One of the things I don’t understand about the whole McCain contraception/viagra thing this week is why insurance agencies wouldn’t want to provide coverage for birth control.
Pregnancy costs lots of money and medical care, and that is if there are no complications. Babies cost money. Not only does pregnancy and the ensuing birth cost money, as every insurance policy I have been part of would offer coverage to dependents, doesn’t that mean the insurance company is also on the hook for the next 18 years? Not only do they have to pay for the pregnancy and the birth, but then they also get to eat every single health care cost for a child. Every e-room visit because they wrecked their bike and broke their arm. Every doctor’s visit for strep throat. And so on.
So putting aside all the other issues (should government tell companies what they can cover, etc.), what I don’t understand is why WOULDN’T an insurance company want to provide birth control. From where I am sitting, it looks a helluva lot cheaper. Adding to that, why WOULD they want to provide coverage for viagra, as that will possibly lead to… more expensive babies.
Could someone break this down for me- is this just something in the actuarial modeling that I do not know, and that it is cheaper to deny birth control than it is to take the chance on paying for pregnancies? Or is it really just as simple as there would be a boomer riot if they had to pay for Viagra, but there is no such comparable pressure from people who would use birth control?
*** Update ***
For obvious reasons, if you use the word Viagra in your comment, it will automatically get sent to the spam filter. Just substitute V-pill or whatever and it should be fine.
KyCole
You have to pay extra for pregnancy coverage- my 28 year old daughter didn’t have that until this year, when her husband got a new job with better benefits. They decided to risk it, since she was covered for birth control under the old policy.
KyCole
Also, to cover a child would mean you’d have to go up to the “family plan”, which is MUCH more expensive.
Ugh
I would think that people who are motivated enough to use birth control are going to use it whether or not the insurance company pays, so the insurance company chooses to not pay.
Joy
I absolutely agree. It’s something I’ve been wondering about since I began using birth control. It makes no sense and would seem an economically prudent thing for an insurance company to do. I would imagine it would also help lower abortion rates. It probably harkens to the Dark Ages when it was widely assumed that young women using birth control were naturally sexually promiscuous and they wouldn’t want to be associated with that. I wish women would stand up and demand coverage for birth control.
JR
Because corporate leadership is ideologically aligned with the Right wing. By its very nature.
This is one of those odd facts of our world that lie out in the open, unseen.
Random Asshole
I don’t think there are many people who, after learning that they need to pay for their own birth control, decide to just fuck it and have a baby because it’s cheaper.
jenniebee
What Ugh said.
What I want to know is why insurance companies can get away with not paying for fertility treatments. Not being able to reproduce naturally is a treatable medical condition, and if Viagra is covered ferheavensake, why not Clomid?
just me
I have had about 8 different insurances coverages over my lifetime to date. All of them have covered birth control-pills or devices. I did have one that didn’t cover newborn nursery care though.
In general it isn’t the insurance companies that don’t cover BC but the plan the employers choose, and some of them do not cover. I understand that employers associated with the Catholic church do not cover bc, because the church is opposed.
shirt
Besides people are considered production units of money: every person represents a percentage of their earnings.
KCinDC
What is the likelihood that the person will have the same insurance company in 18 years? There’s a reason insurance companies don’t care about the long term. With the mess that is US health insurance, by the time the long term comes it’s going to be some other company’s problem.
Geek, Esq.
Because the Pope doesn’t think that the v-pill is a mortal sin?
cleek
even though it’s dispensed and controlled like a medicine, it’s really more of a lifestyle modifier than a therapeutic medication, for most women. it’s not (generally) treatment for injury, disease or defect; most women are perfectly healthy without BC.
still, i think it should be covered.
jrg
The only thing I can figure is that impotence is a medical condition, but sex is a recreation. Therefore, the V-pill is covered because it “treats” a condition, but the pill is not covered because it’s purpose is largely recreational (except in those cases where pregnancy must be avoided for medical reasons).
