Thursday, July 31, 2008

The Third Wave vs. Coverage for the Uninsured

What is the best way to insure that some folks won't be able to afford health coverage for their strokes, broken bones, and heart attacks?

Simply require insurance companies to cover particular pills and procedures, whether or not this is the patient's preference.

The women at "Feministing" are angry that insurance plans are required to cover Viagra, but not birth control, and are taking McCain to task for it (it is true that he could have constructed a better response to the challenge than embarrassed stammers). I understand their concern, but I don't believe either medication should be mandatory.

First of all, it's a matter of priorities. Yes, prevention is the best medicine, but no one in her right mind would choose a "prevention" plan over a "catastrophic" plan, provided she couldn't afford both. She can assess her family planning options, not her "susceptibility to cancer" options. When various goodies are added to insurance plans, the cost of coverage is unnecessarily increased, and the patient can no longer opt-in for an "I'm not quite as screwed if I get cancer" plan. Of course, a few bucks here or there won't suddenly price-out millions, but all of these consequences occur at the margins.

Second of all, it is questionable whether or not, even for the well-off consumer, it is preferable that her birth control be covered by insurance altogether. Insurance is best for situations that are unpredictable. We are fully aware that we will likely end up paying the insurance companies more than we will cost them, in the long run. Yet, we consider it worthwhile to have the piece of mind that we'll be able afford our treatment if something terrible happens to us. However, birth control pills are a non-emergency, continuous, relatively predictable expense. For such medications, wouldn't it be best to buy directly from the pharmacy, rather than invite an unnecessary middle-man, who arrives with a chock-load of bureaucratic expenses?

Thirdly, the feminist movement is not always consistent when it comes to the concept of "choice." If it is the woman's choice whether or not to have an abortion or take birth control, shouldn't the pharmacist, doctor, or insurance company get to decide whether or not to be complicit in this choice? (I would make an exception for emergency situations or instances where the provider does not inform the woman of all of her options. That could arguably considered professional neglect).

The women of "Feministing" would be wise to consider the unintended consequences of their cause. If they want to help women, they should allow for more affordable coverage for breast, ovarian, and cervical cancer, not birth control.

As an aside, I can never tell anymore when exaggeration of "ideal" women's bodies is considered, by the feminist establishment, as unacceptably sexist or simply ironic re-appropriation. Is it me or do the naked silhouettes on the banner of the Feministing webpage resemble those on the storefront of Orlando's strip club?

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