Food, Guns, and Contraception: A Random Followup to Some Random Thoughts on the HHS Rule
Instead of responding to comment on my previous post in the proper place, I decided to do a followup of sorts to clarify two issues and to expand on a few of the initial thoughts and their reactions. As a starting point, I want to consider the following comment left by “Mary”:
What about an employer forcing their religious beliefs onto their employees? My daughter is a nurse and works at a catholic [sic] hospital. She is not Catholic and feels birth control should be a woman’s decision. The woman has the right to decide when she wants to start a family. She was surprised when she found out that birth control was not part of the insurance program. She has been buying it on her own, and it is not cheap. What about those who can not afford to purchase birth control? Viagra is covered under the insurance program, and that is health care? Don’t think so. I’m not surprised that the article and comments here are all by men. It is not your body and you should not make the decision for women who want to use birth control.
It seems to me that this misses the point I was initially trying to make, and I take responsibility for any lack of clarity in my presentation. To make up for this, I want to consider Mary’s argument from two perspectives. Both perspectives will consider Mary’s assertion that women have the right to use birth control. First, I will temporarily grant Mary this assertion and re-present the argument that it still does not make it right to force Catholic hospitals, Catholic-owned businesses, or Catholic-run insurance companies to cover contraception. Second, I will challenge Mary’s assertion by arguing that women don’t in fact have the “right” to oral contraceptives.
1. What if Mary is Right?
What if we temporality lend credence to Mary’s statement that women have the right to use birth control? At the risk of sounding like a broken record, I will direct you back to my initial analogy of gun ownership. I firmly believe in the right to bear arms, but this in no way means that I believe the government should purchase a gun for me, still less does it mean that the government to force my employer to purchase a gun for me. There is a difference between the right to posses and use something and the “right” to have it at no cost to ourselves. This distinction has been lost in the national conversation. Even if Mary is correct that women have the right to use oral contraceptives, it still leaves me wondering why the cost for this should come out of the employer’s pocket or the pocket’s of the insurance companies.
Allow me to illustrate this point with another analogy. I think all of us can agree that the human person has the fundamental right to eat food. Should our employers then be required to provide us with our weekly groceries? Should they be required to give us vouchers with which we can obtain meals? Correct me if I am wrong here, but I thought the point of employment was to provide labors with a fair and honest wage, and the wage earners then get to decide how to spend those wages. Think here for a minute how you would feel if instead of providing you with a paycheck, your employer gave you vouchers for very specific kinds of food. Is this not a restriction of freedom rather than its expansion?
Actually, when you see the contraceptive coverage in this light, I think you will come to see that having the employer/insurance company forced to cover it is actually the more inequitable scenario. Allow me to explain. First, understand that contraception itself is not “free.” It is a product, and as such it has a cost associated with its production. If an employer is forced into providing this coverage for all employees, the cost of the plan will be effected somehow. I will leave it up to the actuaries to weigh in on how this cost works out, but the fact remains that the cost needs covered in some form or another. Contrary to popular belief at the moment, money cannot be arbitrarily created out of thin air. (This is a more complicated way of putting the age-old adage, “Nothing in life is free.”) Now, once the employer has this cost added to the plan, his budget must take that into account somehow, which will translate eventually into wages in some form or another.
Why is this inequitable? Because it effectively means that all employees will suffer the economic effects of some people choosing to use contraceptives. Of course, I am not naive enough to think this is a dollar-for-dollar transaction. Rather, the costs will be spread out through actuarial means. Nevertheless, would not a more “fair” system be to not cover contraceptives, to pass on the savings in the form of wages and salaries, and to allow those women that choose to use oral contraceptives under Mary’s claimed “right” to do so?
