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February 20, 2012 | Posted By David Lemberg, M.S., D.C.

Contraception, women's rights, and religious freedom have dominated the headlines in recent weeks. The Patient Protection and Affordable Care Act, the Obama Administration's useful beginning on the road to meaningful health care reform, was signed into law in March 2010. In August 2011 the administration announced it had accepted recommendations of the Institute of Medicine (released on July 20th) and expanded the definition of women's preventive care. The new guidelines require new health insurance plans to fully cover women's preventive health services, including the provision of birth control pills without co-payments. The administration estimates that by 2013, 34 million American women aged 18 to 64 will receive the benefits specified in the new ruling.

Naturally (also, sadly), considering that this is the United States, a firestorm of ill-will began gathering in response. Lately the anti-contraception forces have been in full cry. The wedge issue focuses on inclusion or exclusion of religious-affiliated organizations in the requirement. The House majority party and affiliated presidential hopefuls have announced their fierce opposition. Recently the United States Conference of Catholic Bishops rebuffed a White House compromise, stating that the requirement still infringed on religious liberty.

But houses of worship, including churches, are already exempt. The administration's compromise relieved Catholic institutions from paying for coverage and instead requires their health insurance companies to pay. These institutions include universities, hospitals, and charities that employ and serve many non-Catholics.

Religious freedom is one of the most important guarantees of our Constitution's Bill of Rights. The right to practice religion freely, without impediment from the state, is one of the hallmarks of American life and a prime attractor for immigrants from nations whose governments trample upon such a basic human right.

But religious freedom is a red herring in the current uproar. The First Amendment states that the free exercise of religion shall not be prohibited. Further, "Congress shall make no law respecting an establishment of religion". This language is subject to broad interpretation. Regarding freedom of religion, it is appropriate to err on the side of free expression. However, none of this relates to the civil matter of providing health insurance to employees of religious institutions or the policy parameters of such insurance. Employee benefits are rightly construed as matters of federal and state regulation. Such considerations are not circumscribed by the First Amendment.

Further, the rights of women to a full range of preventive health services are the main concern of the new guidelines. Women's health requirements are not the same as those of men. Access to birth control and family planning services is as much a component of preventive health care as is prostate and colon cancer screenings for men. If women are denied access to such necessary services while men are not, this would be a violation of the Fourteenth Amendment's guarantee of "equal protection of the laws".

If we take a breath and step back from this latest manifestation of America's highly destructive "culture war", we might notice that this entire argument could be avoided by instituting a single-payer health care system. With a single-payer system access to birth control services would be open to all women. There would be no requirement for religious organizations to offer such services to their employees, as their employees would already be covered by the national program. Persons and institutions would be free to exercise their First Amendment rights and voice opposition to such programs without actually interfering with the delivery of these services.

In 1969, a long, long time ago, America was able to put men on the moon less than 10 years after President Kennedy's bold prediction. At the time, it seemed as if we could do anything to which we set our national mind. Now, more than 40 years later, a dysfunctional do-nothing Congress enjoys the confidence of only 13% of Americans. We are past due for a change.

The Alden March Bioethics Institute offers graduate online masters in bioethics programs. For more information on the AMBI master of bioethics online program, please visit the AMBI site.

0 comments | Topics: Bioethics and the Law, Bioethics in the Media, Health Care Policy, Health Insurance, Religion, Women's Reproductive Rights


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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.
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