The Kansas City Star, Mo., Dave Helling column [The Kansas City Star, Mo.]

Feb. 15--Last week, more than 100 Kansas City police officers crowded into City Hall as Mayor Sly James released his proposed budget.

Angry about their pay? Worried about layoffs? Frustrated with their equipment?

Partly. But they also were there to protect their health insurance.

Most people who get their health coverage at work -- that is to say, most of us -- probably sympathized with the blue crew. Our health plans change all the time, too.

But their protest once again illustrates a strange American reality: Control of your health care usually doesn't rest with you, or your doctor, or even your insurer. Instead, your employer almost always picks a company to provide insurance and what its policies will cover.

Is this a good idea?

Let's ask workers at religious institutions such as Catholic hospitals and universities. They were sharply reminded of our employer-based health system this month when their bosses launched a furious campaign against a federal rule requiring no-cost coverage of birth control at their workplaces.

Outrageous, fumed politicians and religious leaders. A violation of the First Amendment.

They've certainly got an argument. In fact, the White House backed slightly away from its original rule, although not far enough to satisfy many conservatives.

But the First Amendment belongs to everyone. If government can't tell religious businesses what health coverage to offer, why should businesses have the right to dictate health choices to their workers?

Well, because -- as an accident of history -- they provide health insurance.

And that has consequences beyond birth control.

Let's say your boss decides tomorrow he or she has a moral objection to childhood immunizations.

Under the bishops' worldview, that employer would have a First Amendment right to cancel insurance coverage for those injections. U.S. Sen. Roy Blunt has proposed a bill recognizing this fact, explicitly allowing a moral exception for any employer objecting to any health procedure.

So, you can see the problem. Your boss might also oppose blood transfusions, or end-of-life care, or transplants, or drugs treating depression or anxiety. If the bishops' view prevails, out they go -- leaving you to seek other insurance, pay out of pocket, go without, or quit.

America's system of employer-provided health insurance leads directly to deep conflicts like this. If we all obtained our own portable health insurance -- just like we do for our homes and cars and lives -- it wouldn't matter what our bosses, religious or not, thought about our health choices.

Yes, switching to individual health insurance would be enormously complicatedand potentially expensive.

For now, though, consider what the bishops and the cops are really telling us: We lose freedom when we surrender choices to anyone, the government or the boss.

To reach Dave Helling, call 816-234-4656 or send email to [email protected].

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