The Women's Vote

Today, Barack Obama unveiled a strategy for economic security for America's women and did a well-received joint appearance with Hillary Clinton on women's issues in New York. Meanwhile, Jessica Valenti draws our attention to this slick clip from John McCain:

For context here, McCain surrogate Carly Fiorina was arguing the other day that it's unfair for insurance companies not to cover birth control as part of her pitch to women voters. Then it was pointed out that McCain had voted against legislation that would address the issue. When asked about it he, well, didn't have much to say.

Comments

Let me be the first to say:

Straight talk! You tell 'em McCain!

Posted by Chris B | July 10, 2008 12:45 PM

Speak up, John, I can't hear that straight talk!

Posted by Chet | July 10, 2008 12:50 PM

Well, some reporter just lost her BBQ privileges.

Posted by DTM | July 10, 2008 12:53 PM

So, is he back to the "comparable worth" idea that was just about the boneheadedest idea of the 1970s?

Posted by Steve Sailer | July 10, 2008 12:59 PM

Where did the birth control / viagra equivalence come from? Inasmuch as impotence is an actual malady, why shouldn't it be covered? I know for some women, BC is also used to treat irregular or unusually heavy periods, so it seems perfectly reasonable to hormonal BC to be covered. But HBC for the purpose of not getting preggers does not appear to me as a medical treatment for anything.

Mind you, I think that BC should be freely / inexpensively available to anyone who wants it, but that's not necessarily a job for the insurance companies.

Posted by Matt B | July 10, 2008 1:05 PM

But no mention, sadly, of what would improve women's earnings and savings the most: repealing the marriage penalty (both in tax rates and in caps for tax-preferred retirement accounts).

Posted by bottomofthe9th | July 10, 2008 1:08 PM

If this were Bob Dole, maybe the reporter could have gotten a straight answer out of him.

Posted by lampwick | July 10, 2008 1:15 PM

Mind you, I think that BC should be freely / inexpensively available to anyone who wants it, but that's not necessarily a job for the insurance companies.Mind you, I think that BC should be freely / inexpensively available to anyone who wants it, but that's not necessarily a job for the insurance companies.

The comparison to Viagra may be inexact, but birth control is absolutely as much an element of women's health as almost anything else one could name. The fact that it is not specifically related to a particular illness does not make it any less so than say, covering yearly checkups or teeth cleaning.

Posted by brent | July 10, 2008 1:17 PM

Matt B:

I think that the prevention of pregnancy is a legitimate medical goal, and one that most American women have for decades for their lives.

Speaking for myself, I just don't understand how an insurance company can decide not to cover one of the most commonly prescribed classes of medication in this country. Either you cover prescription drugs or you don't. But I think what medications I take should be between my doctor and I, and I don't want my insurance company inserting itself into that decision.

Posted by dckatiebug | July 10, 2008 1:19 PM

So, are there no insurance plans from any company that cover birth control? Would that law have required birth control coverage be included in all plans? If so, I have to say I support McCain's vote.

Much of the healthcare debate has a big problem with coverage requirements that can really only fairly be solved, I think, by allowing more flexibility by consumers, deciding what types of coverage they specifically want to include or exclude. Devout Catholic women would presumably not want to buy insurance that covers birth control.

Posted by mike | July 10, 2008 1:24 PM

It seems bizarre to me that a health plan wouldn't cover birth control, since I'd have to guess that the average medical costs of a single pregnanacy probably exceed 50 years worth of birth control prescriptions.

Posted by Doug T | July 10, 2008 1:40 PM

John McCain and his surrogates are just a train wreck.

http://tpmelectioncentral.talkingpointsmemo.com/

Posted by Kathleen Fallon | July 10, 2008 1:41 PM

mike -- you don't get to pick and choose what services you want your insurance company to pay OTHERS. Can I make sure my insurance company doesn't pay for lung cancer treatment or treatment of people who drink and drive? No. I don't get to make judgements about other people's decisions and care.

And if men needed birth control, it would have been covered long, long ago by all carriers.

