In recent weeks, many women have driven or walked up to their pharmacy window to pick up their birth control pills. They were all pleasantly surprised to get told, free. Women tend to forget if the free isn’t needed. I was with someone who did need free. What a nice surprise.
However, the free pills just generated more questions. Is all birth control free? If someone wanted a tubal ligation or a vasectomy (the operation REAL men seek) is that going to be free? What about condoms? If those are free, do you just get the utilitarian kind or do you get the fun ones? How about depro shots and IUDs? Are those free also?
It sounds like a great concept. If the financial burden is removed from the contraception equation, won’t that prevent unintended pregnancy?
Probably not but it goes a long way towards making a dent in the problem. What do the contributors have to say on this issue?
Boy, how do you step into this one without getting stuff all over your shoes? “Utilitarian” condoms? Hmmm-I wonder what they look like; some gray, heavy duty thing or what? The military used to issue what we called “birth control” glasses, so ugly, no one in their right mind would have sex with someone wearing them.
Oh God, why must I explain? I am not so old and over the hill that I don’t know that fancy condoms exist. I know that some even have special names.
I suspect I’m gonna catch hell for that last sentence.
I have no problem whatsoever with birth control. I just don’t understand why it has to be “free” (as in, somebody else pays for it)
Food, clothing, housing, and fuel to heat your housing are all very basic necessities. But they are not free to all. The government subsidies them for the very poor, but otherwise you are on your own.
What’s so magical about birth control?
I’ll go head and say it: If a woman can’t figure out how to afford $10/month for the pill and a pack of condoms, she isn’t mature enough to be having sex. (The same thing goes for men, but they don’t deal with the consequences as directly.)
If you really want to reduce unplanned pregnancy, go for better sex education. Things like teaching girls better skills to negotiate using condoms and understanding how their BC actually works. Next to zero pregnancies are due to people being unable to afford birth control. Free BC is just a sop to a small special interest group (that happens to be overrepresented here.)
Furbee
You just said “Free BC is just a sop to a small special interest group (that happens to be overrepresented here.)” Are you implying that Elena and I are over-represented here?
In the first place, birth control pills cost a smooth $50 a pop without insurance. There are plenty of people who would have problems even if they did cost $10 bucks. You are probably right about many people being too immature to have sex. Since when did that stop anyone? That’s sort of the point.
It’s a lot cheaper to buy birth control pills than it is to pay for WIC, Medicaid, free lunch and all the other things that it takes to raise a child of a poor woman. Free contraception also reduces the incidence of abortion.
To me, its money well spent. Ounce of prevention being worth a pound of cure.
Furby, surely you come from some other time or some other planet when you say:
“If you really want to reduce unplanned pregnancy, go for better sex education. Things like teaching girls better skills to negotiate using condoms and understanding how their BC actually works. Next to zero pregnancies are due to people being unable to afford birth control. Free BC is just a sop to a small special interest group (that happens to be overrepresented here.)”
If you will note what I read, some things that I consider invasive would require payment on a sliding scale.
If you are at all interested in seeing what the costs of birth control are, you might take a peek here:
http://money.usnews.com/money/blogs/alpha-consumer/2010/08/27/the-real-cost-of-birth-control-
And here is some interesting information about who pays, it might just surprise you:
http://patients.about.com/od/drugsandsafety/a/freedrugstores.htm
And about the woman who can’t figure out how to afford $10/month–well read the second link above. And for someone on a very limited budget, $10/month might just feed your family for a day or so. Yes, it won’t be a grand meal, but then grand meals are few and far between for poor folks. And despite everything, poor folks do have sex. Sometimes it’s the only thing they have in the way of entertainment. (Joke-sorta).
http://www.huffingtonpost.com/2014/03/05/mom-drives-van-in-ocean_n_4903057.html?ncid=fcbklnkushpmg00000063
Maybe just one too many unwanted pregnancies drove this woman to commit a desperate act.
Actually, you can buy a 28 day supply of BC pills for $10 Target or Walmart or Kroger. It’s a little cheaper if you buy a 3 month supply:
http://www.reproductiveaccess.org/contraception/lowcost_pills.htm
Of course, condoms are even cheaper. In bulk, well under $1 a pop (My sorta-joke)
If your budget is so tight that you can’t afford $10/month then it is irresponsible for you to be having sex in the first place.
But more to the point. I never said I was against subsidies for the genuinely poor, even for birth control. My point is why should birth control now be “free” for people who aren’t poor? If you have to buy your own food, which is a heck of a lot more essential to life than the Pill, why do you get BC for “free”? The vast majority of women in the country were able to afford birth control before now and it hasn’t suddenly gotten more expensive. As I said, this was done to curry political favor, not for genuine policy reasons.
