Having read the above, I’m ready for a single payer system.
John Mace: Sorry if I missed this, but I can’t see what you’re going on about.
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If insurers cover something, there’s generally a copay. That’s the same as a discount, as opposed to giving something away for free.
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If you believe that the costs of an unplanned pregnancy are not wholly internalized by the insurance company, then you would want to drive the cost of contraception down even further. Maybe even to “Free”. Or beyond.
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Factual inquiry: Obama proposed requirements for insurers to cover contraception. (Um, right?) But that doesn’t imply “Free contraception” does it? See #1. Or did the old proposals say something else?
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You made a decent point earlier: why don’t insurance companies do this anyway? I find it baffling frankly: I would think that it would be cost-effective to set up a deal for discounted contraceptives at Amazon or whatever.
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This article explains why some insurance companies don’t cover them, but I don’t understand the argument:
NPR: “Does Contraception Really Pay For Itself?” Does Contraception Really Pay For Itself? : Shots - Health News : NPR
Agit-prop:
Think Progress: 5 Reasons Why The Contraceptive Coverage Guarantee Is So Important
http://thinkprogress.org/health/2012/02/16/426605/5-reasons-why-the-contraceptive-coverage-guarantee-is-so-important/
Evidence that, yes, demand curves slope downwards and copays may increase unplanned pregnancies:
ETA: Admittedly, the argument appears to turn on the lower and lower middle classes.
We have to make a distinction:
The marginal cost and marginal gain of an insurance policy vs the marginal cost and marginal gain of particular cases covered by an insurance policy.
If the insurance policy is “provide subsidized/free birth control pills”, there are certainly cases covered by that policy where the marginal gain will be above marginal cost. For example, there are cases where a woman wouldn’t have been able/willing to purchase BC pills and would have gotten pregnant. In those particular cases covered by the policy, marginal gain is above marginal cost.
But this does not mean that the policy as a whole has a marginal gain above its marginal cost. Because it also covers a lot more cases where marginal cost may be above marginal gain.
This policy covers lots of women who would have bought BC pills without it being covered by insurance and perhaps women who wouldn’t have gotten BC pills and wouldn’t have gotten pregnant but since it was free/cheap, figured “what the hell, I’ll take it”.
Figuring out the precise trade-off of that policy is why insurance companies hire actuarians. It seems most insurance companies figured it wasn’t worth it.
Including this obligation isn’t much more than a wealth transfer from women who don’t use BC pills to women who do. If one wishes to help women who can’t afford BC pills, don’t make it an Rx and send poor people a gov’t check.
Insurance is mainly helpful for low probability large expenses. For example, if I have a 1/1000 chance of having a 100K$ expense, if I save for it and it doesn’t happen, I’ve massively oversaved and could have used my money better elsewhere. If I don’t save it and it happens to me, I’m fucked. The efficient thing to do is for people to pool resources and each pay about 100$. That way, you don’t risk oversaving or undersaving for that particular risk.
It seems that way, but that doesn’t really matter. Things that can benefit everyone don’t have to be in individuals’ interests. It’d be better for everyone if HIV positive individuals didn’t run around having unprotected sex. It’d be better for everyone if the shy but good-looking girl/guy who doesn’t have a lot of sex took on some more partners. But we’re asking individuals to bear all the costs while the rest of us receive some of the benefits, so obviously this won’t happen to the socially optimal degree.
In this particular case, it seems to me that we’d be better off with more people, not less, though. But anyway, if society decides women are having too many kids, making birth control cheaper is one possible way of dealing with the situation. I think the best way would be to make it OTC, but whatever.
All of society has a stake in this if women are having too many kids (for other reasons). Their incomes really don’t matter: everyone is on their own margins, right?
That doesn’t really change the equation. The non-copay part is still a subsidy. But in this particular case, does the law allow insurance companies to demand a copay? If not, and I think not, then it’s a moot point for this discussion.
Again, it depends on how many people would buy it anyway. Right now, most do.
Of course not. Everything has a cost, and that’s why I’ve generally put quotes are “free”. People see it as free, but someone is paying.
I don’t think insurance companies are stupid, and the math here is not very complicated. This is what insurance companies do. It’s their lifeblood.
