McCain and Birth Control

Carly Fiorina, surrogating for John McCain, raises a good point:

Carly Fiorina, the former Hewlett-Packard chief who is now the Republican National Committee’s “Victory Chairman,” was discussing consumer-driven health insurance at a breakfast with reporters when she proposed “a real, live example which I’ve been hearing a lot about from women: There are many health insurance plans that will cover Viagra but won’t cover birth-control medication. Those women would like a choice.”

Unfortunately for her, McCain had an opportunity to vote in congress on a measure that would guarantee that health insurance plans cover birth control and he voted against it. As Dana Goldstein points out that's just one piece of a larger reactionary McCain agenda on reproductive rights and safe sex.

Comments

Okay, a question:

How the FUCK does the McCain use Carly Fiorina as a surrogate without getting laughed out of the room? This is a woman who was never held public office, elected or appointed, and who is best (and only) known to the public for getting shitcanned from the private sector for spectacular incompetence. And this is one of McCain's advisors?

At least Michael Brown didn't get fired by the Arabian horse association.

Posted by Gabriel | July 8, 2008 5:46 PM

This isn't the first time Fiorina has been talking out of her ass while on point for McCain.

To echo Gabriel's sentiments above, I find Fiorina singularly unimpressive, and thus a fine candidate for a slot in a McCain administration (or Bush, for that matter).

Posted by John | July 8, 2008 6:05 PM

the Republican National Committee’s “Victory Chairman,”

Do they also have a "Defeat Chairman?" You know, just in case. Bob Dole seems ideal for the position.

Posted by urbino | July 8, 2008 6:15 PM

Unfortunately for her, McCain had an opportunity to vote in congress on a measure that would guarantee that health insurance plans cover birth control and he voted against it.

Maybe Matthew didn't understand the word "choice" that Ms. Fiorina used. The word "choice" means that women could get health insurance that covers birth control if they desire that type of plan. If they didn't desire that type of plan, they would have the option of obtaining a plan without birth control coverage. McCain voted against a bill that would have prevented women from having that choice; it would have mandated the type of insurance plan women were required to get.

It's strange how authoritarians like Matthew seem to understand the word "choice" as it pertains to abortion but not when it pertains to other things like types of health insurance plans.

Posted by Al | July 8, 2008 6:24 PM

Matt's not an authoritarian, Al, he's an authoritarian trust fund scumbag. Get your canned epithets straight, please.

Posted by Curly | July 8, 2008 6:31 PM

That's somebody else's epithet, Curly. Matthew's not a scumbag, and I have no knowledge he has a trust fund.

Posted by Al | July 8, 2008 6:46 PM

Okay, so men get Viagra for free, and women get to pay for birth control by buying a health plan that explicitly includes it and costs more because of it. A blow(job) for the free market! Teh awesome! Al for McCain health bureaucrat! Idiot.

Posted by elle loco | July 8, 2008 6:53 PM

The logic for not including birth control in insurance is that it is largely a predictable expense. So therefore, it is not insurable in the classic sense. (The point of insurance is to pool risk, so that instead of having a 1 in 100 chance of incurring $300,000 in medical bills in a year, you pay $3,200 a year so that that $300,000 will be paid by the insurance company - the extra $200 per customer goes to pay the companies' expenses and their shareholders (granted, it's more complicated than that, but that is the genral principle).

To pay for birth control either requires people choose to add birth control to their plan (which would, one would suppose, simply add the cost of birth control to the premium*), or to have everyone, whether they use bith control or not, pay for those who use birth control, either by mandating birth control coverage in all plans or by mandating that adding birth control coverage not cost more than not adding it.

In essence, what those who want to mandate birth control coverage want is to subsidize birth control. I can understand that position, but let's be honest about what we are really discussing here.

As for Viagra, I suppoe that it makes sense to have plans that cover Viagra if the erectile dysfunction is not part of a pre-existing condition (that is, if it not predictable condition). Again, it could make sense for either Viagra or birth control to be covered by a plan if the plan can get the drugs at a reduced price from what individuals can get.

(To be honest, I do not want to see Viagra funded under any government plan, or that it be mandated that Viagra be funded under any plan; it shuld be the business of the insurance to determine that).

*If the insurance company could get birth control at a discount, then it would make sense to have birth control coverage and to charge less than birth control would cost the consumer.

Posted by Glaivester | July 8, 2008 6:57 PM

Al,

Currently, under many plans, birth control pills are not covered. Women have no choice except to pay out of pocket. Men in many of those plans have no choice either: their plan includes access to Viagra.

