Why health care should include contraceptive coverage
I've asked two bloggers, Scott Morizot and Father Christian, to share their thoughts on the controversy between Obama and the Catholic Church, Rush Limbaugh and Sandra Fluke. These bloggers have differing perspectives but I deeply respect and sincerely appreciate both of them. I hope you will, too. Today: Scott Morizot of Faith & Food.
I have to confess up front that as someone born in the 1960s and raised in a heterogeneous spiritual environment, I'm a little bemused that oral contraceptives are even a matter for national public debate. Moreover, the Roman Catholic Church remains the only Christian group that takes a dogmatic position against not just oral contraceptives, but all means of contraception including condoms. Not even the Orthodox Church (arguably even more ancient than the Roman Catholic Church as it includes the patriarchies of Jerusalem and Antioch) takes a similar position against contraception.
Moreover, it appears to be a situation in which the Magisterium of the Church has adopted a position with which the laosor people of the Church, at least here in the United States, seem to disagree more than they agree.
Now, in light of the hateful and venomous things Rush Limbaugh and others have said, I feel it's important to clearly state several things up front. First, and perhaps foremost, oral contraceptives are actually oral hormones which have therapeutic use that goes far beyond avoiding pregnancy. This truly is a health issue for women.
I still clearly remember how my wife was plagued with a unceasing headache after our youngest daughter was born. Try to imagine the toll that constant and inescapable pain would take on you. For six months we went from doctor to doctor and had test after test performed. My wife tried many treatments and none worked. Finally, a doctor decided to try placing her on "birth control pills" to see if perhaps there was an underlying hormonal imbalance causing the constant headache. And it worked. If we approve a policy denying reasonable access to these drugs to a significant portion of our population, we are denying legitimate medical care. Do not mistake or overlook that fact.
It's not all about sex.
Ok, but sometimes it is about sex. Still, let's not confuse sex with promiscuity. Many of the women who use oral contraceptives to avoid pregnancy are married. Even those who take them for this reason and are not married do not tend to be promiscuous. (Among other things, it takes a great deal of trust in today's world to shift from a primary reliance on condoms and other barrier methods to oral contraceptives.) And fundamentally, I'm not sure how anyone can reasonably argue that pregnancy is not a significant health matter for women.
Can we argue that it has other dimensions? Certainly. But it's certainly a health issue. Throughout human history, it's been one of the leading medical causes, if not the leading cause, of death among women of child-bearing age. It simply defies logic to assert that a leading cause of mortality is unrelated to a woman's health.
So, let's move on to the disputed regulation as originally proposed (before the modification to shift compliance to the insurance provider instead). I like to start where almost nobody else seems to begin in these discussions, with the regulation itself. Please take a moment to read through it. Also take a moment to read the HRSA guidelines referenced in the regulation.
The most common prescribed contraceptives for women are oral contraceptives, which is why I suppose the debate has focused primarily on them, but the regulation would cover other contraceptives available only by prescription and procedures like tubal ligation and tubal implants. Notably, despite the hyperbole, the regulation does not cover abortifacients such as RU-486.
Contrary to some of the often repeated rhetoric, it's also not clearly a "violation" of the first amendment. The first amendment to the Constitution does not and has never granted carte blanche to do anything we wish.
Freedom of speech or the press does not allow us to say or print anything we want in any context. Freedom of assembly is not unlimited. Similarly freedom of religious practice has been constrained for reasons that have been determined to be for the public good. The first amendment does establish a higher standard for such regulations, but it's not clear that this regulation fails to meet that standard and we won't really know until the federal courts issue their rulings.
But the regulation is consistent with many existing state regulations (apparently spurred by this 2000 EEOC decision) and under those regulations some Catholic universities and hospitals already provide contraceptive coverage to their female employees. The application and wording of the regulation (implementing a law passed by Congress, I'll note) may be tweaked by the courts, but at least when it comes to Catholic hospitals and universities, which employ and serve broad swaths of non-Catholics in a manner largely indistinguishable from similar non-Catholic institutions, I would be surprised if the courts overturned it. Still, I don't have a crystal ball and it can be hard to predict what the courts will or won't do in even what would seem the simplest of cases, much less the more complex and nuanced.
I look at the full scope of the coalition against contraception and I notice there are some pretty strange bedfellows in it. Frankly, I believe it has more to do with political ideology and hatred of anything and everything related to Obama than anything strictly religious in nature. Furthermore, I stay pretty familiar with Catholic teaching, doctrine, and dogma -- even though I am not Catholic and have no plans to ever be Catholic.
I would probably be less suspicious of the motives of the Bishops in this case if I saw them take similar unified, vocal, and public stands against GOP policies, practices, and votes that contravene Church teachings. Absent that consistency, though, you'll pardon me if I look askance. While I try to extend the benefit of the doubt, it can be hard and when groups and institutions pick and choose their sources of public "outrage."
We've been arguing over health care reform essentially my whole life (at least since Nixon's presidency) as costs have skyrocketed and quality and access to care have plummeted. If the ACA is the best we can do, I'll take it. We're decades past the point in time when we should have done something rather than just talk about it.
And yes, universal access to health care certainly includes universal coverage for prescription contraceptives.