Government Involvement in Health Insurance & Mandated Minimum Standards

[dblack]

The freedom to choose what your business does and does not sell goes out the window when the people buying your particular product from your particular company have no or very little choice in the matter.

As long as the insurance industry insists on limiting their competition and my choices by tying health care coverage to my employment, I insist on mandated product descriptions and price controls. You can't have your monopoly and eat it too.

I appreciate the sentiment, but I can't agree. You're viewing mandates and price controls as 'fighting back' against the insurance cartels but those kinds of restrictions only limit our freedom further while giving the monopolists exactly what they want - even tighter control over market conditions and even more protection from competition. We need to 'fight back', to be sure, but not by reducing our choices even more and doubling down on the monopolist practices.

 

[Flopper]

That WASN'T auditor's point at all (sorry Windbag, I know it can be hard to understand sometimes, when you've got a giant silo wrapped around your head that only allows you to look at things in one way).

The point was that it's much cheaper for an insurance company to cover a $300/yr pill for a sexually active woman who wants it, than cover an accidental pregnancy that can cost on average about $12,000, and sometimes even reach $300,000 when there are complications (as in auditor's example).

Insurance will have to cover both, which is why most all insurance companies offer BC pills; it's a mechanism that protects the insurance pool against costly pregnancies that are unwanted. "Unwanted" meaning people who are sexually active, but don't want children at this time. You give them the pill and there's a 3% chance they'll get pregnant, you don't offer the pill and the chance of pregnancy might rise to 30-40%.

No one said anything about "sterilizing" people. Offering the pill to protect the woman, insurance company, and overall healthcare system against costly unplanned, unwanted pregnancies is not the same as saying that "we should sterilizing people". You should know this, I hope.

BC pill will bring down the total costs of the insurance pool, there's nothing magic about it (that is unless you can't understand these simple economic concepts above).

If you're going to argue against this issue, take the side that it's wrong for government to force an employer to do something, because at least you'll be making a valid and debatable point.

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I've seen first hand, what happens to unwanted children from poor families. The cost to society is far greater than just the cost of the pregnancy. In the US we spend 3.5 billion on birth control bills and over 23 billion to support children from low income families, many who are unwanted. Unwanted children from poor families are much more likely to be victims of child abuse, become low achievers in school, and become involved in criminal activity. IMHO, birth control should be free to all low income families. I think the savings would far exceed the cost.



http://www.clasp.org/admin/site/publications/files/0317.pdf

I am very familiar with "unwanted children from poor families". Guess what? In most states, Medicaid already pays for BC, as does most insurance policies. There are far fewer "unwanted pregnancies" than people think. They may not want the child; but they sure like the check. Why aren't there millions of children put up for adoption?

The controversy is about Catholic institutions - WORKING, SEXUALLY ACTIVE, SINGLE women who for some reason???? cannot afford 10 bucks a month. Anyone have any stats on that?

Well not quite. The average cost of birth control varies from $15 to $50 a month. In addition you need a prescription which will cost another hundred bucks for a doctor's visit plus repeated trips to the doctor.

 

[AVG-JOE]

The freedom to choose what your business does and does not sell goes out the window when the people buying your particular product from your particular company have no or very little choice in the matter.

As long as the insurance industry insists on limiting their competition and my choices by tying health care coverage to my employment, I insist on mandated product descriptions and price controls. You can't have your monopoly and eat it too.

I appreciate the sentiment, but I can't agree. You're viewing mandates and price controls as 'fighting back' against the insurance cartels but those kinds of restrictions only limit our freedom further while giving the monopolists exactly what they want - even tighter control over market conditions and even more protection from competition. We need to 'fight back', to be sure, but not by reducing our choices even more and doubling down on the monopolist practices.

I'm right there with you... one or the other... the current bullshit is NOT working.

 

[Quantum Windbag]

That WASN'T auditor's point at all (sorry Windbag, I know it can be hard to understand sometimes, when you've got a giant silo wrapped around your head that only allows you to look at things in one way).

