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Contraception, health-insurance reform & religious freedom

From the editorial, "An Illiberal Mandate," just posted on the homepage:

In August, the Department of Health and Human Services issued a draft ruling that would mandate coverage of contraception and sterilization in health-insurance plans, including those provided to employees of Catholic institutions. The ruling offers an exemption from the mandate only to religious institutions that primarily employ and serve coreligionists, and whose work is strictly religious. As HHS sees it, access to contraception is a fundamental component of any health-care plan, especially for women. That claim seems commonsensical to many people, including many Catholics. The USCCB argues that compelling the church to pay for plans that cover services the church has long held to be immoral violates the religious-freedom guarantee of the First Amendment. Catholic hospitals, universities, and social-service agencies see their mission as caring for people of all faiths or none, and they employ many non-Catholics. Given this understanding of mission, inevitably there will be a degree of entanglement between any large religious institution and the modern state. That should not be an excuse, however, for imposing secular values on more traditional religious communities. Religious diversity is impossible without a degree of autonomy from the state. Is there any evidence that such autonomy poses a serious threat to liberal democracy?...[E]xcept when life or limb is at stake, it is hard to see what is liberal in coercing religious individuals and institutions. There are other ways that contraception can be made available to employees of Catholic institutions, should they choose to use it. One does not need to oppose contraception to see that, in this case, its far less important than the principle, and practice, of religious freedom.

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The Catholic bishops are not credible for more reasons than attacking the Obama administration on dubious grounds. They have proven themselves to be spineless, calculating politicians for far too long on so many moral issues it defies imagination.Religious freedom is not at stake on this issue of contraception and sterilization. Contraception is a sin in the eyes of the bishops alone. The vast majority of Catholics around the world left the bishops behind on that issue a very long time ago. Please explain to me,Editors, how a woman is to easily get contraceptives if she is denied coverage as the Catholic bishops desire? When I saw the full page ad from the Catholic bishops in today's N.Y. Times I thought ,my God these people are so out of touch with the important issues of today's world. They should all get married, get jobs and get a life!

I just had to pull this quote from David Nickol: "Perhaps a government panel should be set up to study Humanae Vitae, and agree if they find it persuasive to allow broad exemptions for Catholic employers."I cannot think of a more clear violation of the First Amendment than having the government hold hearings to declare whether particular religious beliefs are reasonable or not. Next you will be asking the FDA to determine whether the Catholic Church should be punished for false advertising by claiming the bread and wine (whether in a cup or chalice) are truly transformed into the body & blood of Christ. Does the faith in the benevolence and wisdom of government and corresponding animosity to Church teaching know no bounds among the commentariat here?

Nobody's being coerced into anything.If you don't want to provide tax-subsidized medical services, don't. "There are other ways that contraception can be made available to employees of Catholic institutions, should they choose to use it."No, not rilly. The hieracrchy will twist and turn and sneak through loopholes and resist anything expect a flat demand.

It seems we have two lines of discussion on this thread. The first involves whether or not the federal government to force Catholic institutions institutions by the way, that already provide health insurance for the employees to revise their existing insurance plocies to include contraception meansures and abortion. The second issue being discussed on this thread is whether or not the Catholic Church ought to change its teaching on contraception.Since I am confident that most on this blog can agree that abortion is wrong, let's start where we all agree. Lets go back to the first line of discussion and by way of simplifying, clarifying this, leave out the part on contraception measures:Q - Should the federal government force Catholic hospitals and universities (for example) to change the health insurance they provide their employees in order to cover abortion?

I just had to pull this quote from David Nickol: Perhaps a government panel should be set up to study Humanae Vitae, and agree if they find it persuasive to allow broad exemptions for Catholic employers.MikeD,That was, of course, a facetious comment. Do you really think a government panel would find Humanae Vitae persuasive when Catholics do not?However, as the Commonweal editorial itself points out, religious exemptions are not always granted, nor would it be appropriate for them to be. Government ultimately had to decide whether Mormons got to practice polygamy, or whether whether people who used an illegal drug (peyote) for religious purposes should suffer consequences for it.

