Since When Is Birth Control a Medication?

Those who have read this blog know that I'm very opposed to the HHS Mandate. I've talked about here: Why I Hate the HHS Mandate and here: Our Sacred Duty and the HHS Mandate. With the latest news about the Supreme Court granting a temporary injunction for religious organizations that conscientiously object to the contraceptive coverage, I wanted to renew my detest for the mandate with a thought I had on the way home from work today.

Regardless of whether you agree or not with the Catholic Church about birth control, I'm still baffled with why so many people think birth control should be covered by health insurance. If you look at what health insurance really is, and then you look at what birth control really is, it makes no sense (at least in my head) as to why it should be covered.

Insurance is all about the transfer of risk. In other words, if something bad happens to you, then your insurance helps cover the risk financially. If you're in a car accident, then your auto insurance covers you. If something happens to your house, then your homeowner's insurance applies. If something happens to your health (illness, injury, disease, etc) then your health insurance should help you out.   

Health insurance helps cover your health care costs- things such as physician services, testing, procedures, medications, etc. So does birth control fall under this? A lot of people think yes. I say NO.

Birth control by prescription (pills, patches, and whatever other methods there are) has everyone fooled that it's a medication. Medication helps treat illness, injury, and disease; but pregnancy isn't any of those things. It isn't like a head injury, diabetes, or cancer; all of which should be prevented whenever possible. Pregnancy is a part of being human and what's supposed to happen when a man and woman have sex. It's a medical condition that requires care, but not an illness that's supposed to be treated or prevented like the flu or kidney stones. Just because birth control requires a prescription doesn't make it a medication. (There are plenty of medications that don't require a prescription.) It's not the prescription that makes something a medication, but its therapeutic or prophylactic use for illness, injury, and disease.

Of course, I have no problem with a woman taking birth control for genuine health reasons. Medical issues like endometriosis, hormone problems, or even acne are reasons to take medication. I see no problem with Yaz being covered by health insurance for a 38 year old celibate nun who takes it for premenstrual symptom relief. Birth control taken for reasons other than birth control isn't actually birth control.

If birth control should be covered by health insurance, then I've got a ridiculous list of things should be covered, too. How about food and water- shouldn't these be covered since they're medically necessary to live? Then there's diapers and formula for my 6th month old, she can't live without either. Oh and someone could argue that toilet paper should be covered- we all know how bad it could be when the TP runs out! Toilet paper may not be strictly medical, but it's absolutely preventative. I can go on and on, but I won't.

Instead I'll end with a serious example. I know a patient who has to pay over $500 for 28 days of Lovenox (she needs it for a provoked DVT, and this is with her prescription coverage). If she doesn't get the medication, the chances of her getting another blood clot (and so many other life-threatening problems) are really high. Perhaps the Affordable Care Act should have focused more on people like her instead of forcing the Catholic Church to violate its morals. But hey, at least this patient has coverage for birth control if she wanted it.