In marveling at Limbaugh’s attack on college student Sandra Fluke something popped up in my brain. Did I hear that right? Does a year’s supply of birth control pills really cost $1,000? Surely not. Hormonal birth control has now been around for, well, most of my lifetime, and that’s more than enough time for it to have gone generic. A web search reveals that the cost varies a great deal and ranges from $10 to $100 or more a month. What the article did not explicitly explain was why the cost has such a wide variance. There can only be one reason: when the cost of a medicine or procedure is borne by health insurance the consumer loses her motivation to shop by cost. The article says, revealingly,
A 2009 study by the American College of Obstetricians and Gynecologists showed that one-third of women using birth control were more mindful of their contraception because of economic concerns. For women using hormonal methods, 13% reported being worried that they might not be able to pay for it.
Get that? If only 13% worry about the cost, then 77% are not worried about the cost – they have insurance. Now I’m really worried here because I am coming close here to agreement with Rush Limbaugh. OMG! No, not agreement with his misogynistic, crude, uncivil, aggrandizing attack style, but with the basic premise that something is wrong with the idea of the public paying for medical care in a way that does not control medical costs. Limbaugh’s aim is misdirected of course – he should be attacking the system and not Miss Fluke.
I have written about this before of course, but in the birth control issue we have an excellent example of why the country is drowning in healthcare costs. I submit that if hormonal birth control pills were not by prescription but over the counter and out of pocket, the cost would plunge overnight.
There is irony in the rise of this issue at this time. As has been pointed out by the Obama administration, health insurance providers actually come out financially ahead if they facilitate reproductive health. To that view, Wikipedia, as usual, is instructive. It says,
The most significant cost in birth control is the cost of failure to prevent pregnancy. Childbirth is expensive and risky, and raising a child takes a tremendous investment of time, energy and money. For example the average cost of a birth in the US is over $9,000 (cost to health plan, 2007 dollars). The US Department of Agriculture estimates that it costs $196,000 to $393,000 to raise a child from birth to age 17. (Depends on household income, total inflation adjusted estimated expenditure in 2007 dollars). By comparison, in the US, method related costs vary from nothing to about $1,000 for a year or more of reversible contraception.
The thought occurred to me that Limbaugh might have done the nation a favor here by highlighting the inefficiency of the so-called system we have, but I may have to reconsider that. Limbaugh’s obnoxious style has diverted public attention away from the real problem.