In the wake of the discussion about contraception and whether insurers should have the right to deny coverage based on religious or moral beliefs many newspapers and bloggers have jumped on the cost of generic birth control pills at Target and Wal-Mart: $9 a pack. Someone even posted, in reference to Sandra Fluke at Georgetown, that $9 is cheaper than two beers in most D.C. pubs.

Yes it is true that Target and Wal-Mart have the best price in the country for oral contraceptives. As of yesterday they both carried two pills: Sprintec and Tri-Sprintec (the generics of Orth-Cyclen and Ortho-Tri-Cyclen). Both fine pills, although why anyone would want to take a tricyclic pill is beyond me (they were a marketing invention of the 80’s, not born of and medical breakthrough, and that is true insider information).

So there is a limited choice of relatively inexpensive generics. However, many women desire other forms of highly reliable contraception. Some like the Depo-Provera shot, there is also Implanon, and IUDs never mind the option of tubal ligation and vasectomy. So while the pill will work for some, getting your contraception at Target leaves many women without their contraceptive of choice. It also leaves many women without the option of the most effective contraception as the birth control pill has a pregnant rate of 8.7/100 women/year but with a copper IUD the pregnancy rate is 0.3/100 women/year and with a Mirena it is 0.1/100 women/year.

The other issue is cost efficacy. Contraception is a sound investment. Period. Every dollar spent on contraception saves $1.40 in maternal and reproductive health costs. Put another way, contraception keeps the costs of a health plan down.

Finally, so what if you can get the pill at Target? What if someone finds paying for high-blood pressure medications for a patient who refuses to lose weight, start exercising and quit smoking morally and religiously offensive? Target has $4 blood pressure medications. If health plans can opt out of contraception on moral or religious grounds, then of course they should be able to opt out of covering any other medication.

And then who decides what is morally acceptable medicine and what isn’t?

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  1. I would love to see birth control pills become OTC. Women are fully capable of managing their own health and making BCP an OTC would certainly decrease unplanned pregnancies. It is also more efficient for everybody of all incomes, insured or not. I have insurance but I always practice home remedies or OTC before resorting to a doctor’s visit. Competition would keep costs reasonable. I have no doubt about that. Those who oppose do so for political reasons because they would lose a big platform. If the pill was OTC, we’d stop having debates with religious organizations and Planned Parenthood would lose the bulk of it’s services. I can see why the latter and it’s political party find this proposal a threat.

  2. Just because something requires a doctors prescription doesnt mean should be automatically covered by health insurance. Not getting pregnant is not a health risk…why should health insurance pay for something that isn’t a health risk?

  3. The point is simply this…NOT being pregnant is NOT a health risk. You have control through personal choice to not get pregnant.

    1. This argument could extend to a wide range of prescriptions that are covered due to choices made by an individual. Poor nutritional choices, lack of exercise, living in a polluted area that leads to asthma, etc. are all personal choices linked to chronic conditions and diseases. Many of the prescriptions for these are covered by insurance. Like everyone else, I pay high premiums even though I am relatively healthy because I help fund those who are not, including those who have made poor lifestyle choices.

      The fact is that insurance companies do treat pregnancy as a type of condition. Whichever side you are on, It is much cheaper to provide birth control than to cover prenatal and infant checkups, childbirth and ongoing care, or even abortions (which many people don’t want insurance companies to cover anyways, even if the pregnancy is difficult and proves to be a health risk to the mother).

      It is a win for everyone if people have access to birth control and help avoid pregnancy until they are ready to be parents. Prevent pregnancy from the start and avoid even tougher moral and society issues down the line.

  4. I’m going to cede that this is actually one of the better arguments against the conscience clause, but that’s really not saying much.

    Yes, the idea of not including something on moral grounds can be taken in any number of directions, but the example you use isn’t a great one. I still feel like it’s not so outlandish to say, “well, he should take care of himself and it’s only $4.” As well, the Church’s opposition to contraception is set by the Vatican and has been well-documented, so it’s not just some fluke thing they pulled out of nowhere.

    But that’s not even the most important thing. The biggest problem I have is that the Democrats can just say “eff their beliefs.” I mean, even if in theory, the government can say, “when it comes to healthcare plans, there are certain rights you have to wave if you want to have one,” it’s pretty obvious that the Obama mandate was meant to draw the ire of religious groups whom the Republicans would defend. And when they did, it was more of their, “war on women,” malarky.

