I apologize that this post is going to be a bit slap-dash. I have to run off to meetings in a few minutes, where I’ll be pretty much all day. But this was on my mind.
So, why do I think hormonal contraception should be covered by medical insurance? Because it’s a medication that requires a prescription, as it should remain. Because it carries risks that should be monitored by a medical provider. Because managing its use is a medical issue.
Simple.
Yes, one might argue that keeping women from getting pregnant is a lifestyle choice, not a medical problem. Fair enough. But then again, so much of what medical doctors do is essentially about maintaining lifestyles.
Or shall we stop prescribing Lipitor for patients who clearly have no intention of ever shopping in the produce department? Shall we withhold labetalol from patients who are perfectly content being hypertensive and sedentary? Are those recurrent sinus infections an indicator that the patient should stop smoking already, and am I depriving him of an important moral lesson by doling out the amoxicillin? And don’t even get me started on anti-retrovirals for AIDS.
We all, to some extent or another, have to pay for the choices of other people, disagreeable to some of us as they may be. As I understand it, that is part of being in what we call a “society.” If that makes you want to go Galt, well… I guess we’ll miss you.
And finally, though my time in the heterosexual dating world was fleeting and preposterous, from what I observed men and women pretty equally wanted to have non-procreative sex. (Those of you who dispute this are invited to spend an hour channel-surfing and report back. Skip C-SPAN.) Sadly, through divine design or the vagaries of evolution, the risks of recreational sex are borne disproportionately by women. Providing easy access to effective contraception is a way that we as a society (there’s that word again) have of making that disproportionate risk more equitable. Silly addle-brained liberal that I am, I happen to think that’s a good thing.
And now I’m off to five hours of meetings. Have fun without me!
I know you’re off to meetings. But I’m curious if you, or others, could expand on why contraceptives should be prescription only. I can see the argument for that, but I can also see an argument for making them generally available. (In part, this reflects my own ignorance of the side effects, etc., of such contraceptives.)
Got thirty seconds between meetings — in short, there are rare but significant side effects that should be clearly discussed, with a thorough risk factor evaluation, before the medication is started. Also, while relatively easy to use, there are important instructions that should also be reviewed before prescription.
Gotta run!
Other than as encouragement for women to see the doctor once a year, is there any reason why the prescriptions can’t be for a longer period of time?
Can you clarify the time period you mean?
Docs don’t prescribe BC for more than a year at a time, necessitating an annual visit. Is there a reason for this beyond general health monitoring, or do the instructions and risk factors change such that it needs to be annual?
Will,
That’s the standard time for all drugs. It’s intended to get everyone to show up and get monitored, I believe. You can get your PCP (not gyn) to prescribe birth control pills (they don’t do a gyn exam for it either)
I understand the reasoning when someone is first on the pill. I’m curious after the first few years, if follow-ups are still necessary. Honestly, I wonder about this with a lot of drugs.
(This isn’t a declaration that I think they are not. I really don’t know.)
It’s generally a good idea to do follow-up every year or so, just to make sure the medication is still working as desired, there are no untoward side effects, it’s still being taken, etc. Pretty much true of any medication.
My wife had to eventually stop using BC because of complications with blood clotting.
And Mrs. Teacher might have to as well for the same reason.
A lot can happen medically in a year and if one of the outcomes of an unmonitored complication is, ya know ~DEATH~, I think it’s reasonable to have people check in to minimize that risk.
I mean I am kinda attached to Mrs. Teacher, letting her have my baby and all….
A Teacher is a Mr? Same here. What do you teach, good sir?
Math. Geometry to be particular.
I was initially skeptical about requiring coverage of contraceptives, based on my being skeptical about most efforts to require that party X do something for party Y. But I’ve become persuaded that contraceptives have significant enough therapeutic uses that to treat them any differently from other prescription medications/devices isn’t justified by any relevant distinction in what they are. So if we’re going to say it’s ok for the government to require certain types of coverage, there’s no good reason to leave contraceptives out of that requirement.
