Contraception, Yet Again
While wars rage on and the economy continues to limp along for the working class, considerable attention is still focused on contraception. On the one hand, this can be seen as a mere distraction from what should be regarded as more important matters. On the other hand, it can be regarded as a fundamental struggle over rights.
One key conservative talking point regarding contraception coverage is that the real issue is whether or not the state has the right to require health insurance providers to cover contraception. This, of course, falls under the more general issues of whether or not the state has the right to compel health insurance providers to cover anything at all. Naturally, this falls under the very general topic of the legitimate limit of the state’s compulsive powers.
Since I just wrapped up discussing John Locke in my Modern Philosophy class, my inclination is to say that the state’s legitimate purpose is the good of the people and it is limited in what it should do on the basis of the rights to life, liberty and property. As might be imagined, this general guide is not very helpful in this matter. After all, it can be effectively argued that compelling such coverage would be for the good of the people and it can also be effectively argued that doing so would be an imposition on the liberty of the providers. As in most such cases, my inclination is to take the stock approach of weighing the good of the imposition against the badness of said imposition. For example, some people argue that the state should have the right to use its compulsive power to ensure that a person can only marry one other person (at a time) and that the other person must be of the opposite sex. In supporting such a view, the usual argument (apart from the appeals to religion and tradition) is that same sex marriage and polygamy are harmful to society. As such, the liberty to marry as one pleases must be taken away using the compulsive power of the state. Interestingly, many of the folks who are opposed to compelling contraceptive coverage are in favor of using the compulsive power of the state in the domain of marriage. As such, they apparently do not have a principled objection against the state compelling people in regards to their moral beliefs. Rather, their view seems to be that as long as the state is compelling the right people, then such compulsion is fine. Of course, a person can be against contraception coverage and not be against, for example, the state using is compulsory power to impose a specific moral view in regards to marriage. In fact, one way to argue against the compulsion of contraceptive coverage is to argue against state compulsion in all matters other than those that involve harming others. So, for example, a person could be consistently against the state compelling a specific religious/ethical view of marriage and against the state compelling the coverage of contraception.
In regards to the matter of coverage, I am willing to accept (and in fact insist on) the principle that the burden of the proof is on the state in regards to compelling such coverage. That is, it is up to the state to show that such coverage should be compelled by law. This is a general principle that I accept, mainly on the assumption that there is a presumption in favor of liberty.
One standard way to argue for the legitimacy of state compulsion is to show that something is harmful (generally to others rather than just to oneself) and thus the state, under its legitimate role as protector of the life, liberty and property of the citizens, has the right to compel. This approach seems quite reasonable and is used to justify such things as the state compelling people to not murder, rape, or steal. As should be clear, this approach does not justify compelling coverage. After all, it is not preventing someone from wrongfully inflicting harm on another. Of course, this is a rather minimalist view of the state and one that only the most ardent libertarians seem to hold.
Another standard way to argue for the legitimacy of state compulsion is to show that compelling it creates a public good that warrants the imposition on liberty. For example, drafting people in times of war can be justified on the grounds that the public good requires such service. As another example, the compelled paying of taxes to provide for roads, police, defense, fire departments, schools, bridges, and so on is justified on the grounds that this serves the general welfare and the common good. John Locke argues for the state using its power to serve the general good and, of course, American government is supposed to have a legitimate role in providing for the general welfare. In general, it seems fair to say that the idea that the state should compel people to act for the general good only seems odd when it is proposed that the state compel something that a person does not like (like contraceptive coverage). When the state is compelling people to do what someone wants, it generally seems perfectly reasonable to that person. However, it would be rather nice for folks to have a consistent general principle regarding under what conditions the state can compel (other than “in cases in which the state is doing what I want”).
As with all conflicts between liberty and the general good, one key part of the dispute is whether or not the imposition on liberty is warranted by the gain to the public good. For example, compelling me to pay my taxes is warranted by the fact that my contribution is needed for the general good.
In the case of contraceptive coverage, the argument rests on the assumption that preventative care should be covered (this is already a matter of law, but naturally can be challenged on moral grounds) for the general good. If this assumption is accepted, then the question that remains is factual: should contraception be considered preventative care? The experts at the bipartisan Institute of Medicine have claimed that this is the case. Given their expertise, I am inclined to accept their opinion over that of non-experts. As such, it would seem that contraception should thus be covered.
Of course, it can be countered that the coverage preventative care should not be compelled by the state and that the insurance providers should be free to cover or not cover what they wish.
This does, of course, have a certain appeal. No doubt folks in all industries feel imposed on by the state compelling them in regards to what they can do or not do. For example, those in the food industry probably are not thrilled that the state imposes restrictions on what they can sell as meat and that they are required to divulge the contents of their products to the consumers. However, these compulsions are justified by an appeal to the common good. Likewise, the imposition of contraceptive coverage can be warranted on similar grounds. After all, such coverage is claimed to have numerous benefits for the people covered as well as the general public (such as lowering the number of unwanted pregnancies and all that entails).
It might be countered that the coverage of contraception violates the ethics of some employers (such as the Catholic Church) and thus contraceptive coverage is a very special case. In fact, Arizona is considering a bill that would seem to allow employers to fire employees for using contraception. In these cases, the argument is that this is a matter of religious liberty. As I have argued at length in other posts about this, I will not repeat my arguments here. I will, however, add that these cases are not clear cases of a cruel state imposing on the liberty a hapless church, insurance company or employer. Rather, there is also the rather important matter of the liberty of the employees and their rights.
There is, of course, a stock view that employees have no right to expect their employers to respect their rights or liberties as the state is supposed to respect them. On this view, our rights and liberties exist relative to the state and not relative to employers. However, I am inclined to follow Locke here and take the view that our rights are not merely against the state, but also against each other. As such, it is just as wrong for my employer to compel me in ways that violate my rights and liberty as it is for the state. At the very least, if the state lacks the right to compel them to provide coverage because they disagree, then they would seem to lack the right to compel their employees to conform to the ethics of their employer.
It might be countered that such rights are only for the powerful (churches and employers) and that the weaker folks (such as employees) must take it or leave it. That is, an employee who wants to work has to be willing to accept the moral imposition of his employer in this matter while his employer has a perfect right to not be imposed on in such a way by the state. If the employee doesn’t like that her employer refuses to include coverage of contraception in the health care benefits, she can just go and find another job. If she cannot, then she will have to accept being unemployed or she must conform to the religion/morality of her employer. This, of course, seems to be rather wrong. After all, it seems rather absurd to justify an imposition on liberty on the basis of an appeal to liberty. Of course, this is nothing new: in the pre-Civil War South people routinely argued that forcing the southern states to give up enslaving people would be a violation of their liberties.
In light of the above discussion, mandating the coverage of contraceptives does seem to be morally acceptable.