Survey Says: Contraception Coverage Does Not Save Money, and Other News
Survey: Nobody in the health insurance industry thinks that contraception coverage saves money.
If you are covered by a Medicare Advantage plan and you elect hospice, the payment for such care reverts back to fee for service Medicare (pointer from Austin Frakt).
NYT reviews the history of conservative support for a health insurance mandate. See our previous posts here, here, and here.
Do we have to keep reading about contraceptives and conservatives battling over mandates?
I’m a little skeptical of the claim that contraceptive coverage saves money. It’s probably safe to say that generic versions of The Pill are more likely to have a negative cost than name brand versions. And I can see how the immense cost of labor & delivery for the small number of women who would become pregnant might offset some the contraceptive costs for the many women who would take advantage of free birth control.
However, there are few drug therapies (or any other medical interventions) that are actually money saving (which is not to say they aren’t sometimes a good value). The problem is one that plagues many other interventions: you have to treat a lot of people who would never have caused a problem to affect a change in the very small number of people who would have caused a problem.
With respect to contraceptive coverage, you have to compare marginal cost (the cost of providing free contraceptives to the entire populations of enrollees who want them) versus the marginal cost of the very few women who would become pregnant without getting birth control for free. Presumably, women are not going to get pregnant on purpose because contraceptives are not free. The occasions when free contraceptives might pay for themselves are in small populations, when one costly outlier results in a neonatal ICU stay.
Yeah, whenever lobbyists for providers and specific diseases wants coverage for a given service mandated they always claim it’s somehow money-saving or costs little compared to the benefits. However, if a given medical service was really money-saving, health insurers would have covered the service long ago.
Contraceptive coverage has the added disadvantage of being political. Advocates for the poor and for women argue it is discrimination to not cover contraceptives. Many insurers do cover contraceptives, but I don’t think it should be mandated. Let insurers decide in the marketplace whether they want to provide free (or highly subsidized) birth control.
If mandatory contraception coverage doesn’t save money, doesn’t that betray the original intent of Obamacare?
It seems that a lot of Republicans had it in their mind back then that they would support an individual mandate for basic catastrophic coverage, not comprehensive coverage.
In my view, one of the most glaring aspects about how the health care debate has changed: Back then, it was about who the burden of buying health care should be put on: The individual, or the business.
Today, people recognize that it’s really about whether the burden of universal health care should be put on society at all.