Politicization of Contraception

Published in China.com
(China) on 20 February 2012
by Xue Yong (link to originallink to original)
Translated from by Lisa Ferguson. Edited by Gillian Palmer  .
New York Times special columnist Gail Collins recently wrote that back when she had just gotten married, her mother-in-law sat down with her at the kitchen table and told her of a bitter event. Her mother-in-law, who was still young at the time, had already had several young children, and times were difficult. She went to see her church's priest to confess that she and her husband had taken contraceptive measures. At once, the priest said to her, "You’re no better than a whore on the street."

Collins was born in 1945. Judging from this, her mother-in-law's story likely occurred in the '40s. As she said, this was something that happened "a long time ago." Today, a priest would not say that; however, churches — especially Catholic churches — still firmly oppose contraception. This is also why Obama's recent policy requiring that Catholic churches and organizations provide their employees with health insurance that includes contraception has given rise to a political firestorm. Archbishops have protested one after another; the Republican Party has risen to attack it, calling it yet another war waged by Obama on religion. It is important to know that the United States' Catholic population is nearly 80 million, and their political might is not to be underestimated. Under enormous political pressure, Obama quickly pulled back, proposing a compromise: Religious groups do not have to purchase health care for their employees that covers contraceptives, but the insurance company must offer contraceptive coverage to the employees. Although the revision of this detail has yet to be realized, this will likely mean that contraception costs of church employees will be fully covered.

What is the background of this policy? First, 99 percent of American women between the ages of 18 and 34 use contraceptive measures; yet, about half bear the burden of paying the associated costs. Those with lower income are at an even greater disadvantage. Secondly, churches play a decisive role in American society, having numerous organizations and employees. The main targets of this policy are Catholic universities and hospitals. While Catholic churches oppose contraception, according to surveys, almost all Catholic women have used contraceptive measures at some point in their lives. Two-thirds of Catholic women continue to use these measures.

Thirdly, Catholic organizations receive substantial financial subsidies from the federal government every year. In addition, they also receive the protection of being deemed tax-exempt charitable organizations, which in turn means that the federal government has the right to require Catholic organizations to take certain actions and comply with federal government regulations. Not to mention, Catholic organizations employ numerous non-Catholics, such as janitors, cooks, doctors and so on. These people do not have to recognize Catholic ideology, yet they must sacrifice contraception insurance because the Catholic Church opposes contraception, and are thus virtually discriminated against.

Two Opposing Opinions

Conservative opposition to this basically consists of two types. One type of opposition stems from the issue of religion and constitutional government. In the eyes of these people, the federal government's forcing of church organizations to purchase insurance coverage for contraception is really forcing churches to violate the conduct required of them by their religious beliefs. This is equivalent to stripping churches and their adherents of their right to freely self-govern. Many even go so far as to say that this could ultimately become a lawsuit, which could be waged all the way up to the Supreme Court. As a result, Obama quickly retreated; the Supreme Court case that some had anticipated becoming "the judgment of the century" has thus probably been avoided. However, supporters of contraceptive insurance coverage reject this self-governance theory, posing the question: If a religion were to oppose "man interfering with God's will," and thus oppose medical treatments such as the transfusion of blood or other fluids, would employees of these religious organizations (regardless of whether they were believers of the religion) be refused the related insurance coverage?

The other source of conservative opposition is based on the market economy. For example, University of Chicago finance professor John Cochrane pointed out on The Wall Street Journal blog and microblog that what insurance covers are life's uncertainties that are beyond a person's realm of control, as well as those factors that cause great losses: car accidents, fires, diseases and so on. You pay the expense for this kind of insurance and receive in return a basic sense of stability in life. Insurance companies will not cover the cost of toothpaste; this small regular amount is entirely within the control and ability of the individual. If the cost of toothpaste must be added into the scope of health insurance, then it would be necessary to fill out forms for it and to pay a little more for insurance; competition in the toothpaste market would diminish, and in the end people would be paying more for their toothpaste. Presently, anyone with a cell phone can afford to buy birth control medication or condoms. Moreover, people with health care come from all industries and all occupations — they all have jobs, and most are not considered to be poor. The cost of contraceptives is already included in the cost of their insurance, and [the cost of] toothpaste is no different. He goes on to say that including coverage of consultations for women's health, breastfeeding, domestic violence and so on leads to climbing insurance costs and a drop in efficiency.

Unfortunately, this market economy group cannot explain why twice-annual teeth cleanings are included in health insurance. Is this not a regular expense? In reality, if it was not covered by insurance, even fewer people would get a teeth cleaning on time, and the incidence of dental diseases would rise, thus also increasing dental expenses. Other developed countries all have national insurance and also often cover preventative consultations for women's health, breastfeeding, domestic violence and other such issues. The result is that ordinary people's lives are healthier and medical fees are much lower than in the United States.