Ken,Abortion is irrelevant to this discussion.

Some people, instead, have the juvenile idea that insurance means . . . Studebaker, I don't see that you can keep pushing this point of what insurance "really" means when we all know that most health care coverage is not limited to being insurance in that sense. People with good insurance basically expect for it to pay most of their medical bills, and in many cases these bills are for routine, expected costs. In this one particular instance involving contraception, you want health care coverage to be thought of as "real" insurance, but I can't imagine you are consistent.Note: "Although some plans don't pay any maternity costs, federal law requires companies with more than 15 employees to supply coverage that includes pregnancy-related medical expenses."This violates the principle of subsidiarity! Who is the federal government to make this requirement???

I dont see that you can keep pushing this point of what insurance really means when we all know that most health care coverage is not limited to being insurance in that sense.David, you're getting the positive confused with the normative. I know very well that "most health care coverage" does pay for routine expected costs, but that's PRECISELY why I think it's a matter of intellectual confusion that anyone calls it "insurance." Look, if you want, you can just blindly accept whatever the world comes up with. If car and home insurance cover certain types of expenses (emergencies) and not others (routine small expenses), while health insurance seems to be expected to cover everything anyone can imagine no matter how small, you can just shrug and say that's the way it is, and who cares what the concept of "insurance" is anyway. Alternatively, one can rise above merely looking at the world and seeing what exists, and think more deeply about why insurance exists and what purposes it serves. Only then can one even understand the questions that are raised whenever someone claims that insurance "ought" to cover something that is no more a proper subject for insurance than deodorant or toothpaste.

"Why should the moral matrix be different if compensation is being provided in the form of employee benefits,. . . "Barbara --Because the Catholic bishops and other administrators see providing certain employee benefits as against their own consciences. Their consciences might be wrong, but that is irrelevant when the issue is freedom of conscience. I think that the Jewish prohibition with regards to ham is irrational, but they have a right to preclude serving it in their cafeterias.

I have just read the USCCB submission to HHS explaining its objections to including "contraceptives and sterilization." I did not find anywhere a statement that it would be sinful for Catholic individuals or institutions to provide such coverage, but I did find this:"When a religious organization in particular pays for private conduct, the inescapable message is that it does not disapprove of that conduct. As noted above, a religious organization cannot communicate an effective message that conduct is morally wrong at the same time that it subsidizes that conduct. In particular, Catholic organizations cannot effectively and persuasively communicate the Churchs teaching that contraception and sterilization are immoral if they simultaneously pay for contraceptives for their employees or (in the case of colleges and universities) for their students."As I suggested in an earlier post, Catholic institutions could counter that impression by stating clearly that the Church teaches that contraception and sterilization are immoral and we include coverage for them only because the law requires us to do that. As a separate issue, the letter notes that some contraceptives are, in the Catholic view, also abortifacients At the end, the USCCB explains what it would be willing to settle for:<i

David N, I beg to differ. All of the digging and squirming around and using sophist weasel wording to describe everything associated with trying to avoid child birth; it always leads eventually to abortion.On the basic chronology of legal contraception, one need only follow the arc to discover where it leads. In America, we took a slight detour to accommodate the mad and racist eugenics doctors (ugh what a stretch that is), but otherwise we followed this sequence- Condom(eugenics, at least until old Hilter screwed that up for the secularists)- BC Pill- Abortion- EuthanasiaIf we stay on this course, we will probably round back to Eugenics with all its horrors. This all works together you see, it is an integrated system important to any purely secular society. In some corners it is known as the culture of death.