Still, it does not make a lot of sense because 1) even if the Vpill is a treatment, it’s primary purpose is still recreational and 2) If you and your partner are old enough to consistently need the Vpill, your chance of conceiving a healthy child is much lower.
Both should be covered, IMO.
Halteclere
Could it be that women who unexpectedly get pregnant are more likely to not have decent health insurance, and therefore the insurance industry is not as impacted? I only have my family (over 35 cousins and second cousins) to use as an anecdote, but the couple cases of “whoops” babies happened to those who were not in the best financial situation.
Or maybe women who want or need (i.e. hormone regulation) the pill will find a way to get it with or without insurance help, as compared to viagra being more of a “luxury” that the insurance industry wants to subsidize?
Unfortunately I don’t have any wide-ranging data sets to draw upon for an in-depth analysis.
Jake
It basically comes down to the following:
Every sperm is sacred,
every sperm is great,
when a sperm is wasted,
God gets quite irate.
D. Mason
Actually, from some insurance companies perspective it might make sense. At least a fair percentage of the women using birth control are high school or college aged ladies on their parents insurance. The insurance co doesn’t have to pay for those offspring so why should they pay for the birth control? If the insurance company mostly does business with people who already have had all the kids they’re going to have and whos kids are reaching adulthood this is a cost saving measure, sick as it might be.
rob
My wife bought the insurance for our small company, so I don’t remember exactly, BUT, I think it was up to us if we wanted to cover birth control.
Punchy
Shorter, more-to-the-point John: Old white rich geezers have the money and the power, young minority whores wield no power whatsoever.
By the way, if you think that insurance companies “eat” all the costs associated with young kids, you have NOT seen a “family plan” policy premium, nor have you looked at their deductibles. It’s nearly criminal.
calipygian
Shorter McCain:
Birth Control: Bad.
Polygamy: Good
No wonder he wants Rush-Pills covered by insurance. Takes a lot of stamina to satisfy TWO wives!
just me
The insurance co doesn’t have to pay for those offspring so why should they pay for the birth control?
Actually most insurance plans that I have been from will not cover maternity or delivery care for dependent children. If a child is being covered by mom and dad and gets pregnant they usually have to apply for medicaid for maternity coverage.
So future cost of maternity or child care is moot when it comes to why bc is covered or not.
But once again this coverage is a function of the employers choice not the actual insurance company. The insurance that didn’t cover newborn nursery care didn’t cover it because the company my husband worked for opted out of that plan, the insurance company had plan choices that covered it.
The problem isn’t always the insurance company, but the employer.
libarbarian
V-Shizzle.
The Moar You Know
None of you get this? Really?
It’s plain and simple about wielding power and control over women. End of story.
lou
It’s also shocking how expensive the Pill is when not covered. I did have insurance at one time that did not cover it (15 years ago) and it cost me something like $65 a month. I shudder to think how much it would be now without co-pays.
cds
The V-pill has medical uses that aren’t associated with impotence. I know that it can be used for people with pulmonary hypertension, for instance. I would be interested in looking at the insurance plan’s coverage of the medicine. I would be willing to bet that the plan covered the pill for its medical uses and not its recreational issues. However that is a very small point that doesn’t translate well through the media.
D. Mason
Thats what I was saying, sorry if I was unclear. And I see your point about the employer making the choice not the insurance company but the principle is still the same I think. If the company knows that most of the people working there are done having kids, but old enough to have sexually mature daughters covered on the family play then not covering birth control is a cost saver, because any pregnancy resulting from lack of bc is not their problem.
In other words – if the customer or employee base of the company making the decision is unlikely to have a pregnancy regardless of birth control there is no reason to pay for it because it doesn’t matter to the co if the insureds dependent gets knocked up.
Fwiffo
Actually, and this is just a guess, but it might not make financial sense to reduce the costs of covering a person. Let me explain…
An insurance company can increase its profits by selling its policies to more people, or by increasing the amount of money it makes per person. In many places (or all, I don’t know insurance law), there are restrictions on how much profit insurance companies can make on a policy. A minimum percentage of premiums needs to go to actual coverage, and certain maximums are placed on how much can go to administrative costs, or to profit.
