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Catholics, vegans, etc

January 30, 2012

I don’t usually talk about political stuff here but for reasons* I’m going to now.

Most people know that new health-care regulations in the US mandate that all organizations that provide health-care for their employees have to cover contraception. There is a religious exemption but it’s written narrowly enough that Catholic hospitals and schools don’t qualify, which is a big problem for them–complying with the law requires them to commit acts they see as gravely immoral. What I’m interested in here is this comparison (I don’t read that blog but it’s the source for the meme) between that mandate and a hypothetical mandate that vegetarian grocery stores sell meat–which would, of course, be to make them do something they consider immoral.

Most people who hear that comparison say either “great analogy!” or “no it’s nothing like that!”, depending on where they stood on the issue in the first place. The objections usually revolve around how a meat mandate is unnecessary because 1. no one has trouble buying meat and 2. the government doesn’t have a vested interested in getting people to eat meat, while neither of those are true of contraceptives**.

I have a different objection. The analogy just isn’t, well, analogous. A truly analogous case to the contraception mandate would look like this:

  • A group of Jains–who are religious vegetarians–own a grocery store that operates according to Jain principles.
  • The store employees are mostly Jain; some aren’t. Same with the customers. But everyone involved knows that this is a Jain grocery store, and most people know that means they don’t eat meat.
  • The government doesn’t care what they sell in their Jain grocery store.
  • It does, however, care about the well-being of its employees.
  • For example, since food is a basic human right, the government has decided that the Jain store has to provide food for its employees, or else pay a fine.
  • Since meat is an essential part of a balanced diet, or so say the government’s chosen experts, the Jain store has to include meat on the menu of the in-store cafeteria.
  • Since not everyone who runs a business wants to tack on an employee-only cafeteria, most people hire a catering company. It’s this catering company that would actually provide the meat to the Jain store’s employees.

I’m not trying to make a libertarian point here, exactly, but I do find it striking how insane that all sounds. Not just the requiring Jains to do things against their principles; the whole thing. It sounds crazy to say that because people need to eat, therefore their employer has to provide them with food, rather than just pay them a salary with which to buy food.

I find the idea that health care is a universal right, therefore the government must mandate health care coverage, similarly puzzling. After all food is more of a basic human right than health care, not less. And as-is, employees do, for the most part, bring their own food, and the hypothetical outlined above is just not an issue.

Still I’m always wary of espousing overly idealistic reforms (whether traditionalist, libertarian, or socialist in origin). I’m not saying we should go back to the good-ol-days before medical insurance made everything complicated. I’m not trying to say anything, really, other than this: part (though not all) of the reason it’s hard to see the problem here is that collectivized insurance makes responsibility so murky. It’s not A is forced to buy X; it’s A is forced to pay B to give C any of {X…Z} for free, and A isn’t allowed to exclude X from the list. This is where my love of technology conflicts with my love of decentralization.

A thought experiment: if A were allowed to pay B to provide {Y…Z}, and it cost $f less per person than {X…Z}, and then C could pay $g to bump their insurance up to {X…Z}, what effect would that have on the situation?

*: The first reason is that this is an important issue–lots of Catholics, of which I’m one, are saying it’s the biggest threat to religious liberty in the US in the last, oh, century?–and so it’s important to be able to think intelligently about it. The second is that the vegetarian analogy intrigues me because the moral status of vegetarianism intrigues me, for reasons I’ve discussed, e.g., here.

**: For the record, I think the best response to the first objection is that you’re not preventing people from acquiring contraception, you’re just not paying for it. They can still buy it on their own if they like. My internet skills tell me that without insurance it costs about $50 a month, which is a lot but not exorbitant–if consequence-free sex isn’t worth that to you, don’t have any. It’s a luxury, the same way eating meat is a luxury. The best response to the second objection is that the government does not have that vested interest. Meaning, it does have a vested interest in reducing unwanted pregnancies, but that there are good reasons to want not to do that using contraceptives, so it has no interest in promoting contraceptive use. But both those arguments presuppose a lot. The question is, how good do those arguments have to be to convince people, not that there shouldn’t be a contraceptive mandate, but that the religious exemption should cover schools and hospitals?

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5 Comments leave one →
  1. February 7, 2012 7:28 am

    The trouble is… contraceptive use (and 50$ per month without insurance might be exorbitant for a certain economic class, though one could ask, if they can’t afford that, how do they afford insurance?) is not always prevalent – many people tend to use abortion as a contraceptive. Which comes to a choice between two evils – allow for contraceptives in insurance or know that by not doing so, more abortions will be committed.

