NJ Truthiness Watch — Women’s Health Is Too Expensive

This new bit of tone-deafness and just plain disinformation from the News Journal Editorial page on the possible inclusion of contraception for women as a must cover with no co-pay item (as part of a number of women’s wellness services) inspired this collaborative post from Unstable Isotope, Pandora and me in response.
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Ground Zero of Delaware truthiness printed up an opinion piece today on the recommendation by the International Institute of Medicine that health insurance plans be required to include women’s contraception as a basic part of their services and that contraception be provided with no co-pay. Titled Free birth control comes at a cost, the apparent point of this is to tell people that contraception costs money. And if it is required care and required to have no co-pay,then the entire cost gets covered by insurance.

Yes, people, that seems to be the point.

One of the things to keep in mind as you listen to people have on about this proposal is that it recommends a total of eight services be offered to women as preventive care. From an NPR report on the recommendations:

The study — released a day early — actually calls for eight additional services for women to be added to the list of preventive care patients should be offered with no cost-sharing. The new services include annual “well-woman” visits; screening of pregnant women for gestational diabetes; screening for sexually transmitted diseases, including HIV; more support for breast-feeding mothers; and counseling and screening for possible domestic violence.

Adding in contraception to the services that insurance must cover is part of adding in a wide array of preventative health services for women. All of these services cost money — some of them more expensive than contraception!– and all of them supportive of a woman’s health. So why would the NJ just focus in on contraception?

They note that the number of unwanted (yes, they use the term unwanted. And I’ll remind everyone that an unplanned pregnancy ≠ an unwanted one) pregnancies is soaring in the US. They cite no data, but as the NPR piece notes:

But it’s clearly the recommendation for free contraception that’s getting the headlines, as it probably should, since the Guttmacher Institute estimates that 98 percent of sexually active women will use contraception at some point during their reproductive years, and that cost concerns are frequently cited as a reason for inconsistent use or use of a less then optimal method.

In fact, Guttmacher said in testimony submitted to the IoM earlier this year, “Women citing cost concerns were twice as likely as other women to rely on condoms or less effective methods like withdrawal or periodic abstinence.” […]

“Women with unintended pregnancies are more likely to receive delayed or no prenatal care and to smoke, consume alcohol, be depressed, and experience domestic violence during pregnancy, the panel wrote. “Unintended pregnancy also increases the risk of babies being born preterm or at a low birth weight, both of which raise their chances of health and developmental problems,” it noted.

Contraception is cheap — babies and pregnancies are expensive. Efforts to make more effective contraception available to women will make sure that women have real choices for effective reproductive management. And this is always cheaper than the insurance and societal costs of women giving birth to children they are unprepared for. This counts as one of the places that the ACA is looking to decrease some of our overall costs. We are paying NOW for at risk pregnancies and babies in that soaring number of unplanned pregnancies in already at risk groups of women via insurance and taxes and yet the only thing that the NJ can focus on is the cheapest part of the equation — better access to contraception for all women.

The NJ asks:

Additionally, in arming women against the risks of unwanted pregnancy, do we eliminate the social costs of alienating men from a mutual responsibility?

It is hard to believe that this is a serious question. Because the IoM recommendation is about improving women’s health care, with an eye towards long term cost reduction. Whether or not men are alienated from their own responsibilities *isn’t* a health care question. And I suspect that if the IoM was recommending some counseling and screening for prospective fathers at risk for abdicating their responsibilities, I’t bet that the NJ editorial would wag its finger about the nanny state created by Democrats. Pregnancy and childbirth have health care needs and issues very specific to women and not really dependent upon the responsibility of men for their kids. Certainly there is a societal interest in getting men more interested in their responsibilities here, but this is not a societal or moral issue and not exactly something you can get insurance for. At least not that I know of. If the NJ is trying to advocate for some similar contraception benefit for men, then they should provide some details on what they want covered. Because the most effective methods currently available (outside of a vasectomy) are focused on a *woman* preventing pregnancy.

This is all of a piece of the poisonous war on women that the GOP has been waging over the past year. It takes a special kind of cluelessness to wag your finger about the costs of contraception without even referencing the costs and the consequences of the lack of it. There’s no doubt that the public does want to see a reduction in the number of and the consequences of unwanted children as well as wanted children who aren’t being cared for well. None of those goals are free, and if you can achieve some of those goals by making sure that women have better access to effective contraception, isn’t that a good thing to provide?

UI’s thoughts

One consequence of the war on women is that women’s health care needs are treated as foreign, alien and other. We wouldn’t be arguing about not providing insulin to diabetics, would we? Reproductive health is just part of general health. One thing this ignorant NJ editorial ignores is the importance of family planning in the overall health of a society. It is so important that the Centers for Disease Control ranks family planning in the top 10 public health achievements of the 20th century, along with vaccination.

One of the offensive things about the editorial is the handwaving about condoms. Hey, it’s a compromise! Now I don’t have anything against condoms, but they rely on a partner to control family planning. Many women don’t have reliable partners or have partners that refuse to wear condoms. Having reliable birth control is extremely important for a woman’s health.

Pandora’s thoughts

Cassandra and UI did a great job summing this up, so allow me to point out this part of the editorial:

But in targeting reproductive health as a no-copay freebie, the Obama administration has to set clear barometers limiting the discretion of insurance companies in meeting the required coverage. Expect insurers to react delightfully to the added demand by spreading the costs among all policyholders, regardless of where they are in their reproductive lives, or have a stated preference or need of the benefit.  [emphasis mine]

First, gotta love the use of the word “freebie.” Second, since when do we only pay for health services we will definitely, absolutely, without a doubt need? Bet the writer won’t need a liver transplant, dialysis, or a variety of other treatments either, but… they won’t complain about paying for those treatments – treatments they don’t “have a stated preference or need” for.  Know why?  Should we say it all together?  Because it’s about women having sex, and it’s only about women having sex – and attempting to control that sex with a “pay to play” mentality.

And let’s not forget that many insurance companies cover Viagra… which leads to sex, which could lead to pregnancy.  It boggles the mind.