Copyright 2000 The Baltimore Sun Company
THE
BALTIMORE SUN
July 30, 2000, Sunday ,FINAL
SECTION: EDITORIAL ,3C
LENGTH: 765 words
HEADLINE:
Using the pill to spawn new attitudes
BYLINE: Ellen
Goodman
BODY:
BOSTON -- By any
standard, Jennifer Erickson is a Planned Parenthood poster plaintiff: She's 26.
She's married. She's pre-parental. She's even a pharmacist for heaven's sake.
Ms. Erickson was the one behind the counter at Bartell Drug telling
customers that their insurance plan covered nearly every pill except the one
known far and wide as the pill. So it's not surprising that the Seattle woman
spoke up when she realized that her own company's insurance plan left her in the
lurch. She too was spending more than $300 a year for
contraceptives.
Hers is, in some ways, an old story. Women have been
paying for contraceptives ever since the first diaphragm was smuggled into
America.
But a few years ago, when insurance plans began picking up the
tab for Viagra, the light bulb went on over the medicine cabinet. How come
employee health care plans covered pro and not contra-ception? Some of us
thought it was time to redefine the pill as a female impotence drug. What
greater turn-off, after all, than the fear of pregnancy?
In any case,
some 13 state legislatures have now mandated that private insurance plans which
pay for prescription drugs must also pay for contraceptives. But today only half
of insurance plans cover any of the five contraceptives for women -- from pills
to Norplant -- and the issue has been stalled in Congress.
Now Ms.
Erickson has filed the first class action suit of its kind, citing Title VII of
the Civil Rights Act to win contraceptive coverage for women at
Bartell. When men get their basic health care covered and women don't, the suit
charges, it's employment discrimination.
Employers have long maintained
that contraceptives aren't covered because they aren't "medically necessary."
Many have described pills and diaphragms as a "lifestyle choice" on a par with
Retin-A or cosmetic surgery or -- as one California legislator put it --
"hairspray."
But this time, they'll be girding their lawyers to defend
against sex discrimination charges. And be prepared for some gender-bending
arguments.
One of the arguments already being aired rests on the notion
that as long as the same policy is applied the same way to both men and women,
there's no illegal bias. Companies may well claim they aren't discriminating
against women but against contraceptives. Why, they don't pay for the pill for
men either!
All five methods of prescription contraceptives are for
women. So, this is like saying that women are equally covered for prostate exams
and men for pap smears.
There is a history to this sort of "equality."
Some 25 years ago, health insurance plans excluded vaginal deliveries. The
Supreme Court actually ruled that denying insurance for pregnancy was not sex
discrimination. The employer merely had two categories of workers: pregnant and
non-pregnant persons.
The tortured absurdity of this ruling led Congress
to pass the Pregnancy Discrimination Act. This banned sex discrimination on the
basis of "pregnancy, childbirth or related medical conditions" in all employment
areas, including benefits.
Fertility is, um, a pre-existing condition
for a huge number of working women. And the need for contraception is nothing if
not a "related medical condition."
A policy that covers the cost of
basic health care for men but makes women pay for contraceptives discriminates
quite simply because it has a disparate impact -- on the woman and her
pocketbook. Women are the ones who get pregnant. Without contraceptive
coverage, women end up paying 68 percent more of their own money for
health care.
Ironically, the cost of adding this coverage would be
$22 a year. Yet more insurance companies pay for abortion than
contraception. Indeed, more pay for sterilization than contraception.
Gloria Feldt, the president of Planned Parenthood, says that employers
have counted on the fact that "women want contraceptives so badly, they'll pay
anything. And they do."
But there is something larger at stake in this
discrimination suit. As Ms. Feldt says, "men's health and bodies have always
been the norm in designing health plans. Women's have been the abnorm." What if
women were the norm? Would contraception still be considered medically
unnecessary ?
This is one area in which anatomy is destiny. We can't
treat insurance coverage the same anymore than we can treat bodies the same.
Until -- let us pray -- a male contraceptive pill comes on the market, separate
is the only way to get equal.
Ellen Goodman is a columnist with the
Boston Globe and her e-mail address is ellengoodman@globe.com.
LOAD-DATE: August 7, 2000