If only we had some commodity that employers could give to their employees in exchange for work and that the employees could then use to purchase whatever they wanted.
Milton Friedman (not exactly a bastion of liberal thinking) once commented that it was ridiculous for employers to have to provide health care. He said to either leave it up to each individual, or have a societal system, but that having employers have to pay was absurd.
Unfortunately, we’re stuck with it.
And the cost of those are pretty reasonable–about $10.
If expensive prescription BC methods were the only methods to prevent contraception, then it would make sense to discuss having them be a mandatory part of the coverage. But when there are many other methods that have a reasonable cost, there’s no pressing need to have it be a mandatory part of the ACA.
And the ACA made that worse. I actually like part of the ACA. The part where consumer protection is added and people can shop the marketplace without regard to pre-existing conditions is nice. I can pick a policy that isn’t tied to an employer and can keep it for as long as I want, much like auto insurance or anything else I buy. If I quit my job or get fired, I don’t need to scramble to make sure that me or the family has new health insurance. (I still think the whole thing is unconstitutional, though. Just because I like the idea doesn’t mean that the feds have the power to do it).
But it giveth and taketh away. There is not that choice for companies with over 50 employees. Also under the guise of “consumer protection” this administration has mandated things like contraception and maternity care, something which as a male, I would certainly like to leave out of my policy. As a person nearly 40 years old with no mental health issues, I would like to be able to leave that off as well.
So, the administration has cemented this bastardized employer provided health care regime which people on the right and left seem to hate, and have loaded up the mandate with social policy.
As far as cost savings, if providing free contraception saved money, the insurance companies would have done so long ago.
Also, pregnancy is not a “disease” that needs insured against. It is a lifestyle choice for a woman of fertile age to decide not to have a baby, and it is an important one. But it should be provided for in a system which delivers it with that idea in mind instead of treating it like a cancer. It’s something that every single woman will need and as such the risk cannot be pooled and is a poor candidate for insurance coverage.
It is also killing a fly with an axe. I don’t think that Warren Buffett’s wife needs no copay birth control. Have the government provide it to people who are too poor to afford it. Wait, we already do that in Medicaid. Where was the problem that this was going to solve?
Well, no, this is more of the rhetoric I mentioned to stir up the base.
You apparently have been successfully stirred up. No doubt next December the other side will also be stirred, with equal justification, or lack of it.
Regards,
Shodan
Well actually this appears to be about co-pays: you’ve already conceded that it’s appropriate to pay for the doctor’s visit (which incidentally the ACA doesn’t necessarily cover completely: I suspect that this is connected with multiple issues being covered during most appointments, but I’m not sure.
I’m including the Doctor’s visit, which your link ignores.
Cite? Seriously, people are just assuming that this is a huge boondoggle, when really it essentially boils down to copays.
My take is: look at the science, rather than the political hyperventilation. One of the cornerstones of the ACA is evidenced based policy, something that tends to freak modern conservatives out. Contraceptive coverage was grounded on a report by the Institutes of Medicine by the National Academy of Sciences. Here is the recommendation. Here is the front page with links to the 2011 report, “Clinical Preventive Services for Women: Closing the Gaps”. Their concern was that with 49% of all pregnancies being unintended, that it made sense to push contraceptive use a little harder: it’s a matter of incentives, something that affects middle classes as well. Unintended pregnancy incidence is lower in other developed countries, so trying out their best practices makes sense.
There may be counterarguments to the opinions expressed by these experts. But they have not been presented in this thread: all we’ve gotten is wild and baseless accusations.
Can you cite the part where they recommend that Employers pay for the insurance that covers this? Because that’s the issue. Hand out contraception on every street corner if you want. No one in this thread has said women shouldn’t be able to get contraception. It’s the choice to force the financing on employers that is being debated.
In what other developed countries are IUDs and the pill free as a default? I did say “as a default”, not “for certain insurance schemes which are on top of whatever is the default”.
For the Canadian province of Ontario anyway (quickest data I could find), this says 10$/month for the pill (http://www.ppottawa.ca/contraception.aspx?id=4) and IUDs are 60-80$ (http://www.ppottawa.ca/contraception.aspx?id=13)
You say that it should be evidence-based. Well, an evidence-based approach would show that making contraceptives free to the user as a default has been shown to save more money than it costs. This report only seems to show that A) a lot of pregnancies are unwanted B) pregnancies and abortions cost a lot C) contraceptives reduce pregnancies.
All of which are true but do no add up to “making contraceptives free to the user will save more money than it costs” which may very well be the case, it’s just too bad that the report fails to provide evidence for it. I confess that I may have missed where it does as I only read the brief, the recommendations and word-searched through the whole thing.
Here’s the thing: Few Americans have issues with contraception, in general. Even Catholics. Quite a few Americans, however, have an issue with certain types of contraception which they believe can result in an abortion. You are asking for trouble when you promote a public policy which makes those people take actions which conflict with those beliefs. Period. Anyone looking for the best way to expand women’s access to contraception should know that placing employers in the middle of the fray ain’t the way to do it.
But that’s the way the American healthcare system works. The whole organization is based on the idea of healthcare as a paternalistic benefit (where the details change from employer to employer and are controlled by the employer); once it starts getting treated as a right and regulated universally, the regulations affect the system that´s already in place. Would you rather get Yet Another Government Agency?
They’re covered by UHC in Spain. That’s not “free” in that it’s paid by our taxes, but it carries 0 out of pocket cost unless you choose to go to a private doctor.
It’s not rhetoric, it’s a statement of plain fact. You can choose to ignore it or deny it, but it does not make it any less true, nor will it be negated by the outcome of the next election.
Which is why the OP is asking the question.
It is not written in stone that it must be this way; it was government that created and government that has reinforced it.
Can you please direct me to any resources explaining how did the US government come up with the notion of “medical insurance linked exclusively to employment”? In those countries with whose UHC systems I’m familiar, some insurance started from worker’s unions (they could be blue collar or professional ones), some as a benefit offered by employers; eventually the government regulated what was already in place.
The idea of the US government being the ones who created the structure seems to go against the general trend.
If goes back to WWII when wages and prices were frozen. Employers had to offer benefits, like HCI, to lure workers. Additionally, for employers, HCI is tax deductible. For individuals, it is not. So the system is rigged to favor employer based HCI, and the ACA has rigged it even more strongly.