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HHS Mandate: A Bridge Too Far
Obama has set off a culture war, for real.

By Conrad Black


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The last two weeks have produced an astounding convergence of profound philosophical public controversies in the United States that finally does justify the phrase, much bandied about for some years, “culture wars.” That expression was coined originally for Bismarck’s mad Kulturkampf against the Roman Catholic Church (and, to a lesser degree, other churches) in the mid–19th century. It was the usual self-aggrandizement of secular states against a vast, international, unsubmissive, foreign-governed church, and recalled French and Spanish railings against the Jesuits, Napoleon’s detention of Pope Pius VII, and many other church–state frictions.

But the interim final regulation in the Affordable Care Act that would require Roman Catholic–affiliated hospitals and agencies to pay for insurance of abortion-inducing drugs, sterilization, and contraceptives for their employees, gratis, was an astonishing affront to America’s largest religious denomination.

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There are 77.7 million Roman Catholics in the United States, a little over 25 percent of the whole population. The majority of them oppose abortion, probably only about a fifth or a quarter of them have any serious problem with birth control, and 80 to 90 percent of them would likely object to the U.S. government’s grinding its hob-nailed regulatory jackboot into the face of their church.

This ukase claims that 28 states are already doing the same thing, but this is piffle as there are carve-outs for Catholic institutions in the states or they self-insure. This attempted coup was a mortal assault on the Catholic leadership, which the administration thought an anachronistic paper tiger; it was tossed off very arrogantly and flippantly, and the administration quickly retreated to a fallback imposition of the costs on the insurer. At first glance, this looks a bit like the shutdown of offshore drilling during the Gulf oil spill, with the demand that BP pay the other oil companies their losses and expenses. If the government had started with some such plan as the one to which it quickly climbed down, it would have avoided the firestorm that forced such an early retreat. Even if it ends here, this episode leaves the bishops incredulous and opposed, and most active Catholics uncertain; and it disquiets many non-Catholics as an insolent abuse of regulatory power to humiliate the country’s (and the world’s) premier faith institution.

There is doubtless still a reservoir of anti-Catholic sentiment in parts of the country, but this is a relatively small minority of superstitious bigots raving about the Scarlet Woman of Rome, and any identification with them would be a disaster for the Democratic party (the only party to have nominated Catholic candidates for national office — Al Smith, JFK, and John Kerry for president, and Ed Muskie, Sargent Shriver, Geraldine Ferraro, and Joe Biden for vice president).

A very large number of non-Catholics could get on board with the opposition, if the compromise doesn’t take and if the Roman Catholic leaders and the principal Republicans play it right — not as a dispute about birth control itself, but as a matter of the freedom of religion and conscience that could as easily be inflicted on any other organization or individual, an assault by the government on the rights of the people. New York’s archbishop and cardinal-designate, Timothy Dolan, was ready: “Never before has the federal government forced individuals to go out into the marketplace and buy a product that violates their conscience. This should not happen in a land where free exercise of religion ranks first in the Bill of Rights.” (The New York Times was dismayed at the swiftness and uniformity of the Roman Catholic Church’s response. The Wall Street Journal dismissed the compromise, which the administration pridefully calls “an accommodation,” as “Immaculate Contraception.”)

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COMMENTS   42

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RichC
   02/15/12 07:45

Wake up America, if this doesn't expose the beast what are you waiting for?

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   02/15/12 09:37

I'm not Catholic, but this controversy bothers me greatly, for the same reason that virtually everything else the Obama administration has done bothers me: it's blatantly authoritarian. Obama and his minions are never content to leave people alone if some Democrat interest group wants to boss other people around some more. The abortion zealots, the unions, the teachers, the greens -- they all get to tell Obama how to whittle away at the liberty and property of the rest of us.

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Juan Jose Morales
   02/15/12 21:30

This blowhard windbag from Chicago is not the President of all Americans. He is the slave of every interest group of his party, and his servile condition demands that he serve only those interest groups. The rest of the American people?: as far as he is concerned they simply do not exist.

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ajn
   02/15/12 09:39

I have not read Mr. Black's FDR:Champion of Freedom, but the title itself suggests to me that Mr. Black's stated objections (with which I agree) in this article to intrusions of the secular state could be a bit disingenuous and not fully representative of his past opinions.

Can anybody enlighten me?

