The problem with subsidizing contraception

There has been some talk in the US about subsidizing the cost of the birth control pill. After reading all about it, I've come to the conclusion that it's a bad idea. Here are some of the reasons, taken from comments on articles relating to the issue (comments are not mine unless in square brackets):

• After spending $1000/yr for 10-15 years for birth control for these gals, how much are we going to be asked to spend on fertility treatments for them when they realize that their best reproductive years are behind them? Most IVF pregnancies are considered high-risk, so obstetrical care would be more than "normal". Many IVF babies are fragile at birth, so you're looking at NICU costs.
• It DOESN'T reduce the abortion rate, and it DOESN'T reduce the number of unwed mothers. Statistics pertaining to abortion and unwed and teen mothers show that those numbers have increased lockstep with the availability of low-no cost contraceptives (available at your neighborhood county health/PP clinic). [See the reviews of this book Promises I Can Keep: Why Poor Women Put Motherhood Before Marriage]
• So studies say free birth control pills are actually a cost savings. What does that have to do with the federal government mandating that every insurance policy (a private product) must include them? No one is outlawing birth control. The issue is whether the federal government should force private companies to provide a particular coverage at a particular cost.
• Why should I pay my money to buy protection for someone's else's sex life?
• Of course insurance companies overwhelmingly choose to provide BC coverage. But they don't for the most part choose to offer it without copays, and certainly not for the range of contraceptives that ACA is going to require them to offer. If every woman who currently has a $10 copay didn't buy her birth control and got pregnant, it might very well be more expensive for private insurance companies than if they'd just offered her the bc for free. But that's not what happens because women with insurance and some income will happily pay some small amount of money in order to not get pregnant. What this article and the research it refers to show is that for women who are in groups that are high-risk for unintended pregnancies, it is probably cheaper for the state to provide contraceptives because when the state provides them, contraceptive usage is actually getting shifted: by providing birth control to women with low-incomes, a lot more of them take birth control. But that's not what this particular policy debate is about: it's about women with non-public insurance, who are overwhelmingly not poor. They're not looking at their copays, deciding not to take birth control, and getting pregnant. (Or, like I said, if this is happening and there's anything approaching research showing that it's happening, we'd be hearing about it.) If the contraceptive provision of ACA were "simple math," we wouldn't have to legislate it because insurance providers would already be providing no-copay bc for a range of contraceptives. They don't, so it probably isn't simple math, and I'm suggesting this is because it's a rare women with non-public health insurance who looks at a $10 copay and decides to not get on birth control. (She may, however, be spurred by zero-copay contraceptives to switch contraceptive type to something with higher costs and only marginally better efficacy.)
• If WE keep them "healthy" after an entirely predictable outcome of having sex--what does that have to do with being healthy? Sounds pretty enabling to me. Note, of course, I'm not saying it should be illegal to make these decisions for yourself, just that I should not have to pay for it.
• It might help if you understood the purpose of insurance. There's a reason why BlueCross doesn't cover my Advil.
• Do you know what's a lot less expensive to ME than paying for other people's birth control? Not paying for it. Even when you start rationalizing my suffering from societal ills--color me skeptical.
• Plenty of societies have expected that if women aren't abstinent, then they should risk getting pregnant - heck, you probably don't have to look back more than 100 years.
• In what way is not covering birth control "punishing" women? My employer subsidizes medical and vision insurance but not dental insurance, and my daughter just got a cavity. I had to pay out of pocket for a dentist to fill it. Is my employer "punishing" me?
• The government is allowing the Amish to opt out of the contraception mandate but won't let Catholic dioceses and institutions, which are morally opposed to it, do the same. That's a bit more like "punishment."
• Insurance doesn't pay for your skiing, it pays if you have a health injury as a result of skiing. [And premiums for skiiers are higher, I imagine.] So it reasons that insurance doesn't have to cover your birth control, but it does cover your health costs if you become pregnant. To use a cruder analogy: Insurance should not cover condoms and lube, but if you contract HIV it does cover your health expenses. Do those who want free birth control pills also want to mandate free lube and condoms?
