I didn’t really want to weigh in on the recent scandal about forcing Catholic-run institutions, like universities and health charities, to provide birth control to women. But it turns out this is a thorny issue that has gotten a lot of press, and most of it seems subpar. If you want a job done right…
The issue is that the Catholic church has a religiously based objection to birth control: its official policy is that “any action which, either in anticipation of the conjugal act [sexual intercourse], or in its accomplishment, or in the development of its natural consequences, proposes, whether as an end or as a means, to render procreation impossible” is “sinful” on the basis that it “is in conflict with God’s laws.” I will not address this position on its merits because it has none, so instead, let us assume it is a fact and proceed.
The first amendment is quite clear that “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof” and religious freedom is one of the most jealously defended rights in America. Forcing a religious establishment to engage in behaviour that it finds to be “sinful” and “in conflict with God’s laws” clearly seems to make difficult the free exercise of not engaging in sin and following God’s laws. One counterargument is that no one is forcing Catholic women to use birth control, and that it should be up to them to do the honourable, guilty Catholic thing and bring that damned accident to term (read: post-collegiate job interviews); but in practice, given that a vast majority of Catholics use birth control despite its sinful nature, the church will end up directly paying for something it finds abominable under this rule. That means individual pharmacists filling prescriptions for the morning-after pill against their consciences, to say nothing of selling condoms and the pill to insured employees, etc. So I understand the rancor.
But consider the flip side of this argument. The first amendment prohibits any law “respecting an establishment of religion” too. Allowing a special exemption to a rule the rest of America has to follow on the basis of a religious belief seems as much a violation of the first amendment as the requirement was in the first place. Salon‘s Joan Walsh recently articulated a point that had occurred to me as well: suppose the Catholics had objections against child labour and occupational safety laws, to use her example. Would we then similarly grant them an exemption and let their altar boys into the coal mines? Then again, juvenile coal mining would never be an issue, since the same bishopric now crying foul about sinful behaviour have been putting those altar boys to a very different kind of use for the last few decades.
In response to the loud whining about this rule leveled not just by the child-molesting, latin-chanting, zombie-worshiping monotheists, but also by leading republicans (including Rick Santorum and the House Speaker), the Obama administration has changed the rule: now objecting organizations need not provide coverage, and instead women can get it directly from insurance providers. This strikes me as a reasonable compromise, except that, as NPR points out, many Catholic organizations are self-insured, meaning the rule change has no effect for them. And as that same NPR piece documents, not all Catholics are placated by this choice. Indeed, Rick Santorum still maintains that birth control shouldn’t even be a health insurance issue since it is comprised of “relatively small expenditures.” Nothing like Viagra, right Rick?
Really, this issue serves to underscore how unworkable partial health regulation is. Obamacare is the underlying justification for this rule, but if the administration really wanted to ensure health access, it would have demanded stricter legislative regulation on coverage if not a public option outright. Then the answer to this and related dilemmas wouldn’t be a change of the rule, but an option to abandon Catholic coverage entirely. By leaving health care to the private sector, there is still every possibility that market forces will leave gaps in coverage that government insurance would not abide. Of course the question remains whether a public option as a coequal to the private options could be competitive without being an unsustainable subsidy. The question of Obamacare generally is one I plan to explore iff it survives its pending Supreme Court challenge to be argued next month. Stay tuned.