Real information on "contraceptive pills" and health insurance
Jon Hammond from econographia reseached the topic of contraceptive pills on the cost aspects involved with health insurance at my request. Instead of losing real data in the comments sections on previous posts, I am posting his findings here:
Here are some of the empirical findings dealing with the insurance costs and cost-savings of coverage for contraceptive services. The direct costs of providing contraception as part of a health insurance plan are very low and do not add more than approximately 0.5% to the premium costs per adult enrollee (see Daroch, J. E.). In 1998, Buck Consultants estimated that the direct cost of providing contraceptive benefits averaged $21 per enrollee per year (see Daroch, J. E.). The most recent actuarial analysis, completed by the Actuarial Research Corporation in July 2011, using data from 2010, estimated a cost of about $26 per year per enrolled female (see Callahan, C.)
However, with respect to the effect on insurance premiums when medical costs associated with unintended pregnancies are taken into account … including costs of prenatal care, pregnancy complications, and deliveries … the net effect on premiums is close to zero (see Washington Business Group on Health, Sept 2000). And when time away from work and lost productivity are considered (factors salient to employers) . . the total costs to employers are reduced.
PriceWaterhouseCoopers issued a report in 2007 which found that providing contraceptive services yields a net cost-savings (see Campbell, K.P.).
The cost-savings impact of contraceptive services has also been demonstrated via the Medicaid Section 1115 Family Planning Demonstrations conducted in six states in the 1990s. Please refer to Tthe February 2012 U.S. DHHS brief on this subject .. it contains both the content and full citations noted in abbreviated form above .. see here:
http://aspe.hhs.gov/health/reports/2012/contraceptives/ib.shtml#_ftn17
rdan – thanks for posting
rdan-That’s great info. I’ve mentioned my wife before…she’s a labor and delivery nurse in a hospital that delivers around 6 to 8 thousand babies per year. (Last year was a slow one. Only 6,100 births.) 90% of those births are paid for by Medicaid. And although my wife is certainly not a bleeding heart liberal, she cannot understand (from a pure financial perspective) why Medcaid doesn’t pay for contraception.
My thanks go to Jon.
Entirely consistent with other studies that I bumped into, including some sponsored by insurance companies that, presumably, are motiveated to charge extra for an added coverage. It’s relevant that the baseline in these studies is no coverage for contraception–rather than no usage of contraception. Lacking coverage for contraception, individuals who purchase contraception out of their own pockets are reducing the insurance company’s costs. Perhaps if an insured group really does not use contraception (perhaps for religious reasons), the group should pay more in insurance premiums.
It can be argued as in previous posts and comments on including such prescriptions, but most ignore the actual complexity of medical conditions. And ignore real insurance costs. Fantasy fuels dollar amounts measured in emoticons.
The pay ‘I won’t pay for a service or product I onject to’ objections may be heartfelt. But then paying for a family plan is the same price whether you have 3 in a family or 6 for identical coverage…maybe a family of three should pay less than a family of six?? a per child premium in the works?? At some point the arguments cost structures probably would cost more to administer than basic care. And the smoothing functions of insurance are lost.
PJR….good point…I missed it.
I don’t have any empirical statistics to support this comment, but I think its a safe bet to say that orthodox religious practitioners of all faiths have bigger families than the less devout part of the population. Assuming that that is correct, why are those of us who believe in the wisdom of small family size supporting the medical costs of those who are attempting to raise their own tribe. Would it be consistent with the effort to allow an organization to refuse benefits which go against the emotional grain to allow for a refusal to cover pregnancy and child birth costs after the second child. And let’s include the cost of childhood medical care and the educational costs of all but the first two children in a family.
It turns out that Wal-Mart sells generic birth control pills for between $4 and $9/ month. Costco and Target do the same. So even at the outside the pill costs $108/year if the generic works, not $1000/year as claimed unless you go to gold plated branded pharmacy inc. Of course one needs to push back and ask the physician to tell you why the generic is not ok, if he does not prescribe it. Actually as has been pointed out this kind of program greatly undercuts the pharmacy benefit managers in many case.
In the case of my blood pressure medicine the $10 3 month supply is less than the copay, although the PBM web site does not show it. So I just ignore the insurance and buy it at Wal-Mart.
Now if you include the needed exams and lab tests it might come to $1000 per year but most of these should be covered under other preventative services (pap smear, exam etc).
A lot of women do poorly with the old generic pills. There are lots of medical reasons but they boil down to everyone is different. Assuming generics are acceptable, the biggest costs for uninsured people are the doctor’s visit, the papsmear and the resulting lab fees. Without clinics like Planned Parenthood, the process of obtaining contraception becomes difficult and expensive. YMMV. NancyO
Dan
Thank you very much.
I will assume the figures are accurate, and that we don’t need to go back into religion bashing or woman hating (vs man hating) to “settle” this issue.
I would suggest that the religious issue can be quieted by just letting the dr prescribe “the medicine” and it being nobodies business what he prescribes. I may run up against some gov’t need to monitor doctors against prescribing, or billing for, “bad” medicine, but I really like the idea of “privacy.”
Then as for big families (more religion bashing?), or blood pressure (i control mine with free exercise) [note i am being provocative for a reason], yes we could get back into a fight about paying for other people’s “excessive” use of medical care. Not sure where that would lead us, but I think I would suggest we turn the whole thing over to “the government” and let it be decided by “democratic” means and then just make up our minds to pay the tax and figure we all get whatever WE need from the coverage and as for the other guy “What is that to thee?”
In some sense, the other guy having a big family is just another “accident” of life (yes,his choice is an “accident”, caused by all the random factors that went into it), no different from your “pre-existing condition,” or my late in life out of the blue terrible, terribly expensive accident that end up costing more than your family, or your inherited diabetes, or whatever…
but again, Thank you so much, Dan, for finding us some real numbers.