This struggle doesn't just end here. Obama, whose popularity is wavering, seeing that the economy is starting to improve and not wanting to create any new problems or invite criticism, immediately took a conciliatory stance. Republican presidential candidate Rick Santorum was already nearly knocked out of the ring, but because he is the most religiously conservative candidate, he has assembled support within the Republican Party. He suddenly won the Colorado, Minnesota and Missouri primaries all in a row, causing a political earthquake within the Republican Party. From this the conservative vigor on this issue can be seen.

However, we cannot forget that in the U.S. election, women voters outnumber men. In the long term, this religious conservatism could hurt women voters. For women voters, sex is a shared issue between men and women. Unfortunately, men often do not want to wear protection, thus forcing women to single-handedly foot the bill for making love. If these costs were covered by insurance and spread out among all people, would this not make things more equal (with everyone sharing the costs equally)?

Reportedly, men within the Obama administration want to compromise, while the women want to continue the fight — they are divided into two distinct camps. Secretary of Health and Human Services Kathleen Sebelius, who is herself a practicing Catholic, declined to comment on the male-female divide within the cabinet. Yet, she pointed out that on the issue of contraception, the market discriminates against women, and public policy is needed to advance equality.

Due to his political popularity on the contraception issue, Santorum appears to be somewhat deranged. He even began to question the performance of women on the battlefield, saying that soldiers should be driven by nothing other than the desire to serve their country, but that women can be distracted from their duties by other emotions. This evaluation not only stirred dissatisfaction among women, but U.S. military officers could not help but speak out, saying that women have already been fighting for more than 10 years. They run the same risks as men and carry out the same missions, and have performed outstandingly. Many military posts, such as snipers, have strict requirements that must be met; while many men do not make the cut, there are quite a few women in these posts. The most qualified person will get the position, regardless of sex. If extremely conservative Santorum really becomes the Republican presidential nominee (which presently does not appear likely), he can rally together conservatives, but this will also make it that much easier for Obama to win re-election.


避孕政治化

观点中国 opinion.china.com.cn 时间:2012-02-20 人物:薛涌

《纽约时报》专栏作家盖尔·柯林斯(GailCollins)最近在专栏中提到,当年她刚刚结婚时,自己的婆婆在厨房的桌边坐下来,告诉她一段辛酸的往事。那时还年轻的婆婆已经生了几个孩子,日子非常艰难。她跑到教会的牧师那里忏悔,说自己和丈夫采取了避孕措施。牧师当即对她说:“你和街上的妓女没有两样!”

柯林斯是1945年生人。由此推算,她婆婆的往事大概发生在四十年代。如她所说,这是“很久很久以前的事”了。现在的牧师不会这么说。但是,教会特别是天主教会反对避孕的立场,依然是非常坚定的。这也是为什么奥巴马最近要求天主教会组织,为雇员提供包含避孕在内的医疗保险的政策,引起了一场政治风暴。大主教们纷纷抗议,共和党群起而攻之,称这是奥巴马对宗教发起的又一场战争。要知道,天主教徒在美国的人口接近8000万,其政治力量不可小视。在巨大的政治压力下,奥巴马迅速后撤,提出了妥协方案:宗教组织不必为自己的雇员购买包含避孕的保险;但保险公司在为所有人提供的保险中,必须提供避孕这一项。虽然这一修改的细节还没有全部浮现出来,但这大概意味着教会人员的避孕费用,将由全体承保的人平摊。

这一政策的背景是什么呢?首先,美国99%的18-34岁的妇女采用避孕措施。但是,大约一半的人有承担避孕费用的困难,特别是低收入阶层,在这方面就更加吃亏。第二,教会在美国社会生活中举足轻重,有大量的机构和雇员。这一政策主要的对象,就是天主教的大学和医院。虽然天主教会反对避孕,但根据调查,几乎所有的天主教妇女都在一生的某个时刻采取避孕措施。三分之二的天主教妇女持续使用这些措施。

天主教反对避孕,使一些天主教的组织不为雇员提供含有避孕的保险。不久前《纽约时报》报道称,像福特汉姆(Fordham)大学这样的名校,因为坚持天主教的信条,不给女生开避孕药物,搞得已经通过学校买了保险的学生,不得不再到校外的私人诊所寻求帮助。由于这在保险范围以外,费用格外昂贵。

