Friday, February 10, 2012

A Violation of Religious Freedom or a Prevention of Religious Domination? - part two, The Real Problem

The real problem which is causing the controversy between the Obama administration and some US Catholics is not one of religious liberty.  It is one of the public sector using the private sector to accomplish its purposes.  
There will soon be an individual mandate for health insurance coverage in the United States. Here is a small snippet of an exchange between Mitt Romney and Rick Santorum where Romney offers up a concise and effective argument for the individual mandate for health insurance coverage.

"If you don't want to buy insurance, then you have to help pay for the cost of the state picking up your bill, because under federal law if someone doesn't have insurance, then we have to care for them in the hospitals, give them free care," said Romney. "So we said, no more, no more free riders. We are insisting on personal responsibility. Either get the insurance or help pay for your care." 
"Does everybody in Massachusetts have a requirement to buy health care?" asked Santorum.
"Everyone has a requirement to either buy it or pay the state for the cost of providing them free care," Romney shot back. "Because the idea of people getting something for free when they could afford to care for themselves is something that we decided in our state was not a good idea."

But this is a bit of a side note, as whether we accept it or not, the individual mandate will soon be the law of the land.  And of course, if we are required to purchase health insurance, it must meet certain criteria for contributing to the health and well-being of the citizenry.  The individual mandate would be worthless if individuals  could satisfy it by buying insurance thats cost $5 a month and only covered a bottle of aspirin a year.  There must be standards as to what constitutes an insurance that adequately satisfies the individual mandate.
Access to birth control is widely considered to be an essential part of a woman’s health and well-being.  It was listed by the CDC as one of the top ten most important health advances of the twentieth century, and it is promoted by a myriad of mainstream science-based medical organizations. Therefore it must be covered under any insurance that would meet the requirements of the individual mandate.
According to a recent study by the Public Religion Research Institute, a poll quoted in USA Today, most Americans, and even most Catholics, believe that birth control should be covered under health insurance plans.
So the real problem is not that health insurance should be required to cover birth control.  The problem is the primary method the government uses to satisfy the individual mandate - the employer/employee relationship in the private sector.
If health insurance was done completely publicly, then we might disagree with a national health care system and/or birth control, but we all pay taxes and watch the government do things with which we disagree (because it represents us all).  But this will not happen in the foreseeable future.
However, if the individual mandate was satisfied by individuals purchasing insurance directly,  instead of having it provided through their work benefits,  then there would also not be a huge problem with the requirement that insurance must include birth control coverage.  Catholics who disapprove of birth control would still be purchasing insurance from a company whose benefits would almost certainly include someone else’s birth control.  But this different accounting scenario would eliminate the perception some have that Catholic institutions are specifically being forced to purchase something with which they have moral objections.
So the real problem here is that the government is maintaining the link between the employer/employee relationship and health insurance coverage.   There is a middle man that might disagree with what the government, the public, and the medical community deems a very necessary component of adequate health insurance coverage for women, and the perception then emerges, because the benefits they offer must meet these standards, that the liberty of these middle men is being violated.  
But unfortunately, this is the world we live in.  Therefore the government simply must maintain standards for what constitutes adequate health insurance coverage, or else the individual mandate loses its effectiveness.  


  1. I'm sorry ... this whole issue still doesn't make any sense to me. If you are against birth control, then don't use it. Covered or not covered, no one is forcing people to use birth control at gunpoint.

    The issue seems to me more like that of the veil in Islam- can one vociferous group force others to do as they wish (though probably not as they do!) by way of legal and financial coercion?

  2. Catholic institutions do not want to be in a position where it appears they are paying for birth control for others. Apparently, if the health insurance policies that Catholic hospitals, charities and universities provide cover birth control, they feel that they are being forced to purchase birth control for others against their will.

    But yes, it is an interesting side note that most Catholics approve of the idea that health insurance policies must include birth control, and 98% of US Catholic women, who have had sex, have used contraception.

    I think the US bishops are in a situation where they have no incentive to compromise. They are effortlessly scoring points with their base by portraying this as an issue of religious liberty. BUt as you said, no individual is being required to take or prescribe birth control.

  3. I understand. But it is like paying taxes.. they are buying aircraft carriers and CIA black prisons as well. It comes with the communal territory. Or are Catholics only familiar with the hazards of communal decision-making when it suits them?

    At any rate, it is one more argument for making health insurance completely nationalized and untethered to the employer, as you say.

  4. Yes, it's more of an accounting issue than anything to do with religious liberty!