    Not only are they so dismissive of the rights of established religion, but they act like “access to” (read: your employer paying for) contraception is the most basic, fundamental civil right imaginable, like free speech or so-forth. Moreover, some comments I read act as if the Republicans’ positions is that employers should get to CONTROL what BC people can and can’t take, as if they’re giving them the right to monitor it even if their employees pay for it out of pocket. That’s what it seems like anyway.

  5. On a sidenote: I know I’m not the only woman who suffers from extreme nausea to the point of vomiting from those oh-so-cheap tricyclic generics.

    1. No, no you are not. It’s why I stopped taking them in college, actually. Also, I can’t swallow pills easily, even the little bitty birth control ones, so nerving myself to take a BCP when I knew there was about an 80% chance I’d choke on it and start coughing to the point of vomiting or get it stuck in my throat became just too much.

      I use the NuvaRing now (out of college, much more comprehensive insurance, but it’s still freaking expensive). It’s working out much better for me, which is the point. Women need to be able to choose the birth control option that works best for them, which is not always the cheapest option.

  6. “And then who decides what is morally acceptable medicine and what isn’t?” Exactly, it shouldn’t be the government’s role to make anyone offer it or pay for it. Individuals are the ones who choose if it’s moral. Nobody is preventing anyone from getting it or making it any easier. Just because your employer or insurer doesn’t facilitate it doesn’t mean they prevent/inhibit. Lack of facilitation does NOT equal inhibition/prohibition.

  7. Okay, so teamrns is willing to spend more to make sure that she can’t possibly be subsidizing somebody else’s fun. Not me– I’d rather save money *and* keep out of other people’s business. The best way to keep out of somebody else’s bedroom is to obtain the least amount of information possible about it, and not insert busybodies between a woman and her doctor whose only purpose is to make sure that she’s getting contraception for the “right” reasons.

    She still hasn’t said where the limits of her “recreational” exclusion for medical care lie.

    National polling suggests that this isn’t such a liberal/conservative issue: something like 63% of Americans support contraception coverage.

    But really– surely she’s joking. Somehow she would *increase* privacy by letting insurers pry into our lives to find out if we want contraception for pure and acceptable reasons. And she’s willing to pay more for this intrusion.

    I honestly fail to see why it’s a bad thing for the federal government, or any government, to tell insurers that if they want to sell insurance, they have to save money and keep out of our bedrooms… at the same time.

  8. So teamrns is proposing to institute a strict interpretation of “medical necessity” for contraceptive coverage. Pity the poor woman who accidentally lets it slip that she might enjoy sex, or that her family can’t really afford another child right now. Then the “recreation” side would outweigh the “medical necessity” side, and we just can’t pay for those hussies to have any fun, can we? I don’t envy her the task of deciding which particular patient’s situation is “medically necessary” versus “recreational.” But I’m sure she’d have lots of fun with it.

    And I’m extra fond of her Limbaugh-like implication that contraception is only needed if somebody wants to have “lots of sex,” and if a married couple have the nerve to do that, then they should lose coverage. I guess in her world people will use one OC pill if they think they might have sex some time in the next few days, like Cialis (which is already covered, without objection from teamrns). Or they can use condoms, the cost of which does go up with frequency of use. I guess she forgot that they can and do break during proper and correct usage.

    I’m curious about her new federal vs. state criterion. I’ve read and re-read her original comment, and nowhere does she argue that Federal regulations are intolerable but State ones are hunky-dory. If a government requires something, does it really matter what it calls itself?

    I’m not sure what “taking responsibility” has to do with anything, but teamrns has made it clear- she wants her insurance coverage to cost more, so she has the (im)moral high ground of not paying for those sluts to have “lots of sex.”

    And finally, I hope she enlightens us about the limits of this “recreational” criterion. Will she deny coverage to an overweight alcoholic? An unsuccessful suicide attempt? Anyone with T2DM? Injured athletes? Or is it just those insufferable sluts who have to pay?

    1. “she wants her insurance coverage to cost more, so she has the (im)moral high ground of not paying for those sluts to have “lots of sex.””

