Birth Control Right

This should go over like a lead balloon but I am pretty naive about something I just read. This is from the Washington Post:

The Trump administration has drafted a regulation that would dramatically scale back the federal mandate that employers provide free birth control coverage, by providing an exemption to anyone who raises religious or moral objections.

I don’t want to have the religious and moral objection discussion here.  That is not the focus of this particular blog.  My question why doesn’t anyone object to the birth control mandate due to financial reasons?  Why is birth control a “right”?  Why does it HAVE to be provided free?  Generic oral contraceptives are $9 a month.  Why should any medicine HAVE to be covered by any employer or insurer, for that matter?  And if it does then it seems to me blood pressure medicine may an important drug to cover as well.

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The rest of the Washington Post article takes the religious exception spin and those points can be debated but there would be no debate if ALL mandates were just removed.  We need to let the public shop around and bring the prices down.  That means colonoscopies.  That means Pap smears.  That means mammograms.  That means guaranteed physicals with your family doctor.  Get rid of it all.  Even now a $9/month drug is not budget breaking especially in an era of mega bills for smartphones and cable.  Some will respond that everyone needs to have their iPhone.  Oh yeah, then why are they not mandated for free?

It seems to me that the more you pay for things yourself the more you help the free market work.  Getting third parties to cover you only muddies the water and eventually hurts us all in the long run.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected]

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6 Responses

  1. John Kelly, MD, MPH says:

    I’m amused by the obvious faith you profess in the “Perfect Market” solution to all our problems, both personal and scientific. Consumers are not trained and cannot “shop around” for medical care, are not given the costs up front, and often cannot delay treatment. Besides those who cannot for some reason tolerate the $9 per month pill, most health care is guided by their PCP, who doesn’t bother to know the costs and cannot advise them on choice, plus insurance only allows certain procedures from certain providers, who do not advertise the charges, nor the hospital charges, nor the success rates of providers. Insurance coverage is mysteriously documented, not to be understood. Patients call up and a high school grad with a computer of rules just confuses them more, and the disclaimer tells them anything they are told doesn’t assure actual coverage. Many services now require you sending the patient to the ER, as because of burgeoning copays and “coinsurance,” they have waited until it’s much worse and hasn’t just resolved on its own, so an urgency means they cannot shop or sit around for two or three months in line for specialists or surgical intervention, imaging, labs and testing. The ER can plug them in, and nobody is shopping in the ER, nor is the ER assuring every doc they see takes their insurance and won’t bill them directly for the entire “insurance grade” charge for their dropping by for a look-see. I know, conservatism in the defense of lower taxes is such a virtue, but please look at the reality and not wish it were true, no matter how bitter this false meritocracy makes you feel. Every corporate “body” wants the big payoff, and is willing to bury the truth to get it.

  2. David Taylor, MD says:

    Doug: I think there’s a confusion between two kinds of “rights.” Birth Control has not been designated a natural right, and consequently it must be paid for by the feds — rather, the law requires that birth control be covered in any health insurance plan, and therefore it is a legal right under an insurance policy. My assumption is that the motives for making birth control a legal right were a combination of politics (it would be popular) and economic (the costs of unwanted pregnancies far outweigh the small cost of including birth control in health insurance…)

    Many countries provide ‘the pill’ OTC, and that seems to me to be one good option in the U.S. to avoid the kinds of issues that you raise, including the price. I saw packs of Ortho-Novum in a grocery store in Rio de Janeiro, in the check-out lane, for about $1 each.

  3. Sir Lance-a-lot says:

    “Why is birth control a “right”? Why does it HAVE to be provided free?”

    Because there are a lot of people that I don’t want reproducing, Doug, and if free birth control helps to achieve that, then I’m all for it.

    If they could write a health care law that included mandatory birth control, I’d support that as well.

  4. Chad Savage says:

    Yes, and when it is mandated there is no incentive for the manufacture to decrease the price. Just look at EpiPen’s. They were mandated to be in schools and the manufacturer knew they could get away without outrageous pricing because the purchaser had no right to defer the purchase.

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