Uncovering Contraception

Uncovering Contraception March 5, 2012

I appreciate the irony of writing about birth control while six months pregnant; I keep imagining the looks I might get when I pick up my research from the library. A bit late for this sort of reading, no? But the recent controversy over birth control in the Obama administration’s healthcare reforms illustrates that birth control is about far more than whether or when women get pregnant. The current issue is fraught with legal and religious ideologies that are difficult, if not impossible, to untangle. For many conservative believers, the difference between abortion, abortifacient, and contraception is murky at best, and yet there cannot be a thoughtful Christian response to this healthcare mandate without a thoughtful consideration of what contraception does—and doesn’t—signify. Taking that line of reason further, I believe it is essential to ask for whom contraception is significant, but the “religious freedom” debate and governmental panels seem to have removed women from the picture entirely.

The original mandate required employers to pay for insurance plans that include free birth control, though that plan has since shifted to offer religious organizations an alternative where employees could obtain birth control through insurance companies rather than employers. What happens when the employer is also the insurer remains to be seen, and that exception is one of a number of issues cropping up as the conversation over contraception continues. Responses to the policy shift tend to fall into one of three categories: those who feel the concession violates women’s rights, those who find the compromise acceptable, and those who reject the compromise for the limitations it still promises for parachurch organizations. If this issue were easily divisible between women’s rights and religious freedom, it would perhaps seem simpler to solve, but it’s not. It’s both.

Both supporters and opponents invoke the First Amendment, albeit different clauses. Consider the amendment’s first line: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof.” Typically, those who support universal access to contraception feel that the faith of employers or insurers should have nothing to do with the medical care available to employees, a position based on the anti-establishment clause. People of faith who oppose the distribution of contraception, meanwhile, invoke the “free exercise” component and claim that the government’s mandate interferes with the practice of their religion; some religious leaders are calling for civil disobedience, though the penalties to employers and their missions would be costly. Even with the compromise to allow insurance companies to pick up the tab instead of employers, questions still remain about the status of faith-based insurance companies and companies who serve as both employer and insurer. At the heart of this issue is a fundamental problem in the ideology of natural rights. What happens when two parties, both appealing to Constitutional rights, conflict? Whose rights predominate?

Neither of the groups discussed above necessarily includes the actual women who may want or need access to contraception. Although controversial since its inception, the pill provides medical benefits beyond contraception and it seems fair to ask what will happen to women who use it for reasons other than birth control if their employers or insurers refuse them access because of faith. There are also important distinctions between kinds of contraception, which fall into four main categories. The least controversial for religious conservatives is Natural Family Planning (an updated rhythm method) where tracking a woman’s cycle and physical symptoms can predict ovulation—to prevent or achieve pregnancy. There are “barrier” methods like condoms and the sponge that work by preventing sperm from accessing the egg, thus eliminating the opportunity for fertilization. Then there are hormonal methods like the pill and the IUD that work by suppressing ovulation and creating a uterine environment hostile to implantation. This third category tends to be more controversial to religious groups; some call hormonal birth control “abortifacients,” or abortion-inducing drugs because it is still possible for egg and sperm to meet, but unlikely to thrive given the uterine conditions. The fourth, and most controversial, method is known as “emergency” contraception, including drugs like Plan B, which is intended to prevent pregnancy if taken within seventy-two hours of intercourse.

Once more the religious and legal worlds collide (all played out within women’s potentially pregnant bodies) and grapple with definitions. Drugs like Plan B are classed by the FDA as contraceptives because pregnancy is not a legal state until implantation, whereas many Christians view the beginning of life at conception. But while conception may be obvious to God, there are no signs for humans (unlike the slight bleeding that sometimes occurs with implantation) to discern that point of origin—making contraception that allows the egg and sperm to meet theologically slippery territory. Given different beliefs about when life begins (not to mention from whom it comes), it’s easy to see how conservative Christians clash with the current administration’s birth control agenda: there are different definitions of contraception, abortion, and life itself at stake.

There are also judicial precedents that protect individual privacy with regard to reproductive rights. I don’t underestimate the controversial nature of Roe v. Wade, yet it has remained the law of the land since 1973, allowing women access to legal abortions. I don’t endorse that case’s decision or the practice it legalizes, but any discussion of legality needs to consider the standing precedents; I also find it dangerous to conflate abortion and contraception, when the latter at least exists in a spectrum of technologies and practices. In addition to Roe V. Wade, there is also the lesser known and at least somewhat less controversial 1965 Supreme Court case of Griswold v. Connecticut, where the court overturned a state law banning the use of contraceptives on the basis of the right to marital privacy. Neither of these cases is a direct parallel to the current situation, yet each demonstrates the range of possibilities for interpretation on issues of reproductive rights. I make no attempt here to mandate what the position ought to be, but instead try to illustrate the complexity of reaching agreement, within secular or faith-based communities, on any kind of mandate. What seems to me to be getting lost in this conversation is the fact that all of these legal, theological, and social issues involve real women, real men, and real (potential) children.

