# 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:** 4
**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, 3:21pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/61 "2012-02-16T15:21:02Z")
> [@erislover](#): > > I guess I have a different perspective of cost. Clearly the company must take in more than they pay out. That doesn’t mean the insured takes a loss. Insurance simply wouldn’t exist if that were so. Its called risk aversion. ---
**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, 3:23pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/62 "2012-02-16T15:23:10Z")
> [@John\_Mace](#): > > No. I’m saying that if rich and middle class people don’t get “free” birth control that there will be a negligible increase in in the number of births. So, giving them this benefit does not reduce overall health care costs. It’s just welfare for people who don’t need it. Most people will be glad to take something for “free” that they would normally buy if it wasn’t “free”. I would. > > You’re confusing the effect of offering a smaller subset of society (ie, the poor) subsidized birth control with offering that subsidy to people who can afford it on their own. Birth control is about the only benefit that people under 30 get from health insurance. Otherise its a lot of young people subsidizing the health care of the older people in their pool. I had gold plated insurance when I got out of law school, it included gym membership and massages but for most people my age, birth control was the biggest ticket item that their health insurance covered. ---
**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, 3:25pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/63 "2012-02-16T15:25:00Z")
> [@erislover](#): > > Sure. I take a monetary loss at grocery stores, barbers, and the doctor, too. The average insured pays $100 for medical expenses that cost the insurance company $80. Insurance companies spend the rest on cherrypicking, denying coverage, and paying bonuses and dividends. ---
**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, 3:32pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/64 "2012-02-16T15:32:14Z")
> [@Damuri\_Ajashi](#): > > Birth control is about the only benefit that people under 30 get from health insurance. Otherise its a lot of young people subsidizing the health care of the older people in their pool. I had gold plated insurance when I got out of law school, it included gym membership and massages but for most people my age, birth control was the biggest ticket item that their health insurance covered. I’m not sure how that relates to the point I was making. Do these young people who can easily afford birth control not buy it if their insurance doesn’t cover it? And your gold plated insurance really isn’t relevant wrt what the government is going to mandate.‘’ We don’t give everyone free food because we know that most people can afford it and aren’t so stupid as to not buy it if they don’t get it for free. Birth control is no different. ---
**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, 3:32pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/65 "2012-02-16T15:32:46Z")
> [@Damuri\_Ajashi](#): > > The average insured pays $100 for medical expenses that cost the insurance company $80. Insurance companies spend the rest on cherrypicking, denying coverage, and paying bonuses and dividends. So your argument is that we should eliminate the insurance industry? ---
**Author:** ![kenobi\_65](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kenobi_65/32/13178_2.png) [@kenobi\_65](https://boards.straightdope.com/u/kenobi_65)\ **Post date:** [February 16, 2012, 3:40pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/66 "2012-02-16T15:40:17Z")
> [@Damuri\_Ajashi](#): > > Birth control is about the only benefit that people under 30 get from health insurance. Otherise its a lot of young people subsidizing the health care of the older people in their pool. I had gold plated insurance when I got out of law school, it included gym membership and massages but for most people my age, birth control was the biggest ticket item that their health insurance covered. The other, hidden, benefit is that, if you _do_ suffer a catastrophic injury or illness (not likely, but possible), you’ll be covered. A 20-something who’s active, healthy, and loves extreme sports may never use her health insurance except for birth control…until she falls off the side of a mountain, and racks up a six-figure hospital bill. ---
**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, 3:56pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/67 "2012-02-16T15:56:19Z")
> [@John\_Mace](#): > > 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. You don’t get to pick and choose when you’re going to talk about birth control versus a more general scenario. Here’s what you said: > [@](#): > > 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. You implied that it _never_ makes sense to sell insurance for predictable events. I explained the circumstances under which it might. That’s why we were talking about an abstract scenario. I have _never_ claimed that contraception was a specific example of such a scenario (in fact, I have gone out of my way to point out that I don’t know whether it is or not). You can’t keep coming back to birth control as a way of defending your general claim that insurance should just never cover routine costs. In this debate, you have made three arguments against birth control. 1. Insurance is not intended to cover routine costs, and therefore contraception should not be covered. 2. Insurance does not need to cover birth control because people will buy it anyway. 3. Subsidizing birth control is an unnecessary subsidy to the rich who would have paid for birth control anyway at the expense of the poor who have to foot the increased premiums. All of my points have been targeting _only_ the first part of argument 1, which is a claim that you’ve made multiple times (including in the post I quoted above). I am merely arguing that it can make sense for insurance to cover routine, predictable costs. This is all so we can move on from the argument that insurance should only cover unpredictable costs, and that’s why health insurance doesn’t cover routine checkups, or dental insurance doesn’t cover semiannual cleanings, or auto insurance doesn’t subsidize (for everyone, regardless of income!) the purchase of safer cars, or homeowners insurance doesn’t subsidize the purchase of a home alarm system. Oh wait. ---
