Should Insurance Companies Be Mandated to Cover Contraception - Essay Example

Author’s Name] [Professor’s Name] [Course Title] [Date] Should Insurance companies be mandated to cover contraception? Introduction According to the expert analysis in an effort to put right narrow inequity, several state legislatures have react by introducing state legislation need private health plans to comprise contraceptive pills and plans, as January 1998, twenty states accessible a variety of bills to their state assemblies intended to augment insurance reporting of contraceptives for women. Insurers terror that adding birth control instruction to health insurance will augment the cost of insurance and may grounds minute employers, already short of money by health care premiums, to drop their insurance. No doubt, the Roman Catholic Church and others opposite birth control say companies should not be compulsory to pay for amazing that they be in opposition to on ethical or religious grounds (Should Health Insurers Cover Contraception Costs, 1998). Consider these particulars: A frequently debilitating brain illness afflicts millions of Americans. This illness is one of the country's most killers. Its wounded often suffers from despair and many physical ailments, and frequently become powerless to work efficiently. The disease costs the U.S. financial system hundreds of billions of dollars annually other than cancer, further than heart disease. Providentially, though no cure exists, medical treatment can allow recipients to live usual, healthy, and creative lives. Treatment is contemptible contrast to lots of other ordinary medical events and is extremely cost-effective. Now believe this: For the vast preponderance of victims of this illness, effectual treatment is out-of-the-way. The majority health insurance plans moreover do not cover it or put a diversity of limits on reporting that do not be relevant to further diseases. Except they can pay out of pocket, victims cannot get the treatment they require. To make substance inferior, they are frequently told that their state is not a real illness, or that it is their responsibility, or that suffering from it makes them an illegal. The disease is drug and alcohol addiction, and the facts are real. Ever-present benefit caps on insurance reporting of matter abuse treatment put effectual revival out of reach for the majority addicts. In this research, I review the nature of this difficulty and a few probable ways to address it. The general standard that I supporter is essence abuse treatment equivalence, which means that insurance plans should give exposure for addiction treatment that is equal to that offer for similar conditions. In some cases, stoppage to offer such equality should be careful illegal disability favoritism on the part of employers and insurers. Furthermore, new laws should be take on to require insurance equivalence openly (Clarence Williams, 2000, PP. 12). Insurance and Gender Discrimination Although many insurance companies prefer to draw a distinct line between Viagra and female contraceptives, both prescriptions are used by men and women to achieve the same "vital human function", the freedom to control their own sexuality. Generally, prescriptions issued for either Viagra or female contraceptives are not intended to cure a patient's illness. Viagra provides temporary relief from impotence and contraceptives prevent unwanted pregnancy. While these prescriptions work in entirely different fashion, medically speaking, both enable men and women alike to engage in the vital human function of sexual intercourse. Consequently, equity demands that insurance companies providing prescriptive coverage to one sex to enhance sexuality must provide the same prescriptive coverage to the opposite sex (Andrew Stark, 2003, PP. 52). Defining Contraceptive Use as a Medical Necessity For years, insurance companies have excluded some if not all forms of contraceptives based on the determination that prescription birth control is not a "medical necessity." Most recently, with the introduction of Viagra, insurance companies have revived this "medical necessity" distinction to answer the growing swell of critics who question insurance carriers' coverage of Viagra and continued exclusion of contraceptives. Specifically, insurance companies who claim "full prescription coverage" to all members, deny access to contraceptives by stating that they are simply not "medically necessary" to treat any medical condition and thus are merely "elective" or "optional" medical services. On the other hand, these same insurance companies offer prescriptive coverage of Viagra, classifying it as a "medically necessary" drug to treat male impotence. As an illustration of this mentality, Richard Coorsh, a spokesperson for the Health Insurance Association of America states "there is a clear distinction