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Jewish World Review April 18, 2001 / 25 Nissan, 5761

Jay Ambrose

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Consumer Reports

The need for excess control -- PRESIDENT BUSH has proposed doing away with the mandate that health insurance programs for federal employees must cover birth control pills, and the reaction of some has been to compare the incomparable to make invalid points, to ignore the purpose of well-established institutions, to insist on the wasteful and to wallow in illogic. What is needed, it seems, is the development of excess control pills.

Perhaps the silliest proposition of those who find themselves aghast is that some insurance companies do, after all, pay for some of the cost of Viagra pills and that it is therefore discriminatory against women for them not to pay for birth control pills. This is what is known in the language of logic as a non sequitur. The purpose of Viagra is to treat the ailment of sexual dysfunction in men. The purpose of birth control pills is to prevent pregnancy. Treating and preventing are two different things, and an ailment and pregnancy are two different things.

The traditional purpose of insurance is to compensate people for accidental losses - for ailments that could not be foreseen, such as male impotency - not to compensate them for purchases they planned to make anyway. It's true that insurance companies do sometimes engage in preventive programs, but the money is ordinarily provided for such things as drugs to control blood pressure or for vaccines, not for the sorts of things that huge numbers of healthy people routinely and repeatedly obtain on their own or for ordinary safety devices, such as motorcycle helmets or fire alarms.

There is an obvious reason insurance companies operate this way. They aim to stay in business. If they simply become means of people buying products more cheaply, they will go out of business. Any number of pundits and feminist spokespersons have argued that it would make financial sense for insurance companies to pay for birth control pills, but if it did, more of them would. After all, the insurance companies are experts in the field and employ scads of actuaries to figure such things out. It is an absurdity of the first rank for people outside the business to think they understand the finances better or to believe that insurance companies would intentionally behave in their own worst interests.

It's obviously true that health insurance companies would have to pay less if there were fewer births, but it is equally true that most people will buy their birth control devices themselves if the insurance coverage does not exist, and the fact is, most can afford it. Refusing to force insurance companies to pay for what people can and do buy themselves is not an issue of cutting women off from birth control, as some argue. For those who cannot afford the pills, state governments might want to consider some form of subsidies, but constantly telling insurance companies what they must cover is a surefire way to cripple them and cause larger problems than now exist in the country's health care system.

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