I'm glad Sen. Barbara Boxer, along with Sens. Patty Murray and Jeanne Shaheen, are supporting the Obama administration's decision to mandate contraceptive coverage at Catholic hospitals. I read the Wall Street Journal editorial denouncing it as an assault on religious freedom, and I think there's something that is too easily overlooked here.

Religious institutions like the Catholic Church are not just churches these days; they're major employers and the operators of major health-care facilities that are intertwined with insurance companies. And for a lot of employees and patients, there isn't any choice.

People who work for the hundreds of nonprofit social-service agencies run by the Catholic Church aren't necessarily Catholics, or even religious. They might be receptionists, or janitors, or computer systems operators, or counselors who needed a job and happened to get hired by an agency that needed their (secular) skills. Jobs are hard to come by these days; a person who works in an administrative job at a Catholic nonprofit and is trying to pay the rent and support a family may not have the option of simply leaving because she doesn't agreed with the Church's position on birth control. She's got a health plan paid for by her employer, just like most of the rest of us, and if that plan doesn't cover contraception, she's SOL. It's not fair.

My health-insurance plan recently decided not to do business any more with Brown and Toland medical group and instead contract with Hill Physicians. I had nothing to do with that decision, which was based on some financial negotiations around reimbursement rates that were entirely out of my control, part of an ongoing fight between major hospital groups, physician groups and insurance companies that leave patients entirely out of the loop.

So I had to leave the doctor I'd been seeing for many years (who was a member of Brown and Toland and affiliated with the Sutter-owned California Pacific Medical Center) and I was reassigned to a new doctor, who is a member of Hill -- and because of economic issues that have nothing to do with religion, my Hill doc is affiliated with Catholic Healthcare West. So now any major medical treatment I need is at St. Mary's, or St. Francis, or Seton -- all excellent hospitals, and I have no complaints. My new doctor is great, and frankly, the medical staff who are part of what happens to be a Catholic Church affiliated hospital chain aren't a whole lot different from the medical staff at the secular CPMC -- skillful, devoted, caring, and so far as I can tell, entirely free of any type of evangelism. I have no idea what, if any, religious affiliation the doctor who patched my broken hand back together last year had; it wasn't an issue. Who cares?

But still: It's a Catholic hospital chain. With all the issues that creates. And it's part of the city's public-health infrastructure. A lot of us didn't choose a religious-based medical center; our insurance company did that for us.

Catholic Healthcare West just changed its name to Dignity Health, apparently for marketing reasons (interesting that they chose the name of a longtime group of gay Catholics) but according to the group's website:

All of our Catholic hospitals, as well as those that may join the system at a later date, will continue to be Catholic and follow the Ethical and Religious Directives for Catholic Health Care Services (ERDs).

Among the rules that guide those ERDs:

First, Catholic health care ministry is rooted in a commitment to promote and defend human dignity; this is the foundation of its concern to respect the sacredness of every human life from the moment of conception until death. ... Catholic health care does not offend the rights of individual conscience by refusing to provide or permit medical procedures that are judged morally wrong by the teaching authority of the Church.

I'm all for religious freedom. But under our current healthcare system, a lot of people have no choice as to their employer or their health-care system. And as long as that's the case, I don't see why the Church (which has to pay payroll tax on its employees and abide by the state's employment laws) shouldn't fall under the same health-insurance rules as everyone else.