• By this argument everyone's medicine should be "free" at no out of pocket cost, no co-payment. This sounds great, everyone gets all the health care and medicine they want or need and at no cost to themselves. How wonderful. Unfortunately, its unlikely that this wonderful format would last long in the real world. 
• No health insurance coverage is "free," even when there is no copay for a particular service. And, copays and amount of coverage vary by policy. But, conservatives haven't been arguing FOR copays for contraceptive medications. They have been arguing AGAINST employers and insurers being required to provide ANY coverage for contraception, period, whether that coverage includes copays or not.
• If people know what something is really costing them, they are more likley to be responsible.  When everything is "free" not so much.
• As for theories about the cost savings of prevention -- many disagree with your assessment, including insurers. 
• The proposed regulations when they go in effect in 2013 will require the insurance company to offer contraceptives free and without a copay.
• If you are really paying for contraception with your premiums, then you should just be able to pay for it without the insurance plan at all.  The only reason for this policy is to shift the cost away from the person directly using the product.  Support this mandate or not, I wouldn't think this would be a point of contention.
• It is part of a compensation package that is part of an employment contract.  And only a part.  Religious and affiliated institutions are not requiring that as a term of employment an employee refuse to use contraception.  Religious institutions are stating that they would like to retain the freedom to offer a  compensation package to employees that does not include insurance coverage for contraceptives. The employee is not required to accept the terms of the contract -- they are free to reject the contract (i.e., not work for that employer).  The employee can also purchase their own insurance or supplement their employer-offered insurance that does offer contraception.  They also can purchase their own contraception. Of course on the flip side -- assuming that the provision of free contraception reduces medical costs -- which the insurer has a vested interest in doing -- insurance companies could also refuse as a vendor to offer packages that don't include free contraception. 
• Having a "greater tendency" towards an unexpected disease or covering an accident in a more dangerous profession clearly is not the same as a routine, fully foreseeable expense, that every person will have.   It is not a difficult concept:  You cannot "insure" against a certainty; the argument for paid contraception is simply an argument for expanding welfare benefits to a group that generally does not get them.  (Traditional cash welfare payments can of course already be used to purchase contraception.)  And there is a reason insurance costs more for firefighters, miners, smokers, etc -- because the relative risk of incurring large expenses is higher. 
• Whether or not "sexuality is an essential part of being human" or not is completely irrelevant.  Food is also essential for Ms. Fluke, but she would have been laughed out of Congress had she made a plea for food stamps for students at an elite law school.  Yet this is no different: She would like a normal expense of life paid for by someone else -- often, I note, by people with far less lifetime earning potential than she has.  This is neither progressive nor fair, and it does not make one a sexist to point it out.  I would add that the argument made by Mr. Fisher only holds if one considers people as a drain on the system and not as future resources.  You can't make the argument honestly without considering the lifetime earnings and contributions of the people being born, not just their expenses in childhood.  And if the argument is that we should be only discouraging reproduction in poor people because they are not likely to be net contributors to society, well, that's fairly odious in my book.  I don't think Fisher is saying that, of course, but it does mean his argument is half baked and not very persuasive.
• There is something faintly unsettling here, the underlying idea seems to be that children are a disease that women need to be protected from.  Children prevent women from gaining an education or a good job and they're so expensive!  While its true that poor, unmarried, young women will do a lot better if they don't have children while they're poor, unmarried and under educated, generalizing this idea out to the rest of the population because "half of pregnancies are unplanned" begins to seem like we wish to commit demographic suicide in the name of access to free birth control. 
• The argument appears to be that women have very little agency, indeed, the belief must be that they have so little agency--even in preventing their own unwanted pregnancies--that they won't take any such action unless its at no cost at all to themselves, no matter what socio-economic bracket or race they are.
• Thats an argument for government subsidy of birth control for poor women which already exists and which I support.  When you extend the argument for a subsidy of birth control for ALL women the argument you are making is that women have little agency and that children are such a terrible burden on society that no cost is too great in order to prevent pregnancies, this is a dangerous argument for any society to embrace.
•  There is a good  argument for subsidizing birth control for poor women, but it doesn't, in my opinion extend out to subsidizing birth control for all women.
