Two perspectives from two committed Catholic women. The first comes from Valerie Schultz, an occasional contributer to America:
We Catholic women are often cast as "less than" by the policies of the religious hierarchy of our church. We are forbidden ordination, and yet we fill the pews, teach the children, run the offices, clean the parish facilities, care for the sick and minister to others in countless ways. We love our church. We trust that the Holy Spirit is moving among us in mysterious ways, and we attend to what is in front of us.
But enough already with the politics. Enough with the posturing about the Obama administration attacking the church, and the hyped-up outrage. This laywoman has a few things to say.
For me it is strange that contraception is suddenly a big Catholic concern. For over 10 years, while our own family was growing, my husband and I taught Natural Family Planning classes at our local parish. The Billings Ovulation Method is a scientifically proven way of charting the menstrual cycle in order to space the births of one's children without artificial contraception. It takes the guesswork out of the old Rhythm Method, and when taught and used correctly, is as effective as the pill in avoiding pregnancy. We used it ourselves, and it works. As Natural Family Planning methods are the only ones that are sanctioned by the Church, you might think that our classes were much in demand, standing- room only. The stark reality is that, in a parish of more than 800 families, we taught about 20 couples in 10 years. Twenty. And not all of them were even Catholic. Despite bulletin blurbs, newsletter articles and weekly announcements, our classes were usually individual tutorials. Judging by our experience, the reported statistic that 98 percent of Catholic couples at some point use artificial birth control rings true.
My point: In over 50 years as a Catholic, I don't think I have ever heard a homily on Natural Family Planning. I have only rarely heard a whisper from the pulpit regarding why the church opposes artificial birth control. Meanwhile, Catholic families have been shrinking, and Catholic spouses have been comfortable in following their consciences in the matter of family planning. And all has seemingly been well.
The ringing response by the Catholic bishops to the Affordable Care Act's stipulation that insured American women be covered for contraception at no cost, therefore, seems disingenuous. It reminds me of the scene in "Casablanca" where Captain Renault closes down the bar and protests to Rick, "I am shocked -- shocked -- to find that gambling is going on in here!" Just then, the captain is handed his winnings. The bishops simply cannot pretend to be shocked that contraception is going on in the lives of American Catholic women.
Teresa Tomeo offers a defense of the bishops' resistance to the HHS mandate in this interview with National Review Online. Ms. Tomeo is the author of Extreme Makeover: Women Transformed by Christ, Not Conformed to the Culture:
LOPEZ: You seek “to tell as many people as [you] can — especially women — that [you were] wrong and that the Church was — and is — right!” When the White House is moving against the legality of practicing some of the stuff Catholicism teaches, why the heck would anyone be receptive to such a message?
TOMEO: Because, as Glenn Beck recently said, “We are all Catholics now.” In other words, the HHS-mandate issue is about religious liberty and the right of conscience, which affects everyone of any faith — not just Catholics. The government does not have the right to tell any religion what it can and cannot teach — and that is basically what this administration is trying to do. They are trying to define their version of “religion.”
LOPEZ: What does the new “free birth control for all” policy of the United States mean to you?
TOMEO: That according to those in the current administration, there is only one acceptable ideology in this country — pro-contraception and pro-abortion. It’s their way or the highway, as the old saying goes; and it is very eye-opening as the lines are becoming much clearer. I see this, though, as a great opportunity for all people of faith — particularly in the Church — to lead the way in the fight for our basic constitutional rights.
LOPEZ: What do you think when you hear Catholic conscience protests dismissed because so many Catholics don’t practice what priests don’t even preach?
TOMEO: Most people go at least ten miles over the speed limit; that doesn’t make their actions correct. There is a very high percentage of young people who engage in underage drinking. That doesn’t mean we should lower the legal age limit to 14 just because “everyone” is supposedly doing this or that. To me, this is such an immature response. Just as with particular laws we have established in society, the Church has also established her own set of teachings for our benefit. It seems that this type of argument is only brought up when we are dealing with issues below the belt. I also question some of the statistics that the anti-Catholic pundits are using when it comes to the number of Catholics using contraception.