At the end the USCCB explains what it would be willing to settle for:III. ConclusionThe HHS mandate should be rescinded in its entirety. If HHS refuses to do that, then it must address the most grievous and intolerable aspects of this misguided mandate by (a) excluding from the mandate those drugs that can cause an abortion, and (b) exempting all stakeholders with a religious or moral objection to contraceptives, sterilization, and related education and counseling.My guess is that the administration will probably get rid of the abortion-producing (by Catholic definition) contraceptives and will broaden the exemption to cover most Catholic institutions but not so broadly as the USCCB proposed. The USCCB letter is at: http://www.usccb.org/about/general-counsel/rulemaking/upload/comments-to...

David N - Think of it this way. What good is the right to BC pills if (in case you forget the pills one day) you dont have the right to have a state-funded abortion, and what good is the right of an abortion if you cannot also have the State pay to put old grandma or some handicapped person down?Jeez You dont understand anything!;-)

Oh and how could I forget eugenics: Why do our sons have to fight and die in wars when our government can fund research to allow us to clone and/or genetically engineer (read breed) special people who would be especially suited to be warriors? Just look at the jobs that sort of research program would create! I guess it really would be a brave new world. I do not know why the Catholics are so against science.

"David N, I beg to differ. All of the digging and squirming around and using sophist weasel wording to describe everything associated with trying to avoid child birth; it always leads eventually to abortion."There you have it, folks: chastity and NFP (both "associated with trying to avoid child birth") are all part of one big trend that always leads to abortion.Nor is this the only deadly trend that ought to alarm us. Just look at the chronology of the following inventions, the "arc," if you will:-- the wheel-- the printing press-- the steam engine-- nuclear weaponsThis all works together, you see. All of these inventions are part of an integrated system important to any secular society. Start using carts to carry things you used to carry on your own back and before you know it there are mushroom clouds appearing over Japanese cities. Some call it technology; others, the culture of death.

Their consciences might be wrong, but that is irrelevant when the issue is freedom of conscience. Ann,No one in the United States has the right to absolute freedom of conscience based on something their religion or they disapprove of.

When should religious institutions, or individuals motivated by religious beliefs, be exempt from laws that are otherwise applicable to all citizens? That has always been a hard question to answer. Conscientious objectors can be exempted from military service, but not from the taxes that pay for national defense. No exemption was made for polygamy among the Mormons, despite the fact that the practice was unquestionably central to their faith. Christian Scientists are not free to let seriously ill children go without medical care. Traditional religious groups can bar women and homosexuals from certain ministerial positions and still enjoy their tax exemption. Bob Jones University, however, lost its tax-exempt status for discriminating against interracial couples. Might Catholic universities one day lose their tax exemption because of their treatment of same-sex couples?

Ken's slippery slope:- Condom (eugenics, at least until old Hilter screwed that up for the secularists)- BC Pill- Abortion- EuthanasiaHow did you fail to interject homosexuality in that linkage?Come to think of it, homosexuals don't have any need for any of these practices in order to prevent births. All we do is adopt children unwanted by their birth parents.

David N,Of course you were being facetious, but in your response you make the strange analogy between the Catholic position on contraception (which this particular Catholic finds perfectly pursuasive - regardless of your insistance on knowing the private conduct, fertility cycles and consciences of all married Catholics in the world) which is a prohibition on conduct and the position on poligamy and peyote use of other religions. For religious acomodation and exemption issues there is a big difference between a government policy that involves a generally applicable prohibition on conduct (like the ban on poligamy and peyote use) and a government policy requiring conduct in direct violation of a religious belief. Do you think the government can force the kosher deli to serve BLTs because it is open to the public the vast majority of which finds the jewish and muslim prohibition on eating pork to be utterly unpersuasive (even when the message is delivered by Samuel L. Jackson http://www.youtube.com/watch?v=c0zJSgHDnpw).