**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, 4:02pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/68 "2012-02-16T16:02:46Z")
> [@kenobi\_65](#): > > The other, hidden, benefit is that, if you _do_ suffer a catastrophic injury or illness (not likely, but possible), you’ll be covered. Apparently, this isn’t a benefit we’re allowed to count, because people who purchase insurance “take a loss.” ---
**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, 4:22pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/69 "2012-02-16T16:22:19Z")
**MilTan** : OK, I see the confusion. I should have been more specific earlier. It doesn’t make sense for insurance to pay for routine stuff that people would buy anyway if it wasn’t covered. Hence, Insurance doesn’t cover the cost of buying toothpaste to prevent cavities or the cost of winter coats to prevent colds. Insurance companies are really smart about this kind of stuff. If it would save them money to cover birth control, they wouldn’t need Obama to tell them to do so. Somehow, the actuaries they have on staff would have stumbled on this. ---
**Author:** ![Cheesesteak](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/cheesesteak/32/3694_2.png) [@Cheesesteak](https://boards.straightdope.com/u/Cheesesteak)\ **Post date:** [February 16, 2012, 4:34pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/70 "2012-02-16T16:34:26Z")
John Mace has it right. People will generally buy birth control on their own because this: > [@Voyager](#): > > if childbirth is covered and birth control isn’t birth control does not save money for the insured. Isn’t true. Having a baby is a HUGE burden (financial, physical, emotional, etc) even if the pregnancy bills are covered. ---
**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, 4:48pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/71 "2012-02-16T16:48:30Z")
> [@John\_Mace](#): > > **MilTan** : > > OK, I see the confusion. I should have been more specific earlier. It doesn’t make sense for insurance to pay for routine stuff that people would buy anyway if it wasn’t covered. Hence, Insurance doesn’t cover the cost of buying toothpaste to prevent cavities or the cost of winter coats to prevent colds. > > Insurance companies are really smart about this kind of stuff. If it would save them money to cover birth control, they wouldn’t need Obama to tell them to do so. Somehow, the actuaries they have on staff would have stumbled on this. I completely agree with all of this 🙂 Though I would like to know how often insurers cover birth control in states without coverage mandates vs. in states with the mandates. That would let us get a handle on whether it’s cost-effective or not. I suspect that many insurers cover birth control even in states without mandates (though distinguishing profitable coverage from loss-leader strategies will be tricky). ---
**Author:** ![Babale](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/babale/32/15666_2.png) [@Babale](https://boards.straightdope.com/u/Babale)\ **Post date:** [February 16, 2012, 5:46pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/72 "2012-02-16T17:46:34Z")
Aside from the routibe issue, there’s another thing: birth control is recreation. You don’t need it from a medical perspective, like say, heart attack treatment. It isn’t an expansive and rare cost, like childbirth. It’s a relatively cheap recreational activity. Should health insurance pay to fix my seatbelt? That could save money in the long run. Should my dental plan cover toothpaste? Should the company buy a skateboarder a helmet and pads? ---
**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, 6:12pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/73 "2012-02-16T18:12:04Z")
> [@Cheesesteak](#): > > John Mace has it right. People will generally buy birth control on their own because this: Isn’t true. Having a baby is a HUGE burden (financial, physical, emotional, etc) even if the pregnancy bills are covered. I wanted to write “If birth control isn’t covered and birth isn’t also” - so you are agreeing with what I meant to say. ---
**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, 6:12pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/74 "2012-02-16T18:12:45Z")
> [@Babale](#): > > Aside from the routibe issue, there’s another thing: birth control is recreation. You don’t need it from a medical perspective, like say, heart attack treatment. It isn’t an expansive and rare cost, like childbirth. It’s a relatively cheap recreational activity. Should health insurance pay to fix my seatbelt? That could save money in the long run. Should my dental plan cover toothpaste? Should the company buy a skateboarder a helmet and pads? Once we accept one slippery slope argument, do we have to accept them all? ---