Tim Reidy
Expecting employers who do business with the US government to provide an employee benefit that all other employers are required to provide is not an infringement on religious liberty.
If Jewish agencies do business with the US government, they do not have a right to say that school lunch programs should not include pork options if their cafeterias are providing school lunches using federal funds. If they have a rule that pork products not be on their premesis, then the government is likely to offer an accomodation so that does not happen. Jews would still be free to tell all their students and employees that it is against Jewish custom to consume pork even though the school lunch program contains pork products.
Catholic affiliated employers are free to tell their prospective and current employees that it is against Catholic teaching for people to use contraceptives. They can do this every day even though they are providing insurance coverage and insurance policies are supposed to make prescriptions available without copays. They have freedom of religion.
Pregnancy is not a disease, but it can give rise to disease, such as gestational disabetes, toxemia, etc. However, pregnancy all by itself IS a health condition and it is one that raises health risks and mortality risks for ALL women who become pregnant. Women's health is at risk from pregnancy and some die from complications of pregnancy and childbirth - uncontrolled bleeding, for example, is not a disease but it kills women in childbirth. Preventing pregnancy reduces the risk of mortality for women. For women in many third world countries, the mortality risk from pregnancy is quite high. But, it is not my perception that Rome cares much about this issue, because it does not know much about women nor care much about them beyond their role in procreating human beings, nor does Rome care about the exposure of women (and their unborn children) in Africa to AIDS because they don't have access to condoms. Until Utopia arrives, women need access to reliable birth control, including the pill and condoms. This is preventative medicine.
That is a nice idea in theory, but in today's world if you have a pre-existing condition, you cannot get individual health insurance. The only way is through an employer insurance plan.
What is new is that the Secretary of HHS has the final say over what is cover in your and my insurance policies. I don't like the idea that my insurance policy might change after every election. I'd rather be able to shop around and choose a plan that meets my needs, my budget, and my moral beliefs.
http://www.cbsnews.com/8301-503544_162-57395832-503544/poll-most-say-employers-should-be-allowed-not-to-cover-contraception/?tag=contentMain;contentBody
I see that no actual accommodation has arrived yet. I suspect the Obama administration will try to wait this out until after the election and then betray their liberal Catholic allies yet again. But it is great to see there is still a solid majority in the country who support the first amendment (at least outside the editors and reader of this magazine). Maybe, Obama can be forced to do the right thing sooner rather than later?
Are you under some delusion that insurance is a free market product. I don't know of any other industry in America that has more government oversight. Perhaps, you don't like the HHS Secretary having authority over insurers, but do not mind that at the state level insurance commissioners have authority.
The question that should have been asked is "are you in favor of singling out medications prescribed exclusively to women for exclusion from the essential benefits coverage without copays?"
Anne, you are mischaracterizing the issue. No one is trying to deny women access to brith control. It is freely available in drug stores nationwide. The question at issue is who pays for it? And more specifically: should religous institutions be required to cooperate in something they view as sinful? That is why this is a religious liberty issue.
But I agree that insurance has more government oversight than other industries, and I think that's one major reason the costs have skyrocketed in recent years. Each new mandate costs money to comply with, and those costs are passed along in higher fees to employers and employees.
The church is a federal and state contractor. It has received billions in taxpayer funds for work that is not limited to Catholics, nor which is exclusively staffed by Catholics. If contraceptive is the norm for contractors to the government for services provided to all without religious distinction, with employees who are hired for their experience and expertise rather than their religious backgrounds I personally think that they should be required to meet all the requirements the government asks of all of its contractors. If the church is unwilling to do those things required by the government (state and/or federal) of its contractors, then they should no longer accept federal/state tax money. They have the freedom to choose - and if they believe that a specific contract has requirements that violate their religious beliefs they do not need to seek out those ''business'' opportunities. There are many others who have the ability to provide those services with tax funding.
Within its own religious institutions, which are funded by their own members to serve the religious needs of their own people, the church should not be required to pay for birth control pills.