Perhaps because I am currently pregnant I overvalue the embodied reality of using birth control (or not). The difference is that I chose Natural Family Planning with the hope of conceiving, not because it was the only option available to me. I made that decision with my husband, prayerfully, taking into account the calling we feel God has made on our family as well as the wisest route for stewarding our resources of spiritual gifts, attention, time, and money. Some might call my refusal to utterly surrender my fertility to God a lack of faith, but I see it as faith coupled with discernment, sought through the Spirit, however imperfectly I may interpret its whispers. I don’t envision my method of birth control as a universal solution because I cannot possibly understand the nuances of each family’s situation. Whether because of strained resources or health concerns with continued pregnancies or non-birth control related use of contraception, there are a lot of reasons why women choose to use birth control. And while I think the ideal is for sexually-active women to be engaged in healthy marital relationships where contraception usage (or refusal) is a mutual decision between husband and wife, the reality is that women and women’s bodies tend to bear the primary responsibility for using birth control. So while I understand this healthcare mandate as a serious issue of religious freedom, fraught with definitional conflicts between theology and religion, those facts are inseparable from women and women’s bodies. And maybe it’s because I can feel my second daughter kicking me in the bladder that I feel like female bodies ought to matter more in this conversation—whatever the conclusion.

Pregnancy complicates the western notion of individualism, and, for me, raises issues with the kind of “keep your laws off my body”-style feminism that resists any legislation of women’s reproductive rights. Right now, it’s not just my body. It’s my unborn daughter’s body, too. I am responsible for her survival, her nurturance, as well as my own. I am also the primary caregiver for an only slightly-less-dependent toddler who makes a myriad of demands on my emotional, intellectual, and physical resources. My life is not solely mine and neither is my body, as a simple observation of our breakfast makes clear. I don’t even get to eat my own cereal by myself. As a visibly pregnant woman, I am subject to all kinds of social critiques—from comments about how much I exercise to attempts to touch my pregnant belly to questions about my plans to breastfeed (or not). All of these responses indicate the assumption that a pregnant woman belongs not to herself or even her own family unit or her God, but to society, and the underlying message is that we women cannot be trusted to carry our babies, even though we do it every day in a way that even the most sympathetic man can never understand.

When Representative Darrell Issa was questioned about his birth control access panel’s utter absence of women, he responded: “We heard from religious leaders whose positions might not be popular, like MLK’s position was not so long ago.” It’s not the first time that discussion of civil rights has excluded women; long before Issa or his appropriation of MLK, abolitionist Sojourner Truth told a women’s rights convention “Then that little man in black there, he says women can’t have as much rights as men, ’cause Christ wasn’t a woman! Where did your Christ come from? Where did your Christ come from? From God and a woman! Man had nothing to do with Him.” I don’t know what God’s ultimate position on contraception is, or where it fits into the current climate of theological and legal jockeying, but I do know from the Incarnation that God cares deeply about women and women’s bodies, and a Godly discussion of contraception needs to take that into account.

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  • Daniel

    Erin, I really appreciate the time you took to write this article.

    I especially like this quote:

    “Right now, it’s not just my body. It’s my unborn daughter’s, too.”

    I find this particular battleground between Church and State ironic, for two reasons: (1) many–perhaps most–Christians who pay for health insurance from private companies are [i]already[/i] subsidizing birth control through their insurance premiums. In some cases, we are already subsidizing sterilizations, in vitro fertilization and even abortion. Yet I do not know of many (if any) protests or boycotts by Christians concerning these private insurance companies. It seems inspired, IMO, by the visceral dislike–even hatred–of the State (especially of the Federal Government) by many conservative Christians.

    (2) Currently, my tax dollars are being used in hundreds of ways that violate my Christian faith. But 2,000 years ago, Christ’s taxes were being used by a militaristic, arrogant, violent, imperialist power in hundreds of ways that was clearly against God’s law. Yet Jesus paid them.

    I resent my dollars being used to support, say, the corrupt and tyrannical Saudi regime. But do you think Jesus would say “don’t pay your taxes?” On the other hand, as a “ruler” in this realm (a voter), how much action should I take to get the other “rulers” to agree with me? And if I fail to change the other “rulers” minds, what then?

    All in all, a murky issue.

  • At first glance, it appears that the case is easy. Hormonal birth control pills cause fertilized eggs to fail to implant, thus aborting the life. Plan B pills are even easier; they are taken with the intent to abort a possible pregnancy. I cannot fathom requiring an organization that believes life begins at conception to pay for Plan B drugs.

    A second point is this, at what point did it because mandatory for employers to help pay for insurance coverage? Is this the law now? I am truly puzzled by this aspect of the argument because if a company is required to pitch in for health coverage, I did not know about it.

    Third, it isn’t as if one cannot seek health care coverage outside of one’s employer’s plan. It may be more expensive, but if the cost-benefit will be better for you, or the peace of mind it brings, why not pay for it yourself?

    The only argument here that sways me is that sometimes hormonal bc is helpful beyond preventing pregnancy. It helps stifle endometriosis, the growth of ovarian cysts, and it helps women whose menstrual cycle is irregular and otherwise unbearable. I am sure there are other benefits, but these are just a few major benefits I know of off the top of my head. Unfortunately, it seems to me that this is being lost in the political shuffle.

    So think of this, there are many, many drugs that churches and other religious organizations currently cover that can harm a developing child. Some cause abortions, and some medications can cause major birth defects. Yet, never are these questioned because they have a serious medical value for the mother. I think since it is established that hormonal birth control has major value outside of being a prevention or possible terminator of pregnancies, much of this controversy dissipates.

    However, there is still the fact that businesses are forced to pay for medical coverage at all. Is that not negotiable anymore?

  • Adam Carrington

    I appreciate that CAPC is addressing this issue. Erin, I think you are right that questions of free exercise versus legitimate government interests in health are at stake. These issues require judgement of the particular situation and balancing of these concerns. But I don’t think you represent the necessities for balancing properly.

