Copyright 2000 The Washington Post
The Washington
Post
August 2, 2000, Wednesday, Final Edition
SECTION: OP-ED; Pg. A31
LENGTH: 796 words
HEADLINE:
Why Cover Contraceptives?
BYLINE: Lila
Arzua
BODY:
In the midst of the current
brouhaha over prescription drug benefits for seniors, another
insurance controversy is brewing. In what may be a
precedent-establishing case, pharmacist Jennifer Erickson of Seattle, with the
help of Planned Parenthood, has sued her employer, Bartell Drug Co., for not
providing her with birth control coverage. Brought under Title VII of the Civil
Rights Act, the case is the first lawsuit ever seeking to force a health care
plan to cover contraceptives.
Erickson believes it's
not fair that she has to spend $ 300 annually on birth control. Her health plan,
provided by Bartell at no cost to Erickson, does not cover this expense. But if
Erickson should win the case and get the free prescriptions she demands, it
won't be a victory for women. By limiting women's options, this precedent could
do more harm than good. There's no denying prescription birth control is
expensive. Insertion of Norplant costs $ 700, and of an intra-uterine device
(IUD) $ 400, while the birth control injection Depo-Provera can easily set one
back $ 400 to $ 500. The Alan Guttmacher Institute, an affiliate of Planned
Parenthood, acknowledges that a program covering contraception would cost
employers about an additional $ 21.40 per employee a year, a cost that for many
firms can quickly add up. As a rule, workers ultimately pay for extra frills on
health insurance with reduced wages or benefits.
What's
often missed in this debate is how efforts to mandate birth control coverage
through either judicial or legislative avenues hurt women. Rather than
permitting an individual to select a job and attendant health plan suited to her
individual medical needs, she will find herself paying for add-ons she may or
may not need or even want. In some cases these required costs can price people
out of health insurance altogether. Currently, nearly one out
of every four uninsured Americans lacks health coverage because of an assortment
of legislative mandates, according to a study commissioned by the Health
Insurance Association of America. The cost of such mandates is
borne disproportionately by workers in small businesses.
Despite the
price of such coverage and its burden upon all employees, there is scant
evidence such programs are beneficial. The endeavor to require universal birth
control coverage is particularly pernicious for women. While it promotes
contraception as the solution, the Alan Guttmacher Institute's claim that "only
5 percent of women in need of contraception are not using a method" makes
current rates of out-of-wedlock pregnancy and abortion difficult to explain. The
multiplying array of prescription contraceptive options
available to women has done little to stem this trend. In fact, more than half
of women who have an "unintended pregnancy" had been using a
contraceptive method during the month they became pregnant.
Nevertheless, many feminists insist that prescription birth control is
not only a solution but an entitlement. "It is a medical necessity. It is basic
health care," Gloria Feldt, president of Planned Parenthood, said last fall.
"The health care most women need most of their lives is reproductive health
care, and that includes birth control." For a small minority of women for whom a
pregnancy would pose a serious health risk, sterilization could plausibly be
considered medically necessary.
But what is so crucial about
prescription birth control? Many other prescription services are purely
elective, from contact lenses to cosmetic acne treatments, and those who desire
them find a way to pay considerable out-of-pocket sums to procure them. It's not
as though prescription birth control methods are the only option for women. At
nearly every pharmacy, gas station and convenience store around the country,
condoms can be had for a comparative bargain. Not only do condoms offer a higher
efficacy rate than several prescription contraceptives, but
factoring in the protection they offer against sexually transmitted diseases,
they are obviously the best value for the money.
Ultimately, however,
it's not about the money. As Feldt has pointed out: "The underlying feminist
issue, of course, is that women should be able to control their own destinies.
And women can't control their destinies if they can't control their fertility."
But it seems strange that the way to seize control of one's fertility is to get
another party to pay for it. The drive to force all employers--and their
employees--to fund elective birth control prescriptions regardless of individual
practices seems incompatible with a movement that purports to liberate women
from restrictive policymaking and stereotypes.
The writer
recently completed a fellowship at the Phillips Foundation.
GRAPHIC: ILL,,STEVE ANSUL
LOAD-DATE: August 02, 2000 