between Viagra, ... approved as a cure for a medical dysfunction, and contraception, ... a `lifestyle drug.'". Consequently, only fifteen percent of indemnity insurance plans offer coverage of the five most common contraceptive methods, while almost half of all Viagra prescriptions are subsidized by health insurance (Richard H., 1998). Current Shortfalls In Insurance Reporting Of Addiction Treatment In USA The majority Americans benefit from health insurance plans offer by their employer or the employer of a family associate. Others are enclosed by Medicare or Medicaid, or pay for personality or family plans from a confidential insurer or health maintenance organization (HMO). In the middle of employers who give insurance, a few usually very great companies are self-insurers, sense that they serve as their own insurance company, at the same time as others obtain group plans from third-party insurers. About thirty-nine million Americans are uninsured. Even in the middle of those who have insurance policies, though, reporting of alcohol and drug addiction treatment is frequently incomplete or absent. In a few cases, insurers completely keep out coverage of addiction. Further often, addiction treatment is subject to financial caps and other limits on coverage that do not be relevant to treatment of further diseases. Often, coverage is incomplete to short; one-shot treatment programs by no long-term preservation care a plan by little chance of achievement. In general, fewer than 10% of all American workers have a health insurance plan that treats addiction consistently to similar diseases. A few estimates propose that only 2% of matter abusers have health insurance plans that give sufficient reporting for treatment (Daniel C. Maguire, 2003, PP 233-245). The Case For Insurance Equality No doubt, the issues nearby insurance exposure of addiction treatment are multifaceted, in part since of the extremely nature of the health insurance business. Furthermore, there is no such thing as truthfully "comprehensive" health insurance i.e., insurance that wrap each medical treatment. Moreover, Insurance companies habitually decide what events they will and will not cover on the foundation of deliberation such as the significance of the fundamental state and the cost and efficiency of the treatment. Since of the continually changing landscape of medical science, choice concerning whether to cover sure procedures is often controversial. It is thus comprehensible that politicians are often unwilling to jump into the fray by issuing reporting mandates that would take carefulness over exposure decisions away from insurance professionals. Insurers' Responses To Exterior Appraisal Decisions No doubt, insurers can respond in four dissimilar ways to their unrelenting incapability to maintain coverage denials for weight decrease surgery. They can just give in and endorse the majority or the entire such requests. They can carry on declaring their own principles or criteria for medicinal need, relying on the power given to them in the insurance contract's general description of medical requirement. They can effort to make the insurance agreement more open by specifying the exacting medical criterion that will govern reporting of these measures. Or, the contract can specially exclude all weight decrease surgeries. Interviews by means of insurers exposed that each approach is taken by at least a few insurers; these interviews also make known the degree to which each approach be successful or fails (Sylvia A. Law, 1998, 376-83). Writing Insurance Policies To Offer Insurers Further Judgment To keep away from losing appeals, insurers could make tighter up the wording of their insurance policies in a method that allows them to implement more warning or demanding principles of medical requirement. Previously, this was done by condition that medical need will be strong-minded at the insurer's sole carefulness. In spite of these uncertainties, interviewee’s consideration that there are apparent cases of exact exclusions that are not subject to appraisal. Excluding a few or all transplants is one instance. Therefore is exclusive of coverage for Viagra, or in vitro fertilization. Rather than keep out these treatments in total, insurers occasionally comprise them only if definite conditions are met for example, they will cover prescriptions for Viagra but limit the amount allowable to a particular number of pills per month, or they will cover convinced transplants but only if particular eligibility criterion are met. The similar could be done for bariatric surgery, but none of the insurers dialogue had done so. Some clarification were heard for why this is so. Legal Status of Insurance Companies While the U.S. Supreme Court may not have provided a clear set of guidelines regarding health care allocation between men and women, they have clearly