" What employees do with wages is their own business, --"Far from the truth. Wages and benefits are a tax deductible business expense; hence there are some forms of justifiable control. Discriminatory practices based on gender and race are prohibited, among other things. 401K plans have to pass certain discrimination tests that measure the benefits to the highly compensated versus the rest of the employee group and prohibited disparate impact. ERISA comes into play with medical and retirement benefits plans.What employees do with wages is far from their own business!

"Its absurdly paternalistic to treat people generally as so irresponsible that unless I give them $.75 to buy a condom, its somehow my fault that they went out and bore a child instead."Studebaker ---For once I agree with you completely. In spite of my strong liberal leanings I think that we have turned the U.S. into a nanny-state. What confirms this for me regularly are the little signs at exits from USPO's that say "Fasten Seat Belts". Dammit, that money could have been spent on better things, but noooo, we little children need to be reminded to maintain our own safety. #$%(&*& !!!

a government policy requiring conduct in direct violation of a religious beliefMikeD,Catholic organizations will not be forced to provide insurance coverage to employees that pays for contraception, since Catholic organizations will not be forced to provide insurance coverage at all. There are cases where some employers are required to pay a tax if they do not offer insurance to their employees, but as I recall, many who object to "Obamacare" claim that it will be to companies' advantage to pay the tax and let their employees buy their own insurance. The concern is that employers will stop providing insurance coverage. So the government is not forcing Catholic organizations to do something against their will. It is saying if they want to provide insurance coverage, it must meet certain requirements.

"No one in the United States has the right to absolute freedom of conscience based on something their religion or they disapprove of."I never even hinted at denying this. My very narrow point was that this issue is one of freedom of conscience. The particular issue (requiringRC hospitals to pay for contraceptives, etc.) is already a very muddy one, and introducing extraneous issues only muddies the waters further.

Ken --Your arc from condoms to euthanasia is a great example of associative thinking which claims to embody a causal sequence. Just because you have images of people buying and using condoms associated with images of people buying and using BC pills followed by images of people having abortions does not mean that there is any sort of causal relationship between what the images represent. True, we sometimes find that associations turn out to be causal one, but the mere association in your mind and your subsequent judgment ("See? Allowing the druggist to sell condoms results in people buying and using other contraceptives!")This sort of associative thinking seems endemic among fundamentalists. Consider: " My morality is dependent on belief in God. Atheists do not believe in God, so atheists have no moral codes". Or, "Rock music is what contemporary musicians love to play. Rock musicians love to use heroine. Rock music causes drug use. Rock doesn't belong at Mass." Associative thinking (some people call it "common sense") can be worse for a culture than a plague. It corrupts the mind.

". . . but the mere association in your mind and your subsequent judgment (See? Allowing the druggist to sell condoms results in people buying and using other contraceptives!should have ended: ". . . but the mere association in your mind and your subsequent judgment do not justify your assumption that your images represent real causal relationahips among actual things. No matter how strongly you have convinced yourself, the vividness of your associated images does not guarantee that they represent facts in the real world."I'll be quiet now.

By the way, Grant, awesome editorial.

I find the policies of the Church in contradiction and inconsistent, especially the recent USCCB condemnation of the proposed HHS requirement of covering contraceptive services.1. The Church does not want to be required to pay for contraceptive services or be required to offer these services as a covered expense in their healthcare plans. However, they allow contraceptive couples to receive the Eurcharist under the principle of gradualness for habitual sinners without a realistic firm purpose of amendment. The real fact is that virtuall all Catholics don't confess contraception as a sin. The Church knows 97% of married couples use contraceptive methods of birth regulation stand online each week to receive Holy Communion. Yet, they do nothing about this issue but find it offensive to be required to cover such expense in healtcare plans. This is called hypocrisy.2. If Catholic instiutions (i.e., hospitals, universities) are allowed to excluded certain healthcare services from a covered expense in their healthcare plans (which would cover catholic and non-catholc members), then other religious instiutions should be able to do the same. Unfortunately, this would be discriminatory and non-uniform public policy.No one is forcing Catholics or non-Catholic members of Catholic institutions to seek contraceptive services. If Catholics abide by the Church's teachings, there would be no contraceptive expense for the Catholic institution to pay for. The Church wants to force its teachings about contraception onto Catholics and non-Catholics who work for a Catholic institution, while igoring the contradiction of allowing contraceptive couples to receive the body of Christ. This is called the silent pulpit.

