Free Sex?

The introduction of the male anti-impotence drug Viagra seems to have brought the issue of insurance coverage for male and female drugs to the forefront of the public policy discussion. Certain groups cry foul over proposed insurance coverage of Viagra. Planned Parenthood, NOW, and The Center For Reproductive Law and Policy are some of the groups who maintain that insurance companies discriminate against women by offering to cover costs for Viagra but not for contraceptives.

Maine Senator Olympia Snowe has sponsored the Equity in Prescription Insurance and Contraceptive Coverage Act, which would require insurance companies to cover prescription birth control. The Center for Reproductive Law and Policy supports this bill on the basis that the status quo discriminates against women by denying basic health care coverage to them.

It is reported that there are 3.6 million unintended pregnancies in the US each year and almost half of these are terminated through abortion. What the data doesn't show is how many of those unintended pregnancies were due to incorrect contraception usage or women who don't bother to use contraception. An important question to ask is whether people would be compelled to take contraception, in a more efficient manner, if it was covered by their health insurance plan?

Arguments that support insurance coverage for contraception include the premise that unwanted pregnancies and abortions would drop because women would use contraception, such as the pill, if it were provided to them through their health insurance plans. Unfortunately this argument is faulty. First, a University of Michigan study showed, that out of 103 women who had electronic measuring devices attached to their birth control pill packages, only 25% of them had a perfect record in terms of taking their pills every day. Nearly half of the group missed two or more days, which according to the directions printed on the pill package could result in pregnancy. To make matter worse only half of this group then used back up protection as directed on the package.

Second, using simple economic theory we can infer that when the price of sex decreases ("free" birth control) then the consumption of sex should increase. If we apply the numbers from the University of Michigan study to the population in general, there is a very real possibility that the number of unintended pregnancies and abortions would increase. There is no evidence that shows if the pills were "free" (i.e. covered by their insurance companies) women would be compelled to take them more responsibly as the above mentioned Michigan study showed.

Also, oral contraceptives do not prevent AIDS or other sexually transmitted diseases. Will "free" pills translate into fewer women using condoms, spermacides, or even abstinence, which could very well translate into an increase in AIDS and other sexually transmitted diseases.

There are a number of insurance companies PacifiCare, Blue Cross Blue Shield, and State Farm Health Insurance, to name a few, who cover contraception at least in part. A company called femScript offers low cost birth control pills, as does Planned Parenthood. There are alternatives to bureaucratic "solutions" and the best part is that the people who use it are primarily the people who pay for it.

Returning to simple economic theory, there are a limited number of dollars to be spent on health care in general, and forcing insurance companies to cover contraceptive costs can translate into cuts in other coverage, rate increases for the consumer, or probably both. Do we really want to see a cutback in medically necessary treatments in order to fund our sex lives? Some consumers may be forced to cancel their coverage because they simply cannot afford another increase in their premiums. Who will be penalized because insurance premiums are increased to support women who, for the most part, can't compel themselves to their pills properly in the first place?