第三,天主教机构每年从联邦政府获得大量财政资助,并且受到慈善组织免税政策的保护,联邦政府进而有权要求天主教机构的行为,符合联邦的政策规范。更何况,天主教机构雇用了许多非教徒,如清洁工、厨师、医生等等。这些人并不认同天主教的教义,却要因为天主教反避孕的立场而丧失了避孕方面的保险,受到无形的歧视。

两类反对意见

保守主义对此的反对,则大致可分为两类。一类是从宗教和宪政的角度出发。在这些人看来,联邦政府强迫教会组织购买包含避孕措施的医疗保险,实际上是逼迫教会违背自己的宗教信仰行事,这等于剥夺了教会和教民信仰自由的宪政权利。乃至许多人称此事最终可能会成为诉讼,一直打到最高法院。由于奥巴马迅速退却,某些人所期待的最高法院的“世纪判决”也许会免了。但是,拥护避孕保险的人对这种宪政理论反唇相讥:如果某宗教反对“人为干预上帝的意志”,进而反对输血、输液等医疗措施;那么,这些宗教组织的雇员(不管他们是否认同其信仰),是否就应该因此无法享受有关的保险呢?

来自保守主义的另一类反对,则是基于市场经济的立场。比如,芝加哥大学金融教授约翰·科克伦(JohnCochrane)在《华尔街日报(博客,微博)》上撰文指出,保险所针对的,是生活中不确定的、超出个人控制范围、同时损失巨大的因素,如车祸、火灾、疾病等等。你通过支付这样的保险金,换取生活的基本安定。保险公司不会把牙膏费用也包含在保险范围内,因为这是一笔很小、很有规律的费用,完全属于个人可控制、可支付的范围。如果一定要把牙膏纳入保险范围,那么你不得不为此填写许多表格,多支付不少保险金,牙膏市场也变得更缺乏竞争性,最终你反而为了牙膏花的钱更多。如今,能够打得起手机的人都买得起避孕药或避孕套。况且,各行各业从雇主那里获得保险的雇员,都是有工作的人,一般不属于穷人。在他们的保险金里硬塞进避孕费用,和在保险里面加入牙膏费用并无二致。他还进一步指出,现在把关于妇女健康、母奶喂养、家庭暴力等方面的咨询都包括在保险中,导致保险费用攀升,越来越丧失了效率。

可惜,市场派无法解释:为什么两年一次的洗牙会被包括在保险中?这难道不是有规律的费用吗?事实上,如果保险里不包,更多的人就不去按时洗牙,牙病就会增多,反而增加牙医费用。其他发达国家多有全民保险,而且经常把妇女健康、母奶喂养、家庭暴力等预防性的咨询包括在内。结果老百姓生活得更加健康,医疗费用远远低于美国。

这场争议,恐怕不会就此终止。民望不振的奥巴马,看着经济有好转的势头,不愿节外生枝、授人以柄,故而立即作出和解的姿态。共和党的总统候选人桑托勒姆,本来已经到了出局的边缘,但因为他是所有候选人中最有宗教保守主义信誉的,因此聚合了保守派的支持,在科罗拉多、明尼苏达、密苏里的预选中一下子以大比分赢下三场,在共和党内创造了不小的一场政治地震。可见保守派在这方面的气势。

但是,我们不要忘记,美国选民的投票率,一向是女性多于男性。从长远看,这种宗教保守主义恐怕会得罪女性选民。在女性选民看来,性本是男女共享的事情。可惜经常是男的不愿意戴套,这逼着女性单方面为性爱埋单。如果保险里包,费用就通过保险金平摊给所有人,岂不更接近AA制(各人平均分担所需费用)?

据说在奥巴马政府内,男性要妥协,女性要继续抗争,营垒颇为分明。卫生及公共服务部的女部长赛白琳(KathleenSebelius)本身是位天主教徒,对内阁内的男女对峙不置可否。不过她指出,市场在避孕这个问题上一向歧视女性,需要公共政策进行平衡。

因这场避孕政治走红的桑托勒姆,则有些走火入魔。他甚至开始对妇女出现在战场上的现象表示质疑:那些将士本应被为国效力的单一情感所驱动,女性在身边的出现引发了他们另外的情感,分散了他们的职业注意力。这番评论不仅引起女性的不满,美军的将军也不得不出来说话:妇女亲临战阵已经十几年了。她们和男兵冒着一样的风险,执行着一样的使命,表现出色。许多军事岗位,如狙击手等等,要求严格,许多男人通不过资格,妇女却有不少过了。谁能当大任当然要看谁更合格,而不是看性别。如果桑托勒姆这样的极端保守派真成为共和党的总统候选人(这种可能目前仍然很小),他确实可以团结保守主义者,但也使奥巴马的连任变得容易一些。
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