Based on a report in yesterday’s Bloomberg, the decision by the Obama Administration to require many religious institutions to provide contraception through existing health care plans is bearing electoral fruit: President Obama leads Mitt Romney among women by a remarkable 18-point margin. Though the HHS mandate represents an expansion of government power into the heart of many religious institutions, efforts to resist this expansion were portrayed by HHS Secretary Sebelius as a “war against women,” a label that has stuck and a narrative that the Democratic party during its Convention sought to make a dominant theme of the campaign—it would seem, with considerable success.
We should not let its electoral motivations blind us to the actual significance of the HHS mandate.
The origin of the mandate lies in an impulse that can be dated back to the beginnings of the modern era and the rise of the state. Before the latter’s ascent, memberships in various social settings were overlapping and varied, ranging from families, neighborhoods, townships, boroughs, regions, guilds, Church (parish and Catholic), nation, even empire.
The state undermined competing allegiances by demanding primary allegiance to itself alone, and only secondarily and “voluntarily” to these preexisting institutions. Such memberships became less and less “constitutive.” Rather, such associations and memberships came to be viewed as secondary to our primary allegiance to a State that reserves the right to control, oversee, and define any other institution.
No one was more influential in the definition of the modern state than Thomas Hobbes, who through the conceit of the “state of nature,” portrayed humans as naturally autonomous and individual, with a shared membership solely through one institution—the State. While unitary State sovereignty represented a limitation on our natural liberty in the abstract, in fact it promised a new kind of liberty—liberty from the myriad forms of constitutive identification and membership in non-state institutions, especially the Church.
William T. Cavanaugh describes in his excellent study of the rise of the modern state, Migrations of the Holy, how Hobbes’s new arrangement promised liberation, not oppression:
For Hobbes, the individual was not oppressed but liberated by Leviathan. In his view, the State is not enacted to realize a common good or a common telos, but rather to liberate the individual to pursue his or her own ends without fear of interference from other individuals. In the peculiar new space created by the state, the individual members do not depend on one another; rather, they are connected only through the sovereign—as spokes to the hub of a wheel.
The rise of the state hinged on the promise of liberation of the individual from the constitutive constraints (as well as rights and liberties) of non-state organizations and institutions. The state acted as liberator of an oppressed humanity; its power, concentration, and extent increased as a necessary counterweight for the control of non-state institutions. Thus, Robert Nisbet wrote in his classic work The Quest for Community, “The real conflict in modern political history has not been, as is so often stated, between State and individual, but between State and social group.”
The only liberty that could be recognized was the liberty of individuals to “pursue his or her own ends.” The ancient rights, privileges, immunities and liberties of institutions—the Church, universities, guilds, localities—were redescribed as forms of oppression. The increased power, even intrusiveness, of the state, was justified not as a form of oppression, but rather in the name of liberation of the individual. The protections against distant, abstract, and impersonal forms of power, understood to be protections of local liberty, were dismissed as parochial limitations and antiquated restrictions. As Lord Acton accurately described in his History of Freedom,
The modern theory, which swept away every authority except that of the State, and has made the sovereign power irresistible by multiplying those who share it . . . condemns as a State within the State every inner group and community, class or corporation, administering its own affairs; and, by proclaiming the abolition of privileges, it emancipates the subjects of every such authority in order to transfer them exclusively to its own. . . . It recognizes liberty only in the individual, because it is only in the individual that liberty can be separated from authority, and the right of conditional obedience deprived of the security of limited command.
As Hobbes’s illustration to the Leviathan so eloquently depicted, an increasingly “liberated” citizenry, resulting from the diminishment of constitutive memberships in social groups and associations, would be connected only through one bond, one relation, one connection—the state.
Austrian legal theorist Eugene Ehrlich perceptively observed, “After the associations into which individuals have been placed as members of society have been dissolved and destroyed, the only connecting links that remain between the individual and society are ownership, contract, and the State.”
This ambition has informed Obama’s candidacy from its first days to its recently concluded convention. The early campaign advertisement “Life of Julia” depicted its subject as a thoroughgoing dependent upon the assistance of the federal government who is otherwise bereft of human company (except, briefly, for a child named Zachary who ceases to be a presence in her life shortly after he enters public schools).
