What is Right, and Wrong, about the HHS Mandate

My second post on this topic in a row, I know. But why not? We philosophers could be political pundits if we wished; it is just that we are normally too busy contemplating the mysteries of the heavens, cleaning off our glasses, tripping over our own shoelaces, etc.

The HHS Mandate starts from a correct premise concerning the intersection of the judgment of conscience with the rights of others. Here is how the moral philosopher Robert Spaemann formulates the principle:

“Certainly everyone has a duty to follow their conscience. But if in doing so a person infringes the rights of others, then both the others and the state have the right to stand in his way. It is an important element in human rights that the rights of one person should not be made dependent on the way the conscience of another person judges a situation.” See Robert Spaemann, Basic Moral Concepts, trans. T. J. Armstrong (New York: Routledge, 1989), 66.

Supporters of the HHS Mandate sometimes attempt to frame the issue in a similar way. The Mandate is said to protect employees from having their rights violated by employers who claim to be following their consciences in not providing health plans that cover abortion, sterilization, or contraception. A judgment of conscience is, in other words, not a free pass to trample on other human beings. The “right to adequate health care” enjoyed by employees should not be subject to the religious beliefs or “conscience” of their employers.

However, while the underlying principle is true–conscience should not trump human rights–the above is a misdescription of the Mandate. The misdescription comes about becomes of crucial omissions. Here is a fuller statement of the situation:

The HHS Mandate does not protect employees from any aggression on the part of their employer. No life-saving treatment of any sort is withheld (how else would one define “adequate” in terms of healthcare?). No action on the part of the employee is coerced. Rather, the employer of a private business, a free initiative, is pressured to do something he or she finds humanly objectionable.

Not this robe. (Photo credit:  uncrate.com)

Not this robe. (Photo credit: uncrate.com)

No, that is still not adequate. Saying that the owner “finds” it objectionable to pay for abortion and sterilization makes it sound as though his attitude is some sort of passing fancy, a little idiosyncratic quirk. One is left with the image of the “Michael Scott” character from The Office suddenly deciding to grow a beard, wear flowing robes, and declare that he will henceforth lower the salaries of his female employees by $10,000 because he objects to their “whoring” in spending that money on tampons.

In fact, what the business owner–or the Catholic university president, or director of a charitable organization–objects to are practices that have consistently been criticized by religious traditions in place for thousands of years. When a business owner says “I will not pay for you to have an abortion,” or even, “I will not pay for your birth-control pills,” his judgment of conscience is not a nervous tick, but rather a judgment of moral reason shared by billions of like-minded human beings throughout history, including some of humanity’s most serious thinkers. There is, in other words, great precedent for the owner’s actions. The presumption must in this case be that there really is a deeply-held judgment of conscience involved.

And therein is the asymmetry: the “democracy of the dead” in no way stands behind the judgment that it is a fundamental human right to have others pay for one’s contraceptive measures, sterilization, or abortion. Where are the commandments to abort? The old and venerable sermons that the poor have a right to their daily pills? The pro-sterilization hunger strikes? “Give Me Abortion or Give Me Death?”

I don’t support indentured servitude. I don’t assume that employees alienate themselves from their human rights the minute they freely associate themselves with an employer. But it seems to me this right to not only to have an abortion, but to have someone else pay for one’s abortion, sterilization, etc. is a newly-invented right, and thus, highly suspect. In this case, the burden of moral proof does not rest with the business owners.

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6 Responses to What is Right, and Wrong, about the HHS Mandate

  1. Hello, Alexander.
    This comment is in response to the following quote from above:

    No life-saving treatment of any sort is withheld (how else would one define “adequate” in terms of healthcare?).