The point was that it's much cheaper for an insurance company to cover a $300/yr pill for a sexually active woman who wants it, than cover an accidental pregnancy that can cost on average about $12,000, and sometimes even reach $300,000 when there are complications (as in auditor's example).

Insurance will have to cover both, which is why most all insurance companies offer BC pills; it's a mechanism that protects the insurance pool against costly pregnancies that are unwanted. "Unwanted" meaning people who are sexually active, but don't want children at this time. You give them the pill and there's a 3% chance they'll get pregnant, you don't offer the pill and the chance of pregnancy might rise to 30-40%.

No one said anything about "sterilizing" people. Try to use your head, and stop melding peoples words to serve your own purposes.

BC pill will bring down the total costs of the insurance pool, there's nothing magic about it.

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You are the one that got his point wrong, if his point was that it makes sense for insurance companies to offer contraception because it saves them money. He was responding to California Girl's post about not wanting to buy contraceptives for herself with the argument that it would save her money if she bought a policy that covered it.

If birth control does save insurers money, which is debatable if you dig into the numbers, then insurance companies will offer it as part of their policy. If they examine the numbers and decide it doesn't, they will choose not to. I don't have a problem with that, what I have a problem with is the government saying that everyone who buys insurance has to buy contraception.

What are they going to do when they find out that birth control insurance doesn't actually drive down the cost of the insurance pool? Why should people who get birth control for free settle for the $9 generic version of the Pill at Target or WalMart when they can get the expensive brand name pill for the same price? Will the simple fact that it is on insurance suddenly stop people from actually having babies? That will mean insurance companies will be paying for birth control and still paying for pregnancies, which will cost more in one year than a lifetime of birth control.

The only way to make savings work is to somehow reduce pregnancy itself. The only way to actually accomplish that is for the government to step in and tell each woman how many children she can have, and when she can have them. Anything less than that is not going to save money.

I am using my head, unlike most people.

And please explain how that means I want the government to sterilize people? I think you are so full of hot air it's making you dizzy. But hey, keep thinking I want the government to sterilize everyone because I think that it's much more cost efficient to have insurers cover birth control versus not doing so. They good thing is that you have the right to believe whatever it is that you want, regardless of how ludicrous it may be.

If it was as cost efficient as you, and the other idiots, think every insurance policy that covered women would include it already. The problem is a bit more complicated that you seem to think.

1. Not all women use contraceptives.
2. Not all women use contraceptives properly, which reduces its efficacy.
3. Even when they do use it properly it sometimes fails.
4. Even if it doesn't fail some women stop using it because they want to get pregnant.
5. Adding contraceptives to insurance policies will drive up the overall cost of contraception just like it does everything else, which reduces the, mostly imaginary, savings.

The only way to make things work the way you think they will is if people are required to take them or elect to be sterilized. You can live in a dream world where good intentions always produce desired results if you want, but the real world doesn't work that way.

 

[Quantum Windbag]

So you don't want any of your premiums going to a woman who may or may not choose to have birth control included in her insurance policy, but you will gladly pay for the increased premiums caused by that same woman having a child, or having a child prematurely who will require hundreds of thousands of dollars of care? Okay then. My youngest son was born ten weeks early. His bills came close to $300,000 as he was in NICU for 47 days. This was almost 15 years ago. I don't even want to think how much it would cost today.

Another nut that thinks the government should sterilize people.

Where the fuck did you see 'sterilize'?!?

It'd be interesting to hear how you interpret 'Hansel & Gretel'......

Is it my fault I can think and you can't?

By the way, Hansel and Gretel is pretty simple, disobey and die. It is used to teach people that authority is always right.

 

[Quantum Windbag]

The freedom to choose what your business does and does not sell goes out the window when the people buying your particular product from your particular company have no or very little choice in the matter.

As long as the insurance industry insists on limiting their competition and my choices by tying health care coverage to my employment, I insist on mandated product descriptions and price controls. You can't have your monopoly and eat it too.

Are you trying to say people should be able to run down to McDonald's and buy a sirloin? If not, you are making even less sense than I think you are, which is less than none.

