Copyright 2000 The Washington Post
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August 5, 2000, Saturday, Final Edition
SECTION: OP-ED; Pg. A17; FREE FOR ALL
LENGTH: 636 words
Birth Control: Basic Health Care For Women
In "Why Cover Contraceptives?" [op-ed, Aug. 2], Lila Arzua says that
covering contraceptives would decrease health care choice for women because it
would impose insurance premium costs on women who don't choose to use
contraceptives. I thought the whole point of insurance was to spread costs over
a large group.
I don't have diabetes, but my premiums go to pay for
insulin for diabetics. I am male, but my premiums pay for pregnancy care. If
Arzua is right, then I should expect a refund for all these things. But if I
did, I would have no right to expect others to bear the cost of my medical care.
What's fair is fair.
Lila Arzua says that the
cost of covering the full range of FDA-approved prescription contraceptives
would be an "additional" $ 21.40 per employee per year. What she doesn't say is
that typically the employee would pay at least 20 percent of the cost and that
the full amount would only apply to companies that now offer no
In fact, many companies already
provide full coverage and would see no additional costs, and many more provide
coverage of at least some methods. Moreover, even the total amount would
increase annual employer insurance costs by only six-tenths of one percent.
Beyond cost, Arzua alleges that contraceptives are basically ineffective
anyway, since about half of American women who have an unintended pregnancy each
year say that they had been using a contraceptive during the month they became
pregnant. But she misses the point. While it is true that about half of
unintended pregnancies occur to the 39 million women using contraceptives, the
other half occur to the only 3 million women-at-risk who are not.
Undeniably, contraceptives "work." The most widely used contraceptive
methods reduce a woman's risk of pregnancy by more than 90 percent.
--Cory L. Richards
The writer is vice president
public policy at
the Alan Guttmacher Institute.
places contraceptives in the same category as contact lenses or cosmetic acne
treatment. Yet more health risks are associated with pregnancy than Arzua
acknowledges. And I seriously doubt there's a way or a desire to screen for all
pregnancy-related risk in order for sterilization to "plausibly be considered
Furthermore, some birth control pills have been
shown to have therapeutic value beyond their ability to prevent unintended
pregnancies--such as in treating endometriosis, acne and excessive menstrual
Would it be reasonable for a health plan to approve birth
control pills but mandate that they be "covered" only where birth control is not
used to control birth?
Lila Arzua argues that
covering contraceptives in health plans would be prohibitively expensive. On the
contrary, improved access to and use of contraception would save insurers and
society money by preventing unintended pregnancies.
pay the medical costs of unintended pregnancy, including ectopic pregnancy ($
4,994), induced abortion ($ 416), spontaneous abortion ($ 1,038) and term
pregnancy ($ 8,619). In fact, a study of claims under the Utah Public Employees
Health Plans suggests that coverage of contraceptives appears to increase their
use and decrease health care costs because of adverse pregnancy outcomes.
As the American College of Obstetricians and Gynecologists stated, "[t]o
ignore the health benefits of contraception is to say that the alternative of 12
to 15 pregnancies during a woman's lifetime is medically acceptable."
Contraceptives are not a matter of mere convenience, as Arzua implies.
They are basic health care for women.
writer is president
of the National Abortion
LOAD-DATE: August 05, 2000