Hospitals

Is birth control a privilege or a right?

Coleen Monroe felt like a healthcare criminal when she went to her first doctor visit in England. Now she describes another healthcare experience that may never become a reality for American women: access to free birth control. The Supreme Court will decide by next summer whether employers can refuse to include birth control coverage in […]

Coleen Monroe felt like a healthcare criminal when she went to her first doctor visit in England. Now she describes another healthcare experience that may never become a reality for American women: access to free birth control. The Supreme Court will decide by next summer whether employers can refuse to include birth control coverage in health insurance policies.

Everyone is crying religious freedom, but this case has the potential to grow well beyond NuvaRing and the Pill. Employers could decide depression is “all in your head” and refuse to cover mental health care. What if your CEO thinks that vaccines cause autism and refuses to cover shots for your kids? What if your company president thinks that AIDS is punishment for being gay and refuses to cover HIV treatment?

Surely the Supreme Court will see the (un?)intended consequences of granting this kind of latitude to employers and rule against Hobby Lobby. I hope that by June 2014, any American woman who needs birth control for any reason will be able to share Monroe’s experience.

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This is what using birth control was like for Monroe when she lived in the states and now when she lives in England.

“I estimate that over the nine years I’ve been taking hormonal birth control, I’ve paid more than $5000 in out-of-pocket costs to obtain it. $30 per month for six years on the Pill, $45 per month for three when I switched to the Nuvaring, and all the associated costs of OB/GYN appointments over that time period. In the US I get my birth control at Planned Parenthood, and even though I’m at the end of their sliding scale I had to pay out of pocket for the appointment and each month’s supply. Even with the Affordable Care Act, I don’t qualify for free contraception in my home state of Colorado despite having no private insurance and subsisting around poverty line.

Birth control was not covered by my parents’ insurance when I was able to use it. It was ‘preventative medicine,’ which has long been code for ‘things we don’t think are important enough to pay for.’ Imagine my shock when I bothered to read the insurance policy and found that they refused to cover contraceptives of any stripe, but covered Viagra in full. IN FULL. Not even a co-pay. This is what happens when old, rich, white men make the reproductive health policies and can call young women ‘sluts’ if we dare ask for free contraception.

Subsidised birth control is not controversial in many countries, despite what you might have been told. It pays for itself in economic returns, brings down rates of teen pregnancy and high school-dropouts, and relieves young women of the financial burden I’ve been shouldering these nine years. By some estimates, every dollar spent on family planning saves governments six more.

Now, I walk into the Boots pharmacy, smiling apologetically as I hand over the script that was crushed beneath the weight of my laptop. The woman behind the counter glances at it and wanders over to a fridge in the corner. She pulls out a packet of Nuvarings, wraps them up, and asks me to sign the script. Then she hands them over, saying “Thank you, have a great day!” I hesitate, resisting hard to overcome the Pavlovian urge to pay for the medicine. At my home clinic, this three-month supply would’ve been £83 ($135).

The label says £0.00. Free at point of sale. It has my name printed on it. I am part of a true national health service, a publicly funded one that I and others contribute to through taxes and get actual services from.”

[Image from Coleen Monroe’s post on The Collective Outlier]