    It should be reiterated that those opposing mandated contraception coverage do not want to ban its use. My wife and I are supporters of using birth control and still outraged at the decision. We are outraged because President Obama’s decision does not take the balancing of religious liberty with health concerns with the seriousness it deserves . For my Catholic friends, male and female, contraception is a huge issue, one that Protestants often fail to understand. These are deeply held beliefs that go to the core of what God desires for marriages and the families they create. The compromise, by the way, is no compromise and was justly dead on arrival since it doesn’t change the basic fact that these organizations will still be providing contraception through their insurance. It is a platitude which was justly dead on arrival.

    The reason President Obama’s decision fails to strike a balance is because there were ways to accommodate that were by-passed. Obtaining contraception can be done without infringing on these groups’ beliefs. Both condoms and birth control can be readily and cheaply obtained, many places offering one or both for free. And we must remember that the organizations objecting do not dominate employment. There is a large amount of choice in deciding to work for an organization that doesn’t cover contraception as opposed to the myriad which do. I think these realities give reasonable assurance that women who truly desire to use birth control or other forms of contraception can do so without attacking religious liberty. Thus I would not support a ban on contraception while at the same time I would urge an exemption for organizations whose beliefs would be so attacked by being forced to provide it. This might play a bit into your confusing comment about natural and constitutional rights. I don’t think contraception falls under either, though the fact that something is not a right does not mean it isn’t a good idea.

    Finally, your description of Rep. Darrell Issa’s Congressional panel is terribly misleading. There were two panels that morning on the issue. The first largely focused on religious leaders. The second panel including several women, one of whom was an MD. The walk out by certain members from the first panel and the subsequent statements that women were not included in the discussion was cheap political theatre. Women are not being shut out of this discussion. Many of the most enraged people I’ve read or talked to about the decision have been women. Nor is this only a left-right issue. I know many liberal Catholics who are deeply troubled by this decision. As we try to balance women’t health with religious liberty, I think President Obama addressed it here in a way that irresponsibly neglects the latter.

  • I appreciate what you’ve written here. I especially like the end, where you gently approach a conclusion. I am convinced that marriage itself–even before we arrive at the fact of parenthood–that sexual difference itself is antithetical to atomistic individualism. God has not created us as un-created beings, who establish our own being within our own limits on our own terms; we are ontologically bounded, and sexual difference inscribes *within* humanity the necessity of understanding our being as created. We are dependent, and what we value contingent, upon God’s creative and redemptive work not only in general, but in our actual lived relationships; in our being ourselves and our being together. Thus it is important to understand our procreative capacities in terms of those differences, and whatever erases those differences and obliterates their trace is more threatening to our selves than whatever practical problems we encounter when trying to live them out.

  • jill

    Brad Williams, you have conflated Plan B, which is a birth control pill, with RU-486/mifepristone, which is an aboritifacent taken after pregnancy has been confirmed. They are completely different drugs with completely different uses. Plan B will NOT abort a pregnancy.

    I am furious that this entire issue has come down to birth control. If this is *truly* an issue of religious freedom, then I assume that individuals who work for Jehovah’s Witnesses cannot have blood transfusions covered in their insurance. I am confused that employers connected to churches that believe only God should have control over fertility might have insurance that covers erectile dysfunction medication (because that is obviously tampering with the will of God–if you can’t have an erection, then clearly you should just accept that you’re done reproducing and having sex). Can groups that believe AIDS is a punishment from God deny coverage for antivirals? Where does it end? If this is truly about religious freedom, then I expect every religion’s beliefs to be supported.

    That said, thank you, Erin, for a lovely and thoughtful piece.

  • Jill,

    Plan B is not RU-486, and while you are technically correct that it will not abort a pregnancy, it depends on how you define ‘pregnancy’. It will stop a fertilized egg from implanting in the uterine wall. That is unacceptable to people who believe that life begins at conception.

    And no one is denying anyone coverage. They are refusing to pay for it, as I understand. There is a difference. If you went to work for a Jehovah’s Witness company and they said, “We will not pay for blood transfusions, you will have to get that coverage on your own if you want it.” Why should the government force them to violate their conscience? In the end, you can get the coverage yourself or you can work elsewhere.

  • jon

    I am a bit disappionted the author did not mention the key point as to why the Bible states God has people reproduce. i say this because i think this eliminates gender from the discussion and clarifies why a Christian can view it as interfering with conscience and prohibiting religious practice as promised by the US Constitution..

    Scripture clearly has the view that Mankind was created to become the Children of God and to be brothers and sisters to Christ. Ultimately we understand from scripture that gender and marriage as well as reproduction will pass away. Therefore reproduction along with evangelization/discipleship are God’s method of creating His Children. the exception is Christ Himself who existed begotten outside.of time and our understanding of reality, in eternal fellowship with the Father and Holy Spirit.

  • “Ultimately we understand from scripture that gender and marriage as well as reproduction will pass away.”

    This may be your view and the perspective of many, but of the three from Scripture we only explicitly find that marriage will pass away. Scripture says nothing in regard to either the sexes or reproduction (much less genders and sexuality). Strictly speaking, we probably ought to claim agnosticism in regard to these things (unless we also claim an additional infallible authority—e.g. papal proclamations).