  2. February 8, 2012 10:53 pm

    The thing is, Catholicism teaches that you cannot do evil to prevent evil. Even if the Catholic Church could prevent abortions by encouraging contraception use, it doing so would cause scandal by making contraception appear licit. As it is, those abortions happen, but not because of the Church; they happen in spite of the Church. So while when you frame it from a utilitarian perspective it sounds like a difficult dilemma, from a non-utilitarian perspective it’s really rather simple.

    It’s debatable whether the government should act according to utilitarian principles (I don’t think it should), but the Church can’t, and won’t. The question then becomes: can the government compel the Church to act against its principles in order to further what the government sees as a compelling state interest? As I understand it the courts have generally said that it depends on if it IS a COMPELLING state interest… but I have no idea how that’s defined or who gets to determine it.

    Also, while it’s at first seems reasonable that if more people used contraception there would be less abortion, consider: if contraception were not an option at all there would be a lot less pre- and extra-marital sex (because the risk would be much greater, and people would have to take that into account), and that would lead to less abortions too. So even if we were to be utilitarians about this (which we shouldn’t), it’s not a simple equation “more contraception = less abortion”.

  3. Agnes permalink
    February 16, 2012 8:45 am

    Hi Joseph,

    I’m wondering about what you think about the president’s compromise?

    Also wondering about what you think of the claim that most Catholics have used contraception at some point (in fact, the claim is that 98% of women have used contraception at some point), and a majority don’t have a problem with it (this second point I’m not sure about). Is it a strong Catholic belief if the Catholic hierarchy insists on it, but most Catholics don’t?

    Also, in the original plan, the Catholic institutions that wouldn’t have been excluded are hospitals and universities that employ and serve many non-Catholics. Personally, as a user of the birth control pill (the most commonly used form of contraception out there), I would be pretty annoyed if I were a student at Notre Dame or De Paul and my student health insurance didn’t cover my birth control – I would feel to some degree discriminated again, or at least like the school didn’t care about something that was really important to what I think of as my health. (Some people balk at the idea of calling contraception “preventative health,” cuz babies aren’t diseases, but I think there’s a case to be made …). I kinda feel like – why don’t these Catholic institutions just not hire, take the money (tuition fees, payment for services) of non-Catholics if they don’t want to serve the needs of non-Catholics?

    And I feel to some degree compelled by the argument that if you’re going to be a health insurance provider, you should have to follow the rules of health insurance providers and that, given that contraception (probably the pill) is the most widely prescribed medicine for women (fact), it would be wrong not to cover it.

    In any case, I don’t think Notre Dame or De Paul have a problem with covering contraceptives, so I’d probably be fine there (tell me if I’m wrong). In fact, 28 states already had a law like this before the president made it a national agenda (and something like 9 states, including something super-Christiany like Georgia, even made super-Catholic organizations like churches cover birth control!). I’d be interested in hearing the numbers on which non-church religious institutions (health care providers, universities, etc.) have a problem with it, but I suspect that a lot of people don’t (this may be my liberal bias). Again this to some degree goes back to my sense that if you’re going to mix with the non-Catholic world on the level of hiring, serving, taking the money of, you gotta face up to the needs of non-Catholics. And in the 21st century, people need contraceptives. Then there’s my other sense that 21st-century Catholics just aren’t that anti-contraception (that using contraception is compatible with most Catholics’ views of being good Catholics, that it doesn’t go against their most cherished beliefs) – I could be totally wrong on this, but the fact that a staggering (98%) of women have used some kind of contraception at some point (tell me if you think this number is wrong – it’s widely quoted in the media), suggests that I’m not.

    Also, I think the president dealt with the whole thing pretty well with the compromise, and now the fact that many Republicans want to expand the debate to argue that no employer should have to cover birth control (their employers being the source of health insurance for most Americans, I think) if its against their conscience suggests to me that this is starting to be less about religious liberty and more about eroding birth control rights (not to mention the whole creepy “we don’t compromise” tea party bravado).

    I’ve been wanting to talk to this stuff with someone, and I don’t have a lot of Catholics in my life, so I’m interested to hear more of your thoughts on this. If you don’t feel like responding in writing, we can talk about it in real life at some point soon!

    Agnes.

  4. February 16, 2012 11:48 am

    Ooh, lots of questions. So, a long response. Sorry.

    To start with the 98% figure: I could be wrong about this but I’ve read that it’s slightly misleading; but every stat is said to be misleading by the other side so I dunno. (The argument is that it refers to 98% of women who are i) sexually active and ii) trying to avoid pregnancy, and, well, yeah, most people who fall into both groups will use contraception, but that proves little.) I do know that in my experience it’s certainly more than 2% of Catholic families that have 5+ kids, and usually when there’s that many it means no contraceptives (though you can never know for sure); and I know a lot of people who at least talk the talk.