You want to make your case for free birth control? Find a study that shows that the cost of birth control plays any significant factor at all in its use. It doesn’t. The things that would actually prevent unplanned pregnancies are things like getting people to use BC properly and more regularly. (You’d be shocked at how many people can’t even understand the basic BC pill and simple things like antibiotics.)
And of course, the number one cause of unplanned pregnancies…ready for a shocker…Many guys don’t like using condoms and are able to convince the woman not to use them. Teach young women the social skills to avoid being pressured into having unprotected sex and you’ll make some real progress
Sidebar: One of the coolest things going on right now in preventing unplanned pregnancies is the work the Gates foundation is doing to design a high tech condom that makes sex more pleasurable for men. I’m sure some women’s eyes will roll at that, but imagine how rare unplanned pregnancies would be if men preferred to use a condom over unprotected sex. That’s a solving a real problem, not an imaginary one.
Furby
Some of what you say makes sense. Some doesn’t. I don’t think we can say that cost has a thing to do with unwanted pregnancy. It certainly does. I don’t think we have clear cut studies to prove what you are saying or I am saying, mainly because it isn’t all about having pills or devices. Some of it is access and money to afford a doctor.
Interesting about the Gates condom. Has anyone tried it out? Any volunteers?
What is free?? People pay for things all the time and get a certain amount of services for no additional charge. The cost of the BC is just figured into the cost of the insurance. One would think that a group that disliked abortion so much would spring for a little bit of cost to reduce the number of abortions, unwanted pregnancies (including rape and unwanted sex) and children born into broken homes. Think of the overall savings in the system for less abortions and less pregnancies.
Failure rate for an IUD is 0.2% – 0.8%
Failure rate for “the pill” is 9%
Failure rate for male condom is 18%
What’s the difference? The cost of an IUD is $500 to $1000, “the pill” $15 to $50 per month, a condom about $1. Lower up-front costs are associated with higher failure rates.
What’s my point? As you move down the socioeconomic ladder, your choices become more limited and the risk of accidental pregnancy increases. (Or, if you like, as you move UP the socioeconomic ladder, your choices become greater and the risk of accidental pregnancy decreases.) You don’t need a study to prove that point. Reducing the incidence of accidental (unwanted) pregnancy also reduces the incidence of abortion.
While using a condom is responsible, its use alone still exposes the individuals to unwanted pregnancy at a rate twice that of “the pill” and on the order of 36 times that of an IUD. The research I’ve done indicates that employers are required to cover all TYPES of birth control, though not all BRANDS (think generics vs name-brand). All these factors play a part in the “pay now or pay later” equation that Moon discussed earlier. It’s not as easy as saying that if you can’t afford $10/month, you shouldn’t be having sex. It’s easy to sit back and make value-laden statements such as that without knowing the circumstances that caused that individual to “not afford $10/month”.
Great information, Confused. Apparently you aren’t as Confused as you think…you get it.
Interesting that the old ‘just don’t have se still comes into the discussion.’ If it were that easy, the human race would have stopped a long time ago.
According to the MONEY article at the link above, diaphragms seem to be the lowest cost most effective after free BC pils. About $60/year but you have to plan ahead, which takes some of the fun out of sex.
It feel Orwellian turning birth over to “the state”. I’d like free cholesterol meds. I’d like Prozac but in the water in low doses. I’d like free pre-natal drugs for pregnant women. Why birth control over those?
As someone said its built into premiums but why birth control over all other widely used meds?
Because unwanted children that people cant afford are very expensive to the state would be my guess.
Gotta watch out for those squirrels.
http://youtu.be/0nKG_O0Ei_o
We could have birth control added to the water like fluoride and then you have to take a pill to neutralize it in order to get pregnant. Or, everyone gets a hormone activated implant at 10 that kills sperm or prevents ovulation. You can’t remove it without a court order before age 18 which is when the device needs to be replenished.
Roe v Wade makes this sort of reproductive regulation impossible but if the abortion foes have their way and overturn it these are future possibilities. Is there a right to sex and pregnancy at age 13?
@Ed, I would say NO NO and NO.
I suppose in other cultures, there might be some disagreement.
Your plan sounds rather like the Hand Maidens Tale.
The Gates condom (now there’s a name!) isn’t out yet. It’s still being developed. I read about it on NPR a few months ago. Something about super high-tech materials that is supposed to enhance rather than reduce sensation. (That’s probably about as far as I can go without getting an NC-17 rating.) They think it can be made fairly cheap. Even if it’s more than a regular condom it’s such a game changer it’s worth it. Like I said before, imagine how few unplanned pregnancies there would be if men preferred sex with a condom over sex without one.