I'm guessing that you favor both people being given the option of choosing plans that do not offer those features rather than neither being given the option? Or do you favor "letting the market decide"? That is what has led to the current disparity.

From reading the text of the bill, it looks to me like it added birth control pills to the formulary across the board. I guess it would have been more equal to mandate that if Viagra-class drugs would be offered, then birth control pills must also be offered.

Personally, I favor single payer health care, with Pharma R&D paid for by NSF grants rather than "what drugs do folk with money need", but I'm a happy leftie. Oh, and I'd put both on the formulary in "Beth's World".

Cheers,
Bethany

Posted by BethanyAnne | July 8, 2008 7:30 PM

The logic for not including birth control in insurance is that it is largely a predictable expense. So therefore, it is not insurable in the classic sense.

routine dental checkups are also predictable. as are routine things like prostate exams and pap smears. and it's hardly unusual to find people who need to take a specific medication for their entire life. those are all insured.

Posted by cleek | July 8, 2008 7:45 PM

I'm guessing that you favor both people being given the option of choosing plans that do not offer those features rather than neither being given the option?

Yes. Specifically on this issue, I favor decoupling health insurance from the workplace and allowing individuals to purchase the type of health insurance they want, whether that includes birth control coverage, Viagra coverage, both, or neither. People should not be forced to pay for coverage of these type of things. More generally, though, I favor any type of health system that signficantly reduces costs while maintaining roughly the current standard of care - whether that is single-payer government provided care, market-based care, or whatever. I don't see any candidate providing a plan that addresses my concerns. Obama's plan will surely significantly increase health care costs and McCain's plan will likely not do much if anything to reduce costs.

Posted by Al | July 8, 2008 7:52 PM

While it's not the main point, I'm stuck on just what Fiorina meant by "choice" and I'm not sure Al's nailed it.

As to the question do I favor subsidizing birth control, the answer is yes. Especially as the group who has previously been uninsured by choice--the young and healthy and not necessarily solvent--includes a lot of women of reproductive age. Let's just remove "couldn't afford it" for reasons to lapse on birth control. (Yeah, it'd be great if we all had ironclad senses of responsibility and self-control. I'm trying to work with the human nature I've got.) We rightly cover prenatal care as a social good; including reliable birth control seems a logical extension out of that. Avoiding unintended pregnancies amongst the young and healthy and financially insolvent is likely to save more (to society at large, in medical bills and beyond) than it costs.

As for the traditional sense of insurance, health insurance no longer bears any resemblance to it. My home-owner's insurance, car insurance, life insurance are all paid at nominal fees with the assumption I and most of my fellows will make a claim of $0 on them. My health insurance covers every routine doctor's visit. Fiorina's odd formulation drives at what is considered reasonable care, and I think that's "coverage for a certain number of health conditions, including both chemotherapy and birth control." I don't see where "I choose to pay $50 more per month for a plan that includes birth control" is distinct for the consumer from "I choose to pay $50 per month for my birth control, which isn't covered by my health insurance." Just as we wouldn't expect a reasonable minimal policy not to cover cancer treatment, it doesn't make sense for any policy short of catastrophic-care-only to not cover birth control.

Posted by Deborah | July 8, 2008 8:23 PM

While it's not the main point, I'm stuck on just what Fiorina meant by "choice" and I'm not sure Al's nailed it.

As to the question do I favor subsidizing birth control, the answer is yes. Especially as the group who has previously been uninsured by choice--the young and healthy and not necessarily solvent--includes a lot of women of reproductive age. Let's just remove "couldn't afford it" for reasons to lapse on birth control. (Yeah, it'd be great if we all had ironclad senses of responsibility and self-control. I'm trying to work with the human nature I've got.) We rightly cover prenatal care as a social good; including reliable birth control seems a logical extension out of that. Avoiding unintended pregnancies amongst the young and healthy and financially insolvent is likely to save more (to society at large, in medical bills and beyond) than it costs.

As for the traditional sense of insurance, health insurance no longer bears any resemblance to it. My home-owner's insurance, car insurance, life insurance are all paid at nominal fees with the assumption I and most of my fellows will make a claim of $0 on them. My health insurance covers every routine doctor's visit. Fiorina's odd formulation drives at what is considered reasonable care, and I think that's "coverage for a certain number of health conditions, including both chemotherapy and birth control." I don't see where "I choose to pay $50 more per month for a plan that includes birth control" is distinct for the consumer from "I choose to pay $50 per month for my birth control, which isn't covered by my health insurance." Just as we wouldn't expect a reasonable minimal policy not to cover cancer treatment, it doesn't make sense for any policy short of catastrophic-care-only to not cover birth control.