• It makes a difference if there is a co-pay because the further you put the patient from the real cost of health care the more problems you will have controlling it.  Its the same reason why I  think even poor peole should pay some nominal taxs, even $15, so everyone feels they have some skin in the game.  No one who has insurance has any idea what the alleged "cost" is of any of the services because who looks at the bill?  I know I never did because I wasn't getting charged for anything. But, in terms of contraceptives, I don't see why they should be singled out for special treatment and be "free" when other drugs are not.
• Many girls grow up wanting to have their own live baby dolls so they can feel complete.  Government programs pay for young mothers to have their dream, to fit in with other girls who are also moms.  A young mom can have a child for free, get no child support from the father and let the government (our tax dollars) pay for her dream of motherhood.  Hospitals and unwed mom agencies send the bill for birth, diapers, formula and anything else a mom needs for her child.  Dad and mom never pay a dime back into the system and in fact become system reliant.  THE FIX = the bills follow the mother and named father for life until they are paid.  BIRTH CONTROL = young parents beware as you are going to pay your debt, no exception.
• I wish all employers chose to provide it. If they don't choose to provide it, I don't think it's right to force them to. Ends don't justify means. Society should find another way to help people get birth control if employers aren't cooperative. Also, the Catholic church is against vasectomies and other forms of sterilization. I expect if you look into it, you'll see that these are also excluded from many church based plans.  
• This is a good argument for Medicaid subsidizing birth control, but the contraception mandate won't be covering poor women, it will be covering middle-class women who get insurance through their employer.
• This debate has been framed wrongly by both sides. The left puts it in terms of health and the right puts it in terms of morality. Let me put it in terms of economics. The function of insurance is to spread risk among voluntarily participating parties.  "Insurance" that the law says you must buy, and that consists of mandatory types of coverage is not insurance at all, it's welfare. The opponents of Ms. Fluke seem to roughly understand this but are unable to express it. The real question is, why does a 30-year-old Cornell grad and Georgetown law student need or deserve welfare? If that is the threshold for welfare, 95% of the country would be on welfare. Only the most doctrinaire leftist would fail to see why this cannot be sustained.
• IMHO it is crazy to provide free birth control to middle and upper class employed women.  It is not crazy to provide low income women free birth control.  And it is appallingly easy to figure out  who they are.  Healthy insurers pay for not healthy insurers. 
• Strange how the number of unplanned pregnancies and out-of-wedlock children has soared *after* birth control came along. I agree that too many children are being born to unprepared parents, but that's a socio-cultural issue. Tell you what -- you can hand out birth control pills in the classroom if we get to address the family breakdown in a serious way.
• This only goes back to 1980, not prior to the advent of the pill but it is true that the number of live births to unmarried women per 1000 has increased dramatically over the last roughly 30 years -- from 29.4 to 50.6. What is worth noting -- for all the talk of the need of increased sex education the problem is not now principally one of teen moms which peaked in the early nineties and is now almost exactly where it was in 1980. It is for women age 18 to 39 at the time of birth -- thus for example the rate has nealry tripled for women age 30-34  from 21.1 to 59.0 (source).
• The government should simply issue individual plastic bubbles to every one of us to exist in throughout our entire lives.
• How many women with employer-based health insurance are getting pregnant because they're choosing no contraceptives or less effective contraceptives due to costs? If there were a strong case to be made for "many", we'd be hearing about it.
• Unintended pregnancies are caused not by people who are 'too poor to practice safe sex' as you put it, but by people who have sex when they are not ready to have children.  Basically, they are caused by irresponsible behavior. No amount of contraceptive coverage, forced or voluntary, will change this, because contraception reinforces, rather than prevents, sexually irresponsible behavior by offering people a false sense of security.  This same sexually irresponsible behavior also spreads sexually-transmitted infections, which are also a tremendous expense for us as a society. If we want to decrease the amount of money we spend as a society on these 'unplanned pregnancies', the solution is not to increase funding for contraception, or encourage its use. This has been exactly the policy of our government for the past forty years!  It hasn't worked very well, has it? Instead, the solution would seem to be to change the public attitude towards sex, encouraging responsible sexual  behavior.  This is very difficult, of course, because it involves pushing a cultural change, so it does not appeal to many. Nevertheless, it seems to be the only possible long-term solution.