If this means the church may have to give up running hospitals etc, then that is what must happen. Members of the public who come to these organizations, such as hospitals that serve the general population, should be able to expect to be treated according to their own religious beliefs rather than those of the Roman Catholic church. In most non-emergency situations, people have a choice - if they want a tubal ligation, they can choose a hospital that provides them. If, however, they are taken to a hospital with an emergency that is life-threatening, the hospital should provide the ''ordinary'' care they would receive in any other hospital.
St Thomas Aquinas would be surprised at how many bishops and their supporters think that the conscience in somehow located/resides in an institution. At the board, CEO, owners, votes of Majority, unanimous ??? where does the conscience reside? If the bishop is not on the board or the deed how are his liberties curtailed?
The question I posed was to show that the same issue can be presented as something completely different. In fact, I believe the bishops' claim is distorted. As individuals, they do not have to pay for contraception, and as Ed #30 points out, the institution does not have a conscience; it has a teaching. It is not prevented in any way from verbalizing its teaching to its employees. It's employees are free to decline contraception that their insurance policies will provide. The only violation of conscience rights is to have this option excluded from the benefits earned by the employees of Catholic brand institutions engaged in secular activities, thereby not permitting the employees their right to exercise their consciences.
I doubt that complying with regulations is the reason health care costs have gone up. However, I would say that at the doctor's office level, the costs of waiting for payment from insurers and the staff required to deal with billing makes things more expensive than they would be if we all paid on the spot out of, say, our government managed health payments accounts. This, though, is not the reason that health care costs keep rising.
I think there are people who are better able to analyze the reason for health care cost increases than I am. Some people, unfortunately, seem to blame sick people's needing medical care for this as though this was not the point of getting health insurance in the first place. It would be better if these people looked on health care as economic activity - manufacturing of medical products, provision of medical services in a service oriented economy.
No, they don't have the "freedom to choose," because the mandate is not limited to government contractors, it applies to all employers nationwide. Catholic institutions could stop accepting federal money and they would still be covered by HHS rules.
Also, the reason the government contracts with so many Catholic institutions is that they have historically done an excellent job providing health, education, and other services to the poor. If Catholics are forced to stop accepting these contracts, the government will have to replace them with private businesses that may cost more and/or provide lower quality services. And that will only drive the costs of health care even higher, and the cost estimates have already doubled to $1.76 trillion since health care reform passed. How much more can we afford?
Joseph: let me give you an example of where sterilization is a medical necessity....and this is common. A young married mother of 3, who had difficult deliveries, is told that another pregnancy would be life-threatening. She cannot take the pill or be sterilized because the Church says that this is immoral. In this case, the hierarchy of values are turned upside down. The prudent decision to use the most effective means to safe-guard her life is morally irrelevant or subordinate to a decision to use risky PC or celibacy in order to preserve that every marial act has a procreative meaning. In this situation, almost every physcian would recommend sterilization. Who among us would deny that sterilization is not medically necessary and prudent uder these circumstances?
The provision in insurance plans that often govern what is covered or not is called "medical necessity". This is a broad and complex term and using such provisions inappropriately to deny care have been highly criticized.
It is up to the insurance company to determine medical necessity based on the attending physcians diagonsis and justification. The justification can take many forms including preventative and psychological health. The pill is often covered for any number of reasons including, but not limited to: the pain of endometrosis, irregular mentrual cycles, or to avoid another pregnancy that may threaten the health and well-being of the mother and family. As mentioned, taking the pill can also avoid another pregnancy where the mother's life in threatened. Such reasons are grounded in healthcare, not in religioius beliefs.
While there are as many definitions of medical necessity as there are health plans, the definitions do have some common elements. Most include the following:
The care should be appropriate;
The care should resolve a problem or improve the patient’s health, functioning or well being;
The care should be provided in accordance with standards of good medical practice or generally accepted medical practice;
The care should not be experimental, educational or investigational.
Your statement was about as acceptable as calling pregnancy a "self-inflicted injury."