I’m glad to see we are in agreement that there is no evidence to support the argument that the cost of birth control is a factor in unplanned pregnancies. It’s not that there aren’t studies on the causes of unplanned pregnancies. There are. And they show that even access to birth control is a minor factor and cost of birth control isn’t on the radar at all. (There are multiple forms of BC available that do not require a doctor visit or prescription. And assuming the medical data supports it, I think the regular old BC pill should be over the counter to save on the doctor visit.) The actual causes of unplanned pregnancies as determined by real scientific studies (links if you want them) are a lack of understanding of how BC works and proper use of it. Another big factor is apparently women who think they are infertile when they really are fertile.
So if there is no evidence to support that free BC will actually reduce the number of unplanned pregnancies, which we both agree on, why exactly should we me making BC “free”?
The only reason seems to be that a segment of the population seems to have made birth control a cause and is pushing their agenda beyond reason. Take the famous case of Sandra Fluke. Regardless of what Rush Limbaugh says about her, why can’t a 30 year old woman attending a prestigious law school afford $10/month for the pill? I fully support Sandra Fluke having the right to buy whatever form of birth control she wants, and if her health plan wants to include it for free, they are free to do that as well. What I don’t support is making birth control a new entitlement, “free” to all, regardless of need.
If you want to make the case for the government supplying every basic need, go ahead and try to do so. But there are a lot of things more important to life than birth control that we expect adults to be able to provide for themselves.
I wouldn’t care if it had been free or reduced. While I don’t think that there are reliable studies about birth control and cost, I do believe I know from personal experience and friends about how that works.
Is any birth control 100% reliable, NO. Moving on past there, accessibility and cost are a factor with young people and the poor.
There is also the idea that people don’t understand the appropriate use. That’s the reason depro is often good for young people who are careless and don’t understand the value of following directions to the letter of the law.
Its really a small price to pay if it works. Since we are in the infancy of free birth control, maybe its a wait and see. I agree all of it should be over the counter.
Let’s save Sandra Fluke for another day. You do understand that she represented everywoman don’t you? You keep saying $10. That is NOT standard. Even now birth control isn’t free for those who want name brand. A year ago a name brand pack of BC cost at least $50 with no insurance.
As for a description of the Gates Condom, we aren’t prissy here. I wouldn’t shut you down for using accurate terms that aren’t just to gross us out.
Can people reproduce without the means to care for the children or if they will damage the children. Start with crack addicts. Do they have the right to introduce a crack baby into the world for the rest of us to nurture and support? Do child abusers forfeit the right to reproduce?
Typically one could get semi-voluntary agreement to restricting reproduction capability. A sentence reduction in exchange for a tubal ligation, for example. Is that moral?
These are the messy grey areas once birth control pills are available OTC at a low cost.
I don’t see why? We have examined many of those questions in one form or another during the 20th century. Obviously we cant force sterilization on others.
If we could, I would like to be the one who gets to decide. I think we all know of people who shouldn’t be allowed to reproduce.
My husband once said something very wise. He said there were no illegitimate children, just illegitimate parents. I think we can insert any word in place of illegitimate. It isn’t the kids’ fault.
Open and free BC does reduce the number of abortions and unwanted pregnancies. There have been various studies performed world wide.
@Pat.Herve
I’d like a link to a study that shows cost of BC is a factor in unplanned pregnancies. I spent about 15-20 minutes looking and found about 5 studies that said the opposite, so I’d be curious to see what studies you found that said differently.
I’d also point out there is a big difference between free/low cost BC in other parts of the world and in the US. $10/month is a minor, trivial expense (about 0.5% of mean disposable income) for women in the US or western Europe but is a huge part of someone’s income in Africa and parts of Asia. So I can understand that cost is a factor elsewhere in the world, but I haven’t seen any studies that show it’s a factor at all in the US. Like I said, if you’ve got a link to a study that says otherwise, I’d genuinely like to see it.
@Furby McPhee
Here ya go –
http://www.livescience.com/23726-birth-control-abortion-rate.html
http://healthyliving.msn.com/health-wellness/birth-control/us-teen-birth-rate-plummets-report
http://thediplomat.com/2014/01/iran-attempts-to-reverse-its-falling-birth-rate/
http://www.guttmacher.org/pubs/tgr/06/4/gr060407.html
What fun conversation! So poor people can’t have safe sex?