How much of the monthly cost of BC pills goes to physicians and other middlemen and how much just to manufacture the pills?
I think the key point is here:
It doesn’t hinge on it, that’s just who was studied. (It still may hinge on it, but that conclusion can’t be drawn from the study.)
I did a quick and dirty calculation of the cost of birth control compared to the costs of a pregnacy and birth. A simple uncomplicated birth would cost about 28 to 33 times as much as contraception for a year. That ignores medical care after birth for the child.
A complicated pregnacy with no complications for the baby would cost about twice as much as a simple one, or cover contraception for 56 to 66 women for a year.
Cost in 2007 of an average uncomplicated pregnancy and delivery was $10,000
$1,962 pre-natal
$6,520 hospital
$1,500 doctor delivery fee
http://womens-health-advice.com/prenatal/care-costs.html#prenatal
That’s probably over $12,000 today and it does not include well baby pediatrician care which is probably close to $1,000 the first six months.
Birth control pills run around $360 / year. An IUD is cheaper after insersion, in fact close to zero.
So one simple and “easy” pregnancy with no aftercare costs about 28 to 33 person-years of birth control pills. (Probably an average of over 50 per year if IUDs are mixed in.)
A complicated C-section pregnancy would run double that $12K estimate, at least.
If original insurance rates are calculated assuming no covered women use birth control, I would be very safe to assume there would be healthy rebates given that a large number of the women would actually have used birth control instead of given birth.
I find it highly revealing that contraception coverage for women took over 30 years to come about while coverage for viagra came about almost instantly.
But that’s obviously not the case. Even without coverage, most of the women who want to use birth control do so.
What does it reveal? They’re both pills linked to sex of a particular gender but that’s not what makes them controversial or covered by insurance.
Viagra treats a medical ailment, a symptom of the body going wrong and not functioning as it used to.
BC pills are a way for people to have less children and to reduce the risks of sex so as to have more of it.
The proper analogy to BC pills is not Viagra but condoms, which aren’t covered by insurance.
And wouldn’t men also pay for Viagra if not covered?
Womens issue - 35 years
Mens issue - 1 year
Obvious who was in charge of things.
You missed my point which was that each pregnancy avoided would pay for 30, or so women to have birth control. And for at least some women, a dollar a day is a huge benefit. For Mitt Romney $480,000 is “not much”, but the cost of birth control for women in low wage jobs is probably just behind their housing, food, and, perhaps, transportation costs. As a young married it was #3 for my wife and I as we walked everywhere, even when it was 25 below zero F.
“And wouldn’t men also pay for Viagra if not covered?”
I said that most women would pay for BC pills without coverage in response to your assumption that “If original insurance rates are calculated assuming no covered women use birth control” which is quite counterfactual.
“Womens issue - 35 years
Mens issue - 1 year”
The fact that one is a women’s expense and the other a men’s expense isn’t enough to show sexism or bias. In terms of the purpose they serve, BC pills are like condoms, not like Viagra.
“You missed my point which was that each pregnancy avoided would pay for 30, or so women to have birth control.”
Which doesn’t mean it’s worthwhile because the policy could require paying for more than 30 or so women to have BC pills for every pregnancy it prevents.
This is another one of those ill-conceived schemes to help poor people like price controls or subsidies for utilities or food.
Condoms are an over the counter item, health insurance typically does not pay for that type of item.
Heck many plans don’t pay for disposables, I learned that the hard way after being burned and paying $75 per quart of sterile saline to clean my wounds, the telfa pads were spendy too.
It was so expensive I resorted to using eye wash to clean the burns.
They will however pay for vasectomy and if there is ever a practical male pill they will most likely pay for that also.
I’m not sure of the relevance. If BC pills should be covered because they pay for themselves, it doesn’t matter if they’re OTC or RX.
Vasectomy: That’s not analogous to BC pills. What’s analogous to vasectomy isn’t BC pills but tubal ligation. Is that not covered by insurance?
Male pill: And they shouldn’t pay for it.
Not directed at you but more generally:
This policy means that poor women who don’t use BC pills will be subsidizing richer women who do.
I was talking of the false relation of the condoms not being covered in relation to prescription medications being covered.
