More than anything else, the Supreme Court's 5-4 decision in Burwell v. Hobby Lobby vividly illustrates the need for a single-payer health care system that does not involve employers. Only a single-payer system would relieve employers of the burden of having to pay for health care services to which they claim to have a moral objection while ensuring that a worker's insurance coverage is not affected by their employer's religious views.
In the case of Hobby Lobby, a single-payer system would have protected workers from sudden and arbitrary changes in the application an employer's religious preferences. Hobby Lobby's employee insurance plan originally covered two of the types of contraceptives in question. It was only after the passage of the Affordable Care Act and the mandate for coverage for contraception that Hobby Lobby decided to drop Ella and Plan B. (Hobby Lobby's plan has never included the IUD.) To make matters more complicated, Hobby Lobby's moral objections are not supported by science. Plan B and Ella, two of the medications to which Hobby Lobby objects, do not act as abortifacients. The mechanism for contraception is different. Consequently, the worker's health care coverage is not only restricted by the employer's religious views but also by the employer's limited understanding of science and medicine.
Ironically -- and probably inadvertently -- support for a single-payer system comes from one of the Court's most conservative members, Justice Alito, the author of the Court's majority opinion: "The most straightforward way of (providing contraception without intruding on the company's religious views) would be for the Government to assume the cost of providing the four contraceptives at issue to any women who are unable to obtain them under their health-insurance policies due to their employers' religious objections," wrote Justice Alito (Majority Opinion, p. 41).
Indeed. But why stop with contraception? Alito naively suggests that Hobby Lobby will apply only to contraception. To be fair, the Court's majority opinion specifically states, "Our decision in these cases is concerned solely with the contraceptive mandate" (Majority Opinion, p. 46). But the proverbial camel's nose is already under the tent. Justice Ginsburg's dissent points out some of the more obvious potential conflicts: "Would the exemption the Court holds RFRA demands for employers with religiously grounded objections to the use of certain contraceptives extend to employers with religiously grounded objections to blood transfusions (Jehovah's Witnesses); antidepressants (Scientologists); medications derived from pigs, including anesthesia, intravenous fluids, and pills coated with gelatin (certain Muslims, Jews, and Hindus); and vaccinations (Christian Scientists, among others)? (Dissent, p. 33-34).
As Justice Ginsburg pointed out, no one is questioning the sincerity of the faith of the family that owns Hobby Lobby. Are the Justices now prepared to evaluate the faith of future employers who will undoubtedly follow suit? And at what point are the religious beliefs -- or lack thereof -- of the worker considered? Once again, the real winners in a Court ruling are the attorneys who will rack up billable hours in the name of religious liberty.
A single-payer system resolves these conflicts. Single-payer health care would remove the intrusive hand of the employer from the lives of workers, would allow for consistent insurance coverage for all Americans, and would eliminate any concern that employers might have about both the cost and moral implications of employee health care.
To Conservatives, Hobby Lobby represents a conflict between religious liberty and law. However, as Justice Kennedy wrote, "the means to reconcile these two priorities are at hand."
Single-payer health care is the best way to achieve that reconciliation.