The idea of insurance is to protect people against the financial impact of unpredictible bad events, like death, accident, sickness, etc. This is done by a complex mechanism that involves sharing risk, handling claims, classifying insureds, etc. The overhead adds significant cost.
Birth control may arguably be regarded as a part of health care. (Various methods have more or less in common with other health care.) However, someone who uses birth control isn’t sick. The need for birth control isn’t a random event. The cost of birth control isn’t normally a financial hardship.
If we provide birth control through the insurance mechanism, the cost to society will be greater, due to overhead. In particular, society will pay a bit more, while insurance companies have additional business and more profits.
Birth Control Control
Another potential problem can be seen in the aphorism, “He who pays the piper calls the tune.” If insurance companies or the government are funding birth control, then they may gain some control over one’s chices – not a good idea.
I have problems with WH governmentspeak also. What is the message behind this pronouncement?
[ul]
[li]It is not necessary to federally mandate BC for our employees.[/li][li]It is expensive to federally mandate BC for our employees.[/li][li]We are opposed to symbolic laws.[/li][li]We don’t like the symbolism in federally mandating birth control coverage to our employees.[/li][/ul]
I tend to think the last point is the one the WH is trying to make. I could be wrong since I can barely understand the actual words as they appear, much less the motivation behind them.
If the goal is to have all federal employees covered for birth control, then the mandate is necessary (the spokesperson did say “most” not “all”) and substantive. Of course this was the goal of the previous administration and not the current one.
Okay, so by Birth Control we’re talking about “the pill” right? This doesn’t mandate that they provide condoms or spermicidal jelly to those who are covered.
If this is so, then this is a prescription drug benefit. This means that by not including birth control they are specifically excluding one particular prescription. My plan covers all prescription drugs if the doctor sees fit to prescribe them. Excluding one drug or another seems ludicrous.
So, some companies won’t pay for birth control pills which help prevent an unwanted child from coming into the world. But insurance companies see no problem with paying for Claritin so I don’t sneeze so much in the summer? This is just as much a lifestyle thing as birth control. It seems to me that if you cover prescriptions, you should cover prescriptions. Period.
As to whether this is a valid thing for the government to address: Sure. Was the law frivolous if most health care providers used by the Feds have the benefit? Sure.
But does that mean you should cover Propecia? I myself think not. As we get into a world when there are more and ore “convienence” drugs avalible via perscription, this is going to become more and more of an issue.
I also have to agree that failing to cover birth control is probably resulting in no or almost no actual babies. Anyone with a job good enough to provide insurance can afford the $30 bucks a month for pills and is smart enough to realize that $30/month is cheaper than baby.
but again,this isn’t the point, is it? Surely some one with a good job can afford most of their prescriptions (my script for Gloucophage is about 25$ per month, covered).
There are legitimate health reasons to take b/c pills other than for b/c, and, even beyond that, b/c pills may be the most reasonable and safe method for a woman who wishes or should not conceive (there are some women for whom pregnancy can be a serious health crisis).
What, then, is the basis for singling out b/c pills for non coverage?
This reminds me of a two Reagan quotes I’ve never forgotten regarding the Equal Rights Amendment (remember that?). Before his Presidential campaigns, he said that he was against the ERA because it would cause the “differences” between the sexes to be “treated as casually and amorally as dogs and other beasts treat them.” OTOH running in 1980, he simply said that he was not against " ‘Equal,’ or ‘Rights’," he was just against “Amendment.” Of course this is the guy who threatened a “bloodbath” against student anti-Vietnam protestors, but now is held up as an exemplar of advocacy of “limited government.” JDM
Wring, I am not really taking a position at all on the larger issue–I am just pointing out that one supporting arguement: “It makes business sense to cover the cost of birth control pills because it is ultimitly cheaper than paying for the many costs of children” is not really sound. Cutting the easily refutable points out of an argument is important, as it limits the number of red herrings your opponents can dangle.
I’m sorry, I wasn’t trying to argue against you (tho’ I tried to make that same arguement to my insurer - “it’ll cost you $440 per year for me to be on the pill, and you just spent $8000+ on my pregnancy, son’s birth etc.”, they weren’t impressed)
Although in terms of the employer, it makes even less sense, since pregnancy will mean a certain number of lost hours, plus the addition of a dependant on the insurance contract.