**Author:** ![Babale](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/babale/32/15666_2.png) [@Babale](https://boards.straightdope.com/u/Babale)\ **Post date:** [February 16, 2012, 6:30pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/75 "2012-02-16T18:30:09Z")
> [@erislover](#): > > Once we accept one slippery slope argument, do we have to accept them all? It’s not a slippery slope argument. If anything, dental insurance paying for toothpaste makes more sense than health insurance paying for condoms. Like I said, contraceptives aren’t used for health reasons; they’re used for recreation. Health insurance isn’t there to cover recreation. There’s no slope; paying for birth control and paying for skateboarder kneepads are on exactly the same level. ---
**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, 6:31pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/76 "2012-02-16T18:31:56Z")
> [@John\_Mace](#): > > **MilTan** : > > OK, I see the confusion. I should have been more specific earlier. It doesn’t make sense for insurance to pay for routine stuff that people would buy anyway if it wasn’t covered. Hence, Insurance doesn’t cover the cost of buying toothpaste to prevent cavities or the cost of winter coats to prevent colds. > > Insurance companies are really smart about this kind of stuff. If it would save them money to cover birth control, they wouldn’t need Obama to tell them to do so. Somehow, the actuaries they have on staff would have stumbled on this. First, do you have real evidence that women would buy birth control anyway? Some women don’t go to the doctor as much as they should, or even Planned Parenthood, and some women may have been raised to think that if they take birth control they are asking for sex (and that is not a good thing.) Given this, some women will choose to spend their money elsewhere. Insurance paying for it won’t solve the problem of course, but it would help. Maybe we can tax women who don’t take it, since taxes have such a gigantic effect on behavior, right? If all women were of the class homo economicus, there would be very few unintended pregnancies, since they are usually economically disadvantageous. Clearly they are not, so your expectation of rational behavior is not rational. ---
**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, 6:48pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/77 "2012-02-16T18:48:03Z")
> [@Babale](#): > > paying for birth control and paying for skateboarder kneepads are on exactly the same level. We disagree. We disagree on such a fundamental level that I am actually totally unsure how to even debate the topic, which is rare. All I can say is: preventing skateboard injuries is not identical to preventing pregnancy; skateboarding is not identical to sex. Repeated assertion is weak, I understand. But anyone who would think such things are identical clearly thinks so differently from me that basically everything is called into question. ---
**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, 6:55pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/78 "2012-02-16T18:55:52Z")
> [@Voyager](#): > > First, do you have real evidence that women would buy birth control anyway? Some women don’t go to the doctor as much as they should, or even Planned Parenthood, and some women may have been raised to think that if they take birth control they are asking for sex (and that is not a good thing.) Given this, some women will choose to spend their money elsewhere. Insurance paying for it won’t solve the problem of course, but it would help. Maybe we can tax women who don’t take it, since taxes have such a gigantic effect on behavior, right? > > If all women were of the class homo economicus, there would be very few unintended pregnancies, since they are usually economically disadvantageous. Clearly they are not, so your expectation of rational behavior is not rational. Well, there is an assertion being made that this saves money. I am challenging that assertion, so it’s really incumbent on those making the assertion to back it up. I am saying that I cannot believe that women who can easily afford birth control would not buy it. Even if it’s “free”, they still have to go and get it, so it’s just a matter of whether they pull out a credit card at the pharmacy or not. Now, many women probably can’t afford it, and they should be given help (which they already are, through Planned Parenthood btw). I’m not aware of an epidemic of unplanned pregnancies in Middle Class and Rich America due to unaffordable or difficult to get birth control. ---
**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, 7:03pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/79 "2012-02-16T19:03:16Z")
> [@erislover](#): > > We disagree. We disagree on such a fundamental level that I am actually totally unsure how to even debate the topic, which is rare. All I can say is: preventing skateboard injuries is not identical to preventing pregnancy; skateboarding is not identical to sex. Repeated assertion is weak, I understand. But anyone who would think such things are identical clearly thinks so differently from me that basically everything is called into question. Seat belts are perfectly analogous. It’s an even greater public health issue, as it affects every person who drives or rides in a car. Insurance companies should pay for the seatbelts in my car. It wills save them money! ---
**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, 7:34pm UTC](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909/80 "2012-02-16T19:34:03Z")
> [@John\_Mace](#): > > Seat belts are perfectly analogous. If you say so. This conversation has gotten too strange for me. I’m out. [Previous page](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909.md?page=3) [Next page](https://boards.straightdope.com/t/wait-a-sec-doesnt-birth-control-pay-for-itself/612909.md?page=5)