Do you really think that women who had never* considered* BC will be encouraged to get it now? They still need to seeing a doctor to get the scrip–but they’ll make that appointment, just because the pills are free? They won’t ask questions of the doctor or the pharmacist–or read the literature–but just play with the pills…
Do you really think women are that stupid?
(Oh, and I’m wondering why the OP is so hot about this question. As a lapsed Catholic, the idiotic Church-bashing here gets on my nerves, too. But he said he’s Episcopalian, over in the Mormon-bashing thread.)
Oh, these must be the mothers of all those 10 year old girls who are going to have sex because they got the vaccine for HPV! The apple doesn’t fall far from the slut, you know.
Huh? I just said that I don’t believe churches have been exempted. Churches have not been exempted. If Obama wanted to write “all churches are exempted”, he could have done so, but he chose not to do so. Instead he wrote a vague exemption that, at least taken at face value, leaves many churches out of the exemption.
Eh, it’s just because, even without mentioning any quotes from Martin Niemoller, I think it’s a bad idea to let the government take certain freedoms away from one group of people at a time, first because it’s morally wrong to do so, and second because sooner or later it will come back to bite everyone.
I don’t think they are going to initiate treatment just to get free BC, but I think when they do go to a sporadic OB/GYN appointment (or present to the ER), they will be made aware of the resource, will not decline it, and never use it.
You see this with other prescription assistance programs as well. Someone needs insulin for IDDM, they can’t afford it, the NP says “Well, there’s a low-income program, fill this out and mail it in.” That last step never gets accomplished. Instead they control their blood sugars by repeated ER visits.
You can lead a horse to water and all that…
As to your gratuitous attempt to smear me as a sexist, you’ll kindly note that I never said anything about all women and I resent your implication that I did.
I happen to be pretty well-acquainted with how poor people obtain medical care and their relative rates of compliance as compared to more well-to-do patients. I also know that a lot of these folks who can’t spare the $35 for BC often find the cash for a daily pack of smokes.
But again, this is OTJ stuff. Maybe some other posters with experience in this realm will weigh in. I believe WhyNot is a nurse at an inner-city hospital.
Well, I’m certainly convinced! With rock solid substantiation from a reliable expert supporting the conclusions of the same reliable expert, really, what further question might one have?
I might observe that holding you to the standard you want to hold me to, your side really hasn’t shown us by this level of evidentiary support that there are a substantial number of likely-compliant users of birth control who are going without due to an inability to afford the medication.
Could you furnish us with some statistical backing or some research? I think that’s the least we could do before undertaking a substantial subsidy, no?
Whether the current number is substantial or not, won’t it increase dramatically once coverage becomes mandatory? I totally get that battling so that people who can afford a $30/month prescription get free pills is a little :rolleyes: (leaving the preventative care argument aside for now), but I think that pool will eventually include people with a much lower range of descretionary income, especially when you get into families with multiple people using it.
That and you’re also excluding BC types like IUD where once the procedure done there’s no question of being a “compliant user” or not.
Well, I do not believe that when insurance companies are required to provide all types of birth control with no copay, it will reduce the number of pregnancies. This goes right back to what I started the thread to discuss, before we somehow wandered into Catholics’ non-existent support of slavery and suchlike topics. Everyone woman (and man) in the USA has free access to several types of birth control, and access to other types at a pretty low cost, and when women are asked their reasons for unplanned pregnancy, inability to afford birth control is not their answer, according to the CDC. I said as much in my OP. So since women already have access to so many good birth control options that are free or close enough to free, how is free birth control from the insurance company going to change the number of pregnancies? Consider that over the past generation some insurers have offered birth control with no copay–despite your claim that they won’t because “they’re afraid of pissing off the crazy religious people”–and the amount of easily available birth control has skyrocketed. What effect has that had on pregnancies in this country? The fertility rate has been pretty flat. The number of abortions has been pretty flat.
I’m asking you to prove that people, who right now are unwilling to make a minimal sacrifice of money to obtain a product that requires a fair amount of discipline to use effectively, will actually exercise that discipline if we provide it to them for free.
In other words, doesn’t their unwillingness to marshal $35 a month (or a slight bit more than $1 a day) suggest something as to their willingness to take a daily medication at the same time each day, go the pharmacy promptly every three months to keep the prescription current, not skip doses, etc. etc.?
