Obama, religious liberty, and contraception

Some of my conservative friends have challenged me to take a position on President Obama's rule that religiously affiliated organizations must provide contraception coverage as part of the health insurance they provide employees.

Truth be told, I've been torn.

On the one hand, I'm a big believer in religious liberty. E.J. Dionne—no squishy liberal—makes a lot of sense to me when he upbraids the Obama Administration for its choice. He wrote: "Speaking as a Catholic, I wish the church would be more open on the contraception question. But speaking as an American liberal who believes that religious pluralism imposes certain obligations on government, I think the church’s leaders had a right to ask for broader relief from a contraception mandate that would require it to act against its own teachings. The administration should have done more to balance the competing liberty interests here."

On the other hand, I believe that women have a right to contraception and to make their own choices about their health care—and that's a choice effectively denied many women if their employer's health coverage won't cover contraception. Charlie Pierce makes this case more pungently than I would, but he's succinct: "Of course, you're not a Dominican Episcopalian making $16,000 a year cleaning bedpans in a Catholic hospital who can't afford the $600 a month co-pay for the birth control she needs to control her heavy bleeding and yet who, through no fault of her own, finds that she has to live with the theological horse-pucky of Humanae Vitae as enshrined as an 'exemption' in American secular law."

Right. And actually, that highlights the real problem here: ObamaCare is kind of a mess.

There were always going to be conservatives who protested universal health care as a tyrannical threat to liberty. But the way the law actually has been implemented—between this rule and the individual mandate that forces individuals to buy health coverage—seems designed to make many Americans feel like conservatives were right.

It is too late to re-fight this battle. But...

We'd be avoiding a lot (not all) of these problems if we simply had a single-payer system provided by the government. Since that seems to be politically untenable—since the preservation of private health insurance companies was apparently a major goal of the process that created the Affordable Care Act—the next best choice would've been a "public option"—a cheap government-run insurance option to stand right beside private options in the marketplace. Either option would've given folks an easy way to obtain the coverage they needed or wanted without trampling on the consciences of their employers. Despite the rhetoric of the right, the government-centric options are those which would've been most compatible with the interests of liberty.

That's what I wish would've happened. That's what I wish would happen still. But we're years away from such developments—if not decades. And we have to decide what to do with the laws we have now.

And ultimately, I have to come down—somewhat reluctantly—on the side of the Obama Administration. Not because I don't believe in religious liberty—but because I believe that in weighing the competing claims, I must side with individuals over institutions. It is not optimum for the federal government to require Catholic charities to go against their conscience. But it is even less optimum, I think, for the government to stand back and let Big Religious Institutions make that choice for their employees.

If those employees do not want contraception, they do not have to obtain it. No harm done. But if they want or need it, they won't have the choice denied them by their employer. Individual choice is preserved.

I know that some of my conservative friends will A) be disappointed in me and B) point out the Constitution guarantees freedom of religion, while it does not confer a positive right to cheap contraception. I don't have a good answer to that objection, frankly. But if it is wrong for government to override the consciences of individuals, I'm not sure it's much more correct to let non-governmental institutions do so. Both have immense power over the lives over the lives of individuals.

Again, we wouldn't be having quite this argument if government were providing the insurance instead of requiring others to provide or obtain it. (I have no doubt there'd be spectacular fireworks over whether government-run insurance would cover abortions and the like, however.) But this is where we're at. And the Obama Administration's ruling is the best of several bad choices.

Mitt Romney, public health, and illegal immigrants

Kevin Drum takes stock of the "controversy" surrounding RomneyCare and the fact that illegal immigrants can get some medical care on the tab of Massachusetts taxpayers:

Somebody in a rival campaign presumably thinks this is a useful campaign issue because the slavering masses of the tea party base won't be appeased until illegal immigrants are literally writhing in the streets while doctors walk by and pointedly ignore them. Allowing them access to even last-ditch health services is unacceptable, even if the pointy-heads insist that we're saving money in the long run because it keeps them out of emergency rooms.