      What did I say to indicate to you that I wanted my insurance to cost more, and WHEN did I say that women who enjoyed lots of sex were sluts? If it is thought that I agree with Rush Limbaugh, my thoughts were TOTALLY misinterpreted. I no sooner agree w/ his vocabulary and thoughts on OC than ‘the man in the moon!’

      1. You indicated that you want insurance to cost more when you said “Don’t ask me to pay for your recreation.” As noted in the original post, every dollar spent on contraception saves $1.40 in maternal and reproductive health costs. If you won’t cover it for “recreation,” your costs will go up. It’s very simple.

        I am glad to hear that you disagree with Limbaugh, but you might want to watch for your own statements about having “lots of sex.” That was part of the nature of his attack on Fluke, after all. Quantity of sex is not relevant to most forms of contraception, so bringing it up at all, especially combined with your focus on “recreational” sex, was what opened you up to misinterpretation.

        So what are the limits of your “recreational” exclusion for medical care?

      2. ” If you won’t cover it for “recreation,” your costs will go up.” I consider recreation, that night of hot sex. Somehow I’m supposed to be held responsible financially? Have that night of passion, but don’t expect me to pay for it. That is RECREATION and I’m opposed to covering the cost of that and the cost of casual sex. I don’t know many married couples who would want me to feel responsible for their sex lives.

        But, the bigger issue here is that liberals seem to use this issue to deflect attention from the increasing debt, jobless rate, national security. Sure, we’d like to address this issue, too, but let’s prioritize a TAD better.

        Another issue is the invasion of privacy, the sheer, unmitigated gall of the Federal government to tell an institution WHAT it must cover in it’s insurance polity. Such a beginning down a slippery slope, often ends with a fall/A THUD!

      3. @teamrns – there 2 more little flaws in your logic. 1.) If women who can’t afford their OCPs are “probably on Medicaid anyway” then YOU ARE ALREADY paying for their pills. It’s like you don’t mind paying out of your right pocket, but not out of your left one. It’s all the same pants.
        2.) If $1.00 spent on contraception saves $1.40 in maternal healthcare costs, and people who can’t afford them go on Medicaid, which WE PAY FOR, wouldn’t you rather shut up and pay the $1 than the $1.40? Either way you’re paying, but we keep costs down to pay the $1.00. This has nothing to do with religion or politics. (I, by the way, am a Christian Republican) This is a logical choice…and one I would make if it were MY checkbook….which it sort of is!

  9. What could be more “nanny” than getting up in my grill about why, precisely, I want or need a medicine or medical device? Yikes. None of your goddamn business.

    Besides, what is to stop a patient and/or her doctor from gaming the system by just putting down the reason as “to regulate her period” (as opposed to, say, “she wants to enjoy the richness of the marital bond with her husband but does not wish to produce a third child at this time,” which under your logic would result in denied coverage)? That’s great — encourage rampant systemic lying and hypocrisy from doctors and their patients!

    And once again, let us remember: The law would mandate COVERAGE by the insurance company, not PURCHASE AND USE by any individual. No one will be forced to get or use any kind of birth control. The end.

    1. I know you said, “the end.” So, after I say this, I’ll say, “the end.” You say, “Besides, what is to stop a patient and/or her doctor from gaming the system by just putting down the reason as “to regulate her period” (as opposed to, say, “she wants to enjoy the richness of the marital bond with her husband but does not wish to produce a third child at this time,” which under your logic would result in denied coverage)? ”


  10. Dr. Jen, I just discovered your blog, and I LOVE IT! You express just what I want to say, particularly about this birth control issue. I really do believe it is a war on women and our independence from men, who were in charge for a long time before birth control came around. Keep writing your great posts, and I will keep sharing them!

  11. I see a real parallel that I haven’t seen addressed anywhere – sex and dieting. Talking about sex as “recreation” I don’t think is apt – swimming is recreation. Sex is a hard-wired biologial urge that happens to be fun, like eating is. In dieting, people are admonished for being “bad” when they partake in something that “isn’t good for them” but in all other ways is an enjoyable activity, but being “bad” is worthy of scorn and punishment. I see the same thing holding true for sex – it a situation where it is personally acceptable what is “bad” about acting on a natural (and biologically necessary (on a large scale)) urge?

