Thoughts on the Contraception Debate
1. It is insane that "insurance" covers routine birth control in the first place. It makes as much sense as your home insurance covering air filter replacements
2. This is what one should expect when the government engages in coercion to force everyone to a single standard. We have seen arguments like this for decades in public schools over what should and should not be taught.
3. Expect a lot more of this -- the benefits you will be forced to pay for in your health insurance will increasingly be determined by the political power of lobbying groups, as interest groups fight to have their members subsidized by everyone else and businesses work to get their product or procedure on the coverage list. Economic and medical rationality will have nothing to do with what's actually covered. And you can be damn sure that your personal preferences will be considered irrelevant.
morganovich:
i completely agree with you, especially on trying to shoehorn "one size fits all".
however, one thought: it might be quite rational for insurers to cover contraception. pre and post natal care, pediatrics, birth etc cost A TON. birth control pills are cheap. if for $10 a month, i can avoid the cost of your pregnancy, that might well be a very attractive proposition for an insurer on a pure cost/benefit basis.
February 13, 2012, 8:52 amThomas Molitor:
For a rich reductio ad absurdum take on the same issue see Peter Schiff vlog here:
http://www.youtube.com/schiffreport
February 13, 2012, 8:54 amHasdrubal:
Morganovich:
If the pill is only around $10 a month, I can't help but imagine that the number of people who would use it but can't afford it is trivial, while the numbers of people who would use it regardless of whether insurance covers it (or who wouldn't use it) are tremendous. The opportunity costs of getting and using a BC prescription far outweigh the purely monetary costs, I seriously doubt that price is the driving factor in very many peoples' decisions whether or not to use the pill.
February 13, 2012, 9:12 amMark2:
@Hasdrubal
Not only is most birth control fairly cheap, but the whole excuse for the government to give money to planned parenthood in the first place is to allow women who can not afford it, access to free birth control.
Even abortion is only $300 - $600, if not subsidized, just a bit more than a year's supply of pills.
February 13, 2012, 9:48 amMark:
Insurance should be designed to cover extraordinary cost, not as a 3rd party payment system.
Each individual should have a choice. Do I want a policy that covers brith control or not? If yes, then that is the policy for you. If not, then choose a policy that does not cover it.
Almost everyone should be on a high deductible, individual health insurance plan.
THe only people who shoudl not be on such plans are people with chronic diseases like asthma or diabetes, or preexisting conditions. These people cannot be covered by insurance pools and we need to find mechanisms to provide them insurance (for non-prexisting conditions) and to help subsidize their chronic conditions, if necessary.
February 13, 2012, 10:20 amHasdrubal:
Should have done a literature review before I posted. Marginal Revolution has a piece on the price elasticity of birth control (among college women.)
http://marginalrevolution.com/marginalrevolution/2012/02/the-price-elasticity-of-contraception.html
February 13, 2012, 10:33 amaeronathan:
The idea that being a normal, healthy, fertile female is a condition that REQUIRES treatment covered by insurance in the same line as cancer or pneumonia is more than a little disturbing to me. Short circuiting fertility is an elective choice and one that doesn't even need birth control....
February 13, 2012, 12:53 pmlukas:
Well, if the insurer is going to cover pregnancy and birth (which can be very expensive), it only makes sense for them give out anti-baby pills for free. In fact, I understand that most insurers did just this, most of the exceptions being related in some way or other to popery.
IOW: HHS chose this battle. They wanted to thumb their noses at Catholicism. Politically, that's incredibly stupid.
February 13, 2012, 1:35 pmjoe:
I agree. Insurance should cover unforseen (and unexpected) events. However, if we're going to cover quality of life drugs for male sexuality (viagra) we should do the same for women. And given the history of it all, I'd like to see them eliminated from the coverage plan at the same time.
February 13, 2012, 7:13 pmJohn Cunningham:
My view is that if you cannot afford a couple of bucks for a package of condoms, or $10/month for BC pills at Walmart, you should not be fucking.
February 13, 2012, 9:55 pmDan:
Health benefits have been politicized for years. Obamacare didn't write the book ,but it is producing the movie.
n October 1994, Lane Bougie of Minnesota found herself in a fix similar to Nelene Fox's. A bone marrow transplant had been recommended for her breast cancer, but the best that Blue Cross and Blue Shield would do was direct her to a clinical trial at the University of Minnesota. There, even if accepted as a patient, she would have had a 50-50 chance of getting ABMT, since half the participants receive conventional therapy.
"You didn't buy a lottery ticket--you bought an insurance policy," Bougie's lawyer, Mike Hatch, a former state insurance commissioner, told her. He sued the state Blues plan and the Gillette Co. (Bougie's employer of 25 years), claiming that they discriminated against women by withholding a treatment that primarily affects them. The filing got major news coverage in Minneapolis.
In September 1994, the U.S. Office of Personnel Management ordered the 350 health plans that cover 9 million federal employees and dependents to start paying for ABMT--without raising premiums--or risk losing the government's business. A month later, The Wall Street Journal chalked up the OPM decision to political pressure. It noted that the agency previously supported ABMT only in randomized clinical trials. But 53 members of Congress, along with various women's groups, had urged OPM to change its policy. Damaging congressional testimony came from an IRS employee who'd been refused ABMT by three university hospitals because her insurer wouldn't cover it. When she finally got the treatment, she learned that the ABMTs of two other women in the same hospital at the same time had been covered, one of them by Medicaid.
Here's the kicker:
nterestingly, during this period, ECRI--an independent, non-profit technology-assessment firm based in Plymouth Meeting, Pa.--announced that it had completed an intensive review of the published research on ABMT. For the typical woman with advanced breast cancer, ECRI concluded, the procedure was worthless and apt to hasten her death.
A procedure that cost a lot of money and didn't help was paid for by insurance plans under a variety of guns.
February 14, 2012, 3:43 pmCraig:
Mark, agreed on the HDHPs. To get that ball rolling, I think states and the federal government should make them the only options for government employees.
February 15, 2012, 6:16 pmPogue:
I find it hilarious that a bunch of men are slut-shaming the half of the species they fuck for not affording "$10/month" for birth control. Most co-pays for the pill run from $40-$100/month, and more if you are not covered. Every $1 devoted by the government for family planning saves you, the taxpayers, $3.43 in future Medicaid costs for poor children/moms. So STFU or get a vasectomy.
February 15, 2012, 7:14 pmTim Briggs:
Most people don't understand the purpose of insurance in the first place. It's to cover the big hit, not every miscellaneous expense that may happen. Maybe we have been conditioned by bumper to bumper warranties on a new car, but this is not insurance. It's a warranty and part of the purchase price.
There are different types of insurance, and the main differentiator is the risk pool. If I buy fire insurance on my house, chances are I will never have a fire and never make a claim. The risk pool is large, risks are low, and so are the premiums.
Health insurance is vastly different. While the risk pool is large, the risks are likely to happen especially for older folks. The premiums will be expensive. So to partially mitigate these higher premiums, we insist to force low risk people (young people) to overpay for health insurance.
So in this case we are transferring wealth from young people to old people, even if the young people have no money and the old people have alot.
And then we have personal preference. Smart guys like me want to cover the big hit only, and this assumes that I can cover the small stuff. Why pay for something that I may not need. This option should be there for everybody, both young and old. Seeing as I am 66 years old, I don't really care about having more babies or preventing them (I cut the tubes years ago). Of course Medicare will inform me about what I need.
This is not a function of government. It's only because we have Medicare and Medicaid that government feels they can mandate health care for everybody. One government program breeds more government programs.
Enough said for now.
February 16, 2012, 1:46 pmme:
Absolutely correct. There are some problems with this market though - access to medication is restricted (ie a lot of useful medication cannot be bought over the counter but only based on access control through doctors and pharmacies, artifically inflating cost). The line between who pays for consequences of lack of medication in this case are particularly blurry.
It's another case study in why completely deregulating this market and removing barriers to entry would be a great idea.
February 17, 2012, 3:57 pm