  • I feel like it needs to be clarified: preventing a fertilized egg from implantation is only the third line of defense for hormonal birth control. The first goal is to prevent ovulation altogether, therefore preventing the egg from meeting the sperm in the first place. Second, it makes the uterus a hostile environment to sperm – it causes a mucus to develop around the cervix, preventing sperm from passing through. Last, should the other two methods fail, and an egg is released while sperm is presenting and the two happen to connect, then and only then does it prevent a fertilized egg from implanting.

    There’s a lot of misunderstanding circulating about how hormonal BC actually works. Plan B functions on that third method of hormonal birth control, in which it basically forces the woman to have a second period (or an early one, depending on the time of the month), which prevents a potential fertilized egg from implanting. There’s no way to know whether or not it’s actually preventing a pregnancy.

    Here’s a thought: preventing access to good contraception on the slim, slim possibility that a fertilized egg actually occurs (which, as stated, we have no way of knowing has happened until after it has implanted) simply increases the possibility that actual, defined pregnancies will occur and be aborted.

    Here’s my reality: I work for a religious employer (a denomination, though I am not employed by a specific church), so this debate matters intensely to me. I need birth control coverage for medical reasons, and due to the fact that I live in Chicago and work for a non-profit, I don’t have a whole lot of disposable income that hasn’t already been earmarked for something else. I’m already paying a portion of my income into a group insurance plan, which is further subsidized by my employer. Should Synod decide that they are against the use of hormonal BC, and decide that they have a “conscience” issue, I will be looking at an additional $1,200/year expense (approx. $100/month, not counting doctor’s appointments). All for a medication that allows me to function at a normal level for one week out of the month.

    I have insurance. I have good insurance. I’m paying good money for that insurance. I need that insurance to cover that which is vital to my medical care, without my employer having a say in whether or not I do. I have signed no statement of faith in order to work here, and neither have employees of religious employers who run secular institutions (like hospitals and schools). The corporation is not a person, and therefore incapable of a “conscience.” My need to have my medical care subsidized without an extra, excessive cost to myself matters more to me than a doctrinal stance.

    Additionally, it is incredibly privileged to say “If you don’t like it, find a job elsewhere.” I was unemployed for most of last year. This job was number 47 out of 56 that I applied for. It is a financial impossibility for me to just pick up and move back home. I imagine it is even worse for those nurses, doctors, and school teachers who already have a family and an established community.

    And this comment is already too long. Cheers.

  • Dianna,

    While I do empathize with you, I really do, I still do not think that an employer has an obligation to pay for our medical insurance at all. I also recognize that although employers are not persons, they must have some kind of corporate conscience. We can hardly get mad at companies who take advantage of loop holes and ethically dubious practices like the recent loan-scandal if this is not the case. I just do not think that medical coverage is a prima facie duty to employers. (If I can use that term without sounding snobby, I don’t know how else to say it.

    If I hire a teenager to mow my yard, I negotiate a fair pay for them. That does not have to include all medical coverage, but I may have to make certain he/she is bonded to cover any havoc the said teenager may cause with the mower!

    For this argument to get any traction with me, I think it must first be demonstrated that an employer owes its employee medical benefits. If we cannot establish that, then I cannot see how we can be upset if they pay for some things and not others.

  • Carol

    Coming from Australia – I believe health insurance should be universally available to everyone who is a legal citizen. I’m sorry to disagree with you guys but I think not having health insurance of some form for the general population and having to rely on employers to provide it is terrible. I happily paid higher taxes back home to get public health insurance (and public education right thru to university). But these social issues are clearly beyond the scope of this particular blog entry.

    The only thing I’d like to add is the clarification that the Blunt Amendment (which failed in the Senate last week) would have allowed ANY employer to deny health care coverage for ANY health care service that the employer deems immoral, not just contraceptives. So this has now transcended religious freedom and just turned into denying coverage outright based on the moral choices of the employer. Which basically means that anyone can be discriminated against.

    Also – the Obama Administration did compromise to allow religious exemptions to all religiously affiliated organisations and that women who want to have insurance coverage for birth control who work for these exempt organisations would need to work directly with the insurance company to get that coverage, rather than go thru their employer. This compromise was knocked back by Catholic Bishops and the GOP, I believe. I also want to bring up the point that employees do still pay for a portion of their insurance coverage premiums – I certainly pay for a portion of my health insurance premiums every pay check. Yes, employers subsidise the majority but it’s not 100% so I think it’s not that fair to say that employers have to pay for it all and should therefore have the last veto on what they pay for and don’t.

    To me personally, I think this issue has gone too far. Women use contraceptives in all kinds of circumstances and not just because they want to have “free sex”. The concept of “free sex” is misleading too since the Pill works whether or not a woman is sexually active. I’m sorry but I’m tired of being monitored by the Morality Police from the GOP and from Catholic Bishops because seriously, they are probably the two most hypocritical institutions in existence right now when it comes to sexual purity and standing against sexual immorality.

    Bottom line – if an employer feels it’s against their conscience to provide coverage for contraceptives then they should just let their women employees deal directly with the insurance companies to get the coverage on their own. Done. But I believe this compromise from the Administration was knocked back too.

  • Brad –

    Carol’s reply actually hints at something I would respond to you with: I don’t think the employer should be involved in the insurance game at all – I don’t think that whether or not I can see a doctor should be contingent upon whether or not I should be employed, especially as my health does not change whether or not I’m employed (and therefore my need for quality medical care does not change either). But, as long as the employer is involved in the insurance game, this insurance debacle will continue to be a problem. It is certainly not something they OWE me, but it is fair compensation for the work that I do (and if they did not provide health insurance, I would expect that they would pay me a living wage that allows me to obtain my own medical care).

