At this point in time I feel mostly bored with politics and political discussions. Who’s running for president again? Just kidding. I am just barely keeping up with the news. I mainly just know what is going on at the Facebook. I assume Facebook will tell me if any major tragedy strikes. Also, if it’s someone’s birthday. I don’t know what the rest of the world is doing, but on the Facebook people are, apparently, still hung up on the birth control issue, i.e. the government mandating that employers pay for insurance that covers contraceptives. Did I say that even-handedly enough? Because I don’t want to make anyone mad before I’m ready.
As to whether or not insurance companies should cover birth control, my opinion is “whatever.” The health care system in this country in 2012 has a lot of problems. I tend to think that this is not the one most deserving of my attention.
I took birth control pills for a few months back in 1997. Was taking them when I got pregnant with my first child, actually. Ha ha, what a funny time to look back on (now). As I recall, my insurance company paid for them. I mean, I had a $10 co-pay, so I assume my insurance company paid for whatever they cost above that. It’s possible that the cost of the pills was $10 even, but that seems unlikely. If my insurance company hadn’t paid for them, I might have been pissed. Because, you know, it’s medical. What is medical insurance for if not to pay for a medical expense? If I have to get a doctor’s prescription before I can buy them, how is that not a medical expense? So yeah, I get the outrage. However, it’s been a lot of years and a lot of dealing with insurance companies, and I’ve faced the facts of life:
1. Insurance companies don’t want to pay for anything. (That much is a duh.)
2. We’ve become dependent on a system of health care where a third party is supposed to pay for most things, which has increased the amount of things we expect to be covered but also the amount of things insurance companies try not to pay for.
3. The more things insurance companies have to pay for, the more expensive insurance gets. Your personal feelings of indignation over what ought to be covered don’t really enter into this equation.
So this is actually a complex problem, the whole health care/insurance thing, and far too complicated for the scope of this blog post–or any blog post of mine. If I wanted to write about the complexities of the health care and insurance industries and how government relates to all of that, I would hopefully not be giving that skill away for free. So pay me some money and I’ll give you my opinion on how we should manage the health care/insurance thing. Meanwhile, whatever.
No, all I want to write about here is the personal irritation I feel about how people have framed this debate, especially as seen on the Facebook, which hosts lots of indignant people with strong opinions who think their logic is unassailable. This isn’t for money or a good grade that I can put on my transcript, so I’ll just make a list of arguments that bug me.
1. Insurance companies pay for Viagra, so why not birth control pills?
On its face this seems outrageous. I mean, why should old guys whose penises have stopped working still get to have sex? It’s called Mother Nature, dude. Survival of the fittest. Deal with it! I mean, stuff like hearts and livers and kidneys and even gall bladders should be expected to work properly, but your penis? Really? You must think a lot of yourself. Newsflash: No one cares if you never have an orgasm again as long as you live! (Except maybe your wife, but then, what is she doing with an impotent jerk like you?)
Actually, there’s a reasonable explanation for why insurance companies would pay for Grampa’s Viagra but not Suzy’s birth control. Note: I only said it’s reasonable, not that you’ll like it. The reason is that Viagra (and other drugs designed to treat erectile dysfunction) helps a man’s body work the way a healthy man’s body works. If a man can’t get or sustain an erection and it isn’t due to some psychological problem, he has a health problem. Not one he’s going to die from, but one that
he may feel he’s going to die from will seriously impact his quality of life. By contrast, birth control pills (and other hormone-based contraceptives) make a woman’s body work in a way that healthy women’s bodies aren’t supposed to work. A healthy woman is supposed to be able to get pregnant. IMPORTANT NOTE: I did not just say that a healthy woman is supposed to get pregnant, only that she is supposed to be able to get pregnant. A woman who can’t get pregnant has a health problem. Not one she’s going to die from, but one that, if she wants children, she’s probably not going to just shrug at and say, “Oh well.”
Viagra treats a health problem. Birth control pills, while perfectly safe (for most women), are not generally associated with treating a health problem. Of course, they can be and often are used to treat health problems. VERY IMPORTANT ASTERISK–more on this in a moment. (Patience, grasshopper.) But getting pregnant is not a health problem. It’s not a disease. Have we forgotten that chapter of feminism? Healthy women who haven’t gone through menopause can get pregnant. Of course they might not want to get pregnant, which is where birth control pills come in, but for the woman who is taking the Pill for contraceptive purposes, she is not attempting to make her body work the way it’s supposed to but attempting to make it not work the way it’s supposed to.
Believe me, mes enfantes, I have no moral or philosophical problem with contraception or people using contraception to their hearts’ content. I’ve used it myself. Religiously. I think it’s the best thing since sliced bread and the internet. Access to birth control is good. Access to indoor plumbing is good, too. Couldn’t live without either one. Can’t imagine why anyone would want to.
Of course, there are non-contraceptive uses of birth-control pills. If you believe the Guttmacher Institute (and you may not, but whatever), the majority of birth-control pill users take them for non-contraceptive purposes, including reducing menstrual cramps and other “side effects” of menstruation (including migraines) and treating endometriosis and even acne. These are all health problems, so in principle, health insurance that purports to cover treatment for endometriosis and chronic pain related to menstruation and, yes, even acne ought to cover birth-control pills. You will get no argument from me there. No, absolutely none.
But–and here I finally reach my point–this line of logic doesn’t lead to arguments about an old man’s Viagra. Why on earth would you bring up Viagra unless you were just really upset that insurance companies enable beyond-their-prime men to have sex while perfectly healthy young women (who deserve to have sex and are a lot more pleasant to think of than impotent men) are not receiving any assistance with enhancing their own sexual experience (by not having to worry about getting pregnant)? The implication is clear: Viagra is only covered because the evil insurance companies care more about letting dirty old men have sex than allowing healthy young women to have sex and not worry about getting pregnant. Well, probably they do, for the reasons I just mentioned above.