At the risk of sounding collectivist, one of the reasons we have public health efforts is because health is so often collective. That illegal immigrant writhing in the street—and this imagery might be unfortunate—might have a communicable disease, and refusing to offer care to that person might end up communicating that disease to you. Giving them a free dose of penicillin might stop the infection in its tracks ... unless, of course, we decide that the immigrant shouldn't get that dose because, goshdarnit, America!

We provide public health services to the public—including illegal immigrants—not just out of some misguided bleeding-heart do-gooderism, but because it also protects the rest of us from epidemic and death. Think of it this way, immigration hawks: It's like building an electrified border fence around your physical well-being.

On cooking, and accomplishment

I made a cassoulet last night.

Per Mark Bittman's instructions, I started by browning a length of sausage in olive oil, then set the meat aside. Into the pan went onions and zuchinni and celery, cooked a few minutes until they softened a bit. Then tomatoes and herbs, along with the sausage again, brought to a boil. Then I added cooked white beans—Jo did the prep work there. Then a simmer for 20 minutes. I pulled the sausage out, chopped it up, threw it back in the pan with some cayenne, and let it simmer a few more minutes. It was served with a side of warm multigrain bread purchased from the farmer's market (as were most of the ingredients mentioned above). There was wine.

I forgot to throw in two bay leafs. Nonetheless, a tasty, spicy stew. I am looking forward to leftovers.

Saturday's cassoulet was the result of a cooking kick I've been on in recent weeks. Part of the inspiration has been fall—often when I get adventurous in the kitchen—and part of it Bittman's new Kindle Single advocating the practice of cooking at home.

His argument is the same one you almost always hear him make: That home cooking is usually cheaper—and often faster—than ordering from restaurants. That it's usually cheaper and almost always more healthful than the processed foods we so often rely on. And that a meal well-made creates opportunties for community and bonding.

To his credit—and my benefit—Bittman isn't a "foodie," at least not in the sense that such folks attempt to dazzle you with the complexity and fanciness of their efforts. He doesn't require you to have stainless steel kitchen appliances, or spend a day laborer's weekly pay on a bottle of truffle oil. He wants to get you into the kitchen and cooking, and he offers simple-but-tasty recipes to provide you with easy entry into the world of real food. He sets the bar so low that I can leap over it.

Heretofore, my repertoire in the kitchen has (outside of a pretty mean breakfast sandwich) been largely limited to three dishes: Chili, spaghetti, and what we call "Tex-Mex"—a meat, bean, and Rotel concoction that can be wrapped in a tortilla or dumped on top of corn chips. Tasty, I guess, but limited. So with Bittman's guidance, I'm taking what I hope are my first steps into a larger world.

There's another element to all of this for me. In may, I had an emergency colostomy. In July, I had a second surgery, to remove a chunk of diseased colon that had wrapped itself around my bladder. I have diverticulitis. Sometime soon, hopefully, I will have a third surgery to reverse the colostomy and finally end  the long season of what my son has called "poop belly." I'll be able to restart my life, which has felt mostly on hold for many months now.

Now: My surgeon has never told me that 38 years of lazy, irresponsible eating created my medical condition. It could be genetics. But it could also be my 38 years of lazy, irresponsible eating. Making a real effort to cook—aside from actually being cheaper and faster than ordering from my beloved GrubHub.com—seems to be a real investment in my future health.

More to the current point, I am a stay-at-home dad and freelance writer. My surgical recovery has depleted my energy—and, at times, my spirits—to the point that I often feel I do neither job very well. Making a new meal, as I've done several times in recent weeks, gives me a sense of accomplishment that's pretty much been missing from my life lately. I browned the sausage. I chopped the vegetables. I stood over the stove. And I made something that wouldn't have existed without my initiative or efforts. This is, I imagine how amateur woodworkers feel, and with roughly the same odds of losing a finger to blade mishap. This is, I imagine, why my wife knits.

So much of my day, every day, is spent in front of a computer. To make something tangible and useful—not that the manufacture of words can't be useful—is a good and necessary thing. My next Bittman recipe combines just three building blocks: Noodles, butter, and parmesan cheese. It won't be difficult. But it will be something I made.