• This isn't just about dollars and cents. The rhetoric used borders on the obscene. During the fascist reign in Germany the way that they prepared their population to accept the holocaust was to originally frame the argument in economic terms. Posters were hung that explained that it took 5.5 Reichmarks to care for a disabled person a day, and for that you could feed a healthy family of five for a day. Another proclaimed the disabled cost 60,000 RM over their lifetime. "Germans! This is YOUR money!" (See the Eugenics article on Wikipedia.) See! Killing is so cost effective! The web site of the United States Holocaust Memorial Museom reminds us that it was the intelligentsia and the medical profession that were the most easily co-opted by the siren song of totalitarianism. Unfortunately, very little has changed since 1945. What was condemned as a war crime at Nuremberg is now embraced as "enlightened policy" in most of the Western World. The future belongs to those that bother to show up. The West is aborting hers.
• Does Sandra Fluke own a smart phone ? She and her fellow students have money enough for all the trappings of modern life, yet we taxpayers are expected to pony-up to support her "life-style choices". I would like to know why we are obligated to her and her fellow "students". What is the origin of our debt to her?
• its not about being over educated or lacking comprehension or common sense. IT IS ABOUT AN AGENDA. An agenda devoted to destroying the fabric of society: The Family. An agenda devoted to destroying the first ammendment's guarentee of freedom of religion. An agenda about turning a once proud nation of freedom loving into a nation of Marxism and Communism. And above all else it is an Agenda to derail any GOP candidates and to turn the eye away from how poorly Obama has been as a president. There are ulterior motives in every thing a liberal progressive does and they need to be removed from power from this country.
• Some people are born with medical conditions which they must invariably treat but being born with a medical condition by no means obligates taxpayers to pay those bills. This attitude that society owes someone for their misfortune(s) completely ignores the misfortune to which the taxpayers are subjected when they are required to pay someone else's bills.
• Look up the term "red herring". Its irrelevent, the topic is not what one person wants or needs. The problem is that people who expect things for free are seeing the Government, and using deceit.
• Fluke still doesn't have her story right for it was reported elsewhere that Georgetown Law does cover contraceptives that are used to treat certain medical conditions, but they do not cover contraceptives used just as a birth control. Fluke's testimony was a nicely fabricated story completely to fit the agenda.
• why would she care what it costs, all she wants is a free ride.
• Hypocrisy is saying "Stay out of my bedroom and my womb but pay for my birth control." Sorry, but this naive youngster allowed herself to be victimized by the Owebama war against women.
• Sandra Fluck, how was your vacation in Spain with your wealthy boyfriend....I see you make it back to the States and your need for expensive contraceptives that I/We must pay for was no Fluke!!!! Way to Girl....Got laid by a wealthy guy who can't/won't pay for your "Birth"/Side effect control ... So I suppose we must do it for y'all!!!!
• Look, if the pill was THAT expensive, someone would be pimping them on the street corner. Never heard of a black market for BC pills.
• Bet she didn't know how much her plane ticket to Pompeii with her boyfriend was either. Can you say "plant".
• People who want to have sex every day with as many people as they wish is a privalege one can award themselves. I say have fun, be careful and by all means get protection. Cheaper than Target is any Planned Parenthood - who will freely give the condoms away at taxdollar expense.
• It's impossible to educate someone about something they are being paid not to understand. Ms. Fluke is the epitope of this statement. She is willfully ignorant of the many affordable options available because her ideology demands her not to know.
• What an idiot piece of human debris, she wants hand outs but none of the responsibility that is suppose to come with being and adult. I say again, go to any national park, you will see signs "please don't feed the animals, or they won't learn how to take care of themselves". And this turd wants to practice law.
• If she's in no danger of becoming pregnant then the issue is moot. If on the other hand she is conducting herself so that birth control becomes highly desirable, then she needs to take the responsibility to pay for them or curtail the activity. Why is she pointing at YOU and ME asking for free drugs so she can do as she pleases? It's not my job to support her habits, regardless of what they are. And yes her conduct is shameful and wrong in many, many ways.