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   02/15/12 09:43

Well, let's get the ball rolling here:

1. I actually do see the point of Catholic resistance here but let's have some devil's advocacy, which I must say does tempt me on this issue. The Church and its institutions are not being required to preach contraception, install IUDs, strap on condoms, or force feed the pills. They are employers and are being instructed to provide a package of health insurance to employees that is being mandated for other types of employers too. If other employers have to pay for something, which might offend their sensibilities and will certainly cost them money, why precisely should the Church be exempted from paying that money on conscience grounds? Again, they are being required to provide insurance to employees here, not preach anything.

Unless we are arguing that the Church should be entitled to employ only Catholics even in administrative, health care or other specialist roles, or that Catholic and non-Catholic employees will be required to sign on to specific moral and loyalty oaths to work for Church institutions, why should they get poorer insurance packages and the Church save some cash that other employers must fork over?

2. The proper argument to be made is that no employer should be required to cover all this in a health insurance package, and it is offensive that they should be so asked on grounds that are entirely secular but strike me as profoundly moral. The chief purpose of a health care system is to heal the sick and injured and care for the dying. All else is gravy. And healing for the sick and injured and caring for the dying should be the ONLY legitimate scope of a publicly-funded health care system. Or, frankly, an employer one to the extent it is demanded by the state. No gravy should be paid for by lifting money from people's pockets against their will.

That means no plastic surgery unless reconstructive following injury or disease, no gender reassignments, etc. And no contraception, which is equally unrelated to the mission of a health care system and additionally has the benefit of being dirt cheap and widely available in modern Western society.

Up here in Canada these debates come up from time to time. I ddon't have the full list of what Ontario's plan provides, and it probably isn't too bad. But there are likely some fripperies. In the 80s there was public outrage when someone suggested making gender reassignment a listed government provision. As well there might have been. But the idea that equally frivolous nonsense might still be listed under "OHIP" haunts me whenever I contemplate the many things that are not covered [very limited eye care, no dental, very limited many things] and the MANY limitations that exist even in my employer-provided supplementary insurance.

It's a good system for us in some ways, but I resist looking at the full coverage lists of either government or employer packages lest something like contraception subsidies be present and drive me to apoplexy as I write checks for all my dental procedures last year.

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   02/15/12 10:33

Random,

"They are employers and are being instructed to provide a package of health insurance to employees that is being mandated for other types of employers too."

"They are employers (yes, PRIVATE employers) and are being instructed (yes, 'commanded' like subjects, not freemen') ... that is being mandated for other types of employers (yes, 'commanded', again like subjects, not freemen).

That you can type this sentence without a sense of red-faced outrage is to telegraph your lack of understanding about the foundings of this Republic.

Perhaps you should enroll in this 10 week course, and read your sentence again at the end of it ... External Link 

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   02/16/12 08:55

Well, like I said, I'm a Canadian and like all Canadians ought to be by birth or oath but are not reliably, a monarchist. Though that has no direct bearing on social policy.

My usual only interest in these debates, as an outsider who is at least disinterested on those grounds, is in the philosophical elements and general issues.

On your specific point, fair enough. I have grown up with the basics provided by single-payer government system, with its pros and cons. The MANY things it doesn't cover [this is how you keep it going longer than any US equivalent that has been proposed would ever last-you limit the elements it covers- no drugs for most of us, for example; if you want drugs, you'd better have your own supplementary plan or pay through the nose, or be pretty old] are covered by the plan my employer provides through a health insurance company, as would be the case in the US for those lucky enough to have one.

I understand that the scope of that second plan may to some degree be defined by legislation, though not in every detail. It's just what we are used to. And despite Mark Steyn's increasing alarmism, it makes me no more a slave of the state than any other citizen of a modern society, including the US. Damned few people could survive a normal modern lifespan as backwoodsmen [I appreciate that some can still pull a Jeremiah Johnson, but not so many], and we have come to expect one. We need medical care. Modern standards are tough for all but the wealthy to afford, and insurance companies and employers have their own interests to advance. It is a way of allocating resources like any other, and it has pros and cons like any other. I have seen its weaknesses with my own eyes, and argued for market reforms myself, though not so far as the US system.

Unlike many of my fellows, I do not care if you all adopt it. I don't care if you feel the need to use it as a flogging horse in your elections, in however hysterical old womanish a manner this is done.

I get mildly annoyed when some on the site claim it makes my country the USSR, not least because our health care is much better than that and our fiscal policies are better than the Republicans' have been for years.