 

[Quantum Windbag]

I've seen first hand, what happens to unwanted children from poor families. The cost to society is far greater than just the cost of the pregnancy. In the US we spend 3.5 billion on birth control bills and over 23 billion to support children from low income families, many who are unwanted. Unwanted children from poor families are much more likely to be victims of child abuse, become low achievers in school, and become involved in criminal activity. IMHO, birth control should be free to all low income families. I think the savings would far exceed the cost.



http://www.clasp.org/admin/site/publications/files/0317.pdf

I am very familiar with "unwanted children from poor families". Guess what? In most states, Medicaid already pays for BC, as does most insurance policies. There are far fewer "unwanted pregnancies" than people think. They may not want the child; but they sure like the check. Why aren't there millions of children put up for adoption?

The controversy is about Catholic institutions - WORKING, SEXUALLY ACTIVE, SINGLE women who for some reason???? cannot afford 10 bucks a month. Anyone have any stats on that?

Well not quite. The average cost of birth control varies from $15 to $50 a month. In addition you need a prescription which will cost another hundred bucks for a doctor's visit plus repeated trips to the doctor.

Good point, birth control should be OTC. That would save women the price of a doctor visit, and reduce the price at the store because you would no longer have to go to school to sell it.

 

[AVG-JOE]

You're a funny dude, QW.

I'll stand by my posts as published.

 

[Oddball]

The freedom to choose what your business does and does not sell goes out the window when the people buying your particular product from your particular company have no or very little choice in the matter.

As long as the insurance industry insists on limiting their competition and my choices by tying health care coverage to my employment, I insist on mandated product descriptions and price controls. You can't have your monopoly and eat it too.

Except that it's not the insurance companies insisting upon tying your coverage to your employment....It's employees demanding that they get insurance coverage as a term of employment, then bitching and moaning that the insurance isn't good enough.

boo-fucking-hoo...

 

[KevinWestern]

If it was as cost efficient as you, and the other idiots, think every insurance policy that covered women would include it already. The problem is a bit more complicated that you seem to think.

1. Not all women use contraceptives.
2. Not all women use contraceptives properly, which reduces its efficacy.
3. Even when they do use it properly it sometimes fails.
4. Even if it doesn't fail some women stop using it because they want to get pregnant.
5. Adding contraceptives to insurance policies will drive up the overall cost of contraception just like it does everything else, which reduces the, mostly imaginary, savings.

The only way to make things work the way you think they will is if people are required to take them or elect to be sterilized. You can live in a dream world where good intentions always produce desired results if you want, but the real world doesn't work that way.

While I agree that women won't use the BC pills properly all the time, and that you have to factor that in when calculating any of the savings in this risk/reward scenario, but I need to make two quick points in response to two of your bulleted points:

1.) You say that not all women use contraceptives. This is irrelevant because if a women doesn't elect to use the contraceptives, insurance will not have to pay for it.

2.) Women who want to get pregnant need not be factored into this whole discussion. Whether insurance covers BC pill or not will make no difference to this pool of women, because they will not be using the BC pill either way.

The pool of women you need to focus on is specifically sexually active women who don't want babies, and you need to figure will the be more or less likely to be on the pill if insurance offers it. If you're answer is "more likely", then you need to figure if whether or not you think it's worth putting up $100/yr to protect yourself against a $12,000 pregnancy.

 

[Flopper]

I am very familiar with "unwanted children from poor families". Guess what? In most states, Medicaid already pays for BC, as does most insurance policies. There are far fewer "unwanted pregnancies" than people think. They may not want the child; but they sure like the check. Why aren't there millions of children put up for adoption?

The controversy is about Catholic institutions - WORKING, SEXUALLY ACTIVE, SINGLE women who for some reason???? cannot afford 10 bucks a month. Anyone have any stats on that?

Well not quite. The average cost of birth control varies from $15 to $50 a month. In addition you need a prescription which will cost another hundred bucks for a doctor's visit plus repeated trips to the doctor.

Good point, birth control should be OTC. That would save women the price of a doctor visit, and reduce the price at the store because you would no longer have to go to school to sell it.

