Copyright 2000 Plain Dealer Publishing Co.
The
Plain Dealer
August 7, 2000 Monday, FINAL / ALL
SECTION: ARTS & LIFE; Pg. 1E
LENGTH: 813 words
HEADLINE:
PUSHING FOR HEALTH PLANS TO PAY FOR BIRTH CONTROL PILLS
BYLINE: By EBONY REED; PLAIN DEALER REPORTER
BODY:
Alisa V. Powell cringed monthly for 14 years
as she doled out $31 for birth-control pills.
It was money she could
have used toward school, food or savings. But her health and prescription
insurance didn't cover the cost, so she had two choices: pay
for medication she needed to regulate her periods or forgo it and have random
menstrual cycles. "There are other needs in a home - food, clothing," said
Powell, clinical program director at the Women's Center of Greater Cleveland.
"If a parent knows it is not the time for a child and they want to use
contraception, what is wrong with that?"
Powell, 33, of Cleveland, said
she believes employers should treat birth-control pills as they would any
prescription, covering them under prescription plans.
Two weeks ago in
Seattle, Planned Parenthood said the same thing.
The organization filed
a class-action suit against Bartell Drug Co. in Seattle on behalf of female
employees who felt the company should cover contraceptives in
its prescription plan. The case claims the pharmaceutical company is
discriminating against women because their insurance plan did
not cover contraceptives and women are the only ones who take
oral contraceptives.
"Our message is that contraception
is basic health-care coverage," said Chris Charbonneau, Planned Parenthood of
Western Washington president and CEO. "Women pay 68 percent more out of pocket
for health care (than men). Women's needs are not being met."
Charbonneau said this is a women's health issue and it should not matter
if women want the pill for medical or contraceptive reasons.
Powell, who recently decided to stop taking the pill because of the
cost, agrees.
"I help women who are recovering from drugs and alcohol,"
she said. "The majority have children. Maybe when they were using, they weren't
ready. What would be wrong with helping them with birth control while treating
them?"
Other women choose the pill, which is just one of many
contraceptives, because it regulates menstrual cycles and
reduces menstrual flow. It also can reduce risks of ovarian cysts, ovarian and
endometrial (lining of the uterus) cancer, noncancerous breast tumors and
anemia, said Dr. May Hsieh Blanchard, MetroHealth Medical Center associate
residency director and obstetrics and gynecology generalist.
But there
are some risks with oral contraceptives, including blood clots
and strokes. Walter Masanic, public affairs director of Canadian-based
Janssen-Ortho Inc., said negative risks associated with oral
contraceptives are "much smaller" than the risk of pregnancy if
a woman is having unprotected sex.
What about Viagra?
The
question of coverage also becomes somewhat of an equal rights medical battle:
While the pill is not covered, treatment for erectile dysfunction sometimes can
be.
Medical Mutual of Ohio offers limited coverage for Viagra, which
treats erectile dysfunction. But Kaiser Permanente Health Plan of Ohio and
QualChoice Health Plan do not.
As the debate continues about whether
prescription drug plans should cover birth-control pills, some health
insurance companies say hold on. Medical Mutual and QualChoice
say they aren't the culprits and suggest that people look to employers.
"It is employer choice," said Ben Zealman, Medical Mutual executive vice
president for corporate development. "I don't think not paying for birth-control
(pills) can be justified on a cost basis."
Zealman said prescription
drugs are only 15 percent of an employer's out-of-patient health-care costs, and
birth-control pills comprise only a small fraction of the 15 percent.
John Amantea, QualChoice marketing director, said 90 percent of
companies that use QualChoice offer prescription drug coverage, but he could not
say how many employers chose to omit prescription
contraceptives.
"The design of the benefit and
prescription drug plan is at the discretion of employers," he said. "It is the
employer who goes through the menu of benefits."
Ellen M. Pacholski,
education chairwoman of the Ohio Association of Health Underwriters, said oral
contraceptives raise the cost of most company
insurance plans by 5 percent. She said other factors, including
number of employees and whether the drug is brand name or generic, also affect
cost. "Everybody wants everything, but they don't want to pay," Pacholski said.
"Cost of health insurance is one of the big problems today.
There are not enough dollars for everyone to have everything for free."
If the Seattle suit is successful in forcing Bartell to cover the pills,
more employers could find themselves paying for contraceptives.
And Charbonneau, the Planned Parenthood official, said suits in states like Ohio
could follow.
"Not covering them affects women, not men," she said.
"Only women can get pregnant. That's where the sex discrimination comes in. Most
certainly other states will follow."
GRAPHIC: Photo by:
LYNN ISCHAY / THE PLAIN DEALER; Alisa V. Powell, of the Women's Center of
Greater Cleveland, says regardless of the reason a woman is taking
contraceptives, she should be covered by medical
insurance.; Chart: A history of contraceptives;
Contraceptives have been used for centuries and have a colorful
past.Some have worked,such as the pill and condom,while others like mercuryand
lead mixtures are questionable.Today,oral contraceptives and
con-doms are the most widely used because of convenience and availability.A
timeline of contraceptive milestones:; 3,000 years ago
-Egyptians use penis covers.It is not clear if they used thecovers as condoms or
for insect protection while working.; 1,000 years ago -Chinese mix mercury and
lead in food,believing it wouldprevent pregnancy.; 1600s -Animal intestines are
used in England for condoms.; 1700s -Some Canadian women remove testicles from
beavers to use indrinks.They believe the dried testicles could prevent
ovulation.; 1850s -Rubber condoms are introduced.; 1880 -Diaphragm is
invented.It is a molded rubber device that fits over thecervix prior to
intercourse to prevent entrance of sperm.; 1920s -German physician
ErnestGrafenberg introduces intrauterinedevices.; 1920s -Spermicide usage
begins.; 1951 -Carl Djerassi leads a medicalteam that develops synthetic
proges-terone,which with estrogen can preventovulation.This discovery and work
byMargaret Sanger,founder of PlannedParenthood,and other birth-controlactivists
leads to the first birth-controlpill in 1960.; 1960 -The pill is introduced.;
1983 -Today 's Sponge is introducedas a female insertive
contraceptive.; 1992 -Depo-Provera,an injection,isintroduced.;
1993 -Female condom becomesavailable.; 1998 -Morning-after pill
becomesavailable.It can prevent pregnancy if used separately or combined in
multipledoses within 72 hours after intercourse.; SOURCE:Walter
Masanic,Janssen-Ortho Inc.; Graphic by: THE PLAIN DEALER
LOAD-DATE: August 8, 2000 