BTW, if it was, no insurance plan would cover it.
People on the right keep saying that it's not about birth control, it's about religious freedom. Well, if it's about religious freedom, it's certainly not about the freedom of a religion to teach, unless it goes like this: Our religion teaches that the Catholic Church gets to tell everyone what to do and that people have to do it our way, and by not doing everything we say, you are impinging on our religious freedom.
Ms. Schultz, on the other hand, knows what she's talking about.
The idea that employers should not pay insurance would pass my test. We've had many employers and changing groups is always a pain in the neck. I am willing to bet it was the insurance lobby that was against taking away the employer provided insurance. I would prefer there to be a single payer instead of a host of complex insurance schemes to deal with when I get health care. I was in favor of having all citizens pay into a health care pot according to their ability (percentage of income) and taking from it according to their need. However, given the uproar over one small product being included in a host of products and services, I see that that would have been even more offensive to the Catholic Church and people with "moral" objections to women's health care.
Your solution sounds simple, but this is not just about making things easy or simple. It's about satisfying various special interests.
As to your point that Kathleen Sebelius is now setting policy and a Republican could set policy in the other direction. What else is new? I would say, though, that the difference now is that preventive care is being encouraged where this was never the case before. I think this is worthwhile no matter what the details are. It would be blatantly discriminatory to exclude prescriptions that only women use, in any case.
Politicians become actors, understanding that their grip on power rests on their charisma and their ability to manipulate masses of spectators of the game-politics. By then society makes use of "experts" to explain to the spectators the strategies followed by the politicians, in an attempt to give credibity to the jesters.
Without a clear understanding of human dignity, the spectacle ever deforms into a tyranny or anarchy, or both. The phenomena can be called Caesarism. The spectator ceases any active participation but still has to be given bread and circus, which is all that is left.
"We Catholic women are often cast as 'less than' by the policies of the religious hierarchy of our church" is no better.
The government is not merely "allowing" this. If an insurance plan wishes to cover birth control without copayment, fine, I don't object. The government is mandating that all insurance nationwide plans must offer contraception and sterilization and abortifacient drugs free of charge. And since these things cost money to provide, that cost will be passed on to someone, namely the employer.
The religious freedom in question is not merely the freedom to teach, but also the freedom from being forced by the government to participate in actions that violate one's conscience. For instance, we have conscientious objector laws that exempt pacifists from military conscription since fighting in a war violates their religious beliefs. Along similar lines, if I believe abortion is a grave moral evil, I should not be forced by my government to pay for it in violation of my conscience.
However, in no case is anything free of charge given that people are paying insurance or having it paid for them as part of their employment compensation. If you have insurance, you know that copays were instituted to attempt to prevent overuse of benefits. In the case of essential benefits, these are preventive in nature and so are being offered without copays so that they will be used, unless the individual prefers not to use them.
In terms of what is abortifacient, no prescriptions are covered that are intended to end an established pregnancy.
> these are preventive in nature and so are being offered without copays
Precisely which disease does sterilization prevent? Why, for that matter, is contraception considered "health care?" Is pregnancy a disease?
> However, in no case is anything free of charge given that people are paying insurance or having it paid for them as part of their employment compensation.
If that is the case, why not simply drop contraception from the mandate? Employers who wish to exclude it will do so, and the cost of policies will drop accordingly. Employees will pay less for health care and/or get a slightly higher salary, and they can use the extra money to pay for their own contraceptives if they wish. Everyone is happy.
Sometimes women's bodies give out, and when that happens, pregnancy can be life threatening. Some women have heart conditions, for example. If after they've risked their lives for one or two children, they and their husbands decide that it would be best to be sterilized.
Sometimes oral contraceptives help women battle ovarian cysts that can cause them to become sterile. Some women, like me, have had to use them to prevent debilitating menstrual symptoms like uncontrollable vomiting and fainting. Other women use them to regulate their ovulation for the purpose of being able to conceive.