This picture of a radically individuated human being gave rise to the observation during the Democratic National Convention that “government is the only thing we all belong to” [sic]. In spite of the communitarian language struck at the Convention, the actual underlying theme is that the State is needed to ensure our individuated liberty—and thus, the particular emphasis upon sexual liberation for women (and, presumably, men as well). In an admirable display of philosophical consistency and logic, the Obama administration thus implicitly and effectively endorsed the Hobbesian liberal ontology that there ought exist only individuals and the state—all other competitors are to be regarded as oppressors, and require an expansive and empowered government for individual liberation.
This is just the way in which the HHS mandate has been justified. At a recent conference in which I participated at the Georgetown Law Center, a number of speakers and participants described the HHS mandate as the necessary requirement that will liberate women from the “coercion” of the Church that seeks to restrict their access to free contraception—including abortifacients—and sterilization. The expansion of state power is justified for its liberative effects, freeing women from the oppression of an antiquated institution (its irrelevance was reinforced by frequent citation of the questionable statistic that 98% of Catholic women use contraceptives).
Note the conceit: Employees at Catholic (or other similarly informed religious institutions) are “coerced” by not having free contraceptives provided as part of their health plans. The state, through the threat of punitive fines (estimated by President John Garvey of the Catholic University of America to be $62 million per year should CUA refuse to comply), acts as the liberator of these oppressed people. This narrative seems plausible to many, because we have been deeply shaped and trained to associate the word “liberty” with the freedom of individuals “to pursue their own ends”—requiring, among other things, the liberation of recreational sex from any consequences—and not the rights, privileges, immunities and liberties of groups, societies, associations, even a corpus mysticum like the Church. In such a view we find Leviathan run rampant.
During the bloody twentieth century, the Church stood against the totalitarian ambitions of Fascism and Communism. A third ideology is clearly flexing its muscles today—threatening to make those victories of the last century merely Pyrrhic. The totalitarian impulse today is embedded in the very logic of liberalism, which seeks to expand its dominion into every aspect of life and against every competitor to its demand for the exclusive allegiance of individuals. We need to keep firmly in mind the picture that adorns the Leviathan, and resist our absorption as individuals into the body of the state by retaining deep, abiding, and even primary allegiance to family, locality, and Church.
Patrick J. Deneen is an Associate Professor of Political Science at the University of Notre Dame. His previous “On the Square” articles can be found here.
RESOURCES
Bloomberg, Obama Lead Over Romney Similar to 2008 Margin Over McCain
Life of Julia
DNC Video: "The Government Is The Only Thing We All Belong To"
Berkley Center, Contraception and Conscience: A Symposium on Religious Liberty, Women’s Health, and the HHS Rule on Provision of Birth Control Coverage for Employees (See, for example, the question posed during Panel 3, at 1:25:40)
The American Catholic, 98% of Catholic Women Use Birth Control
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Comments:
There is much to be said in favor of your argument. Allow me to quibble. You frame Hobbes as a kind of Millian--the omnicompetent/absolute state exists to free individuals in their private pursuits. This state exists to tear down other social structures so that individuals can by and large do their own thing. I concur that the upshot of Hobbes argument is the evisceration of social structures and institutions other than the state.
But Hobbes has never seemed to me to be a fan of individual liberty. To be sure, he thinks the prudent sovereign will leave the subject some degree of liberty. And he does define liberty as a kind of open ended discretion--to be at liberty to perform an act is to be at liberty to refrain from performance of the same. Even so, the discretion or liberty left to subjects seems, for Hobbes, to be purely prudential. The power of the sovereign is absolute or unlimited--including in the range of things the sovereign might command the subject. And while sovereigns may fail to preserve the commonwealth or the lives of subjects and so doing may (Hobbes says) wrong God, no treatment of the subject by the sovereign is such that it can be considered an injustice (i.e., is such that the subject can rightly consider himself wronged by the sovereign). Hobbes is very emphatic about this.