Posted by evie | July 10, 2008 1:44 PM

Devout Catholic women would presumably not want to buy insurance that covers birth control.
Why would having insurance that offers the option of birth control offend Catholics? The company's not making them take it. Does there really need to be insurance just for people so religiously devout they can't abide the thought of other people getting reimbursed by the same company for contraception?

Posted by Dusty | July 10, 2008 1:48 PM

"It seems bizarre to me that a health plan wouldn't cover birth control, since I'd have to guess that the average medical costs of a single pregnancy probably exceed 50 years worth of birth control prescriptions."

Think long-term. If the baby is born, that baby will eventually have to buy insurance. The cost of pregnancy is a small price to pay to expand the market.

Posted by fostert | July 10, 2008 2:06 PM

McCain just wondered who let this broad in to ask questions about broads.

Posted by asl | July 10, 2008 2:07 PM

asl wins.

Posted by Daniel Shays | July 10, 2008 2:25 PM

And if men needed birth control, it would have been covered long, long ago by all carriers.

Vasectomies and condoms aren't covered, are they?

Posted by Matt B | July 10, 2008 2:25 PM

For context here, McCain surrogate Carly Fiorina was arguing the other day that it's unfair for insurance companies not to cover birth control as part of her pitch to women voters. Then it was pointed out that McCain had voted against legislation that would address the issue.

This is the second time that Matthew is being misleading about what Fiorina said.

She said that women should have a choice as to whether to get an insurance plan that covers birth control - by decoupling insurance from employment and simply letting women choose which health insurance to purchase. She did NOT say that all insurance plans should be required to cover birth control - in fact, that's pretty much the opposite of her position of choice.

But, again, authoritarians like Matthew want the government to tell people exactly which kinds of insurance coverage they can and cannot purchase. Authoritarians like Matthew hate the idea of choice.

Posted by Al | July 10, 2008 2:28 PM

If you have health insurance through an employer plan, it is the employer who decides which benefits are part of the plan. Insurers are happy to add more drugs to coverage-- they will simply charge the employer a higher premium.

If you have individual coverage, you can find a policy that covers BC. Everyone in your risk pool (including you) will pay more in premium for you to have this benefit.

People who advocate for mandatated coverage for particular dieseases or treatments are the same ones who then complain about how much it costs. Each group should decide what level of coverage they want, based on costs and compromises. Of course pregnancy and childbirth and medical care for the child costs more than BC, but that is a consequence that the employer accepts.

Maybe there is a market for a women-only policy where everyone voluntarily agrees to pay for and take BC, and the policy does not cover pregnancy and childbirth (but I believe every state mandates coverage for pregnancy and childbirth as a result of past lobbying, so this choice is theoretical at best).

Posted by Pay Me My Money Down | July 10, 2008 2:34 PM

decoupling insurance from employment and simply letting women choose which health insurance to purchase.

Holy shit, is this ACTUALLY McCain's proposal? Decoupling insurance from employment, without providing any sort of government-run replacement, basically turning health coverage into another personally-borne expenditure like auto?

Wow. Good luck selling that one. If I were a Republican like you, I'd be encouraging distortion.

Posted by scythia | July 10, 2008 2:36 PM

evie, Dusty - My understanding is that the more inclusive a particular health insurance plan is, the more expensive it gets as a general rule. Obviously the actuarial tables are more complex than that, but I think it's fair to say that # of covered procedures/treatments is positively correlated with premia.

Based on that understanding, I think it's unfair to force, by government mandate, people to pay for coverage that they will never use.

The examples of treating other people's lung cancer or birth control needs are not relevant. As a man, I would not want to pay extra for an insurance policy - FOR ME - because it covers birth control. If other people want to pay more to have birth control covered, that's fine, but I shouldn't be forced to buy that coverage.

Similarly, if I want my plan to cover Viagra, I should be able to choose to pay more for my coverage to have it extend to erectile dysfunction medications. If you're a woman, you should not have to pay higher premia for a policy that covers Viagra.

I'm not saying insurance should or should not cover certain things. I'm just saying I shouldn't be FORCED to buy coverage for things that I will never use.