This is precisely what happens with both food and guns. The employer pays the employee, and the employee then decides what to spend his or her wages on: food, guns, or oral contraceptives. I would think that the advocates of “choice” would prefer this system anyway, for in taking money in the form of wages and then making an active choice how to spend the money, is that not a more powerful statement than having an employer (by means of government coercion) tell you how you have to spend your wages? Said differently, the problem with Mary’s “right to contraception” plan is that is actually takes away the right not to purchase contraception – it results in less choice, not more. If the insurance plans are forced to cover it, all employees are forced to purchase it, although some will choose to leave their supply at the pharmacy counter. In effect, Mary’s argument actually reduces choice and freedom.
Two other points are worth considering here. First, Mary claims that contraception is expensive, and that is why insurance companies should provide it “for free.” The problem with this is the illusion of “free.” It is basic economics here, something that seems to be absent from the Obama administration’s manner of administrating. As I pointed out above, the production of contraceptives costs money, and to think that this cost will not be passed on eventually to the employees is naive at best. The insurance companies are not going to take this “bottom line” hit – their very bright actuaries will work to makes sure that the cost is covered in the premiums charged. The employer won’t take the “bottom line” hit either. They employee likes to think of wages and benefits in two separate categories, but to the employer they are both part of a compensation package, and they both cost money. Whatever is added to the cost of medical insurance will necessarily be made up for in salaries. Of course, it won’t be right away, but it will be reflected in future salary negotiations. Anyone who has been a part of contract negotiations knows that it is never simply about salaries and wages. The “bottom line” will eventually be covered by all employees. Thus, Mary’s daughter will end up paying for the contraception anyway through lower-than-would-be salaries. When insurance plans cover something like contraception, it does not “save” the employee money, it simply forces them to spend some of their money in a particular way.
An analogy here is a local collect some years back that “gave” all entering Freshman an iPod. On the surface, it seems like a “free and generous” gift. However, the university is mindful of its finances, which means that the cost of this iPod is somehow or other figured into the cost of tuition. Seen in this light, it is not a “free gift,” but rather forcing all entering Freshman to purchase an iPod.
Returning to the forced purchase of contraception, even from a women’s dignity perspective, I would think that most would find this reprehensible. It is as if the government is saying, “We don’t trust that you will spend some of your money on contraception, so we are going to force you to spend it just to be sure.” Once more, apply this to something like food. It would be like your employer, under government coercion, withholding part of your wages and instead giving you food vouchers for specific items that the government deems “essential” to “healthy eating.” (Actually, the more I think about it, the more fitting this analogy is.) Wouldn’t it be better to have the money passed on in the form of wages to allow the individual the right to choose how to spend it? Once you understand that you will be paying for the contraception in some form or another, does not the whole thing sound rather insulting? In fact, I do something similar with my kids allowance: I give them a certain sum of money, and then I mandate that they put a portion of it in the Church basket on Sunday. Why? Because without the mandate, they won’t do it. Why? Because they are children. When it comes to the forced purchase of contraception, the government is treating women as if they are children: they don’t trust that you will purchase contraception on your own, so they are going to make you purchase it. (This is what they are doing with the health care mandate itself, by the way.)
The other more obvious problem is that this also forces women who chose not to use contraception to carry plans that cover it, thereby essentially purchasing it themselves (one the cost of the plan is passed to the employee in the form of not-as-high-as-they-would-be wages). In this way, then, the whole issue is not about the right to obtain contraception, it is about the right not to purchase contraception.
Further, Mary brings up the idea of Viagra coverage. There is an obvious difference, pointed out by one commenter, in that Viagra is correcting a bodily system that isn’t functioning as it should (and is thus much closer to actual “health care”), whereas birth control is doing nothing of the sort. However, I will say that in this case I agree with Mary. I also think that the government should not force insurance companies to cover Viagra, but that the employer should simply pay salaries and wages to its employees and allow them to choose how to spend their money. The difference here is that, to my knowledge, the government is not doing this in the case of Viagra. In fact, it may help to clarify the outcry over the contraceptive mandate to imagine the vitriol reactions that would surface if the HHS mandate required the coverage of Viagra.
