# Wait a sec... Doesn't birth control pay for itself? **URL:** \ **Category:** Great Debates\ **Created:** [February 15, 2012, 6:50am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909 "2012-02-15T06:50:04Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![MilTan](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@MilTan](https://boards.straightdope.com/u/MilTan)\ **Post date:** [February 16, 2012, 4:59am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/41 "2012-02-16T04:59:52Z")
> [@sqweels](#): > > OTOH, it is in insurance companies’ interests that people are forced to wear seat belts. And along those lines, auto insurance companies _do_ offer discounts to people who, for example, buy safer cars or install anti-theft devices that make a car less likely to get stolen. They’re perfectly happy to pay for predictable items if those things will have a material effect on their claim payouts. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [February 16, 2012, 5:03am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/42 "2012-02-16T05:03:46Z")
> [@erislover](#): > > Who would buy insurance if the benefit they received were not worth the cost? You would buy it in case something happens so that the benefit you would require would be way above what the insurance cost you. And of course, hope that the insurance you bought will NOT be worth the cost. And as a counterpart to your question: who would start an insurance company if the benefits they paid out were more than the insurance premiums brought in? ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [February 16, 2012, 5:05am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/43 "2012-02-16T05:05:17Z")
> [@MilTan](#): > > And along those lines, auto insurance companies _do_ **offer discounts** to people who, for example, buy safer cars or install anti-theft devices that make a car less likely to get stolen. They’re perfectly happy to pay for predictable items if those things will have a material effect on their claim payouts. Offer discounts - yes. Pay for such devices - no. ---
**Author:** ![MilTan](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@MilTan](https://boards.straightdope.com/u/MilTan)\ **Post date:** [February 16, 2012, 5:05am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/44 "2012-02-16T05:05:49Z")
> [@Terr](#): > > Offer discounts - yes. Pay for such devices - no. Money is fungible. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [February 16, 2012, 5:08am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/45 "2012-02-16T05:08:13Z")
> [@Terr](#): > > And as a counterpart to your question: who would start an insurance company if the benefits they paid out were more than the insurance premiums brought in? Obviously the company will take in more _money_. I don’t see what that has to do with the question. The grocery store takes in more money, too, but I don’t take a loss at the grocery store. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [February 16, 2012, 5:14am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/46 "2012-02-16T05:14:22Z")
> [@MilTan](#): > > And along those lines, auto insurance companies _do_ offer discounts to people who, for example, buy safer cars or install anti-theft devices that make a car less likely to get stolen. They’re perfectly happy to pay for predictable items if those things will have a material effect on their claim payouts. Exactly what I said earlier. Offer discounts to people who buy birth control. If we are suffering from an epidemic of unplanned births in the middle and upper classes, I’d like to see it. Otherwise, it’s up to the pro free birth control to demonstrate that a majority of people in the US would not buy birth control if they didn’t get for “free”. Until then, I say, subsidize birth control for people who can’t afford it, and let those who can buy it themselves just like they buy toothpaste and dental floss. ---
**Author:** ![Terr](https://avatars.discourse-cdn.com/v4/letter/t/839c29/32.png) [@Terr](https://boards.straightdope.com/u/Terr)\ **Post date:** [February 16, 2012, 5:14am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/47 "2012-02-16T05:14:35Z")
> [@erislover](#): > > Obviously the company will take in more _money_. I don’t see what that has to do with the question. The grocery store takes in more money, too, but I don’t take a loss at the grocery store. The grocery store is not an insurance company. If you self-insure your life-time medical costs are X. If you buy insurance, your medical costs are Y+Z where Y is premiums and Z is out-of-pocket costs. On the average, in the above situation, X \< Y+Z (absent government subsidies). Thus, on the average, when you buy medical insurance, you lose money compared to not buying it. QED. If you add government subsidies, it still holds, but the number of variables increases. ---
**Author:** ![MilTan](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@MilTan](https://boards.straightdope.com/u/MilTan)\ **Post date:** [February 16, 2012, 5:20am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/48 "2012-02-16T05:20:11Z")
> [@John\_Mace](#): > > Exactly what I said earlier. Offer discounts to people who buy birth control. Offering discounts to people who do X is not materially different from paying for people to do X. Note, though, that I have no problem with your policy position of just subsidizing birth control for poor people. That’s not what I was arguing against, though. I was arguing against this position: > [@John Mace](#): > > This is what happens when you try to shoehorn a Health Care plan into an Insurance model. It would be like making car insurers pay for tune-ups. **Insurance is for things you can’t foresee.** Pretty much every adult has to deal with contraceptives (usually falls on the women in our society, but them’s the breaks). Childbirth is something most people plan. Which, to me, seems to imply that if a cost is predictable it shouldn’t be covered by insurance. I’m saying that it’s perfectly rational for insurance companies to pay for predictable occurrences under some circumstances. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 16, 2012, 5:42am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/49 "2012-02-16T05:42:53Z")
