Should Birth Control Be Insured?

By John Stang

Libertarian blogger Julian Sanchez writes about the recent requirement for insurance companies to start covering birth control pills for women.  While he is not against birth control, he does have some philosophical disagreements with the idea of insurance companies covering the pill:

With limited exceptions—I get that birth control can also be a treatment for certain medical conditions—it seems like birth control is just a predictable cost, not a risk to insure against. It’s like food: You might want to subsidize it for the badly off, but you don’t buy “food insurance,” because there’s nothing to “insure.” You just know you’re going to need food, and so everyone who isn’t poor just buys their own; there’s no good reason to pool the expense.

Actually, it makes less sense even than that, because while everyone needs food, people need birth control only insofar as they’re involved in a sexual relationship (and don’t want children), which (one hopes) is substantially under each policy holder’s control. If that meant everyone in the pool, then requiring coverage would make no difference to anyone, since the exact same cost would just be shifted to the premium. The only reason it makes a difference to anyone is that some people who are having sex get to shift part of their cost to people who aren’t. And that seems a little like salt in the wound: Isn’t it bad enough to not be getting laid regularly without having to pay for the people who are?

If we think it’s of public value to make sure that low income folks have access to contraception when they want it, great, I get that. But it seems like the solution is to just publicly provide it—whether directly or through some sort of voucher. Achieving that goal through the private insurance system just seems bizarre. If, on the other hand, the goal is just to give a free goodie to people who can very well afford it at the expense of those who don’t want or need it… well, that’s just not a particularly worthy goal, is it?

Fair enough.  He argues that insurance should be a tool to cover a necessary cost and to find the line of where we, as a society, decide that necessary cost line should be drawn.  I would argue that the purpose of insurance is to a) be a protector for potential risk and b) be used to make medical procedures or medicines cheaper.  In that world, birth control is preventative measure, like getting a mammogram or colonoscopy would be to prevent cancer.  It is also a medicine people choose to take to protect against something, like when I take allergy medication before I go outside since I suffer from grass allergies.

There are only two ways to make sure women get birth control who want it.  Either you its subsidized through the insurance company or, as Sanchez would prefer, a voucher should be given to women or birth control be distributed.  The latter, in theory, does make others premiums go up who don’t use birth control.  Although, there are many service that are covered by insurance that people do not use.  However, you pay for it just in case and subsidize the cost to protect yourself from future costs against the market prize.  Whereas, if it was just handed out as a voucher that cost would not be offset.

Morally, if you don’t use birth control, for whatever reason, should you still have to pay for someone else to use it?  This debate comes up when we talk about whether tax payer dollars should go to planned parenthood for abortions, which it doesn’t now.  Although, tax payer dollars go to items people don’t want all the time.  Many liberals disagree with the Iraq, Afganistan, and Libyan wars, but their tax dollars stilll go there.  Many Tea Partiers have a  hatred for the EPA, but their tax dollars still go there.  The government is basically a large insurance company that we pay money to for protection, whether we like their policies or not.  Why should insurance companies be any different?

Tell me what you think: Should insurance companies have to cover birth control?

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Filed under economic policy

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