Thursday, February 16, 2012

The anti-reproduction insurance policy (with radio ad)

I've been having some nice chats with my mom about this HHS Mandate business. When I say "nice chats" I mean, of course, that we are achieving harmoniously similar and mutual levels of wrath over the notion, which is really nice in that mother-daughter bonding sort of way. :)

Mom has an idea that I suspect she'd like me to share; I think it's not a bad one, all things considered. She pointed out that when you buy a car (for instance) you buy car insurance. Nobody forces you to pay for motorcycle insurance for all those people who want to own motorcycles (or boat insurance, or RV insurance, etc.). It is understood that the choice to own and ride a motorcycle is a lifestyle choice which includes some built-in costs, and one of those costs is special motorcycle insurance which is separate from your ordinary car insurance. Motorcycle insurance isn't all that expensive and is pretty accessible to most people who want to own motorcycles.

So why (asks Mom, and I agree) can't we remove what is essentially lifestyle insurance from ordinary medical coverage? Why can't insurance companies offer special anti-reproduction insurance policies to people who want lots of sex without the possibility of conception? Why can't these policies be purchased entirely separately from one's health insurance?

Employers wouldn't, in this scenario, be forced to provide anti-reproduction insurance to their employees at all, though some of them could certainly (and would certainly) choose to offer it as a "perk," just as some employers offer life insurance or accidental death insurance and the like. And just like those insurance "add-ons," employees could choose to select anti-reproduction insurance or not, depending on whether or not they actually needed it. Religious believers, the elderly, the infertile, the chaste, or those who already have anti-reproduction insurance through their spouse's coverage could opt out, saving themselves money instead of being forced to pay for something they truly don't need and don't intend to use. And employers who didn't wish to make anti-reproduction insurance available would not have to do so, protecting not only the conscience rights of religious employers, but also the financial rights of employers not to be forced to provide coverage for a so-called "health care" package of pills, prophylactics, implants, devices and surgeries which are not necessary for health, but only desired in order to facilitate recreational sex.

For that tiny handful of people whose doctors tell them (rightly or wrongly, depending on medical evidence) that hormonal contraception is their only solution for a legitimate medical issue, medical insurance could step in and cover it (the way that medical, not dental, insurance will cover some tooth-related problems when there's an underlying medical issue). But for the rest of the people who just want these things to facilitate their Sex Without Consequences lifestyle and practices, the anti-reproduction insurance policy would suffice.

The insurance industry would be motivated to create their own anti-reproduction insurance policies to compete with the big policies offered by corporations; in that way, a man who has pretty much decided to get himself fixed can buy a sterilization policy with a set number of premiums he must pay to get the surgery while avoiding having to subsidize someone else's girlfriend's Yasmin (tm) prescription. This open-marketplace approach would encourage competition and lower prices, making the dream of Promiscuity Without Consequences for All an achievable one.

Now, it will be objected that some small number of people may be too poor to buy their own anti-reproduction insurance policies, and may not be fortunate enough to work for an employer who chooses to provide one. But our nation is committed to the idea that no one is too poor to engage in mindless, meaningless, immoral fornication or sterile sex of any kind, and thus I'm sure that it will be a priority for our leaders to insist that those who qualify for Medicaid be automatically given anti-reproduction insurance as well. For the working poor, low-cost anti-reproduction insurance policies with the possibility of tax rebates to cover their purchase might be an option; and a government anti-reproduction insurance plan that anyone could buy might be discussed, too, though private insurance would probably beat such a plan on price and flexibility of options.

But the bottom line would be that no employer would be required to purchase and pay for anti-reproduction insurance for their employees, who would have plenty of other ways to get anti-reproduction insurance policies to cover their choice of the Sex Without Consequences lifestyle.

To me, there is at least one serious drawback to this idea: if insurance companies really did create and sell such policies, they would probably advertise them. Imagine hearing this ad on the radio:

MUSIC: Sad violins in, up, and under.

ANNOUNCER: Is your anti-reproduction insurance policy leaving you cold?

GIRLFRIEND: Not tonight, hon--I'm due for my next Depo-Provera (tm) shot.

BOYFRIEND: Aww, not again! Doesn't your anti-reproduction policy reimburse us for condoms when that happens?

GIRLFRIEND: No. My company bought (beat) bargain anti-reproduction insurance.

BOYFRIEND: You know I hate having to spend my own money on condoms! My last girlfriend's anti-reproduction insurance paid for them. Maybe you should switch to her company...

GIRLFRIEND: Hmm, maybe I should. What was the name of it again?

BOYFRIEND: You remember...NoTykes Insurance!