> [@erislover](#): > > Who would buy insurance if the benefit they received were not worth the cost? What is “worth the cost” is not as clear as you might think. The curve for losses is steeper then the curve for gains, so a $1,000 loss hurts more than a $1,000 gain feels good. Thus people are willing to pay a bit more to avoid losses than the expected value of the losses. Insurance companies also market to put the idea of a loss in your mind (thus the driving the hearse to the back door strategy) which makes you think a loss is more probable than it actually is. ---
**Author:** ![Voyager](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/voyager/32/133_2.png) [@Voyager](https://boards.straightdope.com/u/Voyager)\ **Post date:** [February 16, 2012, 5:44am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/50 "2012-02-16T05:44:50Z")
> [@sqweels](#): > > That’s not a relevent analogy since insurance companies don’t have to pay for conked out engines. They have to pay for “accidents”. In addition, the cost of covering an old person is greater, while the cost of covering an old car is less, since the value of the car, and thus the maximum the insurance company would pay, goes down. Of course if your mother is a car, all bets are off. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [February 16, 2012, 5:59am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/51 "2012-02-16T05:59:38Z")
> [@MilTan](#): > > Which, to me, seems to imply that if a cost is predictable it shouldn’t be covered by insurance. I’m saying that it’s perfectly rational for insurance companies to pay for predictable occurrences under some circumstances. Under what circumstances? Insurance is for the unpredictable. No one with half a brain would sell you insurance for known costs. Insurance is for spreading risk. If you know the cost, there is no risk. ---
**Author:** ![MilTan](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@MilTan](https://boards.straightdope.com/u/MilTan)\ **Post date:** [February 16, 2012, 6:13am UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/52 "2012-02-16T06:13:23Z")
> [@John\_Mace](#): > > Under what circumstances? Insurance is for the unpredictable. No one with half a brain would sell you insurance for known costs. Insurance is for spreading risk. If you know the cost, there is no risk. Insurance doesn’t cover the cost of a routine procedure to save you the cost of that procedure. They pay for the procedure to save the cost of paying for something else that might happen if you don’t get the procedure. The problem here is that there is a fundamental asymmetry. If you were on the hook for both the preventive action _and_ the consequences of not taking that action, then it wouldn’t make sense for the insurance company to cover the preventive action. But that’s not the reality: the insurance company is on the hook for the consequences, so it’s not surprising that in certain scenarios it behooves them to incentivize, in some way or another, the prophylactic action. In some cases, that incentive might take the form of paying for the preventive procedure. Imagine the following abstracted scenario: I have sold you insurance to cover some eventuality X that will occur with probability P and cost me C to cover. Now suppose there were some action A that I, the insurer, could take, with cost C’, that would reduce the probability of X’s happening from P to Q. It seems clear that, _irrespective of what A is_, I should do A as long as C’ \< C\*(P - Q). ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [February 16, 2012, 1:43pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/53 "2012-02-16T13:43:27Z")
> [@Terr](#): > > The grocery store is not an insurance company. Thank you for that. It was all very confusing for a moment. > [@](#): > > On the average, in the above situation, X \< Y+Z (absent government subsidies). Thus, on the average, when you buy medical insurance, you lose money compared to not buying it. QED. That was not what was to be demonstrated. I have never denied that buying goods and services costs money. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [February 16, 2012, 2:28pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/54 "2012-02-16T14:28:30Z")
> [@MilTan](#): > > Insurance doesn’t cover the cost of a routine procedure to save you the cost of that procedure. They pay for the procedure to save the cost of paying for something else that might happen if you don’t get the procedure. > > The problem here is that there is a fundamental asymmetry. If you were on the hook for both the preventive action _and_ the consequences of not taking that action, then it wouldn’t make sense for the insurance company to cover the preventive action. But that’s not the reality: the insurance company is on the hook for the consequences, so it’s not surprising that in certain scenarios it behooves them to incentivize, in some way or another, the prophylactic action. In some cases, that incentive might take the form of paying for the preventive procedure. > > Imagine the following abstracted scenario: I have sold you insurance to cover some eventuality X that will occur with probability P and cost me C to cover. Now suppose there were some action A that I, the insurer, could take, with cost C’, that would reduce the probability of X’s happening from P to Q. It seems clear that, _irrespective of what A is_, I should do A as long as C’ \< C\*(P - Q). We don’t need an abstract scenario. Women who can easily afford birth control are not going to forego using it because they don’t get if for “free”. Period. It’s a stupid subsidy to the middle class and to rich people. ---
**Author:** ![erislover](https://avatars.discourse-cdn.com/v4/letter/e/71e660/32.png) [@erislover](https://boards.straightdope.com/u/erislover)\ **Post date:** [February 16, 2012, 2:50pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/55 "2012-02-16T14:50:00Z")
> [@John\_Mace](#): > > Women who can easily afford birth control are not going to forego using it because they don’t get if for “free”. When the wealthy and businesses are asked to pay into society via taxation, you grumble because of disincentives. But when women are asked to pay for birth control, suddenly that changes nothing. If you accept that people are always on the margin, then people are always on the margin. Don’t pick and choose. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [February 16, 2012, 2:56pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/56 "2012-02-16T14:56:26Z")