For instance, a long time ago, Gov. Blagojevich wanted to implement a program that would send free books to parents on the purported theory that this would prompt them to read to their kids. (Actually, I suspect it was motivated by the observation that voters love to vote for politicians who give them free stuff.) Now, there is no shortage of free books—there are libraries all over the state. Parents who are inclined to read to their kids were already reading to their kids. Parents who weren’t reading to their kids were not refraining from reading to their kids because nobody was sending free books to their houses.
In each instance, you have a putative (but dubious) public policy interest (Don’t you support reading to kids?!? Are you some sort of ayatollah who thinks women shouldn’t be having sex?!?), but I think the real basis is to reward a constituency.
God knows this isn’t the first or last time this will happen, but considering that I agree with the general rule in these United States that each one of us is expected to pay for our own necessities, I think it’s worth pointing out that this represents socializing private costs with little reason to think there will be much of a public benefit.
Well, I’m still waiting for the cite that shows that there are a substantial number of would-be compliant birth control users whose sole impediment to such use is the minimal expense. But I understand, research takes time. Especially when it doesn’t exist.
We’re discussing women who work for an employer who provides them with health care and that a particular health care option (birth control) requires them to see a doctor, have an examination or at the least a consultation, get a prescription, then have it filled by a pharmacy.
And you’re suggesting that such a woman is likely to be so lazy or indolent as to go through all those steps, then just play with the pills on her lap tray? Because the actual use of the product requires more of a “fair amount of discipline” than obtaining the product did in the first place? So what you’re suggesting is that if BC was given away on street corners like, oh, I don’t know, M&Ms, maybe, then people might not put a high value on it? OK, I’m convinced.
But I don’t know what that has to do with the actual situation under discussion.
This might deserve its own thread. What level of cost effectiveness could an insurer expect from lowering copays for contraceptive services to $0? We must compare the current state of affairs with those in a fully hypothetical scenario — how many further pregnancies would be averted? How much would those pregnancies cost? How might a pregnancy affect a woman or a family’s later behavior?
One could provide free contraceptive services only to find that persons on the margin simply don’t use them effectively, as indicated by Kimmy_Gibbler. Or perhaps people are good enough at substituting cheaper for more expensive forms of birth control that lowering the price of the latter has minimal effect. We should also account for whether greater take-up of, e.g., hormonal contraception would have health implications beyond those related to pregnancy. I can even see other weird little arguments popping up: would increased take-up of hormonal contraception lead to lower condom use and thus a higher incidence of STDs?
Nevertheless, it’s intuitively plausible that contraception — which is quite cheap relative to pregnancy — could pay for itself if a sufficient number of pregnancies are averted. Two possibly relevant studies from a quick search (but I’m not finding a whole lot that’s directly on point, at least not quickly):
Trussell, James et al (1995): “The Economic Value of Contraception: A Comparison of 15 Methods”. American Journal of Public Health, 85.4, 494-503. URL’’.
A more basic question; they look at the savings that would result from every sexually active woman of child-bearing age employing various kinds of birth control relative to no method. All methods were cost effective, some dramatically more so than others.
Foster, Diana Greene et al (2004): “Expanded State-Funded Family Planning Services: Estimating Pregnancies Averted by the Family PACT Program in California, 1997–1998”. American Journal of Public Health: Research and Practice, 94.8, 1341-1346. URL.
More relevant; seems to indicate that we could expect positive effect from providing low-income persons with contraception. From the abstract: “The California Family Planning, Access, Care, and Treatment Program was implemented in 1997 to provide family planning services for uninsured, low-income women and men. We estimated the impact on fertility of providing 500000 women with contraceptives. […] Providing contraceptives to low income, medically indigent women significantly reduced the number of unintended pregnancies in California.”
That addresses one-half of my hesitation. But, this program isn’t means-tested, nicht wahr? So current users, including those who can afford it without a second thought, will also be able to offload their copays onto to the entire pool of insureds.
There are a lot of worthy medications and treatments we don’t do this for. As I mentioned, I pay for my own contact lenses, about equally as expensive. I wonder what explains the difference.
Probably it’s that preventing pregnancy among people who don’t wish to be parents is a net societal good, whereas whether or not you get your contact lenses makes no difference to anyone but you.
