Word that the bishops are rejecting the Obama administration compromise on the HHS mandate means further conversations. DotCommonweal has a great update, but the comment thread made me think that before we Catholics devolve into the usual, unfortunate camps, I want to highlight three lessons that the events up to now should invite us as moral theologians to develop further:
One, the compromise and its rejection display how sorely inadequate our current thinking about “cooperation with evil” is. It would seem the administration has taken advantage of a quirk in the present situation: it may very well be cheaper for insurance companies to offer contraceptive services, and therefore they can be “mandated” to do so, in a separate, “free” agreement between employee and insurer. In principle, given that the institution is not a party to such an agreement, nor is any individual in the organization compelled to enter into the agreement, the problem of cooperation is solved. David Brooks terms this a “polite fiction” – polite, because it does honor the consciences of those who wish not to be party to the agreement, but a fiction, because at the end of the day, the insurance company is simply a pot of money, and so unless the insurer is not providing contraception to anyone, anywhere, premiums are “paying” for contraception. The bishops are objecting to this, and, as Dana points out, they may have good reason to do so. But given the nature of larger insurers, it is difficult to know where they will stand (except for self-funded insurance plans, which will be dealt with in some way that respects conscience, according to the administration). Thus, it is the very practice of collective insurance which renders “cooperation” a difficult problem. It seems to me that such cooperation was worked out most carefully in situations where individual agents either assisted or did not assisted other agents in individual acts. That is, it was not about money, but about acts. Should you drive the cab or clean the abortion clinic? But extending this principle to money makes things complicated. On the one hand, one can set up whatever kinds of segregated accounts one wants. On the other hand, such segregated accounts are obviously fictional when what is being purchased is “collective coverage” – that is, in cases like insurance or taxes. And this is further complicated by the fact that it does seem entirely plausible that insurers would in general find it financially advantageous to provide cheap, “preventative” services – pregnancy is not a disease, true, but it does incur large health costs! The point here is that we need to get much clearer on what “cooperation with evil” really means when we are dealing with collective practices like a modern insurance system. And getting clearer on this would surely be very interesting for Catholic moral theology – for example, what are the odds that my university’s endowment or TIAA-CREF funds are invested in biotech firms using embryonic stem cells? Or firms employing child labor? Or firms selling contraception (whether manufacturers or retailers)?! The collective practice both of mutual funds and of joint-stock corporations are at issue here.
Two, what counts as “health care” is a large issue. At base, the bishops object that contraception, like abortion, should not be understood as medical care. We might rightly discuss how this plays out in complicated cases, like the Phoenix case or cases where a woman is in need of some such services for a medical condition. But in principle, it is unclear why routine contraception should be understood as a “medical” issue… whereas, for example, my diet and my fitness center membership are not so understood. The contemporary problem of “medicalization” is actually a huge reason why health care costs are difficult. Insurance is best suited to systems (like home and auto) where a small number of high-cost occurrences which are difficult for individuals to predict can be smoothed out by pooling the risk. Such is the case for major medical catastrophes. But we mostly do not have collective insurance to cover routine auto maintenance or home maintenance. So, why have insurance for routine care? And what happens when we enter the difficult area of chronic conditions? Especially when those conditions are “invented” to fit new drugs (e.g. Viagra)? We rightly recognize that health care should be a basic right, but the problem of what counts as “health care” requires further reflection.
Three, whatever happens after this, I must admit that in my lifetime, I cannot remember a case where the Catholic leadership has mobilized so swiftly and effectively to highlight an issue, foster a consensus among Catholic groups, and impact a public policy decision in short order. Moreover, it has immediately highlighted the importance for Catholic organizations of living out their mission and identity in concrete ways. Wouldn’t it be nice if we could do this more often, say, on all of the issues highlighted in the second half of Gaudium et spes?
Great response, David! I am enjoying this conversation and learning a great deal from you, Jana and Dana’s posts.
In this post, your warning about understanding cooperation when it comes to money (instead of action) is particularly insightful.
I have a question, for anyone, in response to your conclusion:
The mobilization and conversations as this story unfolds “immediately highlighted the importance for Catholic organizations of living out their mission and identity in concrete ways. Wouldn’t it be nice if we could do this more often, say, on all of the issues highlighted in the second half of Gaudium et spes?”