2. But in the End, Mary is not Right.
All of the previous argument is null and void however, if Mary is not correct in her assertion that women have the natural “right” to use oral contraceptives. In order to address this, we must first re-think the whole notion of “freedom” and “rights.” The problem with our pluralistic society is that everything is couched in terms of “rights,” and further that this terms is never fully defined. Even so, a discussion bases solely on rights, defined or undefined, could never actually be consistent, because “rights,” understood in simple unqualified terms, will necessarily lead to situations of “competing rights.” In this case, we end up arguing over which has precedence: the “right” to religious liberty or the “right” to use oral contraceptives. When we find ourselves at the inevitable impasse of unqualified and competing rights, the only thing left to decide a “winner” is pure power. Whichever “party” finds itself in control will force its priority on the populus, and this is exactly what we see happening with the Obama administration.
The difficulty here is that freedom is not the random ability to choose between contraries. Rather, it is the ability to choose the good. Servais Pinkaers gives a great illustration of this in his book Sources of Christian Ethics by giving the example of a well-trained piano player. An individual who has no respect for the “rules” of music and the instrument is “free” to bang randomly on the keys (a “freedom of indifference”), but a trained pianist who has been taught the “laws” and “nature” of the piano is able to create music, a freedom that is much more authentic (a “freedom for excellence”).
The moral life is not much different than the musical arts. We are created with a purpose, a sort of definition of what it means to be “fully human”, what the Greeks called a telos. We are “free” insofar as we act in a manner consistent with what it means to be human. In a dilapidated view of freedom, we are of course able to act arbitrarily. But such a view is not authentic freedom. Authentic freedom is found when we act according to our design, according to the natural law inscribed on our hearts.
Understanding the natural law is the only way to avoid the inevitable conflict of arbitrary and competing rights. The only “right” we have is the right to act according to our design, to act in a way that is authentically human. Religious liberty falls generally under this one “right” because we know that we need to freely pursue and accept God. One can never be coerced into faith (even if the “faith” into which they are coerced is objectively “true”).
The question then is, does an individual have the “right” to use artificial contraception? Does the use of contraception allow an individual to be more “fully human.” From a Catholic perspective, the answer is clearly, “No.” Now, it is not my intent here to defend the Church’s teaching on contraception – numerous arguments far better than what I could produce have been written about this already. My point here is much simpler: we cannot approach this argument purely from some abstract and ill-defined notion of “freedom” and “rights”, but rather must conceive (pun fully intended) of “rights” and “freedom” under their proper telos of natural law.
I will give only one attempt at an argument against the “right” to oral contraceptives. I mean this not as the only, and maybe not even as the best, but I do think is it the most important one to publicize: oral contraceptives are abortifacient. It is in the very design of the pill that on the off chance (the measure of which is hotly debated) that fertilization occurs, the lining of the uterus is renders unstable so as to prevent implantation. In this case, a newly created human person is destroyed – a life is ended. Now, the fundamental “right”, if we are to speak in these terms, is the right to life. Understanding the notion of “freedom for excellence,” the path towards fulfillment as a human person, or the ability to choose the good … none of this is possible without the possibility of living in the first place. (Another “silver lining” to this tragic situation in which we find ourselves is the mere mentioning of this fact on national television by those members of the Episcopacy (un)fortunate enough to land an interview. It is about time the terrible truth about abortifacients in oral contraceptives gets more press.)
This is not the best argument against the “right” to use oral contraceptives, because it is conceivable (there is nothing worse than the same pun twice in one article) that someday the pharmaceutical companies will develop an effective oral contraceptive that is not abortifacient. Even then, seen in the light of Catholic teaching, there will still not be a “right” to use such medication to prevent pregnancy, the prevention of which drives a wedge in the very definition of marriage which by its nature is both unitive and procreative. In doing so, contraception thereby does not allow a couple to strive towards their fulfillment as human persons in their marital vocation. (For marriage, after all, is a vocation, and hence a “path to fulfillment.”) Nevertheless, it the abortifacient argument is an effective argument here and now, because oral contraceptives here and now are abortifacient.