Monday, November 26, 2007

How Much Should Poor Women and Students Have to Sacrifice for Contraception?

Since the Deficit Reduction Act of 2005 went into effect in January, college students and many low-income women are suddenly having to shell-out much more money for prescription contraceptives. According to the New York Times:
..some students using popular birth control pills and other products are paying three and four times as much as they did several months ago. The higher prices have also affected about 400 community health centers nationwide used by poor women.

The change is due to a provision in a federal law that ended a practice by which drug manufacturers provided prescription contraception to the health centers at deeply discounted rates. The centers then passed along the savings to students and others.
As Cara from The Curvature points out, lawmakers claim that the price hike was an unintentional consequence of the Deficit Reduction Act, and it would be an easy fix since:
...going back to the old rules and lowering the price of contraception for college students wouldn’t cost tax payers a dime, though it would force the pharmaceutical industry to lose out on a tiny portion of their already-monstrous yearly profits.
Yet, lawmakers have been slow to act, causing some speculation that, intentional or not, the higher cost of contraception for poor women and students is widely seen by many politicians as a benefit of the legislation.

While the NYT piece helps to shed light on an issue that has been ignored by much of the press, The Curvature took issue with the article's framing (or invention) of a supposed controversy over whether or not college students should be allowed to purchase contraceptives at the lower rates. The Times article states:

Not everyone is troubled by the price increases. Some people said they wondered why college students, many of whom manage to afford daily doses of coffee from Starbucks and downloads from iTunes, should have been given such discounted birth control to begin with, and why drug companies should be granted such a captive audience of students. Others said low-priced, easy-to-attain contraception might encourage a false sense of security about sex.

“From our perspective, this does bring to light a public health concern, but for a different reason,” said Kimberly Martinez, the executive director of the Abstinence Clearinghouse, which advocates abstinence from sex until marriage. “These young women are relying on this contraception to protect them. But contraception isn’t 100 percent — for pregnancy or for disease.”

After reading the article, I was annoyed that the Times felt the need to go fishing for controversy, and by the deployment of the "latte drinking liberal" stereotype to belittle a problem that is impacting students (who might not be able to depend on their parents for a birth control allowance) and women dependent on community health centers alike. Cara, however, saw the logical fallacies inherent in Ms. Martinez's argument, and her response is too eloquent to merely summarize:

In short, unless you’re living on the street, you deserve to pay through the nose for basic health care... Of course, this is also the same crowd that argues that the rich deserve tax breaks because “they’ve earned their money.” Why the rich are entitled to keep their money to buy boats but the poor and middle class aren’t allowed to buy coffee without being called greedy, I’ve never quite understood...

But just when you think the fun is over, you realize that the second part is fun, too! You see, if a drug doesn’t work 100% of the time, not only should it not be available at an affordable price, but it’s incredibly dangerous to give to people at all.

And, I mean, it makes sense. Think about it: when people have heart conditions, do we give them medication to help regulate the problem? No! Then the heart patients will just think that they’re cured and start skydiving and eating donuts for every meal! We can’t have that. And do we give insulin to Type 1 diabetics? Of course not, they’d just stop paying attention to their blood sugar if we did. And don’t even get me started on anti-depressants. They don’t always work, and they work differently for different people, so it’s better to just not give the severely depressed any hope at all.

. . . Wait. What was that? That’s not how it works? How odd. In that light, it’s almost as though Ms. Martinez’s argument doesn’t make any sense. I think that I have to go lay down.

Or maybe she has a point after all. Maybe we can’t trust the people who we allow to live on their own, have credit cards, vote, join the military and die in Iraq, and operate motor vehicles (but strangely enough, not have a beer) to have TEH SEX. After all, TEH SEX can be dangerous.
Brilliant synopsis of why this sort of thinking is utterly absurd. Cara's whole post is worth reading, so go check it out.

As for me, I'm left simply feeling ashamed that our own government does not seem to understand what Brazil's does - that providing women with easily accessible, reliable contraception reduces unwanted pregnancies, and hence also reduces abortions.

UPDATE: The L.A. Times is running an excellent editorial that lays out how this problem could be fixed. The piece also asks "Has the federal government really been so hung up over a minor wording fix, or was there an underlying reluctance about making contraceptives affordable to young college women, many of whom are single?"

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