> [@sqweels](#): > > How can certain employers complain that they’re being forced to pay for contraceptive coverage in their employees’ health plans? that: > > A) The mandate is that insurance companies provide the coverage for no additional cost. > > B) Birth control doesn’t cost money, it saves money. If company makes it easier for women to get contraceptives then the result will be lower costs for prenatal and maternity care, if anything resulting in _lower_ costs to employers. > > Isn’t that the reason that insurance companies aren’t the ones doing all the complaining here? It doesn’t save insurance companies any money. Contraceptive coverage costs the insurance company about $16 per month. Having no contraceptive coverage doesn’t mean that women are suddenly going to start having babies every other year. Insurance companies aren’t complaining because: (a) Obamacare is a HUMONGOUS boon to them (b) the Obama administration is in the midst of issuing regulation in connection with Obamacare and it can go well for them or it can go badly (c) beating up on Obama doesn’t look as attractive as it did 6 months of a year ago (d) they don’t want to get in the middle of this and if paying $16 for women that work at catholic universities and hospitals keeps them out of the conversation, they consider it a bargain. The reason to cover contraception is because it ia a common health care cost (in fact it is the MOST common prescription drug). We probably consume more birth control pills than we do aspirin or even tylenol. This isn’t Obama saying “I have an agenda and that agenda includes making all your white daughters promiscuous” this is a blue ribbon panel of health care experts telling Obama that a basic health care plan should cover (among other things), birth control. The evangelical christians of today are doing exactly what they accuse the gay community of. They don’t want equal rights, they want special rights. And unlike the gay communities request for “special rights” to give them rights analogous to what everyone else already has, the evangelical christian community is asking for special rights that do not even resemble rights that anyone else might have. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [February 16, 2012, 3:11pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/57 "2012-02-16T15:11:46Z")
> [@Mighty\_Mouse](#): > > If we were a covered religious organization, the insurance company would (per the White House characterization of the plan) have to pay out millions in contraceptive costs, and not pass this on to us, the employer. This would cause them to lose money right away, so they will then try to raise the “adminstrative” fee to cover the cost of the birth control. But that would be against the law, because that would be transparently making the employer pay for the conctraceptive costs.. > > This problem doesn’t really go away even if the employer is not self insured It goes away a great deal. You get rid of the whipsaw. Insurance companies see some of the benefit of reduction in pregnancy expenses. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [February 16, 2012, 3:15pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/58 "2012-02-16T15:15:08Z")
> [@John\_Mace](#): > > This is what happens when you try to shoehorn a Health Care plan into an Insurance model. It would be like making car insurers pay for tune-ups. Insurance is for things you can’t foresee. Pretty much every adult has to deal with contraceptives (usually falls on the women in our society, but them’s the breaks). Childbirth is something most people plan. > > It’s like making dental insurance cover the cost of toothpaste and dental floss. > > Having said that, I can see where insurers might give women a discount if they show that they are using contraception. Sorta like a safe driver discount. I’m not sure how that would actually work, since they wouldn’t be able to prove if a woman did or did not use contraception, but perhaps just good ol’ self interest would assure that most would, since few women want to just randomly get pregnant. > > At any rate, the vast majority of women in this country can pay for contraception. Making it some national crusade to make sure they get it “for free” makes no sense to me. I have no problem subsidizing poor people who can’t afford it, but lumping it into “insurance” for middle class and wealthy people does’t compute. My health insurance pays for my annual check-ups, teeth cleaning, the tests I have to get when I reach certain age milestones, drugs to deal with my cholesteral. All tehse costs are entirely forseeable at the individual level. It is even MORE forseeable at the group level and yet its all insurance. In what way is a birth control pill any different than my cholesteral medicine? Or my annual checkup? ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [February 16, 2012, 3:17pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/59 "2012-02-16T15:17:43Z")
> [@John\_Mace](#): > > No, it wouldn’t be astronomical. You left out the part of my post where I addressed that. Birth control costs about $60/month. Most Americans can afford that. Many can’t, but when most people can afford something, why have the government give it out “for free”? Because its not the sort of thing people will get and flush down the toilet for shits and giggles. You don’t get waste by virtue of the low price tag and access to birth control is an integral part of a basic health care system. ---
**Author:** ![Damuri\_Ajashi](https://avatars.discourse-cdn.com/v4/letter/d/898d66/32.png) [@Damuri\_Ajashi](https://boards.straightdope.com/u/Damuri_Ajashi)\ **Post date:** [February 16, 2012, 3:19pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/60 "2012-02-16T15:19:38Z")
> [@John\_Mace](#): > > Everything an insurance companies pays for increases the premiums people pay. It makes no sense to give rich people “free” birth control since part of the payment for that is coming from premiums paid by poor people. We don’t have to worry about rich people having too many kids. They can figure out how to keep their families small all by themselves. > > It’s like giving everyone “free” food because poor people can’t afford food. > > ETA: Change “rich people” to “rich and middle class people”. Well shit it sounds like youa re saying we should collect insurance premiums from everyone adn just spend it on the poor people. Why not just expand the medicare and medicaid system to cover everyone but the rich and increase taxes accordingly? [Previous page](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909.md?page=2) [Next page](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909.md?page=4)