MUSIC: Bright orchestra, in and under.

ANNOUNCER: Here at NoTykes Insurance we understand your need for constantly available sex without reproduction, and have created a wide variety of anti-reproduction insurance policies sure to please every consumer. We offer comprehensive birth control plans, abortion riders, sterilization policies, and even condom-only plans for our male customers. We believe that you have the right to sex when, where, and however you want it, with no messy complications who will want you to feed, house, and educate them for the next eighteen years. Because sex is supposed to be fun, feel great, and happen when it's good for you, not when it's good for your anti-reproduction insurance policy provider!

SECOND ANNOUNCER (low and very quickly) Not all policies are available to all consumers. Sterilization plans require minimum premium purchase which varies depending on whether you want your reproductive organs surgically crippled or completely removed. If you are being treated for sex-addiction or have ever been convicted of rape or sexual assault our low-cost multi-pack condom plan with delivery guarantee may be unavailable. Other restrictions may apply; speak to one of our representatives for details.

BOYFRIEND: Now that she's switched to NoTykes, I'll never have to wait for sex again! Thanks, NoTykes!

ANNOUNCER: For the best in anti-reproduction insurance, choose NoTykes. Because your sex our business!

MUSIC: Up and out.


freddy said...


Tony said...


Either you don't understand how insurance works (or this was satire with tongue firmly planted in cheek).

Any insurance you buy works because people who don't use the insurance subsidize those who do. Healthy people who buy health insurance subsidize the sick ones. They are pooling their money in case they get sick. The best outcome is that you never use any insurance you buy.

If only people who were planning on using contraception bought contreceptive policies, then the cost would be more than buying the pills/condoms/service yourself since the company has to pay administrative fees and overhead.

This is why car insurance does not cover oil changes and tire rotations.

Red Cardigan said...

So, Tony, is that why there's no such thing as State-provided child insurance, because young, healthy children have to pay for the health problems of sick adults?

Oh, wait...

Red Cardigan said...

Or, to look at it another way, people who engage in the unhealthy behavior of smoking have to pay higher premiums. Isn't that unfair? Shouldn't they have the right to Smoke Without Consequence, just as we demand that people have the right to Sex Without Consequences?

Elizabeth said...

The insurance companies are more than happy to pay for contraceptives. It's considerably cheaper than paying for pregnancy and childbirth.

Siarlys Jenkins said...

What Tony is really pointing out is the difference between pre-paid health care, and health INSURANCE. If there is a shared risk of an unlikely event that definitely happens to some number of people, then insurance makes sense.

I dropped dental insurance because I know, my dentist knows, and the insurance company knows, that a predictable volume of dental work WILL be needed by the average American over a period of several years. They are not in business to lose money, so I'm paying in premiums what I would eventually pay anyway, with a little extra to the insurance company. I might as well keep my money and pay when I need the work.

Now if my employer were paying the premiums, that would be different. I'm always in favor of any means of increasing the net compensation a cold, heartless corporation pays for my valuable services. Most of my passengers would have agreed -- they liked me better than they did the company.

Contraceptive pills come under pre-paid medical, not health insurance. Our medical care financing system "just grew" in ways that obscure the difference, and leave people with the illusion they are getting something for free. If we tackle that, without prejudice to various opinions about whether contraception is evil or not, we'd be having a more productive conversation. As a by product, employers might no longer be paying for contraception, no matter what their religion.

Perhaps in the interim, employers with a conscientious objection could purchase a policy for employees that doesn't cover contraception, and add about $1000/52 weeks/40 hours to their employees' hourly wage. Then employees could individually choose to use the money for contraceptives, or not. Those who use Natural Family Planning could take their two, three, four, or five children out for pizza more often.

Onepony2002 said...

Why do we expect health insurance to cover routine maintenance stuff?

We buy car insurance in case we have an accident, and don't expect it to pay for oil changes and gasoline. We buy home insurance in case we have a fire or a tree down on our roof, not to replace furnace filters or a worn-out dishwasher.

Elizabeth said...


Changing oil, filters and replacing appliances does nothing to reduce the chances of accident, fire or a tree on the roof.

Routine health care can, in theory, increase the chances of preventing disease, or at the least of catching conditions early, when they are cheaper to manage or reverse.

(OTOH, over-zealous use of testing has resulted in many non-lethal conditions getting expensive treatment. Clearly some fine tuning is still needed in the system.)


c matt said...