    It’s important to note here that while health insurance is labeled as a “benefit,” it is not some extra charity bestowed based on the good will of the employer. It is a form of wages – my employer provides me with health insurance as a partial compensation for the work that I do for them. It is a way of insuring that their employees are healthy and happy and able to do the work they are hired to do.

    What I don’t understand in this debate is this principle: There’s an argument that we can’t have universal health care coverage because then the government would be between you and your doctor. But it’s fine for your employer – whose beliefs you may or may not share – to stand between you and your doctor and dictate what medical care you receive, simply because they provide the insurance as a compensation for the work you do for them? It doesn’t make sense to me. If my employer pays me, and I use that money to pay for something they disagree with, do they have a right to tell me I can’t do that? I see the same thing happening here.

  • Jill & Dianna, and everyone,

    First to Jill: The GOP is monitoring you all the way in Australia?! Their arm has gotten long indeed! :)

    Seriously though, this discussion is precisely the kind of discussion that ought to be happening that isn’t happening. It has been played politically as a issue of religious liberty vs. women’s liberty. But wouldn’t this make more sense as a “if medical insurance is going to be private, then let it be private, and if it is going to be public, then let it be public.”

    Dianna, your point about the argument that the government being a lousy middleman but the corporation being a good one is a great point. Also, you are right about people paying a decent wage, but what constitutes a ‘decent wage’ is another imbroglio beyond the scope of this issue. As for hormonal BC being a medical necessity for some women, I know that is simple fact. My wife dealt with endometriosis for years, and without hormonal bc, it was terrible.

    The bottom line with public health care, in my opinion, is that folks who are against it are simply scared that the government will suck at it. There is a tremendous mistrust of the government in the United States, and I think that is as big a factor in this debate as any altruistic idea of a free market economy. If you could guarantee the average American that public health care would equal or surpass current coverage in quality and be cheaper or equally as expensive, I think it would win in a landslide.

    To the churches and/or organizations that help with medical coverage, I would simply say that if the conditions get unbearable, then quit helping with it. Pay the difference to the employee and tell them to handle it on their own. That’s fair. I pay for my own coverage, and that isn’t a complaint. My employer gives me a generous enough salary for me to do that.

  • Carol

    Sadly, most people’s wages & salaries in the US are not high enough for them to afford their own insurance coverage. So we’re at the mercy of our employers who may or may not subsidise a good insurance plan. My husband is a chiropractor and he’s seen some terrible insurance plans come thru his office that did not cover any kind of preventative health care, just crisis care. It’s even worse for self employed people. My husband is self employed and without my job’s health insurance, we’d have none. We do not want hand-outs – but we’d like a fair go at making a living and being able to afford health insurance and not risk having to go bankrupt if one of us gets a major illness.

    You’re right that there’s a huge mistrust of government in the US – and I don’t blame people. Government bureaucracy is terribly inefficient. However – ask anyone on Medicare, Medicaid, Social Security etc or ask anyone about regulations on corporations and most people will tell you it’s a good thing. Being a believer in Keynesian economics, I do think government can do good in limited & specific situations. Corporations do some things better than the public sector and vice versa. I don’t understand the need to select one over the other.

    I can tell you from living in Australia for 17 years before moving to the US, having several family members with health issues (high blood pressure, juvenile diabetes, osteoarthritis requiring double knee surgery, cancer) and coming from a solidly middle class economic background, me and my family have always received excellent care in the public system with no crippling costs. We also, like most people in Australia, supplemented our public insurance with private insurance coverage for elective surgeries so we don’t have to go on a waiting list. So the free market in Australia is not being impeded by universal health care but rather competition from the public sector means private insurance companies have the incentive to provide good coverage plans for customers. It can be done here too, I’m sorry that universal health care was never even an option during the last health care reform debate and I’m even more sorry that the debate was hijacked by extreme elements from the GOP with outrageous talks of death panels and such. But reforms we do have now and at least it’s a start.

    Not to say the public system is perfect, of course it isn’t. But being someone who knows I am about to lose my job due to my company being sold – I’d much rather have the assurance of some form of public health insurance while I am between jobs than none whatsoever. Yes, there is COBRA but the costs per month for just my husband and I are way out of our budget so it’s not an option.

    P.S. Brad – I think you meant me when you wrote Jill =D I’m living in the US now but used to live in Australia since the age of 9 till when I got married (to a Yankee! haha) then moved here. My family are still there.

  • Brad –

    I’m delighted that you’re engaging with me on this, and I think you’re absolutely right in that it is fear of that the government will “suck at it” that prevents people from supporting a publicly-funded health care system. In discussing this issue with my dad the other day (a staunch conservative), he brought up the way that the government “helped” families with disabled children back in the 60s/70s as evidence that the government is not trustworthy now (disabled kids would be taken from their homes and institutionalized [and frequently sterilized as well]). That is why he does not trust the government to hand social issues. But, distrust of the government isn’t a reason to blindly trust a company that is concerned about the bottom line, and I think that’s the crux of the larger issue here of public vs. private.

    I remember back when Hilary Clinton was pushing forward her universal health care plan in the early 90s. I was just a kid, but I asked my dad about it, and he explained to me that the government wanted to take health care out of the hands of private business and that that was bad. But – I’ve since realized – it’s only bad if you function from the premise that government is an inherently evil entity. It’s a clash of philosophies.