I’m not so sure that a 5.00 copay is out of the realm of possibilities, but considering that at some point in their lives, 99% of women are on some form of BC, that is a pretty big effing number, providing the means at no cost seems fair to me. Unlike a disease that gets treated, women maintain SOLE responsibility for not getting pregnant. Pregnancy is still only a singular predicament. Birth control isn’t like any other medication I can think of in that it is so often used by almost all women some time in their lives.
good job pat 🙂@Pat.Herve
@Pat.Herve
Thanks for the links. The livescience one is what I was looking for. The others aren’t as direct on the cost of BC or are outside the US.
The livescience one makes some good points but the study needed more rigor. Their study used women aged between 14 and 45 who were given free BC and then compared their pregnancy rate against the national teen pregnancy rate. That’s not exactly an apples to apples comparison. They would have made their case better if they had reported a drop (even a smaller one) for just teens or against the overall pregnancy rate for women between 14 and 45. Any group that includes 40+ year old women is going to have a lower pregnancy rate than teens just through pure biology. Birth control or not, that biological clock ticks away.
My other nitpick is that at an unreported number of the women in the study had just had abortions. That’s hardly a random sample. A woman who just had an abortion is going to be a lot more careful about BC immediately afterwards so that would skew their results to show a greater effectiveness than is really the case.
I wish their study had been a little more rigorous and make a more direct connection between free BC and pregnancy rates. I’d be more receptive to the idea of free BC if there was evidence to show it worked. This study didn’t quite make the case but it at least got me to agree that a different study COULD make the case.
Your analogies don’t make sense to me Ed. Birth control is voluntary in this country. What exactly will get “messy”? Unwanted pregnancies are “messy”. Giving birth is “messy”. Having access to free birth control is incredibly “clean”!
Sure they can. It’s called masturbation.
@Elena, after we solve the cost problem for BC (if there is one) with government subsidy the next question people will ask is can we hold people liable for not using free (cheap) BC. I could imagine legislatures (AR, for example) making it illegal to become pregnant and ask for government assistance after not using BC. It sounds strange to us now but it might not in 20 years in the same way that government demanded that all cars have seat belts so people had a choice on safety and most people didn’t give much thought about unsecured passengers and now leaving your kids unbuckled is a crime. Free universal seat belts turned into mandated usage. Will free birth control turn it into mandatory usage?
@Cato the Elder Shame on you! Don’t know you that it makes you go blind?
Oh no!! Cato is blind!!!!
I was advisesd once to not have sex with anyone I wouldn’t want to have a baby with as that was always a possibility. I have always thought that was good advice.
I think that is excellent advice.
Of course when I was growing up, the speech didn’t even give you that much latitude. It was don’t do it, you will ruin your life forever. I expect I have a few years on you though, 6 pack.
Is any birth control 100% reliable? Moon, you say NO. I suppose you are excluding sterilization from that NO.
@ Furby: “If your budget is so tight that you can’t afford $10/month then it is irresponsible for you to be having sex in the first place.”
While I probably be put in moderation for this but that has to be one of the most stupid statements I have heard in a very long time–in the 8+ decades I’ve been on this planet.
Some sterilization fails to work. It is very rare.
@George Harris
Really? You are 80+ years old and you think it’s stupid to think that people shouldn’t engage in sex when the consequences of it could be detrimental to them?
Let’s look at what I said. “If your budget is so tight that you can’t afford $10/month then it is irresponsible for you to be having sex in the first place.”
First off, it should be clear from the context (birth control) that I’m talking about Bill Clinton’s definition of “sex”. Sexual activity that can’t result in pregnancy is fun for everyone but really doesn’t factor into a discussion about birth control.
If you don’t have $10/month of discretionary income you are either in extreme poverty or a very young child (most 13-14 year olds have more than that in spending money.) Since you think it’s “stupid” to say that people in those situations shouldn’t be having sex, obviously you must feel the opposite.
Hopefully in your 80+ years, you’ve figured out that sex, even with birth control, can lead to pregnancies. (I’m not sure of the number but I think it’s something like around 10% of people who use birth control still end up with an unplanned pregnancy) You’ve got two ways to deal with unplanned pregnancies: carry the child to term or abortion. From a strictly financial prospective, an abortion costs around $400-450, or 3-4 years worth of discretionary income for these people. (Remember, we’re only talking about people who can’t scrape up $10/month.) Raising the child would cost far, far more. So how are these people going to come up with the money for either when $10/month is already too much of a burden?
