Should the Church Have to Dispense Birth Control?

Megan McArdle Jan 31 2012, 8:33 PM ET

Kevin Drum is not very sympathetic to the Catholic Church's complaints about being forced to provide insurance coverage for contraception to workers in its hospitals and other public institutions:

'm just a big ol' secular lefty, so I guess it's natural that I'd disagree. And I do. I guess I'm tired of religious groups operating secular enterprises (hospitals, schools), hiring people of multiple faiths, serving the general public, taking taxpayer dollars -- and then claiming that deeply held religious beliefs should exempt them from public policy. Contra Dionne, it's precisely religious pluralism that makes this impractical. There are simply too many religions with too many religious beliefs to make this a reasonable approach. If we'd been talking about, say, an Islamic hospital insisting that its employees bind themselves to sharia law, I imagine the "religious community" in the United States would be a wee bit more understanding if the Obama administration refused to condone the practice.

I can understand compromising over a very limited number of hot button issues. Abortion is the obvious one. But in general, if Catholic hospitals don't want to follow reasonable, 21st century secular rules, they need to make themselves into truly religious enterprises. In particular, they need to stop taking secular taxpayer money. As long as they do, though, they should follow the same rules as anyone else.

As Ross Douthat points out, the regulations seem to have nothing to do with whether the Catholic hospitals or other charities take public money; rather, it's the fact that they provide services to the public, rather than having an explicitly religious mission.

I've seen several versions of Kevin's complaint on the interwebs, and everyone makes it seems to assume that we're doing the Catholic Church a big old favor by allowing them to provide health care and other social services to a needy public. Why, we're really coddling them, and it's about time they started acting a little grateful for everything we've done for them!

These people seem to be living in an alternate universe that I don't have access to, where there's a positive glut of secular organizations who are just dying to provide top-notch care for the sick, the poor, and the dispossessed.

In the universe where I live, some of the best charity care is provided by religious groups--in part because they have extremely strong fundraising capabilities, in part because they often have access to an extremely deep and motivated pool of volunteers, and in part because they are often able to generate significant returns to scale and longevity. And of course, the comparative discretion and decentralization of private charity, religious or secular, makes it much more effective in many (not all ways) than government entitlements.

In this world, I had been under the impression that we were providing Catholic charities with federal funds mostly because this was the most cost-effective way of delivering services to needy groups.

Thus it's not obvious to me that we will be better off encouraging Catholic hospitals and other groups to provide services exclusively to their own flock, while exclusively employing members of their own flock. And I'm fairly certain that if I wanted to stage a confrontation with Catholic charities, it would not be over something as trivial as forcing them to provide birth control coverage to their employees. Preventing pregnancy is not a low-frequency, high cost event, and thus it is not really insurable. It's just a backdoor transfer from wages to birth control consumption.

This seems particularly stupid because the Catholic Church will almost certainly be granted an exemption by Republicans if they get even a little bit more power. So I'm not sure I see the benefit in going out of your way just to tell the Church you'd like them to, well, go to hell.