For example, let’s pretend that some state limits the profit margins on insurance policies to 20% of the total premiums. If the cost of covering a person goes up (say, because they deny coverage for birth control, increasing the number of pregnancies), then the cost of the policy goes up, and their 20% cut becomes a larger dollar value.
cleek
why the fuck would an employer give two shits about wielding reproductive control over the women it employs ?
Teethwriter
Simple answer. They want women to have children, and are willing to pay the cost for the kid, because eventually…that kid grows up to get health insurance so the company can eventually screw them out of their money and the wheels on the bus go round and round.
Also this explains why they cover the V-pill–more kids.
Later on I’ll be solving that middle east problem.
ThymeZone
From this link.
Anecdotally, in my situation, all female family members in two large employer organizations, who have Cigna health insurance, have rather liberal maternity benefits available.
The two relevant employers involved here locally have an employee base of over 20k people, so these are large plans.
For what it’s worth.
bliprob
It’s simple — on most plans you’re not covered for pregnancy, unless you opt for the extra coverage. If you get pregnant without the additional coverage, you pay the entire cost of the pregnancy out of pocket.
For us the pregnancy option cost an additional $2k per year (on top of our existing $1400k per month) and you still have to pay for various things — i.e. we got a $250 bill from the hospital for 4 Ibuprofen pills.
I think we figured the out-of-pocket costs would have been roughly $5k, so if you’re planning on getting pregnant (or bad at planning these things) it’s worth it.
Anne Elk (Miss)
KCinDC has it right:
The truth of this has become abundantly clear to me over my past 8 years of employment in a psychiatrist’s office. Most private insurance plans today, even the ones with good coverage, limit psychiatric outpatient visits to something in the neighborhood of 30 visits per year and/or 100 visits for the life of the plan. Hey, that’s some great long-term thinking there! If you’re not better after 30 visits, I guess you can just go to the HOSPITAL inpatient unit, because that’s a whole lot cheaper for your insurance to cover, right? And if you have a long-term, chronic illness (say, bipolar disorder or recurrent severe depression) and you max out your 100 visits in 3 years? Well, no more doctor visits for you – but you could overdose or cut your wrists and get your insurance to cover your inpatient stay then. (Assuming you haven’t maxed out THOSE benefits). Maybe then you can get disability and become the state’s problem, instead of the insurance company’s. The goal is not to promote health or keep people healthy. The goal is not to keep people out of the hospital. The goal is to make the maximum amount of profit while providing the minimum amount of “care.”
It doesn’t matter that covering contraception might reduce future expenses. What matters are the expenses they have to cover NOW. And they’ll find any excuse they can to avoid paying them (such as the previously mentioned “doesn’t treat an illness” clause), even if their excuses contradict each other.
Anyone else remember the Monty Python sketch with the “Never Pay Policy?” Welcome to American health care, 21st century style.
Jim Pharo
Punchy wins!
For those of you who think insurance companies are far too rational for this to be true, you just need to live another 10 or 20 years to realize how naive you are.
Shinobi
The Birth Control Pill CAN be a treatment for medical issues including severe PMD, Endomytriosis and PCOS. There are other medical reasons to use it for women who have issues related to their menstrual cycle as well. (Which is a lot of women.) The assumption that it is only used to prevent pregnancy is false.
I also find it annoying that even though my doc writes a scrip for 6 months worth, I can only fill a month at a time. I mean I get why, who’d live with 20 bucks when you could get 120 bucks. But it’s SO inconvenient. In college they would fill an entire year for 10 bucks a pack. (No longer the case now that colleges do not get discounts on the pill, I’m sure.)
Genine
Well, birth control is a feminist issue. Its true that the V-Pill can treat medical conditions, it is mostly used for reproductive health. The same can be said of the pill. Many women have to take it for hormone regulation for medical purposes other than birth control. It is a very unfair system, which can be argued any way you want, it depends on how you look at it. But, for some, it comes down to regulating woman’s bodies.