If the proposed law said that every health insurance policy sold to a woman in the US had to, by law, include coverage for birth control, I would be opposed to that. If it said birth control has to be an option that some people could elect to receive, I don't have any problem with that.

Posted by mike | July 10, 2008 2:37 PM

It seems bizarre to me that a plan wouldn't cover birth control

While I agree it seems bizarre, the fact of the matter is that many do it.

We can speculate as to why--they don't want to attract women of childbearing age to their plan, they have found that women will pay for it out of pocket, they adopted these policies 30 years ago and have refused to re-evaluate them since. Whatever--the fact of the matter is they do it.

You regulate the insurance companies based on the actions they take, not based on what you think their actions should be if they thought about things the way you do.

It's also RIDICULOUS for McCain to justify his position because he thinks women shouldn't get emergency contraception. It's only OK to prevent pregnancy if you take a pill every day? Whatever. Women should have as many options to prevent pregnancy as they want, and that includes an option where they only take a pill if the condom breaks, okay?

Likewise, it's not fair to say it would offend some Catholics, so no one gets it--especially when you consider that 98 percent of American women will use some form of birth control in their lives. Catholics use birth control! A lot! And overwhelmngly, they think it's perfectly fine! I'm sorry if it offends their celibate clergy...but their religious agenda shouldn't be more important than women's healthcare. Sorry, but if it's such a mortal sin, why don't they put their money where their mouth is and start excommunicating people? That would be a lot more honest than demanding the state enforce their religious beliefs.

Posted by anonymiss | July 10, 2008 2:44 PM

Women should have as many options to prevent pregnancy as they want, and that includes an option where they only take a pill if the condom breaks, okay?

Okay, but that doesn't mean every option should be free.

Likewise, it's not fair to say it would offend some Catholics, so no one gets it

Nobody's saying that. It's not fair to force Catholics who don't want birth control to pay for insurance that covers birth control. If other people want the coverage, fine, but don't force it on everybody.

Posted by mike | July 10, 2008 2:57 PM

McCain: "Get to the front of the plane and stay there, you c*nt."

Posted by Mike | July 10, 2008 3:08 PM

"I'm not saying insurance should or should not cover certain things. I'm just saying I shouldn't be FORCED to buy coverage for things that I will never use."

Mike,
There are a shitload of procedures covered by my insurance that I personally will never use- pap smears, OB-GYN exams, or most likely never use- getting my appendix removed, getting an artificial hip, drug rehab, etc. Cherry-picking procedures that are medically sound fucks up the risk pools, which is sort of the point of insurance. I'm forced to purchase auto insurance that is higher than it should be because people are dumb fucks who can't drive. It's just how insurance works- I don't see the point in getting indignant about insurance covering any particular procedure.

Posted by Waingro | July 10, 2008 3:15 PM

It's not fair to force Catholics who don't want birth control to pay for insurance that covers birth control.

Bullshit. Home contents insurance covers the flatscreen TV I don't have. That's just how it works. But this is the problem with people assuming that healthcare should have the same 'insurance' model as an auto policy, where you can waive stuff.

(Also, any Catholic who gets in that kind of a tizzy over teh evil birth control really needs to stop spending all their time changing the flowers and dusting St Francis at church, because they're embarrassing everyone else in the parish. For Catholics, 'devout' is just shorthand for 'embarrassing'.)

Posted by pseudonymous in nc | July 10, 2008 3:44 PM

Devout Catholic women would presumably not want to buy insurance that covers birth control.
Why would having insurance that offers the option of birth control offend Catholics? The company's not making them take it. Does there really need to be insurance just for people so religiously devout they can't abide the thought of other people getting reimbursed by the same company for contraception?

Also, this is one of those issues where you have to make policy for what people actually do, not what they say. There are probably huge numbers of Catholic women who might answer a survey question on contraception a certain way in order to appear "devout", but who would actually appreciate the opportunity to obtain contraceptives.

In other words, you have a highly stupid religious tenet, and a large group of adherents who don't actually want to obey it. In that circumstance, I think we should empower the people to violate the tenet if that is what they want to do, rather than creating a system that uses the insurance system to police a dumb religious rule.

