Wednesday, February 13, 2013

Healthcare reform: birth control compromise?

One of the really snazzy features in the Affordable Care Act is the increase in no-cost-sharing preventative services for people with insurance.  Sure, the subsidies and expanded (hopefully) government programs that increase access are awesome, but helping make sure that underinsured people get some value from their insurance is my personal favorite part.

One of the preventative services that has to be free is an annual wellness visit.  Clearly, nothing but the visit itself counts as "no cost sharing" or otherwise known as "free."  You'll pay through the nose for blood tests and any extra things your insurance company can manage to charge you for, but it's an improvement.  With a free check-up annually, hopefully we catch more health problems sooner and avoid big illnesses.

Another one is birth control. It got deemed a preventative item just like vaccinations, so it has to be covered at no cost by insurers.

This one gets many up in arms though. Despite science saying that birth control pills suppress ovulation and have nothing to do with fertilized eggs as far as we can make out, some faiths have decided birth control is immoral because life begins at conception and there's an outside risk that these hormones might stop a fertilized egg from implanting.  I can see how you can be of a mind to think life starts at conception, and it is America, so you are free to decide whatever you'd like.

My take: your beliefs apply to you yourself. Your faith says eating cows is immoral? Fine! Don't eat them. Just don't try to stop me (mmm... beef...).

The complexity: employers pay for health insurance, and individual business owners are those employers, and some of those people object to paying for healthcare they disapprove of. If we were a sensible country, we'd fix this by having everyone in a single healthcare pool so no single person would be paying for anyone else's healthcare choices.  But we are not sensible. We are "free market" and how DARE we consider doing something that would save us all money and probably give us better care at the same time... hmm... but this is mostly a distinct issue.

This weird system has been supported for years, where we allow a few religious groups to get exempted from paying for very specific things they deem immoral. IVF is of course on this list. Hormonal contraceptives are on the list. Abortions are, sometimes also other pregnancy ending things like drugs to induce miscarriage (that are used for molar and ectopic pregnancies as well as elective terminations, but of course they don't make that distinction).

To me, this seems like a case of me choosing to make a moral decision for someone else based on my moral views for myself. It bothers me that someone can decide for me whether it's moral for me to use contraceptives or have IVF.  It's my life, my body, I should get to be the boss of it without anyone intervening in the process.

The compromise that the White House has issued is that employers will pay for healthcare, and health insurers will pay for those "morally reprehensible" parts that are federally required (aka contraceptives). It's a shell game at best, but it's a compromise that keeps the technically fussy at bay.

So yay for a compromise that gets women better access to medical care, prevents abortions, and keeps everyone happy enough. I think it's best we let women be the boss of themselves, don't you?


  1. Agreed! I am so not a fan of anyone else forcing their beliefs on me, no matter what the situation!

  2. I agree 100% and just don't get the controversy. Then again, I also believe the planet is older than 6000 years, so clearly I'm not that camp.