Re John Hayes's comment at 4 pm today: What is the status of the USCCB's "bottom line.?" What are we the faithful supposed to do with it? Their statement sounds like a prudential judgment, one that we the faithful ought to take seriously, but that we can rightly respectfully disagree with if we are so minded. Am I correct about this? If not, then what is the unshakable moral principle that would require me to accept the bishops' "bottom line?" If the principle is something like the impermissibility of "proximate material cooperation..." then what is the scope of the applicability of that principle?The ramifications of whatever answer one makes to these questions are far from trivial.Please note that my questions concern matters of moral theology. They are not meant to defendor attack any statement either by USCCB or any particular bishop.

What Michael Barberi said - in spades!

Stuart Buck: Are you capable of being less obnoxious? As usual, thanks for being so careful to include my full name. No one else, except perhaps Mollie, is so thoughtful as to be worried about whether I'll show up in Google searches. And to do so while purporting to oppose obnoxiousness -- well, that just shows what a stand-up fellow you are, always ready to take the high road and debate on the substance.

According to Michael Barberi: "The real fact is that virtuall all Catholics dont confess contraception as a sin. The Church knows 97% of married couples use contraceptive methods of birth regulation stand online each week to receive Holy Communion."This is utterly rediculous since only 22% of self professed Catholics even attend mass at least once a week. Of that percentage, only 79% of those always receive communion. Also, the vast majority of those that do attend mass every week are too old to be needing contraceptives. http://cara.georgetown.edu/CARAServices/requestedchurchstats.htmlBut we should all disregard these statistics and listen to you and David Nichol who know the private sexual lives, confessional behavior and consciences of all those people in the pews each Sunday.

UND and HAS have proposed a compromise? That ghas the Cardinal Newman society all tied up in angst?Does anyone know more? The divisiveness of the coments here make me think the agument here does litle to advance the"mission of the Church."And, also, way too much of "I know better."But we've had those approaches many times before (including, debes en quando, my own.)

MikeD, I'll ignore those statistics when the Bishops stop saying that they represent __ million "Catholics" without qualifying the fact that it's actually only less than 30% of that number, according to YOUR statistics. In any event, when you look at who shows up for weekly mass (at least around here) an awful lot of people are in the two parents plus two kids spaced perfectly two years apart category.

BTW, the Guttmacher (a.k.a. Planned Parenthood) survey that Michael Barberi and David Nichol are likely relying on for their "97% of Catholics use contraception" statements indicates that of the women (survey only looked at age 15-45) who claim to be Catholic, just 3 in 10 attend Mass weekly, 1 in 10 never attend Mass, and the remaining 6 in 10 attend monthly or "less frequently."

Barbara, they are not MY statistics, they are from CARA at Georgetown (hence the link). Nice to know you are joining David N. & Michael B. in looking around you on Sunday and presuming to know the sexual practices, fertility cycles and consciences of everyone else. Maybe you should visit our parish where there are plenty of big families that take up enitre pews, including a few that are adopted because the couple can't naturally conceive their own.