    According to this article, as well as several other corroborating sources I located (yet will omit for the sake of brevity), just under two and a half percent of the world suffers from bipolar disorder, in one of its varying forms of severity. I am one of those people.
    I have never had suicidal thoughts, nor have I ever entertained thoughts of harming another person (save out of defense). So it is safe to say that treatment of my bipolar disorder has never been “life-saving.” However, my illness prevents me from having predictable and regular mood patterns, interferes with sleep, stifles my appetites for food and sex, and sometimes debilitates me completely.
    Can people struggling with mental illnesses go on living, in the biological sense, without any form of treatment for their anxiety, depression, PTSD, or what-have-you? Most of them can, yes (though some may wish life to end). Should they be required to live this way, however?
    Do I have a right to competent and thorough mental health care? If I do, within the context of history, this is also, to coin your phrase, a “newly-invented right,” and one that contradicts the precedent set by the church and society for centuries—to view the mentally ill as possessed by demons or guilty of witchcraft.
    It is my firmly-held belief that any health plan that does not offer a mental health benefit is inadequate—and not just for my needs. No person is safe from the dangers of mental illness. Life’s unforeseen, difficult circumstances are the catalyst for the onset of newly-symptomatic mental illnesses every day. We are all one very, very bad day away from breaking. We are all one tragic loss away from crippling depression. We are all one horrific event away from post-traumatic stress disorder.
    If these things happen, will our life-saving health insurance policies leave us enough of a life worth living?

    • alexanderschimpf says:

      Jason,

      Thanks for reading and contributing. I’m better disposed to your argument than you might imagine, given that I agree with Aristotle that “the mind is mostly what man is.” I don’t accept your reading of history, but I think that is a more minor consideration. The broader point is just that new rights bear the burden of proof. I think you may be able to meet that burden of proof in arguing for coverage of mental health treatment.

      I am far more skeptical, however, that one’s quality of life would simply be intolerable without birth control, sterilization, and abortion (especially to such a degree that others ought to be compelled to pay for those “treatments”). Sexual fulfillment, “reproductive health,” etc. may be goods, but they are lower-order goods than mental health, preserving life, etc.

  2. is a newly-invented right,

    Actually its not, the freedom of being free from religious stupidity is a right. Women’s reproductive health is healthcare and in the rest of the industrialized world with universal healthcare this isn’t even a question.

    Consider that according to some christian sects that blood transfusions are untenable. They make the same impassioned plea you make – shall we let them not cover blood transfusions?

    Kind of absurd isn’t it? Yeah, so when you’re ready to give the religious exemption vs blood transfusions – because religion is completely rational – we can exclude women’s health too.

    • alexanderschimpf says:

      Blood-transfusions are typically life-saving treatments. Hormonal birth control typically is not life-saving. The two are not commensurate, so your analogy fails.

      However, I do agree that states cannot allow for “conscience exemptions” in regard to life-saving treatments–such would invalidate the main purpose of a constitutional state, which is to protect life (and, by extension, things like private property). That is to say, a happy ending is not always possible: there could conceivably be situations in which “church” and state clash. Paying for other people’s abortions, however, need not be such a situation.

      • The two are not commensurate, so your analogy fails.

        Ah, okay. So, it depends on the type of healthcare if we are to regard religious input.

        Religious input on rational concerns rarely ends well.

        Paying for other people’s abortions, however, need not be such a situation.

        Nor should we pay for IVF, so sayeth the Catholic church, again because of reasons not grounded in rationality but rather, in dogma. How is your concern any different?

        I should not pay for women to terminate their pregnancies because I don’t believe in abortion is not a valid reason to deny women access to legal medical procedures.

        You are missing the point about moving toward universal health care. It is meant to help people on the basis of medical necessity, as opposed to dogmatic concerns, religious or otherwise.

      • alexanderschimpf says:

        I doubt I am missing the point, since you just granted it: “Universal healthcare . . . is meant to help people on the basis of medical necessity.”
        I could not agree more, and I understand basic healthcare to be a human right, an extension of a more fundamental right to life and property. But rational people have to make careful distinctions as to what counts as “medical necessity” so as to avoid nonsense creeping in.
        Abortion, IVF, etc. are not typically life-saving; the burden of proof to establish their medical necessity is therefore not on the religious objectors.

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