I don't think there is any strong medical reason why OCs should not be sold over the counter. Although a women should have an exam yearly, there is no linkage between the need for the exam and OCs. If the FDA considered making them available over the counter, I think there would be a strong outcry from conservatives about increased available to teens without parental knowledge.

 

[Quantum Windbag]

If it was as cost efficient as you, and the other idiots, think every insurance policy that covered women would include it already. The problem is a bit more complicated that you seem to think.

1. Not all women use contraceptives.
2. Not all women use contraceptives properly, which reduces its efficacy.
3. Even when they do use it properly it sometimes fails.
4. Even if it doesn't fail some women stop using it because they want to get pregnant.
5. Adding contraceptives to insurance policies will drive up the overall cost of contraception just like it does everything else, which reduces the, mostly imaginary, savings.

The only way to make things work the way you think they will is if people are required to take them or elect to be sterilized. You can live in a dream world where good intentions always produce desired results if you want, but the real world doesn't work that way.

While I agree that women won't use the BC pills properly all the time, and that you have to factor that in when calculating any of the savings in this risk/reward scenario, but I need to make two quick points in response to two of your bulleted points:

1.) You say that not all women use contraceptives. This is irrelevant because if a women doesn't elect to use the contraceptives, insurance will not have to pay for it.

2.) Women who want to get pregnant need not be factored into this whole discussion. Whether insurance covers BC pill or not will make no difference to this pool of women, because they will not be using the BC pill either way.

The pool of women you need to focus on is specifically sexually active women who don't want babies, and you need to figure will the be more or less likely to be on the pill if insurance offers it. If you're answer is "more likely", then you need to figure if whether or not you think it's worth putting up $100/yr to protect yourself against a $12,000 pregnancy.

1. The argument is that covering birth control decreases costs because it reduces pregnancies. The only way that works is if the women who are covered by insurance take the birth control. me pointing out that not all women will take birth control is a direct argument against that position. You pointing out that, if they don't take the birth control the insurance company doesn't have to pay for it makes as much sense as requiring a woman who doesn't take birth control to buy insurance that covers it, none at all.
2. The women who want to get pregnant will still be paying for insurance that covers it. In effect, they will be paying for birth control the entire time they are trying to get pregnant and during their pregnancy, even though they won't be using it. This is a huge waste of money, and doesn't save anyone any money at all. That, again, makes your argument in favor of mandated birth control coverage senseless.

I don't need to focus on anyone, I prefer to see the whole picture. You imagine that there is a pool of sexually active women who want birth control that can't afford it unless the government mandates that insurance companies cover it. Tell me how big that pool is and provide hard numbers, or admit that you are trying to blow smoke up my ass. My contention is that the pool you are worried about does not exist, the ball is in your court.

 

[Quantum Windbag]

Well not quite. The average cost of birth control varies from $15 to $50 a month. In addition you need a prescription which will cost another hundred bucks for a doctor's visit plus repeated trips to the doctor.

Good point, birth control should be OTC. That would save women the price of a doctor visit, and reduce the price at the store because you would no longer have to go to school to sell it.

I don't think there is any strong medical reason why OCs should not be sold over the counter. Although a women should have an exam yearly, there is no linkage between the need for the exam and OCs. If the FDA considered making them available over the counter, I think there would be a strong outcry from conservatives about increased available to teens without parental knowledge.

I don't give a fuck if conservatives are upset any more than I give a fuck about liberals being upset. I prefer a world that runs on common sense to one that runs on ideology, even my ideology.

Speaking of common sense, put them behind the counter like cigarettes and require an ID to purchase them.

 

[chanel]

I like that idea. However, they'd no longer be "free". That might make liberals upset. They love free shit.

 

[KevinWestern]

Tell me how big that pool is and provide hard numbers, or admit that you are trying to blow smoke up my ass. My contention is that the pool you are worried about does not exist, the ball is in your court.

I don't have the numbers (sorry), nor do I feel like looking anything up, but I think it's fair enough to say that there is a large pool of women 18-40 within any given insurance pool, who are sexually active, who have no interest in having kids at the moment.

