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Copyright 2000 St. Louis Post-Dispatch, Inc.  
St. Louis Post-Dispatch

December 22, 2000, Friday, FIVE STAR LIFT EDITION


LENGTH: 439 words




FOR just a moment, ignore the word contraceptive and all the political baggage it carries. Think instead of those tiny pills containing the hormones estrogen and progestin as you would any other medication. Because fairness, not contraception, is at the heart of last week's controversial Equal Employment Opportunity Commission ruling. The ruling has been widely reported to require that employer-provided health insurance cover contraception if it also covers other preventive health care. In fact, the health insurance plan that prompted last week's ruling did cover contraception -- in the form of vasectomy or tubal ligation. What it would not cover, "regardless of intended use," was a class of medications used not only to prevent pregnancy and the need for abortions, but also to control severe menstrual cramping and to help prevent ovarian cancer.

Despite the modest cost of oral contraceptives, which could be added to health insurance plans for about $ 22 a year, such prohibitions are not unusual. Yet many plans, including the one that prompted last week's ruling, routinely cover the anti-impotence drug Viagra. Viagra costs about $ 20 for two doses. Given that, it's difficult to argue, as the employer in this case did, that contraceptives were excluded because of cost. It is illogical and fundamentally unfair that a plan that would pay for pills to enhance male sexual performance would not pay for pills to prevent pregnancy, cancer and cramping. On the basis of economics alone, the cost of birth control pills is minimal compared to the medical costs of pregnancy and ovarian cancer.

And yet, health care costs are a crucial consideration. The price of health insurance has been rising quickly in recent years, and most companies will experience double digit premium increases next year. Driving those large premium increases is the rapid growth in prescription drug prices, which has far outpaced the overall rate of inflation in recent years. Anything that adds to the number or size of covered benefits will surely push premiums even higher. Already, many small business owners complain that they're being forced to re-evaluate, scale back or even drop health insurance coverage for their employees.

The prospect of an additional $ 22 in annual premiums isn't likely to cause most companies to drop employee health insurance. Instead, most will probably make adjustments -- slicing some rarely used benefits to compensate for the added cost of contraceptive coverage.

In this case, equality was the issue. The commission saw what was at stake and lived up to its name.

LOAD-DATE: December 22, 2000

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