• "Shaming is the law enforcement of the People. Nothing wrong with it."
• Fluke put herself on the public stage, and she lied and misled in her testimony. She wants free contraceptives for healthy women and she is trying to obtain her goal by using specific examples of unhealthy women. Shame Fluke, not the many people who see through her shameful sham.
• So now she WON'T need all that money for birth control? Just how many abortions per month was she going to need to have, and did anyone tell her that College is for studying, not sex? I don't care WHAT they say on MTV!!
• HAVE YOUR LIBERALS SPAYED OR NEUTERED, it's like adding chlorine to the gene pool!! Perhaps Fluke will be a volunteer since she is so terribly oppressed by her own femininity?
• Maybe she should tattoo 'No Rubber, No Road' on her backside. Then it would be up to her interloper to provide, not me.
• If you can't afford contraception, then you shouldn't be having sex in the first place! It's called responsibility!
• This woman is intentionally misrepresenting the issue. This is not about Contraception. Contraception costs very little. What she is talking about is a medical condition for which the answer is specific forms of the medicine that also works as birth control. Stop confusing contraception with personal medical needs. 
• So now refusing to pay for someone ELSE’S contraception is “impos[ing] [one's] anti-contraception views on the general public”???  
• If she gives up her morning $5.00 Starbucks Latte just ONE DAY a month, the money saved readily covers a months supply of birth control pills.
• If you’re 30 and can’t afford to buy your own birth control pills (though it appears she can buy clothes and jewelry), then you are a l-o-s-e-r.
• self control is free. Waiting until you are married and ready for a baby is free too!
• "I don’t care and neither should you get into the business of deciding what my health insurance covers!" But she is doing the exact opposite of what you want. She specifically chose a school whose health insurance was not in line with her beliefs with the express purpose of “getting into the business of deciding what my health insurance covers!”
• My health care insurance is already going up with ObamaCare (Affordable [NOT!] Health Care Act) and crap like this that should not be included in a pool of health care billings where ALL end up paying for it. So, the leftists don’t mind making me pay for a bunch of rabbits who can’t control themselves and want something for nothing as part of half of the country who doesn’t pay any taxes. So, yes, I damn well should care when someone is stealing my hard-earned money from me against my will.
• In the same way abortion activists try to hang their entire argument on the 1-3% (at most) of abortions that are done for “rape, incest, or life of the mother,” so this activist is trying to hang her entire argument on TWO cases, one of which clearly would be covered since it is not “contraception for the reason of preventing pregnancy” (her own words for the reason the 2nd woman’s insurance would not cover her birth control pills). Furthermore, although Catholic leadership and some other Christians frown on such contraceptives, these aren’t even the abortifacient pills that are the most egregious problems. In any case, there’s a world of difference (in my opinion) between these two women whose medical conditions require “hormones,” and Ms. Fluke, who merely wants free contraceptives to make her free and frequent sex with her myriad amorous (and hardly chivalrous) suitors free of responsibility or consequences.
• I already got kids to support, I’m not interested in supporting someone else’s 30 year old child with a spoiled brat attitude and an extreme narcissist complex.
• And to try to cover Birth Control as a medical need/treatment is to diminish the real medical needs. . vitamins and nutrition are more important than Birth Control. .shouldn’t everyone get FREE vitamins as part of nutritional health? And what about exercise?. .how about free gym memberships and free home treadmills as part of metabolic health? And how about free cholesterol lowering drugs. . .free for cardiovascular health?
• We lived in a town where not a soul in twenty years had the elite access to a school like Georgetown, and I’m supposed to feel SORRY for a 30 year old WOMAN in the elite stratosphere who is WHINING about “needing” people to pay for BIRTH CONTROL? SHe’s tracking to make ten times what we make and she wants subsidized pills? How CHEAP is she? Mummy and Daddy buy her everything her little heart desired and taught her to look down on anyone who wasn’t as smartl as she??
• Non of us should be concerned with what’s going on in anyone’s bedroom…and neither should we be required to pay for it. Any insurance is based on a pool of resources that the consumer agrees to join by choice! Obama and the Democrats have limited the choosing to none of those in the pool, only to some appointed government official. This is one of the first proofs of how bad the “Obama Care” legislation is, and is going to be.
