Nothing In Life Is Free … but, Should It Be?

In a recent report the Institute of Medicine (IOM) reclassified birth control and other critical health services as a preventive measures.  This ‘preventive’ classification includes STI screenings, HIV/AIDS testing, osteoporosis screenings, all FDA approved forms of contraception, and many other vital health care services.

What does this mean?  It means that, as preventive, these services have a much higher chance of being covered, at no cost to the patient, by insurance programs under new health care legislation.

In case you might think this is too good to be true, check out the actual report.  The IOM states, ”The preventive health care services and screenings specified in the legislation will be fully covered without requiring a patient copayment”(Summary, page 1).

How does this affect you and me?  Well, I can’t speak for you, but I can speak for me.  Sweet heavens, I could not be happier with the prospect of no-cost birth control, annual visits and screenings.  I am 27, in relatively good shape.  I eat right, I walk a lot and exercise frequently.  I don’t drink but a little alcohol, and I get an average of 8 hours of sleep per night.  I have not had any major health issues and I have never been pregnant.  With all of this on my side, I have still spent a number of years uninsured due to (1) a bureaucratic loophole which stamped my file ‘denied’ from healthcare plans, (2) unexpected unemployment, or (3) both.  As a result, I pay full price and out of my own pocket for every check-up, screening, and birth control method I need.  Without insurance this averages approximately $1360 per year ($80/month for birth control, $100/year for doctor visit, over $300/year for lab work on annual exam) if I am getting only the minimum of services.

With insurance I get a little better deal.  If I were to have health insurance I would pay about $460 per year ($30/month for copay on birth control, $100/year for annual exam and lab work) plus my monthly premium.

I know what you’re thinking … $460 with insurance is not that bad.  Actually it is pretty bad.  Let me speak on this for a moment.  A minimum of $460 per year is bad for many reasons.  First, I would have to pay for these services, yet I am not the only one reaping the benefits of these services.  As a hetero-identified woman, I would be the only member of my potential partnership that would have to pay these fees.  A man simply does not incur these costs because they simply do not get pregnant, and they don’t have annual exams.  Not cool on the cost thing.

Second, I don’t make that much money and I know I am not the only one out there that struggles to pay rent and student loans on a small salary.  Not to mention all those ladies that are unemployed due to unmet childcare needs, disability, or simply because they cannot find a job in this economic climate.

Finally, the use of contraception to regulate pregnancy, testing for STIs and HIV/AIDS, annual exams, and so forth are common goods for our communities.  The IOM found that approximately 49% of all pregnancies were unintended.  Furthermore, unintended pregnancy were most likely to occur in young women ages 18-24, extremely formative years.  I for one want my young women and men to complete high school, attend a university or training course of their choice, and contribute to our society without the unnecessary burden of children at a young age.  I think we can all agree, children should not be having children.

The IOM notes that ‘family planning services are preventive services that enable women and couples to avoid an unwanted pregnancy and to space their pregnancies to promote optimal birth outcomes” (pg 91).  Planned pregnancy equals optimal birth outcomes.  Healthy parents equal healthy babies.  And, healthy equals happy.  Need I say more.

I bet you’re thinking, “What about the money?  Nothing in life is free.”  You’re right, nothing is free, but in this case preventive health services like contraceptives save us so much money that frankly they should be free.  The IOM explains, “All contraceptive methods were found to be more cost-effective than no method” (pg 93).  Bam!

This largely political debate is really a personal matter.  I can say with all honesty that no-cost health care services would be a load off my back.  I would save so much money each year, and for me that would be a lot of time saved as well – I wouldn’t need multiple jobs for one.

There was a time not so far in the past that I studied in London.  While there I had my first experience with a national health service (NHS).  Though it often lacked the glitz and glam of some of our doctors’ offices, the NHS got the job done.  In the United Kingdom you are offered preventive services free of charge.  This includes annual exams, consultations with the doctor, contraception, and STI and HIV/AIDS screenings.  Having paid for birth control in the past I was delighted to find that I was offered multiple options, all without a fee.  The pros and cons of each were discussed at length and any misunderstandings were cleared up without me worrying, “Are they going to charge me more for being in the office too long?  Did I go over my allotted time?”

As a nation, even in our youth, we have come so far.  But honestly, reproductive rights seem to be holding us back.  It’s about time we got our act together and start putting our talk of ‘equality’ to practice.  No-cost birth control is one step forward people.