    To me, both government and private companies are value neutral. They are both capable of good and capable of bad, and inherent distrust of either without evidence is a bad idea.

    Thanks for engaging with me on this!

  • Carol

    “To me, both government and private companies are value neutral. They are both capable of good and capable of bad, and inherent distrust of either without evidence is a bad idea.”

    Bingo, I heartily agree!

  • JMC

    First off, thanks Erin for writing this. There are a lot of issues in play here, and, for anyone approaching it honestly, it’s bound to make your head spin.

    I also have to thank Adam C. for representing a lot of what I’m feeling as a Catholic. He nailed it. To put a simple analogy to the early Feb compromise, it went from me buying the beer for the 15 year old to me giving the money to someone else to buy the beer for the 15 year old. Either way, if I’m being honest with myself, I’m buying the beer for the 15 year old. (I also remember what a tool the guy was who wouldn’t buy me beer was when I was 15, but I digress.)

    When my wife and I joined the Catholic Church a few years back, we did so after basically accepting the Church’s anti-contraception stance on faith (that is to say, we didn’t necessarily see what all the fuss was about, but we knew that as Catholics we were obliged to accept it). I won’t say I completely “get it” even today, but I will say that I have come to see the principle behind it as completely relevant and wonderful. That principle boils down to this: the creation of human life and the sexual act are fundamentally woven together, and to separate the two in any way is a grave evil. There is a prophetic side to this observation, and we see it playing out in all kinds of ways today: pornography, higher divorce rates, redefinition of marriage, human cloning, and the list goes on.

    There have been some objections raised about the use of the pill or other contraceptives for the treatment of diseases. While I’m no policy wonk, there is nothing in Catholic teaching that says a pill manufactured for contraceptive use cannot be legitimately used instead for the treatment of disease. If a doctor is going to prescribe it for that purpose, a Catholic employer would be wrong under Catholic teaching not to contribute his or her fair share.

    The other thing that is not mentioned but needs to be noted is the redefinition of the “freedom of religion” to the “freedom of worship.” The HHS mandate is bound up in this. This observation once seemed alarmist, but it now seems prescient, especially given the recent Hosanna-Tabor vs. EEOC Supreme Court case. I’m not sure how much of an election year motivation is behind the HHS mandate, but it seems awful suspcious, as if our President and his administration are trying to remind Catholics in swing states just how “backwards” their religious leaders are.

    What this issue comes down to for me is a question of free will. To coerce someone into violating their conscience goes against one’s humanity. That’s the brilliance that I see in the American way – that we have created a society where we can all live together, and if you decide that you can’t take part in something, you aren’t forced to do so. And I fear that if that falls in principle, if we start forcing those weirdo Catholics to buy us birth control (or if we tell Muslims they can’t build a mosque in our town because they’re Muslims), we are taking a fatal first step towards the obliteration of individual rights in this country.

    This is a great dialogue; I hope it keeps up.


  • Carol

    @ JMC & Adam C,

    Thanks for both your input. I read Rachel Held Evans blog and she has a series where persons of different faith traditions (inside and outside of Christianity) offer themselves up for questions from readers of her blog. She had one for “Ask a Catholic” and here is how they explained the Catholic Church’s teaching on contraception:

    “The contraceptive promise that the feminist movement made to women goes something like this, “you will be free from fertility, so you can enjoy sexual relations without fear of having a child; you will be slim and beautiful and also can enter the workplace, just like men do, finding fulfillment through your accomplishments.”

    But there have been side-effects and unexpected consequences: Physically, the Pill can cause headaches, bloating, and blood clots, as well as increased risk of cancer, infertility, and miscarriage. Since the Pill divorces the marital embrace from procreation, in marriage it can lead to the husband viewing his wife as an object for his own pleasure (lust). (God intended the marital embrace to have both unitive and procreative aspects.) Also, husband and wife often will not communicate about fertility and child-bearing—the woman just takes the Pill and that’s that—which reinforces a lack of respect for his wife and the gift of her fertility.

    Socially, the Pill has led to infidelity in marriage, promiscuity before marriage, abortion (what happens when the Pill fails?), and many other evils. God was wise to connect the marital embrace to procreation, for in doing so He provided an important means for helping men especially control their sexual desires. With that connection broken, men have less need to learn self-mastery (chastity). And so you get these modern relationships where a man and a woman are cohabitating for many years, the woman longing for marriage, but the man happy to have the sexual pleasure without the deep commitment that marriage entails.

    The Catholic Church believes that women deserve to have their fertility honored and cooperated with in a loving marital relationship, where their whole selves are welcomed, including their fertility. If women need to space their children apart and delay conceiving a child, they should have recourse to do that in a way that respects their body’s God-given design. On the flip side of the coin, if women are having difficulty conceiving, they should have recourse to good medicine to diagnose problems and correct them in a gentle manner. (The science of fertility awareness focuses on just these issues.)

    When a couple uses fertility awareness, as my wife and I have done, they are drawn closer together due to the frequent communication both about the woman’s physical signs of fertility as well as whether they are open to receiving the gift of another child from God. The husband grows in respect for his wife and how wonderfully she has been made, and when periods of abstinence are called for in their discernment, he learns self-mastery and the virtue of chastity is strengthened within him.”

    I thought that was the best answer to explain the Catholic Church’s teaching on contraceptives that I have ever heard. It basically changed my mind on how I saw the Church’s stance. I used to think it was silly and antiquated. Now I think it’s quite right and justified.