My answer to this question: yes. For instance, the importance of access to education is highlighted in par. 61. What a great paragraph! How about a broad-sweeping mobilization against those social structures with which the Church may cooperate and which prevent many from full participation in culture?
Or we might consider the ways in which economic and labor structures tend to prevent many from “unfold(ing) their own abilities and personality through the performance of their work” (par 67). Are there ways in which religious institutions are forced to cooperate with this practice, this kind of prevention? What if the Church were to generate a loud consensus (one which points to the Catholic identity of Catholic employers and cries out for religious liberty) against forms of forced cooperation with these practices, with these kinds of harms?
I am not saying that the Catholic world has not addressed these problems, and I am not saying that the questions of contraceptive access and health insurance are unimportant. I am asking why: Why do we not consistently see the kind of response we’ve seen these past couple of weeks on these issues as well?
Why for this, but not for that?
I agree with David’s and Nancy’s points and want to add a #4 to what we’ve learned:
4. We appear to be able to come together regarding issues that relate to the state, and in anger about freedom of religion, as a particular American value. In fact, didn’t it feel kind of good to know that such diverse people as EJ Dionne and David Brooks and Cardinal-elect Dolan were coming together in some way?
Now, I think that this kind of connection is important, given what I understand as Catholic intellectual tradition regarding church and state.
But…. Would that we were able to come together more concretely because of our allegiance to Christ, for theological reasons. Or maybe to put it differently: would that we would recognize that this is what the Eucharist is for us each week – but what that sense of identity might mean for us in addressing the concerns of Gaudium et Spes, among others.
Jana and Nancy– Great points!
I just want to echo Jana’s point that while Catholic togetherness is a nice thing, she’s right to note that this is all of us being “Americans” together, not being “Catholics” together. After all, evangelicals (who mostly do not share the opposition to contraception) jumped on the bandwagon, too. (And how ironic it is on religious freedom, perhaps the most challenging issue debated at V2!) I actually think this is why we need to move on from this experience to other issues, because ultimately this shouldn’t be a teaching moment about religious freedom, but a teaching moment about Catholic mission and identity commitments, and why and how we hold them as institutions.
These postings about the debate have been very insightful and helpful.
It seems to me that there’s a flip side to Jana’s point #4. We agree about the value of religious freedom in part because we agree (and celebrate) that we have distinct traditions of moral reflection and social institutional practice. We may not always (or often) reach consensus about what we think and do within these traditions, but we have a shared sense of their importance. And so I see the formation of quick consensus around this issue as an indication of the level of our commitment to our traditions (to our family, as it were), as much as it is a defense of political freedoms. At a time when many studies report growing indifference among Catholics toward their own institutions, I take this as an indication of health.
At the same time, I share Nancy’s question: “why for this, but not for that?” I have wondered if this episode is fully intelligible apart from the larger context of Roe v. Wade. I think it’s fair to say that Roe v. Wade did more to shape late 20th century American Catholicism than any other single event. It confirmed for the bishops, among other things, that the political legitimation of rights that violate the natural law in matters as fundamental as procreation and the protection of human life is both alarming and dangerous. Perhaps the current episode can be understood as an application of the lesson learned, as if the bishops are now saying, “we’re not going to allow this kind of thing to happen again.” Because of the consensus, their arguments may well have some gravitas when the time (inevitably) comes for the public debate about a “health care right” to free artificial contraception.
Great points again, Jana and David!
I have thought that this experience is fueled more by concern to protect mission and identity than about shared Christianity or Catholic togetherness.
Caveat: My perspective may well be colored by the fact that I do not participate in this togetherness when it comes to belief that the practice of contraception is a grave moral evil. It is hard for me to see how this, my fundamental disagreement, is playing out in my interpretation of the discussion these last couple of weeks!
It is interesting to consider what might make it more appealing for us to “be Americans together” than to “be Catholics together” (following your last points).
I think sometimes that our desire to protect mission and identity is misplaced. The Church is God’s–what does it mean when we, humans, work to “protect” it? I think that the content of mission and identity is true (I mean here our faith commitments). So does it require protection? Ought we not instead be pushing off from it, standing on it, leaning on its strength?
Yes, I think there is a danger of being too overly enthralled with our own efforts to “do” church in a way that makes us forget that the church is God’s, and therefore ours, not the other way around.
It’s why I keep thinking again and again on Patrick Clark’s post a couple weeks ago about witness.