    I don’t think the broad summary of a conserative view is untennable. As I understand it – married couples can have sex when they can afford to add to their family. Sex for fun (with or without marriage), abortion, and children that overwhelm the finanical abilities of a family (thereby adding to the public assistance costs of the nation) are unwanted. No group could seriously put a set of limitiations, expectations, and punishments on food – they would be mocked endlessly (all salty crunch snacks and all sweet snacks will be eliminated with the exception of birthday cake at parties of 10 or more people — really??!).

    I don’t think that is realistic, and what I genuinely *want* someone to explain to me is why none of those things can be discussed in looking for realistic solutions.

    1. Heather, I see a difference like you see the same difference that sex is HARD WIRED. However, as an urge, it can be controlled. Sometimes we don’t WANT to control it, we want to give in and have fun. However, asking me to subsidize your FUN on your WANTS isn’t where where I want to spend my money. I want to spend my money when their is a medical NEED that you have, but not on a WANT for FUN.

      I agree with your last sentence; we should be looking for REALISTIC situations with REAL dialog.

      1. Everyone who has an insurance policy that they pay for is funding things that they do not want to. Those that are in their risk pool have NEEDS created by their own WANTS. Should I have to pay increased premiums because someone who couldn’t lay off the cheeseburgers now has high blood pressure and wants gastric bypass surgery? Should I pay for the liver medication or rehab/counseling for alcoholics who now NEED it? Should I pay for oxygen for someone who has smoked a pack a day for 20 years? They are all doing “recreational” activities and now need these types of medications because of it. Do I mind? No, and here is why – high blood pressure meds and gastric bypass surgery lowers the risk of open heart surgery or other life saving measures that have extreme medical costs that will ultimately cause my costs to rise. Rehab/counseling or medication for alcoholics or oxygen treatment for smokers lessens the risk for costly doctor’s visits and surgeries, that will ultimately raise my insurance premiums.

        People are constantly paying for things that don’t use or want – childless couples still pay taxes that go to schools. People with perfect driving records still pay higher premiums because of those in their age range or gender are more apt to get into accidents.

        I use contraception with a low dose antidepressant for vaginal pain issues resulting in a traumatic birth of my first child. AND, (gasp!) I also use it so that I can have sex with my husband without getting pregnant! What do we do then – only cover half of it?

  12. Bottom line…contraception most likely will be covered in insurance policies as mandated by Obamacare but, to believe that it will be provided “free from cost” is laughable. That’s not how insurance works.

  13. @Teamrns…
    Your bathing suit analogy is a big FAIL.

    Viagra is covered under insurance policies, the catholic church doesn’t have a problem with paying for men to have sex, despite the fact that “god” obviously doesn’t want them to have sex, otherwise they wouldn’t be impotent.

      1. Why is your analogy a FAIL? Seriously?

        Because we are not talking about recreational activities, we are talking about coverage of prescription medicines that have medical uses….you are insisting on equating it to recreational activities….stop trying to force your dogma and your religious beliefs on to me. Freedom of religion means I have freedom from your religion and I can have my own religion and my own beliefs (1st Amendment in case you forgot).

        Viagra is covered for recreational use…where is your pout-rage over that drug being paid for by insurance companies?

        Hypocrite much?

  14. Dr. Jen, I don’t even believe THAT is the point (who should pay for contraception); though I feel that I should not be financially responsible for someone else’s recreation. I will gladly pay for medically necessary contraception, for example the BCP a woman with PCOS needs.

    If I am required to pay for someone’s recreational activities, then let’s turn the tables. Gee, I’d like someone to pay for my new swimsuit because I like to swim. Or, gee, for exercise purposes, I belong to a gym. I don’t think in a million years that you’d agree that you should pay for my ‘Y’ membership.

    I see that the bigger picture is: to what extent does the government (a proposed insurer) MAKE CHOICES FOR US and mandate/require that certain coverages be included in a health insurance policy? Doesn’t the government have better things to do (keeping us safe comes to mind) and keeping out of our bedrooms does, too.This country was founded on freedom of religion (among other things) and to require that something a church or a religious institution offer something in it’s health plan that conflicts with a church’s religious tenant is WRONG.

    I will use as an example the Catholic church, for that seems to be the church under ‘fire.’ Yes, there are many Catholic women who use birth control, but I shouldn’t be responsible for this cost. If these same women have medical reasons for needing contraception, I’ll gladly pay. However, if their only reason for not wanting to run down to the local Target is that they PREFER Depo or another form of birth control, that’s a different matter. In the same token, “many women desire other forms of highly reliable contraception.” Gee, I want a house in the Hamptons, too. “You don’t always get what you want…, but if you try sometimes, you get what you need…”The Rolling Stones.