    I believe a woman should be able to make decisions about her own body. But as a Christian woman, those decisions need to be made in the light of a fellowship with God and desire to live in accordance to His designs for us. In everything, including our sexuality. It’s not an easy task but by grace, we are given all that we need to live a life holy and pleasing to God.

  • Carol

    Whoops, I forgot to provide the link to the full “Ask a Catholic” Q&A. Here it is:


  • Carol

    Sorry for the multiple posts today but I wanted to clear up what I think are some misconceptions about the Administration’s compromise on contraceptives coverage.

    It does not mean that religious organisations would still have to indirectly pay for contraceptives, to which it objects. It gives religious organisation an opt out completely and puts the onus on insurance companies to provide coverage directly to women with no co-pays. The same insurance company is required to offer insurance plans to exempt religious organisations that do NOT cover contraceptives. I’ll link to a great article explaining this better than I am:


    Here are quotes that helped me understand the details:

    “Under this plan, every insurance company will be obligated to provide contraceptive coverage. Administration officials stated that a woman’s insurance company “will be required to reach out directly and offer her contraceptive care free of charge. The religious institutions will not have to pay for it.”

    Moreover, women will not have to opt in or out; contraceptive care will be part of the basic package of benefits offered to everyone.”

    “The way it works is this: Insurers will create policy not including contraceptive coverage in the contract for religious organizations that object. Second, the same insurance company must simultaneously offer contraceptive coverage to all employees, and can not charge an additional premium.”

    The Catholic Bishops wanted to eliminate contraceptive coverage across the board regardless of religious affiliation. In other words – “secular” private employers would be exempt too. Hence the Blunt Amendment. So that’s a much broader reach and I think it goes beyond religious freedom now. Now we are talking about requiring non Christians to conform to Christian moral values and I don’t think that’s going to work.

    As for election year politics – in several states currently there has been laws on the books since the 90’s that mandate requiring employers to offer contraceptive coverage, with no exemptions recognizing the “religious liberty” of religious employers – with no collective freak out from Christians…..but now that it’s also in the Affordable Care Act (championed by Obama)…..NOW it’s an issue?? NOW it’s an attack on Christian liberties? Come on……

    I’m sorry but I think a lot of the arguments from Christian leaders on this issue are disingenuous because it seems like they only care about freedom of religion for Christians. I didn’t see the same Christian leaders speaking out against people saying Muslims couldn’t build mosques (on their own private property, no less) when that whole mess was going on. Freedom of religion has to extend to all – not just ourselves.

    I think the compromise is good. It doesn’t violate a religious organisation’s conscience by making them pay for contraceptives indirectly but also gives its women employees direct access to contraceptives coverage with no copay.

  • JMC


    Thank you for your response.

    You are right, that is an excellent account of the Catholic teaching on contraception. Thanks for sharing it. The part about “self-mastery” resonated especially with me. If I may do so, I’d like to plug Pope Paul VI’s Humanae Vitae. It’s not too long, and it’s an illuminating and relevant read:


    As for your comment 3/7 @ 1:10pm, you quote someone else as saying: “The way it works is this: Insurers will create policy not including contraceptive coverage in the contract for religious organizations that object. Second, the same insurance company must simultaneously offer contraceptive coverage to all employees, and can not charge an additional premium.”

    What this doesn’t say is who will actually be paying for the contraception. I don’t know what that answer is, but insurance companies are businesses, and normally when companies want to provide you a “free lunch” that cost is sunk elsewhere. I ask this without guile and in all sincerity: can you tell me how these insurance companies will pay for the contraception?

    You next state the following: “The Catholic Bishops wanted to eliminate contraceptive coverage across the board regardless of religious affiliation. In other words – “secular” private employers would be exempt too. . . Now we are talking about requiring non Christians to conform to Christan moral values and I don’t think that’s going to work.”

    Hmmmm…I’m not sure that this isn’t an overstatement of the fact. To my knowledge, Catholic Bishops want to eliminate the requirement for anyone to cover contraceptives, while still allowing them to do so if they choose. I believe that’s the essentially the way things are today. But let’s say I’m a Catholic private business owner building non-religious widgets or something. I have some obligation under Catholic teaching to provide generously for the well-being of my employees. Why shouldn’t I have my conscience rights protected as well?

    As for the laws on the books in several states since the mid-90’s, I cannot speak to the details or the history of those. I can generally say that it is entirely possible that they were not viewed as crucial issues because A) they were at the state level and B) Catholic moral teaching allows for some level of indirect cooperation in evil when a greater good is at stake (I’m not saying this correctly, but hopefully you catch my drift). A LOT more could be said on this, but I will simply say that I think this particular talking point is a diversion from the real issue, which is religious liberty, and the laws of the land which have historically protected the first amendment rights of believers to be true to the consciences.

    As for Christian leaders only caring about freedom of religion for Christians, I’m sure you are right in many cases, but I also know that the Catechism of the Catholic Church says this: “Freedom is exercised in relationships between human beings. Every human person, created in the image of God, has the natural right to be recognized as a free and responsible being. All owe to each other this duty of respect. The right to the exercise of freedom, especially in moral and religious matters, is an inalienable requirement of the dignity of the human person. This right must be recognized and protected by civil authority within the limits of the common good and public order.” (CCC 1738) So if Christian (and especially Catholic) leaders haven’t been standing up for the religious freedom of others, yesterday was the time to start. As for me (not a Catholic leader per se, but hey, I do teach Sunday School to 6th graders!), I began to drop my support of of a certain presidential candidate last summer when he came to my neck of the woods and said that a local township had the right to prevent local Muslims from building a mosque there. BS. What a disappointment.