Your suggestion to leave out contraceptives denies the genuine medical benefits, plus it is discriminatory. You might argue that men-only prescriptions should be excluded in the name of equity, and if you did, at least you would be consistent even if you have been insensitive to women's medical needs.
I will tell you, though, that after thousands of dollars are taken out of my pay for insurance and that insurance pays only for the medical care of smokers who get cancer and overweight people who develop a plethora of conditions, but doesn't pay for my prescription that makes it possbile for me to be a good employee and show up every day of the month, I want contraceptives to be covered. So, not everyone is happy.
Pregnancy is not a disease, but it is a health condition. Marie has mentioned several health issues, including diseases, for which the pill is the best treatment. But that is not all. When women become pregnant, they normally go to a doctor, who examines them and tests them for the next eight months to ensure the health of the mother and the baby. Should obstetrician visits not be covered because ''pregnancy is not a disease''? Should all women deliver their babies at home and insurance premiums not cover hospital deliveries because childbirth is ''not a disease''?
The mortality rate to women from pregnancy and childbirth in the developed countries is higher than that of any method of birth control, including the pill. In third world countries, the mortality rate from pregnancy or childbirth are as high as one in eight. That is a health risk. As women get older, the risks go up and once families are complete, many opt for a tubal ligation or the husbands get a vasectomy. Covering the pill and sterilization is health care, and preventing pregnancies may prevent the deaths of mothers and babies. Covering the pill and sterilization is certainly a more important health issue than covering the cost of viagra is.
The problem with the current health care law is that it does not trust individuals to make these decisions, but instead centralizes all power in the hands of Kathleen Sebelius to make these choices and impose them, by mandate, on all Americans.
And even if you happen to like the rules Secretary Sebelius imposes, keep in mind that no party stays in power indefinitely, and eventually there will be a Secretary of HHS appointed by a Republican. If that Secretary uses the same federal power to impose a mandate barring all health care plans from covering contraceptives, will you still think centralizing so much control in Washington is wise?
I don't believe the bishops are objecting to the prescription of the pill as a treatment for disease, but rather as a contraceptive. The purpose and the intent matter.
> Should obstetrician visits not be covered because 'pregnancy is not a disease'? Should all women deliver their babies at home and insurance premiums not cover hospital deliveries because childbirth is 'not a disease'?
I'm afraid I don't get your point here, this seems like a bit of a non sequiter. The purpose of obstetrician visits and hospital deliveries is, as you said, to prevent any number of complications that can result in injury or death to a mother or child. That is the purpose of health care, the maintainance of health.
It has been asserted that contraception is "preventative health care." Real preventative care prevents diseases. Contraception prevents pregnancy. If contraception is preventative care, the implies pregnancy is the disease it prevents.
As a matter of fact it is correct. If you are in the left lane and go the speed limit your life is in danger. It is a matter of common sense.
Be that as it may Valerie's words are powerfully persuasive. This issue is blowing up in the bishop's faces. They are definitive hypocrites. It is only their holding on to the "obey" mentality which makes them continue their incredibly ridiculous path. But as long as they have mindless people echo them they will continue.
In fact, if employers are allowed to exempt themselves from paying for any service they are morally opposed to, I foresee there will eventually be a lot more who will have a two-child policy than a no-birth-control policy. Most people I know think over-population is a much more important moral issue than unprocreative sex.
At that point, the Catholic bishops will probably demand that the amendment to the law they previously demanded be amended to allow only exemptions for services that are displeasing to Bronze Age dieties. The Bronze Age dieties were pretty much unanimous that women should have lots and lots of babies.
> The care should resolve a problem or improve the patient’s health, functioning or well being
Sterilization destroys a healthy reproductive system, therefore it does not "improve the patient’s health, functioning or well being." Quite the opposite, in fact.
> Who among us would deny that sterilization is not medically necessary and prudent uder these circumstances?
I don't believe the "prudent" thing to do is always the right thing to do. I don't think Jesus said that following His way would always be easy, convenient, or without major sacrifices. Periodic continence, and in some cases complete abstinence, are not the easy choice, but sometimes they are the only morally acceptable option.