Moreover, to forestall the state of war, Hobbes says the sovereign must have the power to make all final decisions as to the moral and religious doctrines taught (and practiced in the community). Among those doctrines that tend to the destruction of the commonwealth, Hobbes includes not only the "repugnant" doctrine that the sovereign is subject to the civil laws but also the poisonous and "seditious" doctrine "that every private man is judge of good and evil actions." This doctrine--living according to private judgments of good and evil" tends to weaken the commonwealth. And Hobbes defines good and evil entirely in terms of subjective desire. "Another doctrine repugnant to civil society is whatsoever a man does against his conscience is sin; and it dependeth on the presumption of making himself judge of good and evil." But "the law is the public conscience, by which he hath already undertaken to be guided." In contrast, each person following their own way, exercising as much liberty as possible was the sort of right or liberty individuals possessed in the state of nature and bound up, intimately, with that condition being (and essentially so) a state of war.
In short, I think there is much to lament in Hobbes. And I concur that by and large the modern state system takes something like Hobbesian assumptions (perhaps in place as a matter of practice before theorized by Hobbes) as their point of departure. And I think Millian liberalism problematic (for several reasons). But though their definitions of liberty are kindred spirits, Hobbes and Mill seem to value liberty so defined in very different ways. It is precisely our right to exercise liberty in this sense that must be surrendered if we are to preserve ourselves through seeking peace. If we get any of that liberty back it's by grant of the sovereign--a grant the sovereign is not bound to make. For Hobbes, whether or not we get to pursue our own ends to any degree (and he places sharp strictures here--in matters of morals and religion he doesn't think we should be allowed to do this) is entirely up the discretion of the the mortal god--the Leviathan.
We have in recent times a pretty good example of the positive role that mediating structures played in countering the utter debasement of cultures trapped in Leviathans hegemony over the space between itself and the individual. It is not a coincidence that Poland had the only functioning structure that competed for that space and it was there that the dissolution of the Soviet empire first became evident. There were other factors of course but none had the singular influence of the Catholic Church or the cohesiveness, courage or leadership to stand against the bloody and bloodless Leviathan.
It's not just women that disproportionally support Mr Obama, but Catholics (President Obama is leading Mr. Romney in the polls by about 15% among Catholics). This makes it difficult to claim that there is a conflict between State and Church on this issue as the Catholic laity is the largest part of the Catholic Church. I think the real problem here is that health insurance is usually linked to one's employer, which creates a potential conflict between the corporation and the individual. One role of the State, in my opinion, is to liberate the individual from unnecessary manipulation by corporations. Corporations are no longer allowed to employ young children for long hours under abusive conditions. Should they be allowed to block women from receiving free contraception (and most insurance companies are happy to provide contraception for free as it saves them money to do so)? In my opinion, the answer is no. The decision to use contraception should be made by the individual -- not by the State or the corporation.
Thank you, Paul, for this most excellent reference, which gets to the heart of the controversy.
My employer doesn't give me free sailing lessons. Does that mean that my employer is "blocking" me from sailing, or from receiving free sailing lessons? Obviously not.
Just because an employer wishes not to be forced to give free coverage for contraception, sterilization, and "emergency contraception" doesn't mean that the employer wishes to force women not to use it. They can still use it. They can even get it for free from the government if the government wants to give it out for free.
Which raises the following question: if the government's only goal is for women to have it for free, why doesn't it just give it to them? Why does it insist on *forcing* employers to do so? Prof. Deneen's essay suggests an answer.
For Rousseau, freedom consisted not in the limitation, but in the composition, of the governing power. Power was to be exercised by the whole body of the nation. It is his theory, rather than Hobbe's that Lord Acton is alluding to, when he says, "The modern theory... has made the sovereign power irresistible by multiplying those who share it" - Nothing less than the body of the nation.
““Each man alienates, I admit, by the social compact, only such part of his powers, goods and liberty as it is important for the community to control; but it must also be granted that the Sovereign [the People] is sole judge of what is important.”
His conclusion is well known, “whoever refuses to obey the general will shall be compelled to do so by the whole body. This means nothing less than that he will be forced to be free; [« ce qui ne signifie autre chose sinon qu'on le forcera d'être libre »] for this is the condition which, by giving each citizen to his country, secures him against all personal dependence.”
