Postrel: Make the Pill Cheaper by Making it Over the Counter
Birth-control pills, the crux of an ongoing argument about public discourse and health-care mandates, are artificially expensive, writes former Reason editor Virginia Postrel in her latest Bloomberg column.
It's a must-read, as it casts a very dark light on a costly prescription regime many of us take as a fact of nature. Snippets:
Making the pill available over the counter could reduce the amount of outrage and invective available for entertaining radio audiences, spurring political fundraising and otherwise amusing the American public. But the medical risks are quite low….
Birth-control pills can have side effects, of course, but so can such over-the-counter drugs as antihistamines, ibuprofen or the Aleve that once turned me into a scary, hive-covered monster. That's why even the most common over-the-counter drugs, including aspirin, carry warning labels. Most women aren't at risk from oral contraceptives, however, just as most patients aren't at risk from aspirin or Benadryl, and studies suggest that a patient checklist can catch most potential problems….
Aside from safety, the biggest argument for keeping birth- control pills prescription-only is, to put it bluntly, extortion. The current arrangement forces women to go to the doctor at least once a year, usually submitting to a pelvic exam, if they want this extremely reliable form of contraception. That demand may suit doctors' paternalist instincts and financial interests, but it doesn't serve patients' needs. As [a 1993 editorial in the American Journal of Public Health] noted, the exam requirement "assumes that it would be worse for a woman's health to miss out on routine care than it would be to miss out on taking oral contraceptives."
Why wasn't Congress and the Executive branch working through issues like this during the debate over President Obama's health-care reform law? Or Mitt Romney when he was pushing his state-level version back in the day? Aren't these folks supposed to be interested in making things cheaper and more accessible for ordinary Americans? It's a sad fact that the smartest people aren't in charge of writing the laws that force us into bad situations.
And now, despite unemployment creeping upwards to 9 percent (according to Gallup) and one-year Greek bonds yielding over 1,000 percent (!), another war in the Middle East looming, we're stuck in a sideshow discussion about whether Rush Limbaugh or Bill Maher is the bigger jerk and whether Catholic universities should have to pick up birth-control costs for law-school students poised to make $160,000 as a starting salary if they enter the private-sector.
Can't legislators agree that those of us who are, say, over 18 years old, are adults and if we can buy condoms without a prescription, we should be able to shop for birth-control pills on our lonesome too? And a host of other drugs?
Further reading: "3 Lessons from the National Conversation About Sluts and Twats."