the Cardinal Newman Society all tied up in angstThe letters by Fr. Jenkins of Notre Dame and Sr. Carol Keehan of the Catholic Health Association were sent back in September and are available here:http://president.nd.edu/assets/50056/comments_from_rev_john_i_jenkins_no... both recommend adopting a definition of "religious institutions" that exists in the Internal Revenue Code. That is not enough for the Cardinal Newman Society because it wants to exempt every organization and individual person who objects to contraception from having to provide insurance that covers it.I was interested by the following statement made by Sr. Keehan in her argument for excluding contraceptives that, in the Catholic view, are abortifacients because they may prevent implantation: "For a Catholic employer to participate in abortion in any way, including by paying for an abortifacient drug through its health plan, is a grave violation of the moral teachings of the Catholic Church."As I said in an earlier post, I am not aware of any official position that the Church has taken on whether providing insurance that includes coverage of abortion along with other benefits is proximate or remote cooperation.Since the state of Massachusetts, where I live, requires policies sold through the State program to include overage for abortions, I am pretty sure that I would have heard if the Church felt that Catholic individuals or business owners should not buy these policies. I assume Sr. Keenan is not a moral theologian so i wonder what is the source of that statement.

MikeD,First, on the really important issue, my name is spelled with a k (Nickol).Second, I have no idea how many Catholics who attend weekly mass, are sexually active, and are of childbearing age, use contraceptives. I have consistently seen reports, whether from Guttmacher or other sources, that the number of Catholics who practice some form of fertility break down into those who use NFP (less than 5 percent) and those who use "artificial" contraception (over 90%). I do know the folks who write over at Vox Nova who practice NFP find themselves a very small minority, and I have never, ever heard anyone claim that it is not true that the vast majority of Catholics who are in an actual position to either user or not use artificial contraception actually use it. Of course, occasionally someone says that no Catholic uses artificial contraception, because to use contraceptives is to put yourself outside the Church. (No true Scottsman . . . .)

David,First, sorry about the name (next time I will have to think "St. Nick" rather than "St. Nicholas" to get it right). Second, I do not doubt that the majority of married Catholics of childbearing have use artificial contraception (sterilization seems more prominent than the pill in some surveys I have seen, which leads to an interesting discussion on reconciliation for what may be an irreversible procedure in some cases). I wouldn't claim such a thing nor would I make the no true scotsman claim. I also would never presume that any of those married couples around me at Mass on Sunday were actively using contraception, whether they had 1, 2, or no children. I know enough couples that struggle with infertility and pray for children to assume that any particular couple is contracepting.

"Before you cost-estimate proposals like Mirena for those who do not think as you do, you might care to find out what you are talking about"Hi, Jack, my cost estimate for Mirena was obtained the same way that I assume millions of women figure it out: I googled "birth control prices" and went to some pharmacy sites. If what I posted is factually inaccurate, perhaps you could set us straight. Perhaps you would also indicate the relevance, if any, of the link you provided to my comment.

I do think that Bernard and Barbara have raised an important question: how remote does the cooperation need to be in order to pass moral muster? Barbara, I don't understand your proposal that Catholic institutions have insurance companies handle the contraception reimbursements. Isn't this already what happens, unless the institution self-insures? I understood the USCCB's objection as encompassing what you're proposing, but perhaps I don't understand your suggestion.

I don't think he actual cost of contraceptives affects the issue, but when I gave a dollar vallue I started with the form most women choose - pills:"Nearly half a century later, and despite the introduction of IUDs, patches, injections, and the female condom, the pill remains the No. 1 form of contraception. It's used by an estimated 12 million women in the U.S. and 100 million women worldwide. According to Paula Hillard, MD, "When you say 'birth control,' most women think of birth control pills." A professor of obstetrics and gynecology at the Stanford University School of Medicine, Hillard says that birth control pills are still widely popular, especially among younger women."I then checked what brand had the largest market her - that is Yaz.Drugstore.com's price for Yaz is $252.97 for a three-month's supplySo I used $1000 per year as a nice round number.

