Thursday, March 8, 2012

Covering birth control v. ED pills illuminates what health insurance is supposed to do

By Marc Jampole

After I wondered the other day why those against health insurance covering birth control for women make no such objection to coverage of erectile dysfunction pills, several people tweeted me to uncover what they think is a fatal flaw in my argument: ED pills treat a medical condition, whereas birth control does not.

Medical condition versus no medical condition: At the heart of this distinction by those opposed to birth control for women is the idea that health insurance should not cover preventive medicine, such as annual physicals, mammograms, colonoscopies, Pap smears, mole removals, vaccines and dental check-ups. None of these tests or procedures cure anything, only prevent conditions or prevent them from becoming fatal. Imagine how much more suffering there would be in the world if polio and small pox were still running rampant through the world, or if the many early stage and pre-cancerous conditions were not caught.

To say that medical care and health insurance have as their sole goal to cure ailments is just wrong. Medicine and health insurance also prevent ailments.

The birth of a child is a wonderful thing, but only if the child is wanted. Pregnancy is always fraught with risks for both mother and child. Often women have ailments or disabilities that increase those risks to the point that pregnancy would be life-threatening. Those risks multiply for the child in unwanted pregnancies and can continue throughout childhood and beyond. Unwanted pregnancies can also lead to abortions, which, while not usually dangerous if performed under proper medical supervision, are objectionable to many people. To deny that birth control is part of preventive care requires ignoring a slew of data on women’s health issues.
Health insurers and medical professionals are always trying to figure out what and how many preventive tests, procedures and examinations are needed to keep people healthy while minimizing the unnecessary. After what must have been many studies repeatedly analyzed, most agree that covering birth control is worth the cost because it lowers total medical costs and prevents the pain and suffering of many unwanted pregnancies and abortions.

Now the other side will say that there’s another way to prevent pregnancies and unwanted abortion, the “little white aspirin pill between the knees” method, AKA abstinence. They ask, why make society pay for the personal decision to engage in sex? And of course, the same question can be asked about ED pills.

And so those opposed to coverage of birth control pills are left with a dilemma:
  • Loudly oppose coverage of ED pills (since to engage in sex is a matter of personal choice) or admit they have a double standard.


  • Come out against coverage of all preventive medicine.
Somehow I don’t think either will happen.

Republicans have latched onto the “birth control coverage” issue because they think they can use it to make other messages that will resonate with the right-wing. The overt messages have to do with government interference, especially as it involves health care, and the role of religion in the government and society. The subtext, though, entails some old-fashioned and wrong-headed ideas about the role of women in society.