    If their physician feels that ‘x’ brand of contraception is all that will work, the doc fills out forms and you know the drill.. Fill out the forms and their preferred form of contraception will likely be covered. Have these women not been told of the health risks that birth control pills carry? The minimal risk that condoms carry? That pills don’t prevent STDs where condoms have a better chance of preventing STDs?

    That said, the woman in question knew what Georgetown Law’s insurance covered for their students. Her’s was not the agenda of a woman who needed financial help to get her birth control pills covered, nor a woman who was campaigning on religious grounds. She’s not a religious EXPERT. Her expertise was in women’s rights. Hers was an agenda, as she had a record as a feminine activist, an undergraduate degree in international female trafficking and was on the board of the Law Students for _________. Hers was an agenda to expose Georgetown’s insurance politcy (to which it is entitled) when she had EVERY opportunity to attend a different law school.

    And to her quoted $3000 figure of cost; now, that’s expensive birth control!

    1. So who will review every woman’s medical records to see whether she needs contraception? The “death panels” never really existed, but you’d have us institute “hussy panels.” The reasons for their treatment preference will be minutely scrutinized. Any woman who likes sex even a little bit is automatically disqualified, of course, because she doesn’t really need contraception: she just “wants it.”

      And how will we define this need? I suppose you’d need to come up with a list of Specially Approved medical conditions that could be treated with anything that might possibly be used as a contraceptive. Only women with officially-certified approved “real” needs would be eligible for coverage, of course. Anyone who just doesn’t want a child right now is plain out of luck. Clearly their “need” is just for recreational purposes, no matter what conditions they may or may not have.

      This isn’t a matter of governmental intrusion. The government in every (or nearly every) state now requires that all drivers carry liability insurance. Where is your outrage over that requirement?

      And it isn’t a matter of religious freedom. We already prosecute parents who choose faith healing over effective treatment for their children when those kids die of preventable/treatable conditions.

      Condoms don’t work as well as other forms of contraception, but apparently everyone should choose that (no governmental interference, just teamrns interference in that choice– after all, you know what’s best for everyone). You don’t want to pay for someone else’s recreation, but you want to pay for the consequences of that recreation?

      Please read the original post. Insurance plans that cover contraception have lower costs than those that don’t. If you’re not paying for “recreation,” you’re paying for other costs, and they will be higher. How much are you willing to pay for that high ground?

      1. “So who will review every woman’s medical records to see whether she needs contraception? ” Insurance companies already do this now.

        “I suppose you’d need to come up with a list of Specially Approved medical conditions that could be treated with anything that might possibly be used as a contraceptive” Approval of services based on medical necessity is already in place.

        “Anyone who just doesn’t want a child right now is plain out of luck. Clearly their “need” is just for recreational purposes, no matter what conditions they may or may not have.” NEED is the operative word. If they have medical conditions for which they need contraception, insurance will pay for it. If not, YES, contraception costs should be their responsibility; because they are inexpensive. And if the woman doesn’t have the money, she’s likely on Medicaid; in which case it is covered.

        “The government in every (or nearly every) state now requires that all drivers carry liability insurance. Where is your outrage over that requirement?” That is a STATE requirement, not a FEDERAL requirement. I think you confuse the two.

        ” after all, you know what’s best for everyone” Hardly, I KNOW I do not know what is best for everyone (and I NEVER claimed to), but there comes a point where we CAN’T provide EVERYONE with EVERYTHING that they WANT. That is such a Nanny state mentality. “Government care, from cradle to grave, we’ll suit your every wish, your every desire…”

        I understand the ‘pay me now or pay me later’ thrust of your last statement. But providing EVERYONE contraception on demand, their preferred method, enables people NOT to take responsibility. If they want to have lots of sex, pay for it:YOURSELF. Don’t ask me to pay for your recreation. Again, I say that I’m glad to pay for your contraceptive coverage if you medically cannot carry a pregnancy, or if one method of contraception doesn’t work for you or is medically contraindicated. But to ask me to pay for your Depo when the only reason for Depo is your PREFERENCE for Depo.. NO.