Of course I wouldn’t require any particular coverage, and would leave that up to contractual arrangements between customers and insurers. But as a dad of 3 dependent daughters, I’d damn sure want that coverage to include contraceptives, and not solely because of the risk of pregnancy.
Mrs Teacher actually started taking them for non-contraceptive reasons and would have been in a bad state for a LONG time without them. As a teen she had to miss school for a day or two on a regular basis until she could go on hormone based birth control to help manage the pain.
Do I look forward to the day, 14 years from now, when Baby Teacher Kaylee has to start on those pills because she has the same plumbing problems as her mom? No.
But I’ll be danged if some stuffed shirted conservative neocon know it all insists that she should have to suffer through that because, gosh darn, those pills also make it harder to get pregnant.
They can sit with her and help her keep up from all the missed school.
Damnit… the comment below was supposed to be a reply here… I’m going to copy-and-paste it just to make it make sense…
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“But I’ll be danged if some stuffed shirted conservative neocon know it all insists that she should have to suffer through that because, gosh darn, those pills also make it harder to get pregnant.”
It is not because they will make it harder to get pregnant that is the issue. It is because they assume that taking contraception means they’re going to start fucking. And there are few things that a “stuffed shirted conservative neocon know it all” hates more than fucking.
“But I’ll be danged if some stuffed shirted conservative neocon know it all insists that she should have to suffer through that because, gosh darn, those pills also make it harder to get pregnant.”
It is not because they will make it harder to get pregnant that is the issue. It is because they assume that taking contraception means they’re going to start fucking. And there are few things that a “stuffed shirted conservative neocon know it all” hates more than fucking.
Fluke could use a condom but it easier to insist that we all pay for her pills. Who doesn’t like getting a hand out. Heck, doesn’t Planned Parenthood give away condoms for free?
Actually no.
She’s asking that her ~insurance~ provide coverage for a prescription medication that her ~doctor~ decided, for what-ever reason, she should take.
You’re assuming it’s about sex and handouts.
Heck my kid could probably get through his cough with some honey water and a touch of bourbon. How dare I demand that my ~insurance~ provide him with antibiotics to make it easier?!?
Frankly if birth control pills had no other applications I could almost see the argument, but as I said above, Mrs. Teacher has been on the pill long before she was sexually active because those hormones help with other womanly problems and were deemed necessary by her doctor.
Tell me, Sir Scott, how many conversations and decisions by ~Your~ doctor do you want pundits and politicians to second guess?
If the only reason she got the pills was b/c she asked her doc for birth control then you can hardly say the doc gave them to her b/c she “should” take them. How many times do we hear of docs giving out meds that people don’t need but the docs give them out b/c folks ask/demand them?
Are you suggesting that my wife has been lying to me about her sexual history?
She was on the pill to manage horrible and debilitating cramping which rendered her unable to function for up to two days at a time, instead forcing her to sit in a dark room with a warm towel on her forehead wishing for the pain to stop long enough that she could sleep.
This happened every 28 days.
And you’re telling me she should just suck it up because someone else might have been “Asking” her doctor for the pill to prevent pregnancy?
Dude.
I’m talking about Sandra Fluke the woman who was at the center of all this. Don’t flatter yourself that I’m taking about you.
Yesterday, I spoke to a good friend out in New Jersey who works for a company that does some work with some major pharma companies. We, of course, got onto the topic of Health Care and he explained to me that he was entitled to first-dollar health care coverage equivalent to that which Obama would get. There wasn’t anything that would have any difference. Nothing where he would get a plaster cast but Obama would get a space-age plastic one, or anything like that.
If Obama would get different/better health care than my friend would with a similar malady, then, my friend explained, his own rights were being violated.
It’s through such a lens that I see such things as explanations that failure to pay for someone else’s birth control violates their rights, somehow.
This is basically content-free snark: “I imagine people who disagree with me on this issue disagree with me on other issues.”
If your thinking is applied to the actual topic being discussed, it turns a little strange. The problem is that classes of drugs that are routinely covered for men (sexual drugs and hormonal treatments) are routinely not covered for women. In that context, what you’re saying is that women are unrealistic for believing that they should receive the same insurance coverage as men.