    And that’s the principle at stake. It may seem like a fine point now, but to those who have historically relied on the protections of the First Amendment in these sorts of matters, it is the first step toward greater tyranny. When principle falls, when human beings can be coerced to act against their consciences, what is a human being then?

    Thanks again for your dialogue Carol. I truly value it and respect your disagreement. I hope you’ll forgive me for being slow in my response. That’s the way I roll, but if you wish to continue the discussion I am happy to do so as well.

    All the best,

  • Carol

    Hey no worries John, your response wasn’t slow and I’m in no hurry =D

    I don’t see it as disagreement in any case, just my views on what you were saying and I really appreciate you putting in the time to discuss further. I think my views on contraceptives are markedly different now than they were before (read: when I was young and idealistic…haha) I did use to see it as more about my rights as a woman but since reading the Catholic response to the questions posed on Rachel’s blog, I’ve been challenged to examine my views. I don’t think I would use birth control today even if my husband and I weren’t planning on having more than 2 or 3 children. I think I would use natural family planning methods instead and fully rely on God’s leading and direction in that area.

    Thanks for sharing the link too, I will definitely read it.

    “can you tell me how these insurance companies will pay for the contraception?”

    How I understood the explanation was that employers objecting to contraceptives would not have those services in their plan at all, because there would be a specific policy in their contract exempting them from the mandate to provide coverage. The insurance companies are supposed to provide coverage directly (without involving the employer) to those women who want it – with no requirement for additional premiums. So only the insurance companies will be paying for the contraceptives – direct to the provider.

    So I took it as literally free of charge – the employer doesn’t pay for the services cuz it’s not even in the plan they offer to their employees, the employee doesn’t pay for it, only the insurance company pays for it directly to the provider (which would be either the doctor prescribing the medicine and/or the pharmacy that sells it, depending on the billing, I guess).

    “To my knowledge, Catholic Bishops want to eliminate the requirement for anyone to cover contraceptives, while still allowing them to do so if they choose.”

    I see what you’re saying, it’s really more about the mandate and employers (religious or otherwise) being exempt completely. That is – if I work for an organisation that morally objected to contraceptives then the insurance plan they provide would likely have no coverage for contraceptives at all and the organisation wouldn’t be required under the law to do so.

    Fair point but I think my point stands too that now we’re going beyond religious organisations and covering any and all employers with a moral objection under the exemption. I think that is a much wider reach than originally intended and would open a whole new can of worms.

    I wish I had the link to substantiate that currently in several states, there is already mandates in place for employers to provide coverage for contraceptives. I’ll have to do some digging. I can see your point that it’s at the State level which is clearly different from national level but I feel like that’s splitting hairs, isn’t it? Because if we think it’s bad in general to use contraceptives then why hasn’t the Church been protesting these state-level mandates all these years? Because if it starts in 1 state and before long, it’s all 50 states. Which is why I suspect it’s more politically motivated than a true defense of religious liberty. Even more so when I see, as you did, the positions of some of the Presidential candidates who back the Bishops but are against other religions exercising their freedoms. But again – that’s my opinion only.

    “It may seem like a fine point now, but to those who have historically relied on the protections of the First Amendment in these sorts of matters, it is the first step toward greater tyranny. When principle falls, when human beings can be coerced to act against their consciences, what is a human being then?”

    Excellent point, you’ve said it really well! Which is why I don’t personally support a mandate of any sort, really. But as I’ve stated above – I also think health insurance should be universal and I support a single-payer public system that is supplemented by private insurance that individuals can obtain. Leave employers out of it altogether and let everyone deal with their own consciences when it comes to what kind of private insurance plan they want to buy into to supplement the public coverage. Sadly, that’s not the system we have right now here in the US. I don’t think the mandate was a good idea. But I think the compromise is as good as it’s gonna get – as long as employers of religious affiliation can be exempt from it entirely.

    I’ll go do some digging and see if I can find the links on existing state level mandates.

  • JMC


    Great response. I am in a bit of a rush at the moment, but I will respond in due time. Thanks again for the discussion.


  • JMC

    For some reason my latest comment won’t post. I’ve been trying since Saturday. What givz, o ye admin godz?

  • Kevin

    One issue I didn’t see in the post or the several comments I read is the question of who’s religious views take precedence in the matter? A woman or couple may identify as Catholic while not following all of the practices her or their priest admonishes them to do. Somee people consideer themselves Catholic but refuse to acknowledge the divinity of Jesus or the immaculate conception. The point of bringing this up is that the employer and employee may be reaching a conflict of religion, while at the same time claiming to follow the same religion. At that point, does the employer’s interpretation of the religion take precedence over the freedom of the employee to interpret their own religion, and their ability to make medical decisions based on that religious view when coupled with the advice of their physician?
    If the employer is allowed to refuse medical benefits based on religious interpretation, where beenefits are offered to some employees and not others based purely on religious interpretation, the employer is overstepping the employer/employee relationship in anunfair way, which then drives us into labor law. It also has the effect of forcing the employee to follow not just a religion, but a specific interpretation of that religion, by threatening that employee’s compensation and possibly their job.
    Personally, I would advocate for employers to provide a set stipend to each employee, earmarked for health care, and allow the employee to tailor their insurance coverage to their individual needs. Essentially I would get the employer out of the position to determine the coverages for individuals.