set forth equality in health coverage as the ultimate goal. Consequently, insurance companies are faced with the complex problem of developing a standard to ensure the ultimate goal of equity in health care for men and women alike (Annette B. Ramairez de Arellano, 1983, PP. 221-223). Rather than attempting to correlate various medical treatments between men and women, insurance companies must take into account the basic differences between men and women, and then identify the independent needs of both sexes. After identifying the individual needs of their members, insurance companies can begin to evaluate the services necessary to ensure the health and well-being of all members alike. By applying this "independent" approach it is probable that insurance companies will be forced to be familiar with the critical role effectual contraception plays in the sustained health and well-being of female members (ANDREW STARK, 2000). Costs Incurred Given the amount of resistance insurance companies have shown with regard to providing full contraceptive coverage, it is somewhat surprising to learn that the controversy only equates to $21.40 per employee per year. This figure symbolizes an extra cost to the average employer of $17.12 per employee per year and an further cost of $4.28 to each employee per year. The increase in cost to the insurer would average an additional $16.00 per enrollee each year. Eventually, the added expenditure to employers who offer employees with medical insurance is less than 1% of the average total price of providing coverage. Although this figure may appear expensive to some, when compared with the $100.00 cost per month per male for Viagra, the cost of female contraception is relatively low (Henry P. David,1999. P. 111-113). To recognize the weakness of insurance providers' "medical necessity" argument, contraceptives must be placed in context with other prescriptions. Health care systems prefer to classify contraceptives as "preventative" or "elective" options in order to justify exclusion of coverage. These medications do not "cure" hypertension, they simply prevent the patient's blood pressure from raising, yet they are covered by medical insurance. Another example of preventive medicine includes allergy medications prescribed to prevent the uncomfortable and inconvenient side affects allergy sufferers may manifest (Jane Hochberg, 1996, 10-25). Based on the preventative roll contraception plays in controlling fertility and avoiding the very serious consequences of unwanted pregnancy, contraceptives are essential to a woman's health and well being and as such are a "medical necessity." Insurance companies who describe contraception as "a lifestyle drug" tread dangerously close to stereotyping women who elect to control their fertility as "promiscuous" or "scandalous." Moreover, the fact that Viagra allows men to become more sexually active, suggests it could also be described as a "lifestyle drug." Yet traditional stereotypes of men suggest that men are "meant to have erections and sexual pleasure," and therefore Viagra merely aids what nature intended. On the other hand, traditional stereotypes of women say that women are intended to get pregnant, become mothers and only tolerate sex. Thus, the traditional stereotype of women discourages use of "unnatural" contraception and even abortion. Rather than bind women to outdated and oppressive standards, insurance companies should recognize that both Viagra and contraceptives are medically necessary to the well being and sexual health of both men and women (Andrew Russell, 2002). Conclusion Health care inequity has existed for women for years but the advent of Viagra has brought this inequity to the surface once again. If insurers provide Viagra to men to enhance their sexuality and give them the freedom to control when and where they can have sex, then insurers must provide women the same freedom. This freedom for women comes in the form of effective contraception allowing a woman who chooses to engage in sexual intercourse, to fully control when, where and the consequence of sex. While different in form, Viagra and prescription contraception achieve the same underlying goal, enhanced sexuality (CAL. HEALTH & SAFETY CODE, 2004). Opponents of evenhanded coverage for women defend their position on more than a few grounds including recitation contraception as a "lifestyle" drug and claiming that the additional cost would unreasonably burden small employers and insurance carriers. These arguments, however, are simply mismatched with the facts. Contraception is a medical necessity for women. It make sure sufficient timing among pregnancies and avoids surplus pregnancy frequently consequential in abortion, low-birth weight, baby humanity and motherly morbidity (COLO., 2004, 16-41). Furthermore, the additional cost of $16.00 per person per year for