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"Bad" Samaritans

TheNew York Times carried an article last week on the dispute that is emerging between Democrats in Congress and the White House over Obama's consideration of the Catholic bishops' appeal to widen the religious health care exemption to make it possible for non-ecclesial, religiously affiliated institutions (like Notre Dame) to deny contraception coverage to its employees. In the article, the bishops are quoted making their case as follows:

Under the governments narrow criteria, the bishops said, even the ministry of Jesus and the early Christian Church would not qualify as religious, because they did not confine their ministry to their co-religionists. Moreover, the bishops said, the exemption is directly at odds with the parable of the Good Samaritan, in which Jesus teaches concern and assistance for those in need, regardless of faith differences.

First of all, the issue is not over how and to whom religiously affiliated institutions minister, but it is about who is doing the ministering. If non-Catholics are being employed to teach or doctor in a religiously affiliated institution, why should they be denied coverage for services that have been deemed medically necessary by a board of medical experts for all citizens? If the bishops are so scared of being defined out of their "religion" by the state, maybe they should divest themselves of "secular" ministry completely.Secondly, the story of the Good Samaritan is about providing for those in physical need regardless of the religious or ethnic identity of either the victim or the minister. It seems to me that it is precisely this kind of ministry that health care legislation is aimed at supporting. It is the bishops who are asking for the right to walk by those in need, if they have deemed that their needs are not really needs at all. It is the bishops who are the "bad" Samaritans in this parable by opting out of their obligations as members of a pluralistic society.Given that claiming exemption from "secular" authority hasn't worked out too well for them in the past, I'm not so sure the bishops really want to spend their dwindling moral capital trying to do the same now.


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in other words, it is not some sort of blank-check government funding system for Catholic hospitals we are talking about here -- it is reimbursement for medical services provided.

I've read that 5 of the 10 largest hospital corporations are Catholic. There are many people who end up at Catholic hospitals who aren't Catholic - my mom died in a Catholic hospital and she wasn't even a practicing Christian. Imagine a poor woman living in a rural town that has only one hospital, a Catholic one, and cannot use her medicaid to get full reproductive care. There are end-of-life issues too, like the US bishops order to Catholic hospitals about feeding tubes and vegetative patients, which may thwart some patients' wishes. People have the right to expect health care that isn't compromised by one particular group's religious beliefs, especially when they may not have a choice about what hospital they end up in.

Crystal:ooh, the poor woman living in a rural town! Perhaps she should be grateful that the Catholics are running an hospital at all, no? But no, she must get full reproductive care(meaning comdoms and abortions)! Paid by the taxpayer! By me! Do you realize that your idea of what social and political freedom means is completely upside down?

So there seems to be a lot of confusion over what exactly is on the table here in the way of a potential regulation. A lot of heat and not a lot of light. 1. No one is forcing hospitals to provide any particular service to patients -- abortion or contraception. There have been situations in the past where training programs were reprimanded by accreditation bodies for, among other things, failing to provide sufficient training on procedures that are used in both elective abortion AND the treatment of miscarriage. This wasn't the hospital itself, but the Ob/Gyn GME program that it ran, and the program actually flunked a lot of other requirements as well, but it sued over this one and lost. This is the situation that led to (and I can't remember which, sorry) the Hyde or Church amendment (think it's the latter). 2. The proposed requirement under consideration is the definition of minimum benefits for health plans going forward that have not been grandfathered under prior rules. There is no real controversy that these minimum benefits should include contraception; the issue is how wide the so-called religious exemption should be. The administration basically went with the California model, which was unsuccessfully challenged by Catholic Charities. No one is forcing employees to obtain contraception; no one is forcing Catholic hospitals to stock it or dispense it or even prescribe it. Likewise, no one is forcing Catholic hospitals to provide employee benefits. They can up the salaries of everyone involved and force them onto the open market. But that overlooks the fact that benefits are a form of comp that is highly tax advantaged over normal income, even for non--profit hospitals. (My personal view on this matter is the same as Cupcake's.) So while some are laser focused on the exemption, one might also focus on the give and take of a situation in which, like it or not, Catholic hospitals are receiving the benefit of a tax policy that exists for a reason, and that is to assure that people get a minimum level of benefits. To what extent should they get the benefit of that policy if they aren't willing to advance it? 3. The receipt of federal funding does raise issues about the extent to which an institution should be allowed to deviate from minimum standards that are neutrally applied, particularly if they are health and safety standards. All I can say is, it probably does neither side much good to pull too hard on this particular thread. Catholic hospitals operate pretty much like other hospitals on a funding/service basis. There is just so far they are going to be able to go to deviate from public (rather than private) conceptions of the common good. Not being forced to provide services is probably as far as they are going to be able to insist that a religious exemption extend, and that's already pretty far when it comes to some kinds of services. Thus, Catholic hospitals in Connecticut long ago capitulated to the state's requirements that accredited emergency rooms have emergency contraception for the treatment of rape victims. Likewise, if the St. Joseph's situation in Arizona had ended differently (mother had been left to die), my guess is that it would no longer be in the business of offering high risk OB services.

I thought Eric's post was about the Catholic Bishops and their approach to service.I thought about Bernie Fine - CNN thinks no criminal action is posible because the SOL is past.Which made me thinbk of poor Bishop Gumbleton who was ousted from his parish and roles because he argued for opening SOL.He violated the"communio episccpi"Everyone has to be on point in terms of the institution's needs!Bevilaqua continuyes to be deposed in Philly today and Msgr Lynn's attorney says he was just following orders from Bevilaqua."Communio episcopi" passed down the line.From what I see of our new deacons and the diocesan priests coming along (and their admirers) more of the same -you've got to be on point.Defend the institution's emphasis. Minimiuze service unless it fits.Last thing I thought of this morning was the back cover ad of the current America:"46 Million People in Poverty is Unacceptable. Change It Now." -great message!"Donate Today to Catholic Charities USA."I don't want to disparage Catholic Charities.i think though that our leadership (in so many ways) continues its encapsulted view of service that is taken up first in its own self protection.I see the problem growing as we continue to strive to be more"distinctive."How many times we've said here that leadership has a credibiity problem - and are we just deepnening that issue ?