        As far as condoms not working as well as BCP, Dr. Jen teaches a class about how to use a condom-CORRECTLY. There should be more of these classes, because this is why condoms don’t work. There are side effects that can be lethal with the oral contraception; yet talk about them is thrown around with abandon.

      2. Teamrn:

        Maybe birth control is inexpensive to you, but it certainly isn’t to a great many people. And it is very difficult to get Medicaid — even a minimum wage job is enough to disqualify you. No one is asking you to pay. The issue is whether or not it’s included as part of health care coverage. It would cost you less to have it in any group policy you are a part of.

        As an aside to that, sex is not recreation, it is a normal part of healthy adult life. The notion that it is optional, subject to financial ability, is ludicrous, as evidenced by the numerous unintended pregnancies resulting in further impoverishment or abortions.

      3. TeamRNS…. quote Dr. Jen, I don’t even believe THAT is the point (who should pay for contraception); though I feel that I should not be financially responsible for someone else’s recreation. I will gladly pay for medically necessary contraception, for example the BCP a woman with PCOS needs. unquote

        but then viagra is covered no? as in a MANS recreational drug. are you including that in your statement?


        didn’t think so.

        Your statement reminds me of those women who thinks a working woman can’t be a good mum; that thinks Female genital mutilation is okay because it’s steeped in culture; that we should focus less on the plight of child brides everywhere; that there is a childess loving couple for EVERY forced and unforced pregnancy; believe that incest and rape are always the fault of the victim (and most of these victims are in their own home in grungy cloths and some even under the age of five!)

        You should be ashamed of yourself. Seriously your a woman advocating against fellow women (against a few dollars saved in funded contraception versus much much more for the actual pregnancy and maternity leave)

        If I must pay for a MAN’s recreational viagra then I want to also pay for a WOMAN’s recreational (but usual for medical conditions aside from pregnancy prevention) birth control.

    2. By that logic, then no woman should get to have a maternity leave or have their pregnancies covered either. Where do you think babies come from hun, and why should anyone else (me, employers) be required to pay for your decision?

      By the way, I was put on an oral hormone to correct a menstrual cycle disorder in my late teens through to my early twenties, which had developed due to ‘over training’ from cross country and track, I wasn’t even sexually active then but it did correct my menstruation, and spared me from excruciatingly painful periods; it even helped with my acne problem. The pills were really expensive and it wasn’t covered by either of my parent’s insurance plan–so you really think my parents should have just changed jobs or I should have just sucked it?

      If insurance companies aren’t going to cover the pill used for contraception, then at least cover them when they are being used for medication. Even so, I am surprised no one object the fact that Viagra is currently being covered. If the opponents of this bill argue that the bill shouldn’t be passed because we shouldn’t have to pay for someone else’s choices, then Viagra should not be covered either.

      1. “By that logic, then no woman should get to have a maternity leave or have their pregnancies covered either. Where do you think babies come from hun,” First of all, I’m not your hun. Also, I don’t see how stating that taking responsibility for oneself in a recreational sense AND covering your PROCREATION are the same thing.

        Being placed on hormones to regulate cycles is a medical necessity and would be covered by insurance like hormones for PCOS.

        “If insurance companies aren’t going to cover the pill used for contraception, then at least cover them when they are being used for medication.” They ARE covering the pill for medication; recreation, NO. Individual insurance plans (like the current skirmish between insurance plans of religious institution NOT covering contraception- PERIOD) may have their own requirements; then you have the choice to purchase that plan or NOT.

    3. I will respond only to your penultimate paragraph.

      1. Students often do not have a choice of health insurance, especially grad/pro students who are older and often have aged-out of their parents’ insurance. While in law school, I thankfully had independent insurance, though I utilized my school’s clinic almost exclusively, because it was free*, and I was certainly pleased with the quality of care. (* = Parking tickets excepted.)

      2. Hey, don’t hate on broke law students (redundant!).

      The job market sucks. Most law students actually do not get awesome summer positions that pay well, or at all, especially if it is with a government entity. Yes, things are finally picking up. But, the old model of law hiring (“here is lots of money and cookies, please work for our firm over the six others that gave you offers!”) is pretty much over. Even an excellent GPA and a basic understanding of acceptable human interaction* isn’t guaranteed to get you a job. (* = These are often mutually exclusive qualities.)