There are ever so many ways in which American governments dictate requirements to actors in the economy. IF as a libertarian you oppose them all, fine. But in the grand scheme of things having a requirement to provide this package, or any, is not in principle different from workplace safety, product inspection, or other requirements that were at one time imposed in response to clear needs that employers were NOT meeting and were not about to.

However, the subject here was specifically the Catholic issue, which Black has turned into a Church-State issue of Tudor proportions. THAT is what I was concerned about, since it argues that the Church's conscience should free it from providing the same coverage everyone else is required to provide, and thus reduce its staff to second class and save it money others must pay.

If you want to argue no employer should face this burden, great. But if any employer does, so should Church institutions, as employers.

You will note although I am not so outraged by the notion of mandated employer health insurance, I am disgusted by the notion that these specific services should be included in any such plan, and not solely on the pragmatic grounds of waste of money. In my view the waste of money on such things IS a principle since these are contrary to the primary aims of health care.

We may disagree on to what degree government or employers have a responsibility to financially support health care, but perhaps we can agree that there should be no public or corporate responsibility to fund things that are not health care.

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 JPK
   02/15/12 10:58

Random Observer,

You pretend to a disinterested observer; but, in the end you mouth the President's policies. The RCC is more than just an "employer". Its charities began and continue to be a "free excercise" of religion (See the First Amendment and the prohibitions focused on the government in this regard). The whole matter concerns the federal government's prevention of the Church excerising its religious freedom. What the President and HHS are doing is dictating to the Church what is "religious" and what isn't. In case you are not aware, niether Congress nor the President can dictate to any Church its theological underpinnings. The maintenance of hospitals, women's shelters, food pantries, assistance in paying for utilities, homeless shelters, and schools of all types are an extension of the Catholic Church's religious freedom. Yes, the hospitals recieve some compensation from the federal government; but Medicare (the eldery) and Medicaid (the poor) rarely cover the total expenses of the sick. The Church must rely on donations to make up the losses. Yet, the Church never turns anyone away.

It is your kind of thinking that allows the federal government to force its unconstitutional interpretation of religious freedom on this nation. The goal is to force religious expression out of the public sphere. But, the leviathan knows no bounds. Already, in states like Washington there is legislation afoot that will force churches to marry homosexuals. No, the US isn't Canada. We have constitutional safeguards in place. If only we will force the government to abide by them.

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   02/16/12 09:17

I am extremely disinterested and I think your president and his cronies are nuts on most issues [the Osama thing and the drone attacks are OK].

A genuine question for anyone in the know- are churches currently able to discriminate in hiring, promotion or other employment policies in favour of members of their own religion, for other than preaching and teaching or other doctrinal matters? [Those latter categories of people are directly involved in preserving and teaching the churches' views and it would be both illogical and I would think unconstitutional not to permit discrimination. Illogical unless meant as a direct attack, of course. ]

Are churches permitted to apply doctrinal tests to employees, members of the faith or not, in non preaching or non teaching posts?

If they are, there is a case that these exemptions also apply here.

If not, the ship has already sailed on this issue. If employees are employees, then that's it. If employers can be mandated to provide insurance at all or any particular kind, which is itself in dispute but not the issue here, then there is no reason the Church should be exempted.

I appreciate that all the charitable operations you name are intrinsic to the faith and mandated by it, and halting them would force Catholics to cease to practice their faith in important ways. They are not being halted by this measure. If they were, there would be a valid cause for call to arms against unconstitutional government.

The Church's theological underpinnings are not affected. Neither is its preaching. It will not even be open to a valid charge of hypocrisy, since the origin of the insurance requirement and the contraception coverage is well known.

As to receiving federal money, that doesn't seem to be part of the issue here, as employers are to be mandated whether they receive federal money or not. It isn't a Grove City type of argument. If the government were to impose extra requirements on the Church OR to interfere in its ability to conduct charity or teach and preach due to its receipt of some piddling federal sums, then it would be.

That's all why I think the Church should not be treated differently from other employers, and why, unless there are the above precedents, there is no need, and why its religious nature should not be seen as being undermined.

We must agree to disagree, but thanks for actually hitting me on the issue I tried to address. As to the rest I have said above that on the whole I think this measure IS an assault on important moral principles we could all share, namely on the proper missions of a health care system, let alone a publicly backed one. I do not think the Church should be exempt, but I also think no employer should have to pay for contraception or anything else that does not heal the sick and injured, or comfort the dying.

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richbarnett
   02/16/12 02:41

Ugh. I bet it took you a fair amount of wasted time to write all those random words and random thoughts. Laugh out loud at the "unless we are arguing..." part.

