Gonna try one more time on the subject of Catholic hospitals and the HHS rule, using Ross Douthat‘s, Kevin Drum‘s and Rod Dreher‘s thoughts as a jumping-off point.

What strikes me about each of their comments is that they don’t take seriously the question as a clash of values. From Drum’s perspective, the salient facts are that the Catholic Church is wildly out of step with contemporary culture on the question of the morality of contraception, and that providing insurance that covers contraception does not require anyone to use it. So it’s not a tough call: contraception is a positive good, deserving in a sufficiently wealthy society to be treated as a positive right, something nobody should be unable to obtain because of a lack of means, and a church that finds this positive good to be evil should only be able to impose its views on fellow communicants, not employees who likely don’t share the church’s bizarre view (even if those employees are Catholic).

From Douthat and Dreher’s perspective, meanwhile, contraception is readily available, so nobody is being deprived of access by the lack of insurance (and “insurance” isn’t even the right concept to apply here, since contraception isn’t a remedy for an unexpected condition comparable to treatments for disease). To the majority, it’s morally neutral, but to the Catholic church it’s morally abominable. To say to that church that all its good works count for nothing if it won’t provide this convenience to its employees is the equivalent of driving the observant Jewish community out of town so as to save the rest of the town a few minutes’ commute time, or forcing a Muslim-run hospital to sell Playboy in the gift shop.

In other words, the liberal side in this debate doesn’t take the Catholic Church’s objections to contraception seriously as a moral matter – it’s just a peculiar hangup of theirs – and the conservative side in this debate doesn’t take liberals’ support for a positive right to contraception seriously as a moral matter – contraception may be convenient and morally neutral, but it isn’t a positive good.

If this debate is really just about keeping the Catholic Church’s hands formally clean, then there should be a remedy that satisfies both sides, some kind of formality that could enable a Catholic hospital to say, honestly, that they aren’t directly providing coverage that they deem immoral, but that still gets employees that coverage (and still costs the employer the money). Money being fungible, I shouldn’t imagine such a workaround would be that difficult to engineer. But I don’t think this dispute is about formalities; it’s about the Catholic character of Catholic institutions. If you work for a Catholic hospital or a Catholic university, you are, in at least a peripheral way, joining a Catholic institution and therefore following Catholic norms. Those norms don’t follow you home; they don’t bind you, personally. But they do affect you, in a potentially consequential way.

Drum is right: granting an exemption to contraceptive coverage for employees on the grounds of religious objection to the practice is to dignify that objection, to recognize that it is sufficiently serious as to justify burdening those employees on a matter that, from a liberal perspective, is not trivial. To refuse is to say: no, we don’t dignify that objection. Feel free to follow those rules yourselves if you want, but you can’t burden your employees with them because we don’t recognize their moral logic.

I happen to think the Obama Administration got this one wrong – but that’s because while I disagree with the Catholic Church’s position on contraception, I recognize its moral logic. But I wouldn’t always make that judgment. Here’s an analogy that I think is quite strong: imagine that we live in a world where the Church of Scientology runs a substantial network of charter schools that do a remarkably good job educating poor students. Imagine that, in this world, employees pretty much have to get their health insurance from their employer (one of the things that the ACA is supposed to change, by the way, which is a non-trivial fact). And imagine that the Church of Scientology refuses to provide mental health coverage for employees in these schools. Should that be acceptable?

Clearly, if you don’t believe that there’s any kind of positive right to health insurance, it should be acceptable – employers should be allowed to do whatever they want. But assume you do believe that there should be such a positive right – that, in a wealthy enough society, nobody should be denied access to healthcare because of means. So: should it be okay to systematically disadvantage employees of Church of Scientology schools because that church has a weird hangup about mental health services?

Ultimately, the source of the conflict here is in holding simultaneously that health care is a right and that health coverage will be provided primarily by private employers. If you believe both of those things, then you have to coerce private employers into providing coverage that meets some kind of minimal standard. In our world, where some health care services are deemed morally problematic by some significant private employers, that would mean coercing those employers to violate their consciences. (By the way: what’s special about the Catholic Church in this regard? Does the strictly Catholic sole proprietor of a national pizza franchise lack a conscience? Why is it okay to coerce him into providing services he deems immoral, but not okay to coerce a Catholic hospital?) If you don’t want that level of coercion, then either you need to give up on the idea that health care is a right, or you need to give up on the idea that health coverage will be provided primarily by private employers.

I vote for giving up the second idea.