Universal access to contraception is, or should be, as much a part of basic health care as routine inoculations, antibiotics and blood transfusions. Those who object to that concept do not stand up for freedom of conscience so much as they demonstrate just how removed they are from the real world.
But because Republicans in Congress smell a good wedge issue, and because the American Catholic hierarchy is perceived to be politically powerful, the Obama administration last week was forced to do an embarrassing dodge and weave on its rules for how contraception will be covered by all employer-provided health care plans under the new Affordable Care Act.
The religious issue has been the focus of news coverage and commentary. But the real lesson to be drawn here is that this nation's unique mistake of tying health care to employment remains a bad idea and why real health reform won't come without a progression to single-payer, or at least a robust public option. If we had made that decision when the rest of the civilized world did, or when the issue was last before the Congress, this whole fuss would have been avoided.
From the standpoint of pure politics, the decision by President Obama to make all employers other than churches include contraceptive coverage in their employees' insurance portfolio was a clumsy one. The fact that churches were to be exempt, but Catholic universities and hospitals were not, wasn't enough to satisfy a major institution that abhors the whole idea of birth control, and certainly would be expected to argue that it shouldn't have to pay for it.
The fallback became a rule that religiously affiliated institutions won't have to pay for contraception coverage, or tell their employees that such coverage is available. But their insurance carriers will. It's arguably a fig leaf for the church, but it puts contraception within reach of many more women, even as it allows those who object to look the other way.
Besides, every taxpaying Catholic has long been paying for contraception, even abortion, because the income tax exemption for employer-provided insurance amounts to a taxpayer subsidy for every plan out there. And, one survey shows that up to 98 percent of sexually active Catholic women have used contraception at least part of their lives.
There is no rational objection to the idea that universal access to contraception improves women's health and lives, is key to reducing poverty, is cheaper than childbirth and belongs in any health care plan worthy of the name.
It's just a matter of getting it done without the culture wars getting in the way.
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