That is why Lord Acton says in the above quotation, "
Nisbet summarized his thoughts on Rousseau thusly:
"What distinguishes totalitarianism from anything in the history of Europe since the late Roman empire is not the presence of factors within the political government so much as the radical relation between state and traditional society. It is recognition of this point which brings Rousseau clearly into view as one of the intellectual sources of totalitarianism. Machiavelli, Hegel, Nietzsche, even Hobbes, in their respective theories, left the structure of non-political society largely intact. The Leviathan of Hobbes, while fettering religion, the family, and associations, did not abolish their separate existence. In Hegel the existence of traditional society is held basic to the realization of the ideal state,
and Nietzsche's attitude toward the monistic state is one of aversion. It is in Rousseau's absorption of all forms of society into the unitary mould of the state that we may observe the first unmistakable appearance of the totalitarian-theory of society. More perhaps than any other theorist, Rousseau, by the sheer brilliance of his style, has popularized that view of state and society which underlies totalitarianism and which has indeed made possible the
acceptance of the total state in this century."
Not at all, but if your insurance company, for whatever reason, offered you free sailing lessons, would your employer have the right to block you from accepting? The insurance companies make money by preventing pregnancy, which is why they are happy to offer free contraception. Of course, some employers "self-insure", which is why I would like to see health insurance divorced from the employer-employee relationship. I would like to see everyone insured with some choice of program.
One role of the State, in my opinion, is to liberate the individual from unnecessary manipulation by corporations.
"And who liberates the individual from unnecessary manipulation by the state. Did corporations maintain slavery? Pass the Fugitive Slave Act? Enact The Sixteenth Amendment? Issue Executive Order 9066? Poison people who dared have a drink when it was forbidden? Send 50,000 to die in an experiment called "limited engagement"? Purposely infect people with Syphilis? Expose them to radioactive isotopes? You can always take your business elsewhere-but tell me how do I free myself from the Feds?
"Corporations are no longer allowed to employ young children for long hours under abusive conditions."
Except the state now corrals children in "schools" where, in the name of "education", the little tykes are burdened with hours of nonsense, followed by homework offering the same. So much better that a kid learn to put a condom on a cucumber or learn why Heather has two mommies than milk a cow-and most child labor was in family farms-not corporations. And save your indignity, I had "breaker boys" in my family.
"Should they be allowed to block women from receiving free contraception (and most insurance companies are happy to provide contraception for free as it saves them money to do so)? "
Uh, yes, (whoever "they" are) if for no other reason than routine expenses of any kind are not "insurable events" and cause deadweight administrative losses. We all pay for Meggie's pill and then add a bunch of paperwork,-when that money could go for research into things like Alzheimer's disease-real diseases that require help not yet available-not Frankensteinian drugs that impair a healthy reproductive system.
Insurance that pays for extraordinary expenses, incurred by chance and not choice, works wonderfully. Insurance that is nothing more than a hidden subsidy doesn't. Then again, nothing is free-SOMEBODY has to pay for it. (Econ 101, try taking it-it'll do wonders to disabuse you of this notion that things are free if only they are mandated by a government entity and its edicts.)
"In my opinion, the answer is no. The decision to use contraception should be made by the individual -- not by the State or the corporation. "
And just like my decision to order "Buckyballs", any choice to purchase any routine product of my choosing should be at my cost. Last I checked, Walmart will fill prescription so cheaply that if you can't afford a few bucks, perhaps you aren't ready for adult acts.
Sorry for spelling your name wrong the first time out.
You ask whether my employer has the right to block me from accepting free coverage. Well, in the case at issue, the coverage is facilitated and funded by my employer, so I don't see why not. My employer wouldn't be blocking me from receiving any and all free coverage--it would just be refusing to provide such free coverage itself.
Again: If the government wants to give me free sterilization, it can just give me free sterilization. Why should it have the right to force my employer to participate? The issue is that the government is forcing employers to act in a certain way--and this is particularly worrisome inasmuch as the government doesn't have to (it could just set up a vasectomy clinic in my neighborhood).