Posted by Dilan Esper | July 10, 2008 4:20 PM

What is the market failure mandating coverage of birth control is supposed to overcome?

Why should anything matter other than getting the cheapest birth control possible? It's not like birth control through insurance is free. You just pay the regular price plus the administrative costs of processing claims, etc. Maybe in some situations the buying power of the insurance company would make it cheaper, but if so why wouldn't the market provide it?

Posted by Pithlord | July 10, 2008 5:53 PM

Pith:

You are forgetting the redistributive and privacy-protecting effects. It is a social good for people who don't want to have children to be able to obtain birth control and be able to enjoy their sex lives without worrying about conceiving.

Some people can't afford birth control or going to a private physician to get it. They might buy OTC products, but that's not as private. So some folks may end up conceiving unwanted children or having to give up or alter their sex lives if they don't have insurance that pays for birth control.

If birth control is routinely provided by health insurance, these folks will be able to get it through their insurers privately without paying full price (or perhaps even for free). That serves a social good, and at very little cost to other insureds. (In fact, it might even make insurance cheaper, if some of those people decided to keep their babies and relied on health insurance for prenatal, obstetric, and pediatric care.

Posted by Dilan Esper | July 10, 2008 7:57 PM

McCain reacted as though he were being asked if HE USES VIAGRA.

Which of course he does. By the fucking handful. Guy's older than dirt.

Posted by MoeLarryAndJesus | July 10, 2008 11:48 PM

Dilan,

The Catholic argument against birth control is anything but "highly stupid". It is based on strong arguments from natural law and apostolic tradition. And I won't deny that I find it emotionally and intuitively compelling. At the end of the day, of course, I believe that the Catholic argument is wrong for a variety of reasons, and I think that the condemnation of non-abortifacient, chemical birth control does more harm than good today. I'm not a Catholic, in any case, so I am not bound by what the late Pope Paul (a true hero of his time btw) had to say on the matter. But the Catholic argument must be engaged with seriously and given a respectful hearing. At the very least the Catholic argument is substantially less stupid and dumb than the argument of people like you that practices like "swinging", pornography, prostitution and whacking off are morally A-OK.

I do happen to agree with you that in the interests of the greater social good, birth control should be made available at low cost to everyone (though my vision of the social good probably differs from yours). Whether that be through the government providing it, or compelling insurance providers to provide it, or whatever. But I don't deny that this has a cost, and the cost is paid, unfortunately, in terms of religious freedom.

Posted by Hector | July 11, 2008 12:36 AM

Nobody's saying that. It's not fair to force Catholics who don't want birth control to pay for insurance that covers birth control. If other people want the coverage, fine, but don't force it on everybody.

Not everyone who is a part of Church-administered group plans is Catholic. *raises hand*

IE, not every professor at Notre Dame is Catholic, but those women don't get the option of having their birth control covered, or even available on campus.

Religious means tests in medical insurance are just as dumb as religious means tests anywhere else, and I think 18 other commenters proved this point adequately.

Posted by a-town brown | July 11, 2008 10:01 AM

The Catholic argument against birth control is anything but "highly stupid".

Hector, arguments that one of a hallucinated being's grave concerns is whether, when a woman allows a penis inside her vagina, she intends to procreate as opposed to intending to simply enjoy herself, and that we should care about this alleged concern enough to change our laws and insurance policies, are, in fact, stupid. The fact that Popes have believed this for a long time is nothing more than a great argument for never paying any attention to anything the Pope says on issues of sexuality (a good idea anyway because, at least officially, the Pope knows absolutely nothing about the subject).

But I don't deny that this has a cost, and the cost is paid, unfortunately, in terms of religious freedom.

Hector, as I said, I suspect contraception coverage often saves insurance companies money (because pregnancies cost more). But even if there is a cost, it's no more an affront to religious freedom than it is for Catholics to have to pay taxes to finance an unjust war. We have to pay for a lot of things, including things that offend religious beliefs. As long as no Catholic is forced to use birth control who doesn't want to, there is no violation of religious freedom.

Posted by Dilan Esper | July 11, 2008 11:52 AM