The only reason the pill is an issue is that it deals with the naughty bits, and for some religious people that is the limits of their concerns on “morality”.
Am I correct that you wouldn’t want a male pill to be covered due to your moral objections too?
The reason why poor women tend to NOT use birth control is
a) Some cannot afford it and do not have insurance
b) Due to religious dogma many women do not have good access to reproductive heath education. Good access to reproductive health services reduces unwanted pregnancy and abortion.
As stated before in this thread and ignored by you. For a set of people who belong to a pool of insured persons the cost of providing prescription birth control is less than the cost of the unwanted pregnancy.
Any mental gymnastics you want to play outside of that statement are a strawman against my argument.
I didn’t even mention the societal cost of unplanned pregnancy but here ya go.
http://www.guttmacher.org/pubs/USTPtrends08.pdf
http://www.guttmacher.org/media/nr/2011/05/19/index.html
So if you want to go on that level
$11,100,000,000 in taxpayer costs / 61,994,825 women of child bearing age = $179.04 per woman of child bearing age
The Generic pills cost NGO’s ~$15 a month, so the cost to the country in tax dollars today is quite similar to the costs it would take to give the pills away to every woman of child bearing age.
I am not suggesting it, just offering the numbers up.
Population number pulled from here.
http://www.cdph.ca.gov/data/statistics/Documents/VSC-2007-0115.pdf
Add in the insurance costs and I am sure number wise it would be cheaper to give it away for free.
Of course if your dogma says it is better for women and children to suffer because they ‘sinned’ this will mean nothing to you.
I would ask, are you pro-life? if so does your moral objection to unmarried sex trump the desire to reduce the number of abortions?
I myself am pro-choice but would gladly welcome anything that reduced the number of abortions and unwanted children.
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“Am I correct that you wouldn’t want a male pill to be covered due to your moral objections too?”
I have no moral objection to contraceptive pills, female or male. I’d be quite glad to use them myself if they existed (although I wouldn’t want others to pay for it). I’m an agnostic with a significant amount of contempt for most religions. I think abstinence-only education is irresponsible and emblematic of the sort of thing that’s wrong with the GOP.
“Of course if your dogma says it is better for women and children to suffer because they ‘sinned’ this will mean nothing to you.”
The notion of sin is the sort of nonsense humanity should rid itself of.
“I would ask, are you pro-life”
I dislike the name “prof-life”, it makes it sound like their opponents are anti-life. I am very much in favor of abortion being legal.
“As stated before in this thread and ignored by you. For a set of people who belong to a pool of insured persons the cost of providing prescription birth control is less than the cost of the unwanted pregnancy.”
In post 123 I said “there are certainly cases covered by that policy where the marginal gain will be above marginal cost.”
“I was talking of the false relation of the condoms not being covered in relation to prescription medications being covered.”
The topic of this thread is that BC pills should be covered because the coverage would pay for itself. If this is a sufficient reason why they should be covered, condoms should as well.
Thank you for clarifying your position.
Condoms are prescription medication?
I am still confused why if a prescription medication plan covers an item that accomplishes a particular goal it would also be required to cover non prescription medication solutions.
If I have elevated lipids should they pay for my running shoes because they would pay for my Statins?
I have an acquaintance who was high up in a major UK insurer. According to what he told me some years ago, neither of these statements is correct, at least for the UK. Apparently, UK insurance companies make their money from the income earned on investing the premiums. They take in less than their expected payout and hope to gain the rest from their investments.
Sounds really risky. Thanks, Quartz.
As I understand it, the RCC doesn’t want them to have birth control under any circumstance, and so it is the church that teaches Birth control pill or any method except theirs is sinful, and they are paying for peoples sins. which in my thinking is no more the Church paying for abortions than if they paid for it out of their own pockets and insuracnce is part of the employee’s wages.
To me that is not a good, or true thing, bcause they (in a way) are forceing their beliefs on others who don’t think the same way, and feel it is more moral to not have children they can’t care for or want.Hence they seek abortions, so in a way the church is opening them to decide to have an abortion:there were Catholics who had abortions years ago. Of course the church didn’t know if they were paying for it because they were not providing insurance.
That doesn’t make any sense. Where do the “investments” come from if they take in less than their expected payout?