Also, it's probably the case that a lot of those women can afford BC pills if they just budget, sacrifice some things here or there, but in essence I'm arguing that those women will simply be much more likely to be on the pill if it were covered. If you really want to buy something, would you be more likely to obtain it if it cost you $30/month, or $0/month?

The women who want to get pregnant yes WILL pay for the contraceptives of the pool of women who don't want to get pregnant. I WILL pay for the contraceptives of the pool of women who don't want to get pregnant (despite myself being a man). However, the money that I foot upfront to make it easier for women in my pool to get BC pills if they want it will save me from having to foot 12x that amount of money down the road when they get pregnant. If you don't think that's the case then, fine, we disagree.

I've posted some data that resulted from a Brookings Institute research project. Their data shows that for about every $1 invested into birth control (administered via Medicaid) resulted in about $4 of savings, because it reduced the number of unplanned pregnancies. Obviously, this is medicaid and the pool of people might differ from that of other insurance pools, but nonetheless, the correlation is there.

http://www.brookings.edu/papers/2008/07_reducing_pregnancy_kearney.aspx


Also, I'm not in support of a gov't mandate. What I'm arguing here is that it makes sense for an insurance company/employer to include BC pills as a covered service because it will reduce costs in the overall healthcare pool that the insurance covers.
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[Flopper]

Good point, birth control should be OTC. That would save women the price of a doctor visit, and reduce the price at the store because you would no longer have to go to school to sell it.

I don't think there is any strong medical reason why OCs should not be sold over the counter. Although a women should have an exam yearly, there is no linkage between the need for the exam and OCs. If the FDA considered making them available over the counter, I think there would be a strong outcry from conservatives about increased available to teens without parental knowledge.

I don't give a fuck if conservatives are upset any more than I give a fuck about liberals being upset. I prefer a world that runs on common sense to one that runs on ideology, even my ideology.

Speaking of common sense, put them behind the counter like cigarettes and require an ID to purchase them.

Most liberals would have no problem with selling OCs over the counter. Unfortunately common sense rarely enters into political decisions with issues such as contraception, sex education, abortion, and marriage.

 

[starcraftzzz]

If it was as cost efficient as you, and the other idiots, think every insurance policy that covered women would include it already. The problem is a bit more complicated that you seem to think.

Countless studies show that health insurance companies waste hundreds of billions of dollars on crappy treatments that don't work and dont cover treatments that are more efficient
http://www.nytimes.com/2007/06/14/health/14insure.html?_r=1
Comparative Effectiveness Research | ThinkProgress
The Two Trillion Dollar Solution: Saving Money by Modernizing the Health Care System

The logic and fact still remains that birth control costs less then an abortion or having a child

Not all women use contraceptives.

Yep and making them cheaper to get means more women using them meaning less abortions and less unwanted children.

 

[Quantum Windbag]

I don't have the numbers (sorry), nor do I feel like looking anything up, but I think it's fair enough to say that there is a large pool of women 18-40 within any given insurance pool, who are sexually active, who have no interest in having kids at the moment.

Also, it's probably the case that a lot of those women can afford BC pills if they just budget, sacrifice some things here or there, but in essence I'm arguing that those women will simply be much more likely to be on the pill if it were covered. If you really want to buy something, would you be more likely to obtain it if it cost you $30/month, or $0/month?

The women who want to get pregnant yes WILL pay for the contraceptives of the pool of women who don't want to get pregnant. I WILL pay for the contraceptives of the pool of women who don't want to get pregnant (despite myself being a man). However, the money that I foot upfront to make it easier for women in my pool to get BC pills if they want it will save me from having to foot 12x that amount of money down the road when they get pregnant. If you don't think that's the case then, fine, we disagree.

I've posted some data that resulted from a Brookings Institute research project. Their data shows that for about every $1 invested into birth control (administered via Medicaid) resulted in about $4 of savings, because it reduced the number of unplanned pregnancies. Obviously, this is medicaid and the pool of people might differ from that of other insurance pools, but nonetheless, the correlation is there.