But, for me, the main issue is if you cover the V-pill you should cover BC. My insurance companies have always covered BC. But, obviously, that’s not the case for all.
Napleon
Which is why in the Clinton healthcare fiasco you had companies like GM and Ford, that by any objective economic measure should have been the biggest chearleaders for the proposal, do nothing or actively work against it.
Incertus
Problem with that is that there are lots of women who take birth control for reasons unrelated to sexual activity. My sister, for example, went on the pill when she was 13 because she had agonizing periods, and the pill mollified them. There are plenty of other reasons women take them, which is why not only is this issue an important one for them, but also why allowing pharmacists to impose their consciences on people by refusing to fill prescriptions for reasons other than a dangerous contraindication is a really bad idea.
Tsulagi
And that is just the START with those little money pits.
David Hunt
I don’t have kids, so I’ll simply except that your kids are not entirely a free rider on your health insurance, but that they have to be included in some sort of “family” rate. i.e they insurance company makes money off of them.
Viewing it from a demographics point (and insurance companies practically invented actuarial tables), a population that is made up of more and younger people is greatly to their advantage. Yes kids are expensive, but that is because they’re not income producers. Young people are more generally healthy and the more of them that exist in the general population, the better it is for insurance companies. Pregnancy and babies might be expensive to cover, but they produce more potential customers and lower the median age of the population, which is all gold to insurance companies.
However, I don’t really think that that cold math has anything to do with the problems anyone has with getting coverage for birth control. I think that any such problems are simply an aspect of the mentality of covering as little as possible, and to always be looking for any excuse to reduce the coverage on their customer base. Any success in denying coverage sets a precedent and gives them a new base to stand on as they look for something else that they can deny paying for.
Bill H
It’s economics for the drug companies who are closely allied with the insurance companies.
In birth control is not paid for by insurance people will still use it and the drug companies will still sell it and make money. Whether or not insurance pays will make very little difference in how much of it the drug companies sell.
If The V pill is not covered very few people will use it and the drug compaines will sell very little of it and make less money. So insurance covers it to increase the amount of it which is sold so the drug companies can make more money.
South of I-10
My insurance plan does not cover birth control, but will pay for tubal ligation. I have a $2800 deductible, so it wouldn’t really matter if it did cover birth control. The only year I hit my deductible was when I was pregnant.
Laura W
20 years ago, for my 30th bday, I treated myself to a tubal ligation. Or rather, my insurance plan did. FIVE DOLLARS for voluntary sterilization! I’ve sold health ins. a few times in my life and I don’t recall every seeing such a liberal benefit again. For someone like me – fertile as a bunny and childless by choice with no effective birth control available – it was a dream come true.
jnfr
If men could get pregnant, abortion would be a sacrament.
rasscot
Can you explain why insurance companies will not pay for smoking cessation medications? If someone needs help to quit they are left to foot the bill themselves. Makes no sense for them to rather pay for cancer treatments etc. later.
just me
I don’t have kids, so I’ll simply except that your kids are not entirely a free rider on your health insurance, but that they have to be included in some sort of “family” rate. i.e they insurance company makes money off of them.
The family rate is cost prohibitive in some cases.
My employer covers my insurance at $16 a pay period-$32 a month.
If I add my husband I pay $587 a pay period.
If I added my kids it would be $1,100 pay period.
I do not get paid enough to put my children on my plan. I would get about $20 a pay period if I added my husband.
Needless to say he gets insurance through his employer and while the family plan isn’t cheap, it is far more affordable than mine.
That said-after the initial birth and first year expenses, medically kids are relatively cheap. Most kids do not have chronic illnesses that require lots of doctor’s visits and medications. Most of them go to the doctor less than 2 or 3 times a year for minor ailments that at worst require a cheap and affordable antibiotic (amoxicillan is less than $10 out of pocket).
I have four kids-other than a yearly physical there are maybe 4-6 doctors visits between the four of them over the course of the year for illness. None of them have required hospitalization, and only two have had broken bones.