instruction contraceptive coverage is far outweighed by the monetary benefits gained in avoiding discarded pregnancy. The time for federal legislative intervention has come to remedy this current inequity. Adequate state legislation is scattered at best and ERISA loopholes make it impossible for states to provide full coverage to all women. The passage of EPICC would greatly improve health care for women across America. Until federal reform takes place, insurance companies will continue to discriminate against women as readily demonstrated by the policy many maintain to include Viagra while excluding contraception from prescriptive coverage (Planned Parenthood v. Casey, 2002, 153). Work Cited Article Title: Should Health Insurers Cover Contraception Costs?. Magazine Title: State Legislatures. Volume: 24. Issue: 6. Publication Date: June 1998. Page Number: 9. COPYRIGHT 1998 National Conference of State Legislatures; COPYRIGHT 2002 Gale Group Article Title: Congressmen Hit D.C. Council Vote. Contributors: Clarence Williams - author. Newspaper Title: The Washington Times. Publication Date: July 13, 2000. Page Number: 1. COPYRIGHT 2000 News World Communications, Inc.; COPYRIGHT 2002 Gale Group Article Title: What's Natural?. Contributors: Andrew Stark - author. Magazine Title: The Wilson Quarterly. Volume: 27. Issue: 2. Publication Date: Spring 2003. Page Number: 52+. COPYRIGHT 2003 Woodrow Wilson International Center for Scholars; COPYRIGHT 2003 Gale Group Should Health Insurers Cover Contraception Costs?, supra note 10, at 9; see Statement of Richard H. Schwarz, M.D., supra note 12. If Viagra is Covered, Why Not the Pill? It's Unfair for Insurance Companies to Cover Viagra and Not Contraceptives, GREENSBORO NEWS & REC., Aug. 10, 1998, at A6. Book Title: Sacred Rights: The Case for Contraception and Abortion in World Religions. Contributors: Daniel C. Maguire - editor. Publisher: Oxford University Press. Place of Publication: New York. Publication Year: 2003. Page Number: Sylvia A. Law, Sex Discrimination and Insurance for Contraception, 73 WASH. L. REV. 363, 376-83 (1998). Book Title: Colonialism, Catholicism, and Contraception: A History of Birth Control in Puerto Rico. Contributors: Conrad Seipp - author, Annette B. Ramairez de Arellano - author. Publisher: University of North Carolina Press. Place of Publication: Chapel Hill, NC. Publication Year: 1983. Page Number Book Title: From Abortion to Contraception: A Resource to Public Policies and Reproductive Behavior in Central and Eastern Europe from 1917 to the Present. Contributors: Henry P. David - editor, Anastasia Posadskaya-Vanderbeck - author, Joanna Skilogianis - author. Publisher: Greenwood Press. Place of Publication: Westport, CT. Publication Year: 1999. Page Number: iii. Book Title: Contraception across Cultures: Technologies, Choices, Constraints. Contributors: Andrew Russell - editor, Elisa J. Sobo - editor, Mary S. Thompson - editor. Publisher: Berg. Place of Publication: Oxford, England. Publication Year: 2000. Page Number Survey Reveals Bias Against Recovering Alcoholics and Addicts, ALCOHOL & DRUG ABUSE WKLY., Dec. 20, 1999, at 3 (demonstrating public unwillingness to hire recovering addicts). Cf. Toni Vranjes, Doctor Proposes Major Changes in Health Insurance System, MED. INDUSTRY TODAY, Jan. 19, 2002, LEXIS, Nexis Library, Medical Industry Today File (reporting Dr. David Levy's stance that standardizing coverage is the best solution to adverse selection). CAL. HEALTH & SAFETY CODE [sections] 123420(a), (c) (West 2004) (protecting religious health care facilities and all hospital employees and physicians from being required to directly provide an abortion contrary to their ethical, moral, or religious beliefs). COLO. REV. STAT. ANN. [sections] 25-4-1405(5) (West 1990 & Supp. 2004) (requiring counseling about ways to prevent transmission); IND. CODE ANN. 16-41-14-10 (West 1997) (requiring health care providers to refer HIV patients for preventative counseling); N.Y. PUB. HEALTH LAW [sections] 2781(5) (McKinney 2003) (requiring health care workers to inform a patient undergoing an HIV test about ways to prevent transmission and the need to notify sexual partners). Planned Parenthood v. Casey, 505 U.S. 833, 874 (2002) (plurality opinion) (acknowledging that the right to privacy prevents government from imposing an "undue burden" on the decision whether to have an abortion); Roe v. Wade, 410 U.S. 113, 153 (2003) Jane Hochberg, The Sacred Heart Story: Hospital Mergers and Their Effects on Reproductive Rights, 75 OR. L. REV. 945, 956-58 (1996) (discussing public opposition to the mergers); UTTLEY, supra note 1, at 10-25 ANDREW STARK, a former Wilson Center Fellow, is a professor of strategic management at the University of Toronto and the author of Conflict of Interest in American Public Life (2000). Copyright [c] 2003 by Andrew Stark. Read More