    But even if the 98% figure is right, that’s still over half a million Catholic women (68 million /2 * .02 =) who don’t use contraception on principle. Which is more people than there are Amish in America. I’d rather the Catholic Church not be seen as on the same level of importance as the Amish, but they have the exact same status religious-liberty wise and we seem to be able to accommodate the Amish (who have just as many “strange” beliefs) without too much trouble (except for arguments about having to put warning lights on buggies…).

    The argument against is that the Amish keep to themselves while Catholics go out into the world. OK. I can see why one could be frustrated with e.g. not having contraception covered by one’s school insurance if one went to a Catholic university, but I can’t get behind the principle “if you’re going to interact with non-Catholics you have to face up to the needs of non-Catholics”. Why not: “if you’re going to interact with Catholics you have to be willing to face up to the moral beliefs of Catholics”? You wouldn’t expect to be able to get an abortion at a Catholic hospital; why would you expect to have birth control covered by your insurance if you worked there? It seems like the logic of the mandate would allow for mandating abortion coverage as well, and I bet more people would have a problem with that, but religious liberty shouldn’t be a question of popularity.

    I’ve read various things that lead me to think that the “compromise” is misleading in a few ways (though again it’s hard to get objective assessments of these things and I’m open to correction, particularly on things that are just factually wrong). First, the regulations weren’t actually changed–as in, they went ahead and approved the original regulations that people objected to, and just promised to later add in something clarificatory. Which isn’t surprising, because the change is merely cosmetic; it went from “you must buy a health insurance plan providing contraception” to “you must buy a health insurance plan and if you don’t want it to cover contraception fine but in that case the insurance company has to provide the insurees contraception for free”. Who’s paying for the contraception? Well, you are, but we’re pretending you’re not so it’s all OK…? Second, it’s true that some states have laws mandating birth control coverage, but many Catholic institutions got out of those requirements by self-covering or not providing insurance and just giving their employees enough money to buy it themselves, rather than purchasing it from an outside provider. The new health insurance laws require all organizations with over 200 employees to buy insurance from authorized providers, so these will no longer be valid options.

    I also think some of the post-compromise outcry has to do with how it was handled. They didn’t even consult with the US bishops, so in what sense is it a compromise? And then they used the endorsement of the Catholic Health Association to make it seem as if Catholics were OK with it. This gets Catholics who support the hierarchy upset; the CHA doesn’t speak for the Church, the USCCB does. This goes back to the 98% percent figure and its meaning. The real question is, who gets to say what Catholics believe, the bishops or organizations composed of Catholics but without any standing in the organization of the Church? It’s a position that not many Protestant denominations are in (even the ones that have bishops) because there when there’s dissent they split up, but with Catholics there’s something that goes along with the name “Catholic” that people don’t want to give up. I tend to think that if you want to call yourself Catholic you have to play by the rules, which doesn’t necessarily mean thinking birth control is wrong, but it does mean that you admit that the Church thinks it’s wrong–just as it means you admit that the Church has the ability to excommunicate you, if it so chooses. You can try to change it’s mind, but you should keep those disagreements within the family, so to speak. But the hierarchical aspect of the Church has always made (particularly non-Catholic) Americans somewhat uneasy.

    I have no desire to erode birth control rights if that means access to birth control–I don’t want to make it illegal. I don’t want to pay for it though; and even if I can’t avoid it (e.g. by getting the school insurance at a school whose policy covers contraception), I’d rather it at least not be illegal to not do so. But this goes back to a disagreement about what health care is and what it is to have a right to it. I think the “right’ to health care means a right to go get yourself health care and not have your doing so be illegal because you’re, say, too old, or too disabled. I don’t think it means a right to use governmental coercion to force others to give you health care free of charge.

    That doesn’t mean I’m a heartless bastard. I think that if you can’t afford it those others should give it to you; Christianity is based around the idea of the Good Samaritan. But that should be the Good Samaritan’s choice, not the government’s. This is what Catholic hospitals do for things they consider health care, i.e. not contraception. It’s also what various family planning charities do for contraception, which makes it so it’s never that hard to access, which is why the mandate seems to most who are opposed to be more aimed at forcing everyone to agree contraception is good rather than at making sure everyone has access.

    I actually think the religious liberty argument requires that it not just be about getting Catholic schools and hospitals out of the mandate. Religious liberty isn’t just being allowed to go to some established church once a week and worship without anyone stopping you; it also isn’t just being allowed to follow your conscience if the business you’re running is formally associated with one of those churches.

  5. February 16, 2012 11:50 am

    By the way Agnes we can still talk about it at some point too, I just started writing a quick response to make some preliminary points and it got away from me.

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