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richbarnett
   02/16/12 02:42

Ugh. I bet it took you a fair amount of wasted time to write all those random words and random thoughts. Laugh out loud at the "unless we are arguing..." part.

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   02/17/12 14:22

Are you saying they SHOULD be entitled to do all that?

I would not have a problem with it, as it happens. But as long as they are required to employ others and do so, why should those employees not be entitled to the same as employees of other organizations?

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Dave Nelson
   02/15/12 10:02

I think it's at best a bit sloppy to hint at a free exercise issue here, especially without at least mentioning the jurisprudence at issue. Whatever you think of the wisdom of the policy, isn't it clear in the wake of Employment Division v. Smith that a religious motivation affords no right to avoid compliance with a generally applicable law or regulation?

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 JPK
   02/15/12 16:00

Dave,
And who determines what is religious expression? I hope you don't think it is the State. The SCOTUS just ruled about this thing. In order for ObamaCare to work, it must determine which organizations are excercising thier religion in a way compatible with its political ends. In your eyes, a religious group must first prove that they are religious enough in order to receive the blessings of the State. This is obviously unconstitutional.

Read HHS's mandate, and it is obvious. Unless the hospitals or woman's shelter, or school is employed by clerics and serves only clerics than it must comply. If this isn't tyranny I don't know what is.

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Max Power
   02/15/12 23:40

I don't care about your fancy elitist legal precedents, librul! I just want muh kuntry back!

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Nasty, Solitary, Poor, Brutish, and Short
   02/16/12 09:19

Dave,

You only have the first half of Smith. The second half is "inicidental effect." Requiring a Moslem woman to drop her veil for a few seconds in her driver's license photo is a generally applicable law of only incidental effect. That's the sort of thing which Smith says a free exercise objection will not defeat. Moreover, her decision to seek a driver's license is purely voluntary. No one is forced to drive. Buying insurance (or posting a bond) as a condition of driving on a public road is the same thing.

The oft-discussed on these pages Religious Freedom Restoration Act from 1993 was a response to Smith. It raises the bar to "subsatntially burden" from "incidental effect" and further ramps up a court's review to strict scrutiny, the highest level.

Now is it clear?

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Max Power
   02/16/12 14:31

As opposed to this law which doesn't require Catholic women to do anything

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nasty, solitary, poor, brutish, and short
   02/17/12 18:57

Max,

Well, in fact, the whole fight is PRECISELY about who is forced to do what. Captcha is "fast asleep." Mark Steyn would agree one of is . . . . .

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Carole Smith
   02/15/12 10:49

IF health insurance were sold the way that car insurance is and the purchaser were able to determine what coverage he/she wanted and it were done across state lines in a truly competitive market, many of the problems the Obamacare abomination presents would be eliminated. This whole insurance fiasco has turned into a take over of people's responsibility to care for themselves. It should not be called health care, but rather health insurance, something to help one in need of treatment. I'm retired and pay my own insurance costs (which are high, believe me, and I'm not eligible for Medicare, which I am actually happy about), but unfortunately I have no choice in paying for coverage of problems/issues that I don't have and will never need. Every single thing I've learned about this law has been negative, and in its entirety it is a blatant attack on our lives, our liberty, and our freedom to live our own lives. This administration has attacked our 2nd, 10th, and 1st Amendment rights. Does anyone think that they will stop here? We will soon be a third world country with fewer people working to pay for the entitlements of those who selfishly believe that they deserve our money. I'm not talking about those who are truly needy, but rather those who, according to reports on the "poor," have a heck of a lot more than I do. I don't envy them, nor do I envy the so-called 1%. I find this whole class-warfare nonsense a waste of time and a blatant example of a lack of common sense. And I'm saddened that so many people are envious of others. This is the USA! Everyone truly does have equality of opportunity, at least for now. November 2012 cannot come too soon for me, but, alas, I fear that those who "demand" more so-called "rights" are beginning to outnumber those of us who simply want to be left alone to live our lives responsibly on our own. I am afraid of what's going to happen when this reaches the Supreme Court, too. I wish I had more trust in the "system" and more hope in the American people. Benjamin Franklin said that we have a republic of laws, if we can keep it. I doubt if he and the other Founders imagined Obama and his minions and the present assaults on our freedoms.

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Max Power
   02/15/12 23:45

Right, everybody knows third world countries (sic) have the most generous entitlements.

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