Sunday, March 4, 2012

Contraceptive Debate: Let's Talk About How Much Women Are Being Gouged

There is an enormous point that has been entirely overlooked in the recent brew-ha-ha over who should pay for contraceptives amid the health care debate: Why are Americans being forced to pay such exorbitant prices for our pharmaceuticals—especially birth control where R&D costs have been long reimbursed to the manufacturers—in the first place?

It isn't that we haven't ever had this conversation before. The subject comes up from time to time, but it is rarely even broached by our politicians, and there has yet to be any kind of comprehensive bill to tackle the problem head on and prevent the mass ripping-off of American consumers.

Senator Herbert Kohl, Democrat of Wisconsin, introduced Senate Bill S. 1699: Prescription Drug Cost Reduction Act last October, but two things stand out: It would only cover those receiving medications through Medicare Part B, and as of this date there is not a single co-sponsor. Not one.

Why don't our representatives in Congress want to fight against unfair pricing practices that severely harm our economy, subject consumers to price gouging, and in many cases prevent access to life-saving drugs? And why, while we're arguing about who should cover the cost of contraception coverage for women, are we not talking at all about what we're being forced to pay?

It has been a number of years since I took oral contraceptives for birth control, but when I did, these were the facts:

  • Oral contraceptives for women were not covered under any insurance plan and had to be paid for out-of-pocket.
  • The cost averaged between $20 and $30 per month if you were buying your contraceptives in the United States.

I was fortunate. I had an Ob-Gyn who gave me the free samples the pharmaceutical reps gave to him, so I rarely had to pay for them. Only occasionally was his office out of stock when my supply ran out, necessitating a month or two prescription to be filled at my local pharmacy until they replenished their inventory.

Then I moved to Puerto Vallarta, Mexico, where I no longer had access to my doctor or my free birth control. Lo and behold, this is what I discovered:

  • The same name-brand oral contraceptives, from the same manufacturers, in the same strengths (in other words, the identical products) were available in drug stores over-the-counter without any prescription required at all.
  • A three-month supply of the identical oral contraceptives I took in the United States cost $3.00.

Yes, the decimal point is in the right place. Birth control pills sold to consumers in Mexico, by the same pharmaceutical manufacturers who sold them to American consumers for upwards of $30 a month, cost $1.00 a month. One dollar.

In one of the most Catholic countries in existence.

If the American consumer were treated fairly or equitably by the drug manufacturers, we would most likely not even be having this debate at all. Who would be arguing that women couldn't afford $12 a year for contraceptives? That would be absurd.

It follows, then, that the only reason this is a debate at all is because American women are being ripped off by the pharmaceutical giants, and our representatives in government don't seem to actually care. Big Pharma is still able to wield their power to force us to see a doctor before being allowed access to hormonal birth control, and they keep the price prohibitively high, effectively denying any access to millions of women across this country.

Yet our representatives in government aren't demanding that the prices be brought down to reasonable and affordable levels, they're just fighting over who we're going to shove the overly-bloated cost around to. And in so doing, they're giving the likes of Rush Limbaugh fodder to call women in this country sluts and prostitutes for daring to want to have control over their reproductive and health care rights, and not hand the decision as to who covers the cost over to our employers.

And what they're also hiding from us in this debate, is that "evidence from well-documented prior expansions of contraceptive coverage indicates that the cost to issuers of including coverage for all FDA-approved contraceptive methods in insurance offered to an employed population is zero."
"In 1999, Congress required the health plans in the Federal Employees Health Benefits (FEHB) program to cover the full range of FDA-approved contraceptive methods. The FEHB program is the largest employer-sponsored health benefits program in the United States, and at the time, it covered approximately 9 million Federal Employees, retirees and their family members and included approximately 300 health plans. The premiums for 1999 had already been set when the legislation passed, so the Office of Personnel Management (OPM), which administers the FEHB program, provided for a reconciliation process. However, there was no need to adjust premium levels because there was no cost increase as a result of providing coverage of contraceptive services."
We need to get the conversation on the right track, both for the health of women and the overall economic health of our country. This is not about "religious freedom." It's about forcing women to pay as much as thousands of dollars out-of-pocket, even when they're covered by insurance, for birth control methods that are made available at a minuscule cost to millions of women around the globe, and at zero cost to employers or insurers when they're included in already-existing coverage.

If we take this battle where it belongs—to the unconscionable theft by the pharmaceutical companies from women's pocketbooks for their birth control—and fix that part of our broken health care system, Republicans will never again be able to turn our reproductive health care options into a boxing match, nor will they ever, ever have any leverage to wrest control of it from us again.

We should be able to walk into any pharmacy and buy our birth control in exactly the same way men (and women) can buy condoms, and the same way billions of women around the world are able to buy their contraceptives.



REFERENCES AND ADDITIONAL RECOMMENDED READING

Out-of-pocket expenditures for oral contraceptives ~ Study, Pubmed.gov
The High Costs of Birth Control;It’s Not As Affordable As You Think  ~ by The Center for American Progress
The Cost of Covering Contraceptives through Health Insurance ~ Health And Human Services Brief at aspe.hhs.gov

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