Isn't the cooperation quite remote? Bishop Lynch of St. Peterburg claims he will end insurance coverage for diocesan employees if HHS doesn't broaden the conscience exemption. In order to keep employees, and not to run afoul of the demands of justice, he will have to offer them additional compensation to purchase coverage on the open market, plans that will likely be more expensive and less comprehensive, although they certainly could include contraception and abortion coverage. How clearly is he thinking? What happens when a diocesan employee goes out on the open market and buys coverage that includes abortion and contraception? What happens when an employee can't get very good coverage because he lacks purchasing power, and ends up with a pile of medical pills he can't pay? Or forgoes treatment because it could bankrupt him?In the United States, benefits are part of a worker's compensation package. To what extent is the institutional church cooperating in evil when its employees purchase contraceptives with their salaries? What is the difference between a diocese giving employees money they can spend freely and giving an insurance company money for coverage that may or may not include procedures and drugs the institutional church deems gravely immoral, or necessary to a gravely evil act? What happens if a diocese pays, say, Aetna for a plan excluding the pill and abortions, when other Aetna plans include such services? Is that diocese remotely cooperating in evil? If so, how might a bishop justify such a thing? Perhaps by weighing it against the good of health coverage for his employees--coverage individuals likely could not get for themselves on the open market?

"I have never, ever heard anyone claim that it is not true that the vast majority of Catholics who are in an actual position to either user or not use artificial contraception actually use it."Hi, David, I agree with you that it is well-established that a majority of sexually active Catholics of child-bearing age use contraception, or don't object when the partner does.What is the importance of this fact?One aspect of its importance could be that the Church (conceived of as all of the People of God) is voting with it's, er, feet: that widespread contraceptive usage represents an emerging (or even already-emerged) moral consensus - that this is what the church actually *thinks*.If we wanted to test that hypothesis, we'd need to break down the numbers according to the following:* Those who don't understand what the church teaches on this matter* Those who do understand what the church teaches, but have a genuine conscience objection on this particular topic.* Those who do understand what the church teaches, know what they are doing is wrong, but do it anyway - i.e. have chosen to live with what they know is sinful.I don't know what how the percentages break down among those three categories. My suspicion is that the first bullet - those who are Catholic but don't know what the church teaches about contraception - is pretty high, probably surprisingly high for folks around here who are old enough to remember HV and the conflict that surrounded its issuance. To put this as gently as possible: many of those folks are no longer of child-bearing age, and their children and grandchildren have grown up in a culture in which the use of contraception is not seriously contested. (I take as a symptom of this reality the phenomenon that a number of commenters here genuinely seem to have a difficult time wrapping their heads around the fact that the church objects to contraception and would even establish policies and take actions pursuant to that objection). I believe that a lot of young Catholic adults, especially those who are relatively casual about their Catholiciscm, would be truly surprised to learn that in the opinion of the Magisterium, contraception is a sin.My expectation of the second bullet is that it is a relatively low percentage of Catholics in general, but a relatively high percentage of Commonweal Catholics.My expectation of the third bullet is that it is probably the highest of the three possibilities. This is, from a pastoral point of view, perhaps the most interesting/worrisome thing: that people know something is wrong, do it anyway, and just live with it. Contraception certainly isn't the only example; one need look no farther for another example than the numbers of Catholics who divorce and remarry without bothering to get the previous marriage(s) annulled.And this points to the other possible importance of the fact under consideration, that is, of the widespread use of contraception of Catholics: that it reflects the Magisterium's lack of credibility on this matter. To explore that aspect, we'd need to inquire why the Magisterium doesn't have this credibility, particularly when it seems that, as recently as 2-3 generations ago, its authority *was* recognized on this matter. I have thoughts on that, too, but I'll save them for another comment if I have the time. I still have some Christmas shopping to do.

I don't think Studebaker has come out and explicitly said so, but I'm gleaning from his distinction between "pure" insurance and other stuff that is included with insurance packages but isn't really insurance that he might, conceptually, support health insurance that covers catastrophic events but doesn't require taxpayers to pay for checkups, prescriptions, contraception and other non-catastrophic, relatively routine and inexpensive items.I would, too.I'd add that health savings accounts, which are owned by the individual rather than the employer, would seem to provide subsidies for routine items like contraception while maintaining the appropriate degree of remoteness from the Catholic employer.

