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This blog is the work of an educated civilian, not of an expert in the fields discussed.

Thursday, February 23, 2012

Sandra Fluke Talks About Contraceptives

The free exercise and enjoyment of religious profession and worship, without discrimination or preference, shall forever be allowed in this state to all humankind; and no person shall be rendered incompetent to be a witness on account of his or her opinions on matters of religious belief; but the liberty of conscience hereby secured shall not be so construed as to excuse acts of licentiousness, or justify practices inconsistent with the peace or safety of this state.

-- Article I, § 3 of the New York Constitution
We here in NY manage to have religious freedom as well as a requirement for religious employers to provide insurance coverage that includes contraceptives. It is noted that the First Amendment does not have a proviso like this one has but as noted in the past, it still protects religious exercise more than the current official understanding of the federal Constitution as applied to laws of general applicability. I covered this issue back in 2006 (tempus fugit) here.

The controversy that an application of a similar rule pursuant to the PPACA has received a lot of coverage, but various details are often missed. The important points might still be cloudy. For instance, what is a "religious employer" for purposes of federal law here (note that this is pursuant to this administration's interpretation of the law, underlining the importance of who controls the executive department)? With apologies to Rachel Maddow, this site lets us know:
A religious employer:

• Is a nonprofit organization

• Has the inculcation of religious values as its purpose

• Primarily employs persons who share its religious tenets

• Primarily serves persons who share its religious tenets
Thus, even for religious schools, not merely churches, you do not have to provide birth control to nuns, but it could be different if non-faith employees make up a significant part of the facility and staff. If the institution is so insistent to not provide coverage, or even indirect fund those that do (or, as in reality is the case, some of them), don't hire non-Catholics in this situation and only serve those who follow your tenets. If you don't want to do that, yes, you will have to follow some general laws. Since you are no longer doing something purely religious, but something that can be regulated to deal with the general public affected. They want to have their cake and eat it too, however.

The "threat" to religious liberty led Rep. Issa to hold an oversight hearing (and I wonder if anyone picked up on this) with even the url to the video being politically charged. There was controversy because of the lack of women on the first panel, but he noted: "The hearing is not about reproductive rights and contraception but instead about the Administration’s actions as they relate to freedom of religion and conscience."  [I would add that is wrong for another reason -- the witness was concerned not just about that, but women's health as a whole.]

Sure, that's why there wasn't a woman on the first panel (the stupidity of this underlined by the presence of two on the second -- there are women against even the compromise policy out there) and giving the minority party all of ONE witness. And, "freedom of religion and conscience" is not absolute, nor is it non-germane to have the other side there to address the question. Reasonable opposition recognizes such things. Ms. Fluke was represented on the hearing's website via a link to a press conference that included others like her, which is nice, but it would have been nicer if they were represented on the actual panel. She also came in for a special Democrat only hearing today. Instead, we have talking past each other, made worse given that even the Catholic Charities and Catholic Health Association (why weren't they there?) support the proposed solution.

A real debate on this issue would be represented by having the Democrats' side represented for a few witnesses, instead of the one sided affair that took place. If something that has bipartisan, broad Catholic support results in this, well, that's rather telling in itself. One concern raised by the panel was that Plan B is covered.* That sort of thing has a shred of logic, more than harping on the fact that "pregnancy is not a disease." A moronic statement -- the issue is the real health effects of pregnancy, which is a major reason why Catholics do not generally have ten children, even if they have the money to care for them. But, real debate of possible sticking points is not the point here. Major fail.

One of the women panelists (in the second round) offered "reasonable alternatives" to having the insurance company provide the coverage without charging the institution. I still find this akin to that bit on The Daily Show where it was noted that there are just so many ways for the government to pay for abortion, so what we really need is special money (dollar bills) so that pro-life people will not be corrupted. After all, we pay the salaries of building inspectors to clinics. Pacifists also ridicule them on what the government forces them to do.

Anyways, these "alternatives" would include the women paying for it themselves, their employers or via their spouses. Ms. Fluke notes that contraceptives could cost $3000 over the span of one's attendance at law school. The point of insurance is avoid out of pocket costs. Many of these people are not married, particularly those at college. Many are not employed -- why do they need insurance at all if they can get it that way? -- and many opponents would like to let many employers not cover insurance either. So, these "alternatives" are weak, leaving the option of individual credits. Where will this money come from? Unless this is some sort of unfunded mandate, it will come from somewhere. Perhaps, less funding to education institutions and so forth?

I guess finding not overly credible distinctions is something Catholicism has had a long history putting forth, but the bottom line is that money is fungible and at some point, the religious institutions have to recognize the lines they are drawing here are silly. They are not being asked to directly promote, distribute or even fund contraceptives or even those that do so. They interact with various institutions, down to those who build their campuses and serve their food, that in some fashion support violations of doctrine. Do all cafeteria food come from companies without same sex couples being given benefits? If not, is not the Church funding the promotion of same sex marriage? Seriously, why is that different?

Ms. Fluke's remarks (she doesn't appear to have been sworn in, so it isn't "testimony" as such) underlined the importance of the drugs in question for women's health. It is my understanding, though some appear to be confused here (I say this in part from reading blog commentary), that non-birth control related use of these drugs is not the issue. But, as with narrow "health" rules for abortion, one problem is that once you make it controversial, those who need it for ovarian cysts or whatever will have a hard time. Some providers (and students) will not understand the after all unreasonable lines being drawn. After all, the basic idea of preventive health apparently is too hard for some to understand, sneers of "pregnancy is not a disease" being made.

And, it bears remembering that even Catholic organizations accept the compromise, most Catholics (e.g., Rep. Nancy Pelosi) realizing even the original ones were not some big insult or threat to Catholics as a whole. This plus the thousands of students, employees, patients and others covered by these institutions that are well respectful of "religious liberty" underlines the shallowness of the alleged "threat" here. The modern regulatory state is a major driver for the felt need for some religious exemptions of general laws, even if the institution in question received government funds and serves the general public. It also shows the need for respect for all views and some middle ground. Most seem to respect that.

A hopeful sign.

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* See here for discussion of a district court ruling striking down as a sort of religious gerrymander a local policy held to be applied in a discriminatory fashion. Seems to depend on the facts, which those interested can investigate further. As I noted, if anything, for what it is worth (it's only a district court ruling in a special case), it's possible the logic there would hurt the dissenters here because Obama's proposal seems to be a problem in the other direction!

Anyway, this Plan B issue has received less press. Since some think it is an abortifacient given there is a small chance that it will not merely block conception but implantation, it raises the abortion red flag. Looking at the written testimony of the two women panelists, and this really deserves to be underlined, their main concern (not saying it was their only concern) was in fact this issue. One in fact underlined her institution DOES cover contraceptives (but not sterilization) generally.

The year delay is well used to deal with issues of this sort and if a bipartisan modification merely exempts this sort of drug, it would be acceptable though probably with some sort of rape exception. Those with health problems would still get contraception coverage. It is not ideal, but no compromise is. Rushing this slanted panel for political effect is again not productive to the general welfare, the ultimate bailiwick of Congress under the Constitution.