Why the demand for lesbian and transgender women to subsidize cisgender heterosexual women?
“Mr. Trump’s Attack on Birth Control” (nytimes) is interesting on a few levels.
The context:
the Trump administration is making it harder for women to get access to birth control. On Friday, it rolled back an Obama-era rule requiring most employers to provide their employees with birth control coverage without co-payments.
So the debate concerns only women with jobs who get health insurance as part of their compensation. An employer that doesn’t mind being picketed by an angry Facebook mob can now tweak its health insurance plan so that birth control pills are either not covered or require a co-payment.
The first interesting idea is that insurance is an appropriate vehicle for funding expenses that can be predicted in advance. I.e., an Obamacare policy should provide “health assurance” in addition to what would traditionally have been regarded as “health insurance” (paying for unexpected costs):
These regulatory rollbacks will almost surely reverse years of progress. The percentage of reproductive-age women who faced out-of-pocket costs for oral contraceptives, for example, fell to less than 4 percent by 2014 from more than 20 percent just two years earlier, according to the Kaiser Family Foundation. One study estimates that women are saving about $1.4 billion on the pill.
The second interesting thing is the assumption that if an insurance company is buying something it costs less (maybe it costs nothing because it has become “free”). The assertion highlighted above is that women will be saving money compared to going to Walmart and paying $9 per month (nine different options for pills at that price), perhaps out of a health savings account or flexible spending account to neutralize the pre-tax/post-tax issues (again, remember that this entire debate concerns only those women with jobs). This can be true only if insurance companies have special money trees. If they don’t have money trees then payments come from premiums paid by other members.
Who pays premiums to fund “free” birth control pills plus whatever administrative costs are associated with arranging reimbursements by an insurance company in $9 chunks? To a large extent… other women!
In the hierarchy of American victimhood, lesbian and transgender women are more victimized than cisgender heterosexual women, right? Why would it make sense, then, to transfer money earned by lesbian and transgender women, whose demand for birth control pills is presumably low, to subsidize cisgender heterosexual women? Also, why does it make sense to transfer wealth from older infertile women to younger fertile women? In addition to suffering from any complications of menopause, these older women now have to subsidize the younger women who are often taking their places in society?
[You might argue that some of this wealth transfer does flow in the correct direction with respect to comparative victimhood because premium dollars paid by men are used to fund birth control pills consumed by women. But a lot of women share household expenses with men so taking money from a man within their households reduces their spending power just as much as if the money had been taken from them.]
What does the credentialed American public think? Let’s look at the highest-rated reader comments:
S: I went to medical school for multiple reasons, one of which to make sure abortion services would always be safely available. I was hoping to use that skill as little as possible, but if Trump, Ryan, McConnell, and the Heritage Foundation (holding the marionette strings over all of them) have their way, it looks as though this country is going back to the dark ages.
*** about 10 more top-rated comments that assume that working women will quit using contraception if they have to pay $9 per month. Then they will end up pregnant and will have abortions. But does this make rational economic sense? Can they get an abortion every six months for less than $54? If not, why wouldn’t they choose to pay $54 every six months out of pocket for pills? ***
Laura Haight: Consider a single mom who was finally able to go back to work after her child went to pre school. She can’t afford to take care of another child, so she gets birth control through her company. The cost would be prohibitive otherwise as they are just getting by now. No, she can’t work another job because she needs to be home raising her child. Without birth control, she gets pregnant. She can’t get an abortion. She has the baby. Must quit her job. Cannot work now because she has an infant to care for. She turns to the so-called safety net but it’s not there. And so on. And another well-intentioned, willing to work, American woman begins down a cycle of failure for herself and her kids and their kids. [No explanation for why the “single mom” didn’t learn enough about the U.S. family court system to turn a profit on the second child. Or for why she can’t get an abortion in a country where women are free to sell abortions at a discount to the net present value of the potential child support revenue.]
J.M. Kenney: Not all women are unmarried and poor! Access to effective birth control is crucial to married women and the families who rely on them to earn wages through work. We are now a society where the majority of households rely on two adult wage-earners to survive. Not to afford vacations or other luxuries, but just to keep food on the table and a roof over everyone’s head. [i.e., in a heterosexual couple, with both the man and the woman are paying health insurance premiums, somehow it saves money to pay a higher premium and let the insurance company pay the $9/month… ergo they are being subsidized by people who don’t have sex? Or people who are infertile?]
njglea: Go ahead, Con Don. Try to take away women’s right to choose what they do with their own bodies.
LAllen: This is an attack on many fronts. It’s an attack on women’s health, women’s autonomy, and women’s rights. [Women can be autonomous only when someone else is paying for their pills? But, as noted above, if the payors are lesbian and transgender sisters, isn’t there a zero-sum autonomy game going on?]
A lot of the comments discuss the fact that Viagra is covered by all health insurance plans, while plans from Catholic employers may no longer cover birth control pills. This is evidence for U.S. society being rigged in favor of men. However, it looks as though the most popular insurance plan for older American men, i.e., those most in need of Viagra (except for some prime-age guys at Burning Man), does not cover Viagra: “Does Medicare Cover Viagra.” And it is unclear that there is any Obamacare mandate requiring insurers to cover Viagra for men under 65. Maybe a social psychologist can do a master’s on how Americans managed to convince themselves of something that can be easily fact-checked with Google.
Readers: What do you think? How is it possible that while other countries keep pulling ahead of us in terms of GDP per capita (list) we have a national debate on the subject of who pays $9/month? And, if we are going to have such a debate, why are newspapers that champion the rights of the lesbian and transgender supporting this subsidization of cisgender heterosexuals?
[Update: Today the Times published “The Economy Can’t Grow Without Birth Control”, which uses a figure of $600 per year for birth control, without explaining the apparent contradiction with the Walmart web site. The article is another great example of the idea that insurance companies have money trees and their spending isn’t taken away from money that we could have spent on something else: “Consumer spending makes up about 70 percent of all economic growth, and women are responsible for an outsize portion of that spending. Billions of dollars less a year in their pockets means billions of dollars less that they could spend on goods other than birth control, dampening their ability to support businesses and the economy.”]
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