      Sure, a national name, like Georgetown, does help one’s job prospects, but it is certainly no indicator of what a Georgetown, or any other law school, student or graduate can or cannot afford.

      3. It is amazing that “her expertise was in women’s rights.” Someone’s has to be.

      4. You are correct that she has “an agenda.” You should have the same one. No one is going to enforce your rights and freedoms for you.

      One huge thing that stuck with me in my law school professional responsibility class was this: each individual has a responsibility to represent whatever minority or marginalized group to which he belongs—to “fight the power,” so to speak. I read this to mean that every woman, by virtue of being a woman, has that personal responsibility to represent women’s issues on the whole and to fight, literally or not, for equality of treatment in every capacity. Access to appropriate medical care is absolutely within this role.

      Each individual must enforce his rights and freedoms. Women are traditionally underrepresented in the field of law. My law school class, entering in Fall 2008, was 45% women. Women are extremely underrepresented in elected positions at every level of government, despite doing the vast majority of grassroots organizing and political volunteering.

      5. Yes, this woman could have attended a different law school. But, she had that amazing opportunity to choose Georgetown, which has one of the top Constitutional Law programs in the country (the other one is Duke) and employs an all-star faculty (they literally wrote the book). A less-than-ideal student health insurance medication coverage policy is a burden that she chose to accept with these academic benefits, but she absolutely did not also give up her right to point out an unfair policy.

      But, most importantly, YOU DON’T TURN DOWN GEORGETOWN LAW.

      1. “But, most importantly, YOU DON’T TURN DOWN GEORGETOWN LAW.” Yes, you do turn down Georgetown Law if it doesn’t offer the contraception coverage that you would like to have and you’re no longer covered by your parent’s insurance. Yes, Georgetown Law is prestigious, but so are many other law schools. And I have nothing against students who don’t have money. I was a student and was broke most of the time. Where did you get the idea that I was down on broke law students?

    4. I would like to travel internationally, for recreation, so my insurance should not cover any of the multitude of vaccines I would get for certain regions.

      I would like to lift things, for recreation, like carrying my old dog down the stairs, but I broke my wrist awhile back, so I certainly should never list that wrist brace as a medical expense, anywhere.

      I would like to continue not being excruciatingly itchy from head to toe, for my own recreation and comfort, so my insurance should definitely never cover any of my antihistamines or prednisone. It’s just angioedema in my fingers, it won’t kill me.

      Eating is just recreation. Why would you want a sandwich at a restaurant when you can eat hydrolyzed soy nuggets! No insurance coverage for Epi-Pens!

      1. Traveling internationally and vaccinations: MEDICAL NECESSITY, so should be covered by insurance

        Liftings; not medically necessary. The cost of a brace is an out of pocket medical expense deductible from your taxes if you itemize.

        Excrutiatingly itchy. OTC hydrocortisone 1% not deductible. But if prescription2 % or atarax or tramcinolone cream prescribed for relief, insurance would cover it because of medical necessity. Much rides on the doc to suggest the OTC hydrocortisone or go right to the prescription prednisone or 2% hydrocortisone cream. Andioedema; an approved medical diagnosis.

        Why should we pay for WANTS; I’m MORE than happy to cover your NEEDS, but present them as such. I don’t ask that you pay for my food; because the KIND of food is a personal choice and my personal choice is not a MEDICAL need.

      2. But the travel itself would be for recreational purposes. I don’t *have to* travel, but I really want to, because it would enhance my life.

        You can’t put topical corticosteroids on your face, especially not OTC hydrocortisone. It causes acne. Then, you treat THAT with salicylates, which aggravates hives. And the angioedema fingers are nowhere near my face, so it’s not life threatening, I just don’t like having sausages attached to my hands. Other fun facts: I’m allergic to something in topical benadryl cream. Hydrocortisone is just not any sort of solution to chronic ideopathic urticaria. Look it up, it’s tons of fun.

        People with allergies to some foods tend to develop other food allergies with horrible consequences, which the skin scratch test cannot predict. The safest way to eat anything is to limit your diet exclusively to hydrolyzed soy protein. Yum.