I think insurance companies know kids are a great risk pool-they collect a lot of money from the employer/employee but don’t pay out nearly as much as they take in.
southpaw
I think Julian Sanchez put the case for not covering birth control fairly cogently:
In fairness, though, I don’t think this is what motivated congress to ban coverage.
Anne Elk (Miss)
As stated above, in the long term, you’ll be somebody else’s problem. By the time you actually develop smoking-related illnesses that require treatment, you’ll probably have gone through 2 or 3 different insurance providers. If Blue Cross covers your smoking cessation this year and next year your employer switches your coverage to United HealthCare, how does that benefit Blue Cross?
As an aside, the smoking cessation medication Zyban is the same chemical substance as the antidepressant Wellbutrin (bupropion). Guess how many times our psychiatric office is contacted every week with faxes from pharmacy benefit plans asking “Is this medication being prescribed for smoking cessation?” Can’t have people doing an end-run around their denial of coverage!!
David Hunt
just me @10:53
Thanx for the info. The cost breakdown was worse than I expected, but not really surprising. The stuff about kids being relatively inexpensive in terms of health-care was something I was trying to get across. I appreciate your comment.
D. Mason
What does this ignorant ass statement have to do with this topic?
David Hunt
I’m going to treat that as an honest question. Although the statement was delivered with some of the snarky wit that graces this site, it’s an obvious allusion to the idea that men are almost entirely the ones making decisions about how much control women have over their reproduction. And there is an obvious segue from insurance companies covering birth control to whether they’ll cover abortions and the availability of abortions in general. Which leads to the statement that if the people who, for the most part, have the power to set such policies (mostly men) had to actually suffer the consequences of childbearing and childrearing, policy regarding reproductive rights would tend to be far more liberal. After that, the statement was framed and a sarcastic manner for humor.
Or perhaps you actually took that abortion as sacrament statement at face value?
Davebo
I can think of several reasons. The person most likely won’t still be covered by the same insurer when the cancer strikes.
Or more importantly, it’s cheaper to treat someone for 5 months of lung cancer followed by death than to ensure all the every day afflictions they’ll suffer living 20 years longer.
Bubblegum Tate
My friend’s girlfriend just finished doing set design on a commercial for the other dick-hardener pill (the one that starts with a C). During that time, we ended up giving her the nickname Boner Extender, even making up a snazzy superhero-style theme song to go with it. Now that the commercial is done, I think the Boner Extender nickname can be applied more widely. As an alternative to “V-pill,” for example.
Michael Brown
You are quite correct about Carly and HP. Talk to any HP stockholder or employee. She’s about as popular with them as Bush is with the rest of the world.
Which makes perfect sense in the McCainiverse, of course.
jake
I think you answered your own question.
ThymeZone
Yes, he was taking the theological view. Heh.
Around here, things are taken — or not taken — at face value according to which view fits the purpose of the responder. Not the purpose of the author.
Please keep that in mind for future reference.
HyperIon
Viagra is just a wholly predictable regular expense for most old guys who want to have sex.
Duros Hussein 62
Therefore, the V-pill is covered because it “treats” a condition, but the pill is not covered because it’s purpose is largely recreational
Whoa, pregnancy isn’t a medical condition now?
Dr.BDH
Julian Sanchez just won the big dick award for that “explanation.”
Wholesale oral contraceptives are cheap — pennies per month. My HMO used to bargain for them, so I know.
Many of the comments above are correct — religious attitudes, conservative attitudes, cost concerns and sexism all play a role in influencing employers’ and insurers’ decision to cover contraceptives. But cost is the least of these, in my opinion.
Viagra, retail, is $10 a pill, which we know from Elizabeth Dole’s comment, when Bob lost his spokesman position: “Hell, Bob, we can afford ten dollars a month.”