This is a very careful and well-written editorial. As should be evident from my previous posts, I do disagree with it at several points. However, the most puzzling statement in the piece was this:"There are other ways that contraception can be made available to employees of Catholic institutions, should they choose to use it."Does this mean that while denying access to contraception to their employees with one hand, Catholic institutions might use the other to refer their employees to other organizations, like Planned Parenthood, that provide such services free of charge? This just seems like a way to get someone else to do your dirty work for you. If Catholic institutions are really morally against such reproductive health services, it seems strange for them to cite the availability of such services via other avenues in support of their argument not to have to provide them. Also, I don't see Catholic institutions giving a lot of support, financial or otherwise, to their secular counterparts. Is the Church going to start referring people to Planned Parenthood as a pro-contraception alternative to its own health services?

Grant - well reasoned and makes the bishops' argument weak at best. As a large employer, the church has a responsibility to provide benefits that are comprehensive (in US society, this includes access and coverage for contraception). If the church fails to do this, then it becomes a justice issue and the employees are penalized.The church, universities, dioceses can provide comprehensive benefits as a human justice issue while at the same time highlighting that some access/benefits are not supported by catholic beliefs - it then becomes a "personal, ethical" decision and choice.

Jim P. (12:28pm) -- A price/device like the one you give can be found online ($218.20) at, for example, http://www.birthcontrolbuzz.com/product.aspx?DrugName=Mirena+IUD+Device The link I provided offers directions from the manufacturer intended for the consumer ---" To be inserted by a trained healthcare provider using strict aseptic technique. Patient should be re-examined and evaluated 4 to 12 weeks after insertion; then, yearly or more often if indicated. (2.3)" How do you cover that in your $175/year for the family? Trained health care providers are part of the cost if you choose to suggest better women's birth control options, with or without insurance.

Jim, HSAs often turn out to be punitive to families, and especially, families with chronically ill members, who save nothing and often bear a disproportionate burden of how HSAs dilute the risk distribution and transfer component of insurance. Health plans/insurers play multiple roles for their members -- most basically, of course, they transfer and spread catastrophic risk. In addition, they are power buyers who significantly reduce the cost of services and supplies for their members. They might do other things as well, but those two things are each important enough to justify the inclusion of non-catastrophic but very clearly health related expenses in a health insurance policy. It can be overdone, but $70 per month for Yazmin, versus, half that cost, is a lot of money for most people. BTW, HSAs themselves, definitionally under the IRC are permitted only when the attached health plans pays for preventive services with first dollar coverage, that is, when they are excluded from the deductible.An IUD costs around $700-$1000 when both the device and insertion are included. It can be spread over 5 to 10 years, so works out to be cheaper than most BCPs, but it is not cheap up front.

In addition, they are power buyers who significantly reduce the cost of services and supplies for their members. All of Barbara's points are good, but I want to call attention to this one. If something is not covered by your insurance and you have to pay for it yourself, you are going to pay a lot more for it than the insurance company would have paid. I doubt that it would be acceptable to the Church, but if they don't want to pay for contraceptives by having the cost included in insurance, the people who use contraceptives could reimburse the insurer for the cost of the contraceptives. That way they would at least be getting the discount that the insurance company gets, and the employer wouldn't be paying for the contraceptives.

Jim,I have a problem with the idea that people should have to read encyclicals and study moral theology to know right from wrong. Perhaps all people really need to know (and it is in Wikipedia) is that of the 72 members of the Papal Commission on Birth Control ("including 16 theologians, 13 physicians and five women without medical credentials, with an executive committee of 16 bishops, including seven cardinals") the majority found "that artificial birth control was not intrinsically evil and that Catholic couples should be allowed to decide for themselves about the methods to be employed," while only "4 theologian priests had dissented, and 1 cardinal and 2 bishops had voted that contraception was intrinsically dishonest."

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