    5. #1: $3000 was over the three years of law school.
      #2: You do realize we are in a recession, right? And if birth control is not low-cost and easily available, you will be paying for welfare and supporting babies. Because if you can’t afford bc, you CERTAINLY can’t afford babies.
      #3: There are married people who have sex but don’t want to have babies.
      #4: I applied to Georgetown as an undergrad. It does not market itself as a religious institution, and I would have been surprised to get there and find out they won’t cover the pill.

    6. People balk, quite often, at paying for birth control but I know that most insurance covers erectile dysfunction medication. I don’t understand that at all.

      I don’t believe that insurance should cover abortions but birth control is a whole other issue. I’m a Christian, not a Catholic, so I don’t understand the doctrinal issues related to why they believe birth control is wrong I just don’t think they matter. No one should be able to tell a woman when or even if she will have children and no she should not have to pay for her birth control out of pocket.

      One year, my insurance decided not to pay for yearly Pap smears. I hate to say it but that year I did not have one. I have worked all my life, but at that moment, I did not have the extra cash. If a woman has to choose between paying for good, effective birth control and the doctor’s exam that she will need before she gets them, she may do without. That would lead to more abortions, it seems, some religious groups are backing women into the corner that they have spent over 30 years supposedly trying to get them out of, more abortions instead of less.
      I say, if this was somehow an issue of men’s bodies there would be absolute silence on the subject. I goes that is a sexist statement, however, I believe it is true.

    7. Birth control helps keep people off of government help programs like welfare, which is also something taxpayers pay for. The U.S. has one of the highest rates of teen pregnancy among developed countries because people are continuously being discouraged from birth control. When insurance companies and loud mouthed people make it harder to obtain birth control then teenage girls get pregnant and end up on government programs for the majority of their lives, if not for the rest of them. Allowing insurance to cover birth control pills will actually save money for taxpayers.
      There are lots of costs for taxpayers that are effected by seemingly small things, like the availability of birth control.
      So, would you rather pay for someone’s “recreational activities” or for someone’s baby?

  15. When the Bishops made their first stab at not having to pay for BC for Catholic Universities, I suspected something. Why was it OK for them why not also for Catholic businessmen? When Obama gave them the compromise, they jumped to the second position.
    The trouble with this is that the Catholic Bishops have worked for universal health coverage for years. Now that it’s within our grasp, they are realizing that it will also cover birth control. My response is that no one has to use all the coverage their policy extends. The Bishops, but becoming culture warriors, are giving the Republicans (who don’t want any sort of universal coverage) a weapon to kill Obamacare.

    They should be ashamed of themselves.

  16. Well said!

    Also, this is like that specious bullshit from a few months ago about how “poor people often have refrigerators, therefore they are not actually poor [GET A JOB U LAZY HIPPIE LOLOLOLLLL!!!111!!].”

    I get so angry about stuff like this that I become incoherent and sputtery … so I’m doubly glad you can make the sensible argument, Dr. Jen. 🙂

  17. “Back in the day” when I was on BCP, doctors were reticent about prescribing generics, citing concerns about whether they *really* were equally effective.

    1. That’s because your doctor was getting wined and dined by the name brand companies – THAT’S why doctors don’t prescribe generics – nothing in it for them

  18. Is that a $9 co-pay, or $9 without insurance? I thought it was a co-pay, so when you figure in the costs of premiums and pelvic exam, it’s actually more.

    1. “when you figure in the costs of premiums and pelvic exam, it’s actually more.” What point are you trying to make with this stat? That the government should be responsible for not only your BCP, but our health insurance premiums and exams? When do we bear some responsibility for OURSELVES? Or don’t we?

    2. $9 flat without insurance, for everyone using the specific birth control pill covered. You should be getting a pelvic exam regardless of whether or not you are using birth control pills, so the birth control pills cost remains at $9/month. I’m guessing you can use your insurance to put the amount towards the deductible if you have one, but personally I don’t do that because I don’t want to risk my premiums going up higher for a mere $9 towards my deductible.

    3. For every person on this forum complaining about not wanted to pay for someone else’s recreational activity, you already pay for a lot of things you don’t use on your insurance. It’s like saying I don’t have high cholesterol so I don’t think so people that do have it should have to pay the price. Sure people using birth control don’t always have a medical need for it, but there are so many medications that are covered or partially covered under most insurance plans that you will never use. Not to mention it costs more money to pay for unwanted pregnancies than it does to cover some form birth control.

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