I too would like to see health insurance divorced from the employer-employee relationship. But even then, the problem would still remain, because the state would still want to require that all insurance plans cover contraception, sterilization, and the morning-after pill. Abortion and assisted suicide would be next on the list (money-saving procedures, no doubt). All of this amounts to the state eliminating all competition to its vision. Which brings us back to Prof. Deneen's article.
"But, it must be remembered, the employers were forced by labor, through the coercive power of the State (with the support of salivating insurance lobby), to carry all sorts of insurance. "
The history of employer-based insurance is rather simple. In the early 20th century, employer based insurance had emerged, primarily where assisted the employer. An example was a railroad that provided employer-paid health benefits because it was difficult to replace the engineers that ran its passenger trains, who took years-sometimes decades- to acquire the skills necessary to run those trains safely and with a deft hand on the throttle.
In the 1940's, when the federal government enacted wage and price controls, employers competed for labor resources with "fringe benefits". People soon realized they should seek tax-free in-kind benefits.
After the war, the IRS realized that it was losing money and sought to "protect the revenue" by taxing health benefits under something called the "economic benefit doctrine", which provides that compensation is taxable, no matter what the form.
As these taxes were levied against non-cash compensation, it caused something of a furor and in response, Congress exempted employer paid health benefits without limit as a part of the 1954 codification. That exemption still exists-see Sec. 106 of the Internal Revenue Code.
As long as health benefits are tax-free, there will be a bias to offering them. As long as most healthcare expenses are paid by a third party, there will be market distortions and dislocations-and Obamacare doesn't return healthcare to the consumer-but to bureaucrats, commissions and boards.
Yes, unions sought health insurance-but only because of the bias of the tax code.
As F W Maitland explains, “An appreciable part of the interest of the French Revolution seems to me to be open only to those who will be at pains to give a little thought to the theory of corporations. Take, for example, those memorable debates touching ecclesiastical property. To whom belong these broad lands when you have pushed fictions aside, when you have become a truly philosophical jurist with a craving for the natural? To the nation, which has stepped into the shoes of the prince. That is at least a plausible answer, though an uncomfortable suspicion that the State itself is but a questionably real person may not be easily dispelled. And as with the churches, the universities, the trade gilds, and the like, so also with the communes, the towns and villages. Village property—there was a great deal of village property in France—was exposed to the dilemma: it belongs to the State, or else it belongs to the now existing villagers.”
I am not even ASKING that other people pay for my brother's drugs. I just want people to imagine how it feels to have Leviathan tell someone you love, someone with children who love him, "Your life is meaningless to us, but far be it from us not to pay for recreational sex; in fact, in order to ridicule your beliefs, we won't even pay for it directly, but will demand that your Church be complicit not only in this, but in sterilization and abortifacients." And if you think "free baby-killing for all" isn't coming next - and I mean that literally, now that so many Dems agree that partial-birth abortion was just a cover for infanticide, so why not just allow infanticide? - then I have an uncle in Nigeria who left you a fortune, and all you have to do is wire $10,000 into my bank account as "earnest money."
1) "Nothing is free."
No, but contraception is usually free to the employer. It's not free either to the insurance company or to the insured. It is however covered in most insurance plans, and, as previously stated, it is cheaper for insurance companies to provide contraception than it is to pay for prenatal care, delivery, and then potentially to provide health care to that child until he or she is 26. Vaccinations aren't free either, but, quite aside from moral issues relating to letting people get sick and die, it's generally cheaper to vaccinate than it is to treat the disease later on.
2) "We all pay for Meggie's pill."
LOL! You absolutely do not! My husband and I buy our own insurance through Cigna. What our fellow users of Cigna would collectively pay for, however, would be a sixth child if we were to have one, especially if that child and I were to survive (unlikely). The medical costs of such an event would be truly astronomical. Large families like mine are a disproportionate burden on health insurance companies. People who limit family size by contracepting are the ones who are actually subsidizing my family and our many children.
3) "Well, in the case at issue, the coverage is facilitated and funded by my employer, so I don't see why not."
The situation is not ideal, but this opens the door to all manner of similar objections. If your employer is a Jehovah's Witness, could he refuse coverage if you need a blood transfusion? If your employer believes overpopulation is immoral, could he refuse medical coverage if you were to have more than, say, two children?