Posted by Deborah | July 8, 2008 8:23 PM

Al,

An you tell us where such a health insurance plan exists and functions in the real world? I mean, somewhere on THIS planet?

Posted by athena | July 8, 2008 8:24 PM

Al,

Can you tell us where such a health insurance plan exists and functions in the real world? I mean, somewhere on THIS planet?

Posted by athena | July 8, 2008 8:25 PM

I favor decoupling health insurance from the workplace and allowing individuals to purchase the type of health insurance they want, whether that includes birth control coverage, Viagra coverage, both, or neither. People should not be forced to pay for coverage of these type of things.

Exactly! If I do not want trastuzumab, but I do want casodex, I should have the option to choose a health insurance plan that covers one and not the other. Likewise, if I do not want coverage for lithopedions or 5-Alpha Reductase Deficiency, then I should not have to pay for it.

And you can just put it all in the fine print. No problem! Just put right on it in there. 7 point type is fine. My due diligence team will get right on it. After all, I'm betting my life on whether or not this plan has a loophole I missed!

Next, I would like the choice to eat samonella-infested tomatoes, or to pay more for tomatoes which some organization that is paid to say such things has said are not samonella infested. Also, let's go back to cars with optional seatbelts!

Posted by anonymous | July 8, 2008 8:37 PM

"The logic for not including birth control in insurance is that it is largely a predictable expense. So therefore, it is not insurable in the classic sense."

What about all preventive care? Vaccines, mammograms, cholesterol checks, colonoscopies??

If birth control is not covered there are likely to be more pregnancies (especially unplanned ones) that will result in higher expenses for the risk pool group (prenatal care, labor and delivery, infant health care, and pregnancy termination if that is covered.)

The reason health insurance covers predictable expenses is to keep the population healthier and lower the cost to the pool of treating such things as metastatic colon cancer in the folks who didn't pay for a colonoscopy 5 years earlier.

Posted by Sybil | July 8, 2008 9:17 PM

Two points:

1. Why do you respond to "Al"? He is a troll --thus, by definition, both uninterested and incapable of fact and logic based discourse.

It's like attempting to discuss theoretical physics with the Three Stooges.

2. Carly Fiona was a product --like Jeff Whitesun, who destroyed Gateway, and Bill O'Shea, who helped destroy Bell Labs and Lucent -- of the old Bell System Executive Development Program. (EDP). This program was famous for producing people with a good line of patter, but utterly divorced from reality. Thus, it is hardly surprising that she got booted at HP. What IS amazing, really, is that she could make Mark Hurd, a scumbag with a sincere manner and a few tricks (like killing pensions) look so good.

It is all a matter of comparison.

Personally, I AM surprised that she has secured such a visible role, even in the corrupt and degraded current GOP and McCain campaigns. It is more or less one of the most avoidable fewbars in human history.

Posted by Tim Connor | July 8, 2008 9:40 PM

Carly is universally excoriated in the tech community for wrecking Hewlett-Packard during her CEO time there. As one of the commentators put it, having her back McCain to boost his tech creds - after he admitted he can't even use email - is like "having Pacman Jones boost your NFL cred."

Personally I always thought she was hot back in the day. But that's about it.

Carly Fiorina touts McCain's tech credentials
http://latimesblogs.latimes.com/technology/2008/07/carly-fiorina-t.html

Posted by Richard Steven Hack | July 8, 2008 10:19 PM

Carly Fiorina is a douchebag, just like Dick Cheney.

Posted by MoeLarryAndJesus | July 8, 2008 11:10 PM

Fiorina is the perfect modern Republican candidate. Just ask the people she spied on.

Posted by Jeffrey Davis | July 9, 2008 9:38 AM

As one of the commentators put it, having her back McCain to boost his tech creds - after he admitted he can't even use email - is like "having Pacman Jones boost your NFL cred."

That's really not fair to Pacman Jones - he was much better at his job than Fiorina was at hers.

Posted by Gabriel | July 9, 2008 11:39 AM

Dear Republican Party,

I am from Texas. Before the Iraq war, I had vague, unexplored feelings against welfare, other entitlement programs, affirmative action, etc. I was against abortion but probably would have gotten one if I'd gotten a girl pregnant during college. I also had a inexplicable distaste for hacky-sack and hippies. As a high earner, my tax burden would be much less in a McCain administration. But your brazen hypocrisy and incompetence in the post-9/11 years has made me a lifelong Democrat at the age of 26. Thank you.

Mike

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