Sunday, October 8, 2017

Birth Control is Essential

Listen, birth control was never "free". This is a fucking lie.  Since Obamacare became law, no one with standard employer-based health insurance got their monthly oral contraceptive prescription for free.  If you have health insurance, that means you pay a premium every month.  You pay money.  Actual real live currency.  In fact, you don't even get a chance to decide; it just comes directly out of your paycheck before the federal government can tax it.  That's employer-sponsored health insurance.  It has been that way since WWII.

What changed with Obamacare was the creation of the concept of "Essential Health Benefits".  EHB's are a list of ten categories detailing basic, essential services that all health insurance policies (employer, individual and small group plans) now have to offer.  By law, the category of EHB's deemed to be "preventive care services" have to be offered free at the point of delivery, i.e. without an additional co-pay.  All American adults get 15 preventive care services.  Women get 22 and children 26.

And what are these services?  Basic medical shit: colorectal cancer screening, cholesterol blood work, tobacco and alcohol abuse screening.  You goddam yearly mammogram.  Your kids' freaking vaccines.  And, holy mother of god, contraception prescriptions for all women.  Because contraceptives are actual medications.  Not just some proxy signaling  device in the wider culture war.  Being able to determine when one wants to have children in an era when it costs $250,00 to send your kid to goddam state school is a critical advance in modern medicine.  And some women use contraceptive for non-procreative reasons.  Conditions like Poly Cystic Ovarian Syndrome, PMS, heavy and irregular cyclic uterine bleeding are managed solely with oral contraceptives.

The benefit of preventive care is such that you make up on the back end any lost revenue from forcing patients to pony up with a co-pay.  Catching a breast or colon cancer early in the game is a lot cheaper than surgery and expensive adjuvant chemotherapy.  Not to mention opportunity costs of early deaths of working age Americans.

This is obvious and intuitively good medicine and reasonable public health policy.  People who argue the moral side?  That companies should be able to pick and choose which medicines they want to pay for based on some phony, archaic religious rationalization?  Fuck them.  Hobby Lobby can go to hell.  These women have paid for the right to get these medications via exorbitant monthly premiums.  Taking that away is an unnecessary and vindictive kick in the crotch.

This is infuriating.  Allowing this benefit to lapse would be self defeating and, in the long term, more costly.


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Anonymous said...

Roll Tribe!