Either you don't understand how insurance works

Insurance works by pooling risks, but generally you can choose which coverages, and therefore risks, you wish to pool. For example, if you do not have teenage drivers, you do not pay for the added risk of a teenage driver operating your car - you only pay for the risk of the adult drivers. Likewise, if you don't want to pool the risk with others for vision, maternity or any other number of conditions, you can get exlcusions, and therefore no coverage for those risks, but also (in theory) pay a lower premium. By mandating coverages, the government is actually reducing your freedom - it is forcing you to buy coverages you may not want, and therefore force you into pooling risks you don't want to pool. Part of this is actually driven by the insurance companies themselves - they want to insure (and therefore collect premiums) on people who are less likely to need or use the coverage. In short, they want to pay for somehting you don't need. You notice in all of this sex coverage brouhaha how silent the insurance companies have been.

Anonymous said...


The insurance companies may begin to sing a different tune when they find that too many years of contraception have left women ignorant about their own body rhythms and in the twilight years of their fertility.

The infertility industry is a huge business and continues to climb. It's the spell check effect - as more and more tools become available to correct the issue, the less likely people become inclined to bother putting in the effort themselves. OB-gyns are already reporting several women in their late 40s or early 50s coming in for fertility treatments, or requesting multiple implantation because they are concerned that they cannot become pregnant again.

What then? Will the population then screech for federal subsidizing of infertility ($15,000 per IVF cycle, with only a 43% success rate per cycle) because "it's a health issue", even though fertility was the supposed disease these same women were so desperate to stamp out?

Siarlys Jenkins said...

c matt, in almost every state, auto insurance is legally mandated (that is, if you own and drive a car). There is good reason for that -- innocent people injured or suffering considerable property damage in auto accidents can get almost zero recourse from uninsured and impecunious drivers. But, such mandates are pushed by insurance companies, which find them, of course, quite lucrative.

At present, state mandates as to insurance pricing are limited -- e.g. the cost of teen drivers is not average in to the cost of a standard policy.

There is a reason to mandate medical insurance, as every conservative Republican alternative to the Hillary Clinton plan proposed to so.

Medical care delivery is interstate commerce, on a large scale. Millions are left without coverage (or taxpayers pick up the tab ex post facto) because they are not insured. Our society is not so cold and uncompassionate as to kick an uninsured person suffering a heart attack to the curb. So, since we WILL take care of them, somewhat, they need to be paying in during their healthy years, not being the grasshopper when young and gay (archaic meaning), then wailing at the unfairness of being denied treatment.

After that, the devil is of course in the details. I for one would take a dim view of "free" IVF treatments, especially since, as we all agree, it is not free.

Anonymous said...

Mr Jenkins, my apology if we are getting off topic, but I'd be curious as to why you would take a dim view of "free" IVF. Would you favor heavily subsidized IVFs or other ARTs (Assisted Reproductive Techniques)?

Correct me if I'm wrong, but the rationale for the forcing of birth control coverage so far is that women have a right to free medication that controls their reproductive capabilities, and said right right trumps the right of any private organization. By that line of reasoning, if it is indeed about "choice", shouldn't women be entitled to medication that starts pregnancies as well as stop them? After all, the tap works both ways. And ARTs are significantly more expensive than BC, so if women supposedly can't afford the $30-60 per month for pills, how do you expect them to find the 1000s for ARF?

If you want to argue that there are other ways to have a child, I should point out that adoptions can also run into the $1000s and state reimbursement for adoption is only if the child is diagnosed as special needs. In the case of adoption, families are also removing potential drains on resources - the longer children stay in the system, the more it costs the state. Yet insurance agencies won't cover it, the state won't reimburse the costs and I don't hear any calls to change that system, despite the frequent bleating of: "Of course we need birth control! So many children are already in desperate need!" Yes, what about helping those children into loving families?

Siarlys Jenkins said...

Anony Mouse, you cover a wide range of issues here. I will try to cover as much ground in reply as I can.

In an ideal world, everyone would have sufficient income, relative to costs, to make their own private choices about medical care, insurance, and pre-paid health plans, AND, our culture would have the intestinal fortitude to kick the uninsured grasshoppers to the curb who show up with a heart attack after putting their money into a new wall-size flatscreen TV every year, rather than a modest insurance policy.

In the real world, medical care is expensive quasi-monopolistic interstate commerce, more and more of it for-profit, even including the larger church-originated conglomerates, and we just don't have the heart to turn people away who are near death. Also, millions of people can't afford coverage without risking eviction or malnutrition.

Thus, the attempt to develop some sort of universal access to medical coverage, and make sure everyone pays what they can, with the wealthier by some means or other subsidizing the care of the least able to pay.

Having taken that step, comes the onerous burden of sorting out what is "necessary" and therefore covered, vs. what is "optional," or "dispensible" or "frivolous." (The latter may be insurable, for a price, but not with any public requirement, guarantee, or subsidy).