Reducing Unplanned Pregnancies through Medicaid Family Planning Services - Brookings Institution


Also, I'm not in support of a gov't mandate. What I'm arguing here is that it makes sense for an insurance company/employer to include BC pills as a covered service because it will reduce costs in the overall healthcare pool that the insurance covers.
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And?

The question is simple, how many of them can't afford free or subsidized birth control through Planned Parenthood or Medicaid? Numbers please, and no BS about not wanting to look them up. You are making the claims, back them up.

As I already pointed out, if it made half as much sense as you think insurance companies would already be doing it. They actually have whole departments of people that assess risk and cost to save them as much money as possible. Do you think the fact that it is not universally covered indicates anything at all?

 

[KevinWestern]

And?

The question is simple, how many of them can't afford free or subsidized birth control through Planned Parenthood or Medicaid? Numbers please, and no BS about not wanting to look them up. You are making the claims, back them up.

As I already pointed out, if it made half as much sense as you think insurance companies would already be doing it. They actually have whole departments of people that assess risk and cost to save them as much money as possible. Do you think the fact that it is not universally covered indicates anything at all?

If your insurance plan covers BC pills, I say that one would be more likely to use them despite BC pills being free via Planned Parenthood. If it's covered by insurance, it's an easy phone call and trip to the pharmacy. Obtaining through planned parenthood takes effort, papers, ect, which is a deterrent to obtaining BC pills. To what degree it is a deterrent, I don't know.

I just believe that if the plan covers it, you'll be more likely to use it regardless if you can afford it otherwise, or can get it free somewhere else. That's my belief, and you may disagree and that's fine.

Also, insurance companies generally work with companies to "come up" with a benefits plan. Insurance companies will cover virtually anything the company needs it to cover. From my understanding about 1/3 of insurance plans include the pill, which of course is not the majority.

But is everything that's asked to be included by the company as a "benefit" always determined in the interest of cost saving?

I don't think so.

Take for instance companies that cover Viagra. I can't think of any cost saving measures there. Therefore Viagra was chosen due to some other motivating force.

But anyways....

Sorry too, don't feel like looking up anything anymore.....

 

[Care4all]

And?

The question is simple, how many of them can't afford free or subsidized birth control through Planned Parenthood or Medicaid? Numbers please, and no BS about not wanting to look them up. You are making the claims, back them up.

As I already pointed out, if it made half as much sense as you think insurance companies would already be doing it. They actually have whole departments of people that assess risk and cost to save them as much money as possible. Do you think the fact that it is not universally covered indicates anything at all?

If your insurance plan covers BC pills, I say that one would be more likely to use them despite BC pills being free via Planned Parenthood. If it's covered by insurance, it's an easy phone call and trip to the pharmacy. Obtaining through planned parenthood takes effort, papers, ect, which is a deterrent to obtaining BC pills. To what degree it is a deterrent, I don't know.

I just believe that if the plan covers it, you'll be more likely to use it regardless if you can afford it otherwise, or can get it free somewhere else. That's my belief, and you may disagree and that's fine.

Also, insurance companies generally work with companies to "come up" with a benefits plan. Insurance companies will cover virtually anything the company needs it to cover. From my understanding about 1/3 of insurance plans include the pill, which of course is not the majority.

But is everything that's asked to be included by the company as a "benefit" always determined in the interest of cost saving?

I don't think so.

Take for instance companies that cover Viagra. I can't think of any cost saving measures there. Therefore the reason Viagra was chosen to be covered must have some other motivating force behind it.

But anyways....

Sorry too, don't feel like looking up anything anymore.....

i think i just read in 2007 the majority of major group insurance plans, although by just a smidgeon 51%, covered some form of birth control...

just 25 years ago, insurance refused to cover prenatal care too....amazing! That really was not that long ago!

many states have been pushing the issue to get birth control coverage for insurance policies in their states...

• Women age 15-44 pay 68% more for out-of-pocket healthcare costs than their male counterparts, largely due to the cost of reproductive healthcare

link:

Birth Control and Health Insurance

of course that's 5 years old, not 100% certain what it is now