Contraception has been the topic du jour of late, beginning with a Health and Human Services mandate and now continued with the controversy following a recent Rush Limbaugh comment. The big question is whether contraceptives should be “free” – meaning, should their cost be shifted so that