Demystifying Medicine One Month at a Time

Politics & The Art of Compromise

oral-contraceptives.s600x600The dustup over contraceptive coverage is a fine example of our democracy in action.

Whatever your view on the matter, I applaud HHS Secretary Kathleen Sebelius for both her leadership on the matter and her willingness to engage in compromise.

Here’s what’s at stake:

  • The Affordable Care Act (the health care reform law, aka ObamaCare) includes a provision mandating that employers offer contraception as part of the menu of “covered preventive services” to their employees.
  • Many, especially Catholic-affiliated organizations, find this provision in direct contravention of their fundamental doctrines.
  • The federal government wants to honor basic constitutional principles: the right of persons to practice their religion (and not be bullied to alter their religious practices, so long as those concord with law); also the right of individuals to have access to safe, effective health care.

A noteworthy fact: More than 99% of women aged 15–44 who have ever had sexual intercourse have used at least one contraceptive method. [Source: Guttmacher Institute]

How should the fact that such a preponderance of women use contraception influence the debate? When something is as mainstream as contraception, it becomes a fact on the ground. Even though the framers of our constitution could not have imagined (nor likely would have ever commented on) contraceptive technology, how can such constitutional debate about fundamental rights and freedoms be interpreted in this case?

The latest compromise offer steers a narrow course: Religious organizations (e.g. non-profits like Catholic hospitals or colleges) that employ non-affiliated persons can refrain from offering contraception. However, the insurance companies that provide coverage for those employees will be required to offer contraception under the proposal–at their own cost.

Left out of the compromise (and suing on this basis) are for-profit companies (like “Hobby Lobby“) whose owners/directors cite their personal religious views as a basis for non-compliance with the mandate.

As always with compromise, the remaining question becomes “Where do you draw the line?”


  1. Wayne T. Johnson

    The current conflict over artificial contraception and the Catholic Church’s opposition to it is a further example of widespread misuse of the term f u n d a m e n t a l . It’s a controversial doctrine, a “brand name” doctrine if you will, and a lot of people have a stake in it. And in the minds of some, it may indeed define the church. But as a matter of fact, it is just one moral teaching among many, and one which is widely ignored by potential parents who are Catholic and consider themselves “good Catholics.” When the Church, on rare occasions, defines doctrines, it usually has recourse to the “praxis fidelium” i.e. “the practice of the faithful” to validate its position. Well, a lot of Catholics practice birth control. The ecclesiastical administrators are out of step with the implementers of belief.

    Christ didn’t die on the cross over the issue of contraception. He did die to underscore fundamentals like God’s love of humankind, the primacy of love/charity, the efficacy of grace, and the reality of salvation.


  2. glasshospital

    Thank you for such a thoughtful reply. I was hoping you’d share insights with us from your perspective.

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