Yea, I’m still trying really, really hard to understand why prescription coverage for b/c is something any employer (save for the Catholic church or an entity with a specific, recognized stance on b/c issues), would get involved in. Frankly, as an employer, that’s under the category of “I don’t want to know” re: my employees.
Basically, they called your bluff—and were probably pretty safe in doing so. (Perhaps we need a grassroots movement where we all keep having babies until the insurance companies knuckle under?)I can’t imagene that more than a handful of pregnancies each year are a direct result of pills not being covered by insurance. For one thing, the amount covered by insurance after co-pay comes down to $10-15 a month that you would actually be saving.
I really feel on the fence about this issue. To a certain degree I feel that insurance should be for unexpected expenses. If we assume that virtually every woman in America uses some form of birth control, I can’t see how having insurance cover the cost is going to have any result except to raise all of our rates, and make insured men pay half.
Another thing that occurs to me is that I think the price of birth control is much more responsive to market pressures if the consumer has to pay for it. There are many types of birth control competing out there,and I am a lot more likely to ask my doctor to prescribe a cheaper version if I am paying for it. I mean, times when I do not have prescription coverage I ask the doctor to prescribe amoxicilian, but when I do I don’t question the cutting edge, $3 a pill antibiotic of the month. So I wonder if one of the EFFECTS of not covering birth control pills (if not the intent) is that it has driven the price of birth control down to a level that the uninsured can often afford (obviously some still can’t, but more can afford $30/month than $60 or $100). This is not, in itself, a good enough arguement to settle the issue one way or another, but it does keep me from being quite as outraged as I might be otherwise.
We would all want employer-paid birth control if it were a freebie. Economists claim that the cost of fringe benefits comes out of what employers would otherwise pay in salary. If you could get employer-paid birth control in exchange for a salary reduction of $440 per year, would you choose it?
december are you aware of how insurance co’s operate?
Are you aware, for example, that my company, since it has less than 10 “memberships” pays a substantially different rate per person (for the same sort of coverage) than the corporation that has 10,000?
Point being that, of course the ‘cost’ of benefits is essentially a part of your “wage” package. The corporation, tho’ can get this same product at a greatly reduced price for it’s employees than the employees would otherwise be able to do. And, in many cases, one simply cannot get health insurance w/o belonging to a group.
So, in answer to your question “would I be willing” blah blah blah - I already am paying for it - my employer pays me wages plus benefits, if the benefit package went down substantially in cost, they could afford to give me a raise. Conversly, I haven’t been able to get a raise for the past 2 years 'cause the cost of our health insurance has gone up so dramatically (I am the boss, so I do the budgeting here).
Now, how did your comment at all relate to the OP? Part of the OP was the fact that in the current job market, health insurance benefits are an essential part of the employee package if an employer wishes to obtain and retain qualified employees.
Yes, I do know how insurance companies operate, having been an actuary for 30 years. However, health insurance is not an area I have ever worked in.
I’m sympathetic to your inability to get a raise for the past 2 years due to increases in health insurance costs. That’s the very point I was trying to make, relating to whether or not it’s a good idea to include birth control in health insurance programs. This point may have been a bit off the original topic. Sorry…
december:I’m sympathetic to your inability to get a raise for the past 2 years due to increases in health insurance costs. That’s the very point I was trying to make, relating to whether or not it’s a good idea to include birth control in health insurance programs.
I don’t think anybody disagrees that more coverage of prescriptions makes health insurance more expensive: after all, if health insurance didn’t cover anything, they could afford to make it really cheap!
But I think the point relevant to the OP is, why eliminate birth control coverage in particular? The argument about keeping down costs could be applied to lots of prescription drugs that aren’t “medically necessary” according to some people. For instance, Viagra (as a prescription for erectile dysfunction in middle-aged men) is now covered AFAIK by every insurer (despite its being far more expensive than oral contraceptives). Why? What’s the argument for maintaining that diminished male potency in middle age is a medical condition that routine health care should undertake to remedy, but undesired fertility in premenopausal females is not? Both conditions are equally “natural” aspects of human biology, after all. Prescription contraceptives are not more of a “convenience drug” (and certainly not more expensive) than lots of other prescriptions that are covered by insurers without question, and I think attempting to account for the Bush policy as a mere issue of insurance costs would be misguided.