• ADULTS pay their own bills.
• So are the college females we surveyed who’ve read this and also think Rush is correct that she’s an opportunitst political lying hack … are “male chauvinist pigs” also? I mean, they instantly understood his point and totally agreed. They not “female” enough? I mean, they want a guy to marry, how cavewoman of them, and they want “kids.” So, their voices aren’t GOOD enough for the feminist LEFT?
  
• I thought women were self-reliant, strong, and didn’t need help from anybody. Where are the feminists? Looks to me like these gals are unable to care for themselves and need big daddy government to take care of their needs.Perhaps Georgetown should buy every student a handgun too. Because if they don’t – the school obviously would be denying everyone’s constitutional right to bear arms.
• She is doing the same thing that Obama does when promoting his Obamacare. She is taking situations of the few and far between and trying to make people think that this is a valid reason to pass a law. The same thing is also done with abortion by using the excuse of rape, which accounts for less than 1% of the abortions in a year in America. You cannot pass a law based on the exceptions, that is not good law because it does not apply to the mass majority. The truth is that 99.9% of the people that use the contraceptives would be using them to prevent pregnancy. Married or not married, it just doesn’t matter; catholic churches nor anyone else should not be forced to pay for birth control. If they want to have birth control covered then they should seek employment in places that do cover it. Sometimes life just doesn’t give us everything we hold our hands open for, and Americans need to start realizing it no matter what your sob story is.
• In the video she talks about two woman who need birth control, one because hormonal imbalances cause seizures (is the pill the only way to balance hormones?) and the other because of risk factors involved in giving birth too close together. What is doesn’t mention but what is most likely true is that both woman received what they needed in some manner.
• with some very few exceptions, BC is NOT a medical necessity. In cases that it is, I have no problem it being covered.
• we’ve been INFORMED she’s speaking for WOMEN and what they NEED …. and that’s CRAP.
• I don’t care what people do in bed. I care,in this case, about being compelled to pay for non medically necessary things in my insurance contract.
• That was the one aspect of feminism I liked, that women were gonna pull themselves up by their bra straps.  But it's just vanished.  Now all of these things that feminism had as its goals, they're gone.  They really are gone.  They're back to being subservient and dependent and demanding, and demanding dependence.
• Viagra takes something that does not work as designed and makes it work again. Abortions, abortion pills, and even artificial contraception (IUDs, condoms, Norplant, etc.) do the EXACT OPPOSITE. They take something that works EXACTLY AS DESIGNED, and makes it no longer work. Or makes a human at an early stage of development, who has been given the gift of life, F&&KING DIE, in the case of abortions and abortion pills.
• women are doing just fine getting birth control on their own. It's government overstepping. Do no harm - unless it's to the child in the womb. That's okay. Forcing me to pay for it, that's overstepping.
• contraception is readily and freely available today, and there is no effort to control, rescind, or take that away. There is no "women's" issue here. Contraception is a choice (the pro choice crowd should like that), it is not a right. The decision is up to the family, or the woman. No one is prohibiting the use of contraceptives. Nothing diferent there.
• A large part of our health care cost problem is due to everyone wanting “something” and wanting “someone else” to pay for it. The purpose of “insurance” has been distorted(beginning with Teddy boy’s HMO idea in the 70′s). Insurance is intended to protect against catastrophic financial loss. Everyone seems to want it to pay for everything, so guess what, the cost is out of hand. Adding contraceptive coverage to a health “insurance” plan is simply going to raise everyone’s premiums another 100 bucks a month or so. I’m hoping the employers in the group market start passing some of this on to their employees.
• Let the guys in line pay for it. You want thrill pay the bill. Why should the taxpayer foot the bill? Taxpayers did not get the thrill.
• Fluke whines that the rest of us owe her free contraceptives, so she can have as much sex as she likes without consequences – while on scholarship at a very pricy law school. That’s the issue. Fluke spends whatever money she has elsewhere then demands that I (and you) pay for her contraceptives. That makes Fluke greedy, selfish and self-centered.