wage income, special taxes on the elderly will make her marginal tax rate 50 percent higher than young people earning the same wage.

The tax law is not the only institution that is out of touch with the way modern families live. Here are some other examples:

• Both men and women workers pay the same unemployment insurance taxes, but because women are more likely to work part-time and because they voluntarily move in and out of the labor market more frequently (for example, to raise children or care for a parent), they are less likely to receive any benefits in return for the taxes they pay.
• If a woman temporarily leaves the work force to raise children and then returns years later, she will lose most of the credits she accrued and run the risk of being ineligible for Social Security disability benefits.
• Because Social Security taxes are levied on all earnings until capped at a high income level, dual-earner households generally pay considerably more in taxes than single-earner households, but they will get only a minimal increase in Social Security benefits.

Women are adversely affected by public policies in other ways. In contrast to some other developed countries, the United States encourages employers rather than government to provide such benefits as health insurance and pensions. Our private employee benefits system is not the result of free market forces, however. Instead, it has been shaped and molded by federal law designed to accommodate a full-time worker with a stay-at-home spouse and penalize any other arrangement. For example:

• Because they are more likely to work part-time, women are less likely to qualify for employer-provided benefits.
• Because they move from job to job and in and out of the labor market more frequently than men, women are more likely to be burdened by employee benefit programs that penalize job switching (e.g., lack of vesting in a pension plan).
• When people acquire health insurance and save for retirement on their own (not through an employer), the tax system is far less generous.

Many changes are needed to bring aging institutions into sync with the way people are living their lives in the 21st century. Here are a few suggestions:

• We need a fairer tax system for two-earner couples, ideally a flat tax that taxes all income at one low rate.
• The law should give the same tax relief for health insurance, retirement savings, etc. to everyone — regardless of whether they obtain the benefit at work or purchase it on their own.
• Employee benefits law should permit flexibility, making it easier for dual-earner couples to obtain higher wages rather than unneeded, duplicate benefits and for part-time workers to accept lower wages in return for more valuable health and retirement benefits.
• We need flexibility in labor law, making it easier for workers (especially parents with young children) to choose alternatives to the traditional 40-hour work week.
• We need to repeal laws that prevent employers from purchasing health insurance that is portable — so that people are not penalized when they switch jobs.
• If disability insurance and unemployment insurance were private and individually owned (the way they are in Chile), women would avoid most of the arbitrary unfairness of the current system.
• We need a completely new approach to the treatment of spouses receiving Social Security retirement benefits and widows receiving survivors’ benefits.

Unlike the left wing approach to “women’s issues,” these reforms do not assume that in order for some people to be successful we must limit the freedom or raise the taxes of others. Instead, we need to liberate women from outdated institutions that unfairly penalize them. Women in our society are capable of making choices that are right for them and they are perfectly capable of living productive, satisfying lives, provided that misguided public policies do not hold them back.

America truly became the “arsenal of democracy” (the phrase Knudsen invented). By the end of 1942 we were producing more tanks, ships, planes and guns than the entire Axis; by the end of 1943 more than Germany, the Soviet Union and Britain combined.

Arthur Herman’s entire editorial in the WSJ.

That disparity did not hold true for kids diagnosed with a significant illness, who had the same odds of being admitted to the hospital regardless of insurance status.

Full study in the Journal of Pediatrics. KHN summary by Jenny Gold.

While only one in 20 workers in the 1950s required licensing, that figure has since risen to one in three.

Health-insurance companies must tell customers who get a premium rebate this summer that the check is the result of the Obama administration’s health-care law.

Is the administration lobbying the Supreme Court?

Patients that are discharged during the busiest times for hospitals are 50 percent more likely to come back in within three days.

1. ObamaCare’s essential health benefits package contains new restrictions on deductibles and cost-sharing, which will prevent at least some current HSA plans from being offered.
2. ObamaCare’s medical loss ratio regulations also impose new restrictions that studies show will hit HSA plans particularly hard, and could force individuals to change their current form of coverage.
3. The ObamaCare statute does not specify that cash contributions made to an HSA will be counted towards the new federal actuarial value standards.  And a February bulletin released by HHS in advance of upcoming rulemaking indicates that under the Administration’s approach, not all contributions into an HSA will count towards the new minimum federal standards – meaning some HSA policies will not be considered “government-approved.”

More from Chris Jacobs on ObamaCare’s negative effect on health coverage.

This is from AHIP.

I have argued several times previously that all “marriages” should be basically contractual arrangements between couples, whether heterosexual or homosexual. These couple-specific contracts would specify the duties of each member, including the conditions needed to terminate their arrangement, so that couples rather than laws and judges would determine the conditions under which they stay together or breakup. These contracts would be tailored to the special needs of each couple, and could even be made compulsory in order to take away any information revealed when a person asks his or her mate for a contract…

If such contracted civil unions became the norm, homosexual unions would not be any different than heterosexual unions. If civil unions obtained all the rights of marriage unions, then the issue of gay “marriage” would turn only on language, although it is emotionally charged language on both sides of the debate.

Posner’s view on homosexual marriage at the Becker-Posner blog.

The OECD countries most clearly in or near renewed recession—Greece, Portugal, Italy, Spain and perhaps Ireland and the Netherlands—are among those with relatively large fiscal deficits. The median of fiscal deficits for these six countries for 2010 and 2011 was 7.9% of GDP. Of course, part of this pattern reflects a positive effect of weak economic growth on deficits, rather than the reverse. But there is nothing in the overall OECD data since 2009 that supports the Keynesian view that fiscal expansion has promoted economic growth.

Full editorial by Robert Barro in the WSJ.