You really think it’s stupid to suggest that people who are unprepared to deal with the potential consequences of sex shouldn’t have it? I think you need to think about this without sex in the picture. Would you agree that it is irresponsible for people to do X, when they can’t afford the potential consequences of X? I think most people would accept that as a basic definition of responsibility. If so, then why is it stupid to say that still holds when X=sex.
To be clear, I’m not anti-sex. Sex is awesome. I’m just saying that if you are so poor that you can’t afford $10/month for a basic prerequisite for sex, you need to focus a little more on improving your lot in life before dealing with the added complications of sex. If you are that poor, your first, second and third priorities should be getting out of extreme poverty. Sex is great, but not being extremely poor is even better. Get into a better situation in life first. For you, sex can wait.
If you think that is “stupid”, you have a very misplaced set of priorities. (And to be blunt, a very regressive attitude towards the poor.)
I am howling at this post. In fairness, I know George, father of 6 and I know one of his favorite personal jokes. He also has a whole bunch of grandkids. There might even be a great gkid or two in there. George is actually pretty decent about poor people. He would even tell you he as been poor himself. I think his outlook is pretty darn realistic about how things are rather than how things should be.
I think it is stupid to expect people to figure out their finances before they have sex. I think it is stupid to expect that some kids won’t have sex. Furby, I think you are failing to take into consideration that lack of maturity or wisdom often lead to risky behavior. Too bad that the sex drive is often stronger than wisdom and all the “don’t do it”s in the world.
I think you are not understanding my point or at least not reading what I actually said. I already said I don’t have an issue with subsidizing birth control for the very poor. (although I’m sure your definition of very poor and mine are probably different) However, I stand by my statement that it IS irresponsible for someone who is that poor to be engaging in “sex” (again using Clinton’s definition here) even with birth control.
I never said people wouldn’t do it anyway. Most people who are that poor (again we are talking about people who have less than $10/month in discretionary income) are that poor because they make many bad decisions in life. But I don’t accept your argument that there’s no point in trying to discourage the extremely poor from making bad decisions about sex or anything else. That includes educating them that potentially having a child is a very bad idea when you are that poor. I really don’t understand why anyone would have a problem with that. Honestly, it seems that you have a knee-jerk reaction to the very idea that in some circumstances abstaining from sex should be encouraged.
It is irresponsible for someone who is drunk to drive a car. Everybody knows that, but it still happens anyway. It doesn’t mean society shouldn’t continue to discourage drunk driving. (Yes, this is an imperfect analogy, because drunk driving is illegal.) Breathalizers are only part of the solution. The other (and main part) is educating people on the risks involved with their irresponsible behavior and encouraging them to behave more responsibly.
So again, you really think that it isn’t irresponsible for the extremely poor to either have a child or potential need an abortion that they can’t afford?
I also stand by my comment that the practical effect of George Harris’ ideas is to trap another generation or two in extreme poverty. My approach may have a 100% success rate (far from it) but even when my approach fails, it only does as bad as George Harris’ went his succeeds. And again, anyone who doesn’t understand that needs to learn a lot about poverty today instead of what it was 40 or 50 years ago. This ain’t the Great Depression. Breaking the cycle of multi-generation poverty is the challenge now.
I think there was multigenerational poverty back during the depression also.
Furby, I wouldn’t say it was irresponsible. I would say it is the human condition. People like sex and even poor people love their children. If fact, I am not sure poor children aren’t more loved than some rich kids.
I’ve been yapping on Facebook about the fact that poor people have kids even when they can’t afford to pay for them. In fact, this has always been the case. People living in poverty have more children, not less.
This is true all over the world – it is nothing to do with American politics, or European-styled welfare states. It is true in the richest nations, and the poorest. It has been this way since the dawn of recorded history, as far as anyone can tell.
Given this fact of reality, does it make sense for us as a society – and every other society – to make birth control free to adults? Yes, I think.
Anyone who wants to make argue theoretical point about the proper role of government, who chooses this particular issue to talk about – an issue where hardly any money is involved, and it combats large-scale societal problems – you may have picked the wrong issue to get worked up over. You’re tilting at a windmill. Most of us will never agree with you.
Considering the amount of money the govt has to shell out to care for children of the poor, passing out birth control for free sounds like an excellent idea to me.
I hardily endorse it.
Is it my imagination or do conservatives just go nuts over sexual issues?
Moon, I hope you saw Samantha Bee’s piece on “The Daily Show” tonight (Wednesday night). It discussed the penis pumps that Medicate has been paying for for many years, with no objection raised from the right wing.
Actually I missed it. I will go fetch it right now.
I laughed so hard at Monday night’s first segment re Rick Perry I thought I would wake up the entire house.
Daily Show has been very good for the last week or two.