I am familiar with a five year old allowed to die by the state of Oregon because the state Medicaid program decided to fund NO soft tissue transplants, in order to fund wider coverage of general medical services; also a young woman who could have been saved by a liver transplant but was beyond operable condition when examined by doctors in California, you were furious. On the other hand, I have heard that in New Zealand, where everyone is covered, no questions asked, including visitors, the corollary is that tourists must be under a certain healthy weight ceiling, resulting in some dieting and working out before catching the plane.

I think we can all sympathize with infertile couples who badly want their very own baby. Erin, who resolutely opposes IVF entirely, has expressed sympathy for the desires that lead couples to try it. I put it on the list of things we should perhaps not guarantee to everyone as very nearly a matter of right because:

1) It is incredibly expensive.
2) It carries a higher risk of birth defects -- possibly because the natural process tends to weed out eggs and sperm carrying defective genes, albeit not perfectly.
3) It delivers outlandish results, such as eight babies being born at once, or two live births with one to three others dead or dying soon after.

In short, it is sufficiently questionable that if we are going to make any decisions at all, it goes on the short list not to cover.

It would be the height of personal liberty to say, everything is covered, without exception or reservation. But at this point, the could literally raise the cost of medical care each year to somewhat more than our entire GDP. It simply can't be done.

As I've said before, if we sort out medical INSURANCE from pre-paid medical care, contraception would NOT be in the former category, and there are rational arguments for not including it in the latter. But as long as the two are conflated, its not unreasonable to cover it, and I see no constitutional basis for allowing an employer's religious principles to deny their employees what all other employees are getting.

Anonymous said...

Mr Jenkins, thank you for your reply. I will attempt to unpack your reply to me and counter with my own.

Unless I am mistaken, you suggest the following points:

1. In order to balance the compassionate with the practical, there is a need to only fund procedures with a low cost, or consistent results, or both.

2. While there are no constitutional bases for denying universal ART, sheer cost prohibits it.

3. Birth control falls under the category of low cost preventative care measure. Therefore, it falls under the 'reasonable' category.

4. In addition, other institutions cover it, so it would be inconsistent for religious places to be excluded.

My counters:

1. This would be reasonable. However, if the state has judged that the matter is of both high importance and low cost, then it would behoove the state to take over the issue rather than the employers. I would suggest a grant to Planned Parenthood for fully subsidized birth control and applicants could mail in for refills from Planned Parenthood, similar to the method that insurance companies have recurring prescriptions filled by a mail in pharmacy. Or allow a special medical tax deduction for BC that equals the cost of said BC

2. You are essentially then conceding that the issue is not one of women's health or reproductive rights, as it has been framed, but one of practicality.

3. As a low cost measure, this can and perhaps should be handled by state budgets rather than forcing places of employment to act contrary to their consciences. See suggestion 1.

4. Employers are allowed a certain amount of discretion in the privileges they grant employees and as this is a practical matter and not one of health, it falls under the 'privilege' category and not the 'rights' one.

Red Cardigan said...

Anonymous, can you please add a nickname to your posts? Thanks!

Siarlys Jenkins said...

Employers got into the habit of paying for medical plans because

a) impoverished exploited industrial workers paid a tiny and inadequate pittance took the opportunity to demand, through their unions, that employers undertake to do this. It was one way to get a bigger share of the revenue going to those who worked rather than those who clipped coupons.

b) employers who didn't want to deal with a union began offering such medical benefits as part of their efforts to convince employees they didn't need a union.

c) it became commonplace in our culture and economy that this is how people get medical coverage. (That's why I don't have any).

So, this is not a "privilege" we are talking about, but part of the compensation for services rendered. Last time I had medical coverage, the premiums averaged out to an hourly amount equal to one third of my gross pay.

For the state to pay the cost, would no longer be payment for labor, it would feed the misguided notion that we can ALL get "free" benefits from the state. We can, to some extent, use the mechanism of the state to make sure the least of these our brethren are cared for, but when it comes to something we want to make universal... we'd be taking in each other's laundry.

If employers don't pay, then employers need to ramp up the size of paychecks, and we can all buy our own.

I'm leery of "women's health and reproductive rights" as an ideological position. There is some basis tot he critique that the medical profession is more oriented to what men need than what women need. But basically, I would rank contraception as a commonly used form of medication which insurers should not leave out of any general plan of broad, equitable coverage.

I also oppose making access to plastic surgery universal... but there are always exceptions. What about someone whose face was disfigured in a terrible car accident, or by a stalker throwing acid in their face? The devil is always in the details.