If consumers are expected to be able to handle the costs for insurance coverage of Viagra, which in 1998 had U.S. doctors writing up to 20,000 new prescriptions per day for it, I think coverage for contraception prescriptions should prove to be manageable. It seems to me that the only real reason for the Bush policy change is in order to make a gesture to those who object to contraception on moral grounds. (I join the crowd who’s wondering who really cares so much about this, by the way. I thought most of the people who disliked birth control were, you know [looks around, drops voice], Catholics? Isn’t Bush’s bedrock constituency (well, besides the millionaires) the Christian right, the hard-line Protestants who are at best somewhat wary of Catholics? Aren’t they the ones who pride themselves on being able to go into a drugstore and declare, “because we are members of the Protestant Reformed Church, which successfully challenged the autocratic power of the Papacy in the mid-sixteenth century, we can wear little rubber devices to prevent issue…In fact, today, I think I’ll have a French Tickler, for I am a Protestant”? But apparently there are quite a few members of the Christian right who object to some forms of contraception on anti-abortion grounds, so it seems to have been judged safest to duck the whole issue as much as possible.)
Frankly, I don’t care one way or another. However, for the sake of the discussion, I tried to give these arguments in my earlier post. Birth control use can be differentimated from items normally covered by health insurance, because it’s:
Not a random event
Not an illness or injury
Not (generally) a major cost item.
So there are some sensible reasons to exclude birth control from medical coverage that are not based on religion.
december please give examples of other items you consider to be:
Not a random event
Not an illness or injury
Not (generally) a major cost item
(especially #1).
#3 ? generally major cost item for whom? the patient? b/c pills are a bit more than my prescription for treatment of a diabetic condition, and quite a bit less than my SO’s treatment for high blood pressure. Both of our drugs are coverable, b/c pills not. cost does not seem to be a factor. My son has been written scrips for decongestant. Cost: $1.75, coverable
#2. There are other categories: treatment of a condition, and prevention, both of which are acceptable medical issues.
#1. I’m not sure what you mean by this.
So, again, please, what is the rationale for exclusion of b/c pills?
YOu have tried to counter my 3 criteria and show that bith control should be covered. But, offering counter-arguments isn’t the same as saying that the other side has no rationale at all. There are two sides to most questions.
Almost everything covered by health insurance does satisfy at least one of the 3 criteria I listed. You can try your own examples. Here’s a couple to get you started.
a. Heart attack – This is a random event, in that it occurs at an unexpected, unplanned time. It’s an illness, and it might require expensive treatment. It satisfies all three criteria.
b. Diabetes pills – You say yours are not too expensive. The need is sort-of random in that it occurs to a random person. I assume they’re taken continuously, not at a random time. It is an illness. So this example satisfies #2 and semi-satisfies #3.
Here’s a challenge to you. Find examples of things that are commonly covered by medical insurance, but which fail to satisfy all three criteria. That is,
– they’re low cost, and
– they apply at predictible times to most people, and
– they don’t involve ill-health.
You might find one or two, but there can’t be many…
I just talked to my Blue Cross Blue Shield rep (on an unrealted matter). The option to carry b/c prescription coverage is a specific rider that can be purchased. there are other riders - ‘vision’, ‘dental’, ‘lifestyle drugs’ (which includes viagra and so on), prescription drugs (as a generalized thing), etc.
The rep I talked to worked only for ‘small’ groups (ie those under 24 members), and the difference in price between the prescription drug (general) and the one that would allow contraceptive coverage was less than $2 per month, per person for small groups such as mine.
So, we’re back to my OP which is: for a whoppping $24 per year, the employer can add this coverage. (probably less for a large entity such as the Feds, who apparently, do have b/c b/s as an option see [url=“http://www.fepblue.org/2000/index.html”= this
My daughter’s dormitory at Swarthmore had a basket of condoms in the hallway available to the students. They encouraged safe sex and birth control, which is good. However, they inadvertantly gave students the message that they weren’t able to arrange their own protection – that some outside party needed to provide it.
Young people today don’t have the self reliance of my generation. When I was a kid, we got to school by catching our own dinosaur and riding it!
Anyhow, wring, if you’d like to know what “EOM” means, I recommend the search engine www.google.com. You’ll find it on the second page of listings.