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July 10, 2014

We Were Told There Would Be No Math...

In an unexpected fit of cognitive clarity, the NYT inadvertently allows something that sounds suspiciously like common sense to challenge the prevailing narrative that the distaff half of humanity are delicate creatures who shouldn't be expected to budget or prioritize even fairly minor expenses. No, we need someone bigger, stronger, richer, more powerful to take care of us:

... relative to the cost of delivering a baby, let alone raising a child, contraception is inexpensive. Though prices vary, the pill can cost less than $50 month. An IUD costs about $1,000 and is effective for several years. As any parent knows, children cost many multiples of this. Indeed, a Brookings Institution study found that expanding family planning services to Medicaid beneficiaries saved $5.60 for every $1 invested.

However, the Medicaid population is not the same as a typical, employed population, which is at issue in the cases considered by the Supreme Court last week. Additionally, contraception is not the same as contraceptive coverage. In part because it is so cost-effective, most people are willing to pay for contraception with their own money, if they can afford to. (Many Medicaid-eligible individuals perhaps cannot, but most employed people probably can.) Insurers benefit from this, because every pregnancy avoided is one less they have to pay for.

Therefore, when employer-sponsored insurers pick up the tab for contraception, not very many more pregnancies are avoided — most people were already using and paying for contraception. According to the IMS Institute for Healthcare Informatics, though the proportion of Americans with no cost-sharing for contraceptives rose in 2013 to 50 percent from 20 percent, prescriptions written for contraceptive medications increased only 4.6 percent.

So let's see if we have this straight:

1. Most people were already paying for at least part of their own birth control before the ACA because it's simply not that expensive. And because doing so made financial sense to them.

2. When the proportion of folks able to get birth control with no co-pay (out of pocket expense) rose by 30%, prescriptions for birth control rose only 4.6%.

Next they'll be trying to tell us that there's a down side to all this government largesse:

But when they begin to fully cover contraception, insurers take on its full cost, “crowding out” the willingness of individuals to self-insure for it.

Therefore, the government’s accommodation of religious organizations’ objections to covering contraception (obliging insurance companies to pick up the cost of the coverage, with no offsetting premiums or cost-sharing from either employees or employers) may impose a cost on insurers, even though contraception is cost-effective for society as a whole.

Does it really make sense to talk about contraception being cost effective for society. How many of the children who are born (either planned or unplanned) are being supported and raised by "society"? How much money does "society as a whole" possess? Is there some collective checking account? Can anyone make withdrawals, or only certain groups?

UPDATE: YAG, in the comments:

Don't worry. If we can't make children, we'll just import them.

Posted by Cassandra at July 10, 2014 08:28 AM

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Does it make sense? Why, no. Insofar as society has an interest, it's in keeping demographics such that extant social programs for the retired can be funded by rising workers. Public policy would tend to suggest the opposite policy, perhaps higher taxes on contraception to fund support to younger women with children.

Posted by: Grim at July 10, 2014 04:32 PM

Not that I suggest such a policy be implemented. But I agree that this current policy is not in "society's" interest.

Posted by: Grim at July 10, 2014 04:35 PM

Don't worry. If we can't make children, we'll just import them.

Posted by: Yu-Ain Gonnano at July 10, 2014 04:43 PM

Insofar as society has an interest, it's in keeping demographics such that extant social programs for the retired can be funded by rising workers.

...which we won't have many of, if we continue to implement public policy proposals that benefit older workers at the expense of younger ones, and raise the cost of hiring unskilled, inexperienced younger workers to a level that tempts older, more experienced ones to apply for the same jobs.

Kinda like shooting fish in a barrel. Except the fish are the ones we're expecting to take care of us in our old age.

But except for that, it's totally Smart Power all the way, baybee!

Posted by: Cassandra at July 10, 2014 05:06 PM

Don't worry. If we can't make children, we'll just import them.

See? I tol jou that undocumented workers are only doing the jobs you lazy Americans won't do!

Posted by: Chinese Mexican-American Lawn Chica at July 10, 2014 05:08 PM


Posted by: CAPT Mike at July 11, 2014 02:44 AM

Heck, I was pleasantly surprised they didn't propose to make it mandatory so that we could all "save" five bucks on the dollar.

Posted by: Foxfier at July 11, 2014 10:22 AM