Compromising on Women’s Health

While not Catholic, I spent 8 years employed by one of their fine healthcare institutions, Loyola University Medical Center. I retain an academic appointment there (Clinical Associate Professor of Radiology) of which I am truly proud. I have nothing but respect and admiration for Loyola, and I will always consider myself a Loyolan. Their Maywood campus is a state-of-the-art tertiary care facility that provides the highest quality healthcare in an ethical fashion. Among their workers’ ranks are people of diverse religious beliefs and backgrounds, and I have never witnessed any discrimination whatsoever. Their first Chairman of Radiology was Jewish, and Muslims, Protestants, Evangelical Christians, Hindus, Buddhists, those with little personal religion and perhaps even the occasional Scientologist or Wiccan can be counted among their employees and leaders. There has never been any expectation that Loyola employees share a Vatican worldview.

You’d surely be tempted to think otherwise based upon the events of the past few weeks, with conservatives angrily rallying against the provision of the Affordable Care Act (ie, Obamacare) that requires religious-affiliated institutions like Loyola to offer and pay for contraceptive services for their female employees. While framed by Obama’s foes – led by John Boehner (R-Ohio, Speaker of the House of Representatives, chain smoker) – as a debate about religious freedom, the real issue has always been birth control itself. If religious freedom were the true concern, then leaders of religions not philosophically opposed to contraception would have joined the argument. But they haven’t.

In an effort to minimize political damage, the President last Friday announced a compromise. Insurance companies – not the religious institutions themselves – will now offer contraceptive coverage at no cost. Additionally, the one year phase-in period that was part of the original legislation has been scrapped. Insurance companies are not altruistic by nature, and the only reason that they have willingly offered to foot the bill for this is that it financially benefits them. The healthcare cost savings realized by fewer births that are spread further apart will dwarf monies spent on contraceptive coverage. While probably not a concern to the insurance industry, greater access to birth control also lessens the direct and indirect societal costs incurred when a family has more children than it can afford. The irony that Boehner – whose personal decision to abuse tobacco is one of our largest financial healthcare burdens – so strongly opposes this should not be lost on anyone.

While sold by Obama as a compromise, it’s hard for me to see how he – or more importantly women – did anything but score a victory last Friday. Instead of having to wait until 2013 to get contraceptive coverage, employees at religious-affiliated institutions will now be eligible for it this summer along with all other female workers. The public seems to support this, with the results of a poll released this past Saturday showing that 57 percent of Catholic women favor the compromise. The notion that Catholics as a group were offended by the original regulations is false as well, as Public Policy Polling found that 53 percent of Catholics were in favor of the initial directive. Additionally, surveys conducted by the Guttmacher Institute have shown that 99 percent of all US women – including 98 percent of sexually-active self-identified Catholics – admit to having used birth control. It would certainly appear that these contraceptive benefits are desired.

There is also absolutely nothing new about these regulations. More than 50 percent of Americans live in states that currently require health insurance companies to provide free contraception. California, New York and North Carolina in particular have the identical policy that was originally promulgated by the Department of Health and Human Services, while some states (eg, Wisconsin, Colorado and Georgia) provide no religious exemptions at all. It doesn’t take much cynicism to view the current battle simply as election year grandstanding. From a political point-of-view, however, it seems foolish to potentially alienate half of the voting population. But the far right has never approached me for advice on these matters.