Blue Raven
If men could get pregnant, they’d be the women and the current female gender would run things and make the decisions. I am a feminist of longstanding and have found this statement to be one of the most pathetic attempts at driving home the necessity of safe&legal for quite some time.
brat
Here’s another reason to pay for birth control: It helps alleviate major gynecological funkiness if you have fibroid tumors, which can shoot your cycle to hell and think you’re hemoraghing when you have your period. Using BC can ward off some hysterectomies.
So, while I’m a card carrying lesbian, I’ve been on BC for years because they mitigate the “joy” of fibroid tumors.
McCain is shockingly ignorant of women’s health. Figures, he’s a old-time Navy pilot (= compulsive ass-grabber, see Tailhook).
liberal
KinDC wrote,
This is exactly the problem.
And it’s why the healthcare market is a disaster. Not just health insurance, but the provision of healthcare itself: doctors have no economic incentive to provide care leading to optimum long-term health outcomes. Nor do insurance companies have any incentive to force the doctors to do so. And most health care “consumers” wouldn’t understand the principle of evidence-based medicine if it slapped them in the face.
liberal
cleek wrote,
I think that’s false. Many women take the pill because of problems with their periods (see other comments above also).
liberal
I think the argument for covering the pill for women is much stronger than that for V, at least V as prescribed for men who are old enough that impotence is simply a side effect of old age.
If some 80 year old guy wants to get his rocks off, that’s fine, but honestly I don’t see why I should be paying for it.
b-psycho
Heh…”the V-pill” makes it sound like it’s a product for women.
Yeah, I’m that immature.
Yawgmoth
See, sex in the manner of one’s choosing is a human right for men, but it is a luxury for women. Since we aren’t actual humans.
Notorious P.A.T.
That’s how capitalism works. I wish more people would understand that.
Notorious P.A.T.
I think the intention was “if men could get pregnant also“.
Xenos
Too busy being madonnas or whores to need actual agency. Madonnas don’t need birth control, whores don’t deserve it.
John Cole
I think A-Rod and Madonna can afford a rubber. Why should we have to pay for them to get it on?
Nora Carrington
The long quotation from the EEOC Policy Decision and Guttmacher are the only replies that hold partial answers to your question. There are a few other factors to throw into the mix. I know it’s hard to believe for the “kids,” but information concerning, advertising for, open discussion of, contraception was *illegal* in the United States until the Griswald, which was 43 years ago. That’s not so long, grasshoppers. Most companies didn’t cover it until very recently because most companies had never covered it because prescription contraception is a relatively recent phenomenon. And once prescription contraception did become widely available, it wasn’t covered because there was no one in a position to demand it be covered. Planned Parenthood of Western Washington brought a lawsuit in Washington State arguing that failure to provide coverage for contraception in an otherwise comprehensive employer-provided plan was a violation of Title VII as amended by the Pregnancy Discrimination Act. That case was won in Washington State. A similar lawsuit was filed against Union Pacific Railroad, and was also won, in federal district court in Nebraska. Union Pacific appealed the verdict and the Eighth Circuit Court of Appeals reversed, with a two judge majority arguing, in part, that because contraception is “gender-neutral” [never mind that there are no contraceptives for men that are available only with a prescription], failure to cover it is not sex discrimination. As of today, that is the highest court ruling on the subject.
A. Hidell
I am actually evil enough to work for a large insurance company. (Although not evil enough to work for a private for profit insurer.) Most major employers pay for birth control and Viagra. In the cases where the employer group doesn’t it’s because the ownership of the company has a bugaboo about contraception. Since the majority of CFOs (who have final say about the benefit packages their company decides on) are older men, they tend to favor benefit packages that cover Viagra. Now the small employers and individual markets are different animals altogether. They tend to pass the cost of pharmaceuticals onto the policy holder a bit more. FWIW.
Blue Raven
Then my uterus has no excuse for my being on round two with the little bastards. Sucker comes out as soon as I can afford the six weeks of downtime on partial pay.
littlebird
Yes, but those problems are icky and your HMO would rather not think about them. ED and the V-pill, on the other hand, have co-opted Viva Las Vegas.