There is no real controversy that these minimum benefits should include contraceptionWhich can only be chalked up to invincible ignorance and a fundamental misunderstanding of what "insurance" even is.

Barbara, Thanks for your helpful clarifications. I agree that there is a lot on the table, much of which I did not address in my original post (i.e. specific services provided by Catholic hospitals). I think that this confusion, however, is being sown by the bishops' attempt to bundle several different issues under the same banner of "religious freedom." For instance, the issue in my original post and the NY Time article had to do with exemption as pertains to the Affordable Care Act, which only requires employers to provide access through insurance benefits and not direct services. This, as you point out, is a different issue than what specific services Catholic hospitals ought to provide to receive federal funds. While this is itself debatable, the exemption claimed in the recent case of the human trafficking ministry seems to have more to do with being exempt from providing direct services while still receiving government awards predicated on providing the full range of services, and it is not about being exempt from providing certain healthcare benefits as part of a universal access policy that applies to any employer who chooses to provide such benefits to its employees. Of course, as I understand it, if the employer elects not to provide benefits, it will be taxed, but this is different than being denied government funding that is essential to cover operation costs. These are all complex issues with specific considerations, but the USCCB is painting them all with the same brush by claiming that in every instance it is the same "religious liberty" that is being attacked. This leaves the impression that either the Church expects universal exemption from all "secular" authority or that the government is trying to wage war on "religion" in general. This kind of either/or can only breed fundamentalist suspicion on both sides of these issues by making it seem like either Catholics are irrational or Obama is anti-religious. This is the same conclusion that E.J. Dionne comes to in his piece, but he places the blame more squarely on the reproductive rights folks who are against widening the exemption and thinks that Obama should preserve the Catholic vote by not being seen as caving to their anti-religious interests. I think the bishops have it wrong here, and I think progressive Catholics will see through their rhetorical subterfuge and side with Obama, and the conservative Catholics who buy the bishops' story that the government is out to kill their faith have been lost for the President already.

This is not about electoral politics, it is about religious communities and the freedom to participate in the public square without sacrificing their values.The blogger sees an election and a zero-sum game, the rest of us see the reality of the situation and the steady erosion of first amendment rights.

Brett, that you think we are experiencing a steady erosion of first amendment rights proves how far from the reality of the situation your sight has strayed.

I am not imagining things: the closing of Catholic Charities and institutions in D.C,. MA, IL; the politically motivated denial of grants at HHS; the imposition of medically trivial mandates that are contrary to religious conscious. You don't thing that is hampering free exercise according to the first amendment? Creating politically motivated regulations/mandates to force religious communities from the public is not a problem for you? Even liberals like Sean Michael Winters and EJ Dionne think that something is a miss in this administration's treatment of religious liberty...

On a side note, you're at Yale, right? Do you ever make it over to St. Mary's? Great church right by campus.

This thread saddens me.I went back and read the transcripts again from the Fordham Conference on faithful citizenship in an era of spin.Shining through was the importance of and the rising prioirty of serving those in need.As in many areas, say for example the imposed new/old Mass translation, the role of the USCCB seems to be more of it's about us.Arguing aboput rights is not the same as arguing about how right one's position is how effective in the community not only of beleivers but the broader community as well.I posit that the more encaosulated one's approach is, the less likely the effectiveness of what one wants to see accomplished.I guess that's why I previously mentioned issues of sex abuse handling and the disconnect between the policy makers who want to stress how well they do things and the perception of events on the ground in the broader community.I further posit then that what matters here is service and that thge Church does best when it demonstrates loving service in action and not lots of words about its own perogativers.

"The monks of Belmont Abbey College sued because the government left them no choice. The government is forcing these devout monks to purchase certain drugs for their students and employees, in violation of their religious convictions. For example, the government now requires the college to purchase Plan B (the morning-after pill) and ella (the week-after pill) for their students. These drugs likely cause abortions, which is a grave sin to the monks. It is one thing for the government to decide it should distribute these drugs itself, which of course is not part of this new law. But it is quite another for the government to mandate that religious Americans with conscientious objection purchase these drugs and participate in their distribution.The law also forces the college to pay for related education and counseling about these drugs. The monks may preach to their students against abortion and contraception on Sunday morning, but on Monday the feds will make the college pay for a counselor to send the exact opposite message to its students. The First Amendment forbids this type of forced speech and burden on religious exercise."

Crystal,I wasn't suggesting that Catholic institutions are trying to turn a profit. Non-profit organizations still exist in a market and they can be rendered financially insolvent by not receiving the subsidies that other providers in that same market receive. In order to provide services (be it health care or education or whatever) to poor people who will not be paying for them, you need some clients who will be paying for services. (It is not possible to run certain types of institutions, such as modern hospitals, entirely off of donations.) You will not be able to attract those paying clients if you are not able offer prices low enough to compete with those of institutions receiving subsidies. Thus, being denied a subsidy for being unwilling to violate one's religious principles will effectively force many Catholic institutions to close.

I think whether Catholic institutions wil be forced to close is a matter of fact to be verified.The issue here was whether USCCB with the abc argument is an effective approach to serving the needy and is the view there about service or protecting self interest.

And then there's the nPR report today -worth a thread of its own?