4) "All of this amounts to the state eliminating all competition to its vision."
In Germany (at least this was the case when we lived their in the 80s), one had the choice of buying either standard government-run health insurance or private health insurance. Private insurance was slightly cheaper. There was still competition. Something we have to decide as a society is what should be covered by health insurance and whether provision of health insurance should remain a for-profit endeavor or whether it should fall under something like "defense", which we collectively fund through our taxes and is considered an essential service that is not expected to generate revenue. I'm optimistic that the meritocratic, creative USA will eventually find a win-win solution.
"No, but contraception is usually free to the employer. "
You can't be this economically ignorant. When an insurance company incurs costs, it must be recovered or else it goes out of business.
And yes, we pay for your pill. You can rush right past the point that contraception is a choice, but it is your choice to use it and its not medicine-it impairs a healthy reproductive system-it doesn't mediate disease or restore function.
We all bear a risk of cancer, and it occurs more or less by chance-of course at a higher rate for subgroups like smokers-which is why some employers are requiring mandatory tobacco screening at as a pre-employment requirement.
Please explain this-are you suggesting that the lack of an explicit charge means that premiums charged to employers and employees don't reflect all expenses incurred?
"Vaccinations aren't free either, but, quite aside from moral issues relating to letting people get sick and die, it's generally cheaper to vaccinate than it is to treat the disease later on. "
Vaccinations prevent disease, pregnancy is not a disease.
Adam Baum, I've already explained this twice. I don't know how to make it any simpler for you. Most health insurance companies will charge the same rate, whether or not they are providing the pill without co-pay, because it is CHEAPER for them to provide the pill! In fact it would probably save insurance companies money if they gave women using the pill a break on their premiums -- for the same reason insurance companies will give home owners a break if they, for example, replace a shake roof with a fire-resistant one. For many women, there are significant health benefits (and hence monetary savings) to being on the pill. Pregnancies are very expensive for insurance companies. Even for a low risk pregnancy, one can expect prenatal care to cost about $2K, the delivery to cost about $7K, and then the insurance company has an extra person to cover -- possibly until the age of 26. Then, of course, the mother may stop working to take care of the baby, meaning the whole family now moves onto the father's insurance, and provision of care gets even more expensive for the family. Do the math! And, while you're at it, try to figure out why the health insurance companies actually LIKE Obamacare -- they are not being exploited or oppressed by this provision.
"pregnancy is not a disease."
Does that mean you would be perfectly happy for it to be excluded from an employer's health plan?
Some companies, to keep costs as low as possible, pay for all health care expenses themselves. The insurance company covers things like the administration of the policy and insurance on catestrophic years. Everything else is footed back to the company to pay out. In this instance, it becomes very clear that the company foots the bill for all services rendered.
Now my company is like that. And with rising health care costs, they are trying to cut costs. We have incentives of every kind for better health. But no incentives for 'free contraception'. Our plan is grandfathered so it won't have to cover it, and my company is not jumping aboard for the 'cost savings'.
To note, factcheck.org found that studies showed conflicting information about if free contraception could reduce insurance company's costs. An interesting study though of 15 insurance companies had 5-6 say that it would raise costs, 3 say neutral costs and absolutely 0 say that it would save money.
And this is from a WP article:
Contraceptives won’t cost patients, but that doesn’t make them free. Pharmaceutical companies are not handing contraceptives out to doctors offices’ without sending insurance companies a bill, too. Health plans ultimately end up paying the cost for any increased use of contraceptives. The Guttmacher Institute estimated in a 1998 paper that adding contraceptive coverage would cost $21.40 per person per year in extra health insurance spending.
The Obama administration says that, on the balance, this requirement will save insurers money: While insurers have some upfront costs, they could see savings from pregnancies prevented. The research, however, conflicts: Some state-level studies have shown their own contraceptive mandates to slightly raise the prices subscribers pay.
Very well said! Have you encountered the article by Robert Nisbet entitled "Rousseau and Totalitarianism" from the Journal of Politics in 1943 (http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6335760)? I think Nisbet makes a persuasive case that Rousseau had a large hand in development of totalitarian thought.
---Jonathan Watson