But if you want to tout hormone-based contraception as a medical expense, maybe you should keep Grandpa’s sex life out of it. Don’t imply that you’re begrudging him his Viagra. For an effective argument, you might try something like “They cover insulin for diabetics and Prozac for people with depression–why not birth-control pills for women with endometriosis or chronic menses-related pain (or even acne)?” And of course, since there are women whose health and even lives may be threatened by a pregnancy, you could also say, “They pay for my grandpa’s pacemaker, so why not my birth control?” (A bonus to this approach: When Rush Limbaugh accuses you of being a slut who wants the taxpayers to pay for your slutty sex life–which he probably still will–he’ll look even more like a jerk.)
Of course, an insurance company can decide it doesn’t want to pay for birth-control pills to treat endometriosis or any other health problem because insurance companies have the legal right to suck. But as I said before, that’s a separate issue. Not for this blog post (which is discussing annoyance with rhetorical tactics, not outrage at injustices).
2. Covering birth control is cheaper than covering pregnancy and childbirth and health care for the resulting children.
True. But not a good argument for providing everyone with free birth control–because generally speaking, people don’t get pregnant because they lacked access to contraceptives. Unplanned, unwanted pregnancies are usually the result of people a) using contraceptives incorrectly or b) playing Russian Roulette with their fertility because they couldn’t be bothered with using contraception. Don’t let your own prejudices run wild with this last sentence. I’ve known married, middle-class women who engage in “b” with alarming frequency. Fortunately, those women could afford to have more kids, financially and emotionally (although the “emotionally” part was more eventually). If you’re a woman of limited resources, you really have no business with “b.” If you become pregnant, I blame you, not your insurance company or the government. And here I go off on a bit of a tangent–but only a bit, because I can’t tell you how many times I have seen comments like this on the Facebook: “I’d rather pay for birth control than for women getting pregnant to collect more welfare.” First of all, that person is revealing kind of an ugly streak. Second, they don’t seem to understand human nature very well.
I never find myself wishing that my tax dollars had gone to pay for someone’s birth control instead of her full-blown pregnancy and resulting baby because as the wording of “b” makes clear, you can offer someone contraception–even free contraception, contraception that may reside in their very own home a few feet away–but you can’t make them use it all the time. I don’t feel sorry for myself because my tax dollars are going to be spent on this woman and her child; I feel sorry for this woman and her child because she made an unfortunate choice that significantly increased their chances of living in poverty for several years if not the rest of their lives. I assure you my tax bill can handle your poor choices; I’m not sure you can.
So there’s one reason I don’t like that argument. The other reason is that we’re talking about insurance companies (so far), not the government. First of all, most people just don’t seem to get how insurance companies work. Without getting into issues that are beyond my pay grade (i.e. blogging for free), let me break it down for you: The more things (procedures, drugs, etc.) that insurance companies have to pay for, the higher premiums they have to charge (unless they want to go out of business, which most don’t). The more insurance companies cover the cost of these things, the more insulated consumers become from the cost, the higher the cost gets. If insurance companies have to cover all kinds of contraception at no additional cost to the consumer (aside from higher insurance premiums), there will be no incentive for drug companies to lower their prices or to stop them from going up. If the customer doesn’t care what it costs (because she’s not paying for it) and the insurance company can’t refuse to pay for it, why shouldn’t the drug companies charge as much as they want? And don’t think for a minute that they won’t. (Or have we forgotten this chapter of capitalism?) This is especially sucky news for the uninsured, but also sucky news for the insured because (can you guess why? I’ve already mentioned it) they will pay higher premiums.
Second of all, I don’t want to live in a society with the mentality that paying for contraception makes dollars and sense whereas paying for pregnancy and babies should be avoided. Pregnancy and babies are really important to humanity, even if not everyone wants them at every stage of life. I’m not jumping on the bandwagon that says they’re too expensive and insurance companies shouldn’t be such chumps. (If people are allowed to get hysterical and claim that opposing the contraception mandate is a slippery slope to Handmaid’s Tale territory, others of us should be allowed to get hysterical and claim that the mandate is a slippery slope to a world where only rich people are allowed to have children.)
I haven’t even touched on the issue of religious freedom, which is in fact a relevant and important issue, but it seems to be lost in the effort to point out how hypocritical and stupid insurance companies are for not covering birth control. But I don’t have time for that. (Technically, I don’t have time for this, but I’m bored and want to avoid work.)
Here’s my bottom line: Why are we spending time arguing about a government perk that serves already-employed, already-insured people who probably can already afford their birth control? Most forms of contraception are not that expensive. Yes, there are fancy-dancy versions of the Pill for women who for some reason can’t take the cheaper versions, but most forms of contraception serve most women well and are not that expensive. To make birth control pills even less expensive and increase access for those who don’t have insurance, they should be made available over the counter (with pharmacist screenings for safe use), as is already done in several countries. Not only would the increased price awareness among consumers lead to competitive pricing, but women wouldn’t have to pay for the doctor visit necessary for a prescription. Poor, uninsured women win (along with all the other women who would like some birth control pills). (Of course, a woman who needed birth-control pills for non-contraceptive purposes would still need to see a doctor to know that she needed them.) Another plus: Rick Santorum would have to get elected and go full Handmaid’s Tale/Third Reich on us in order for the public to lose access to birth control pills. (That is not nearly as likely a scenario as Facebook would have you believe.)
Well, I could probably go on, but I’m already at 2,425 words and the kids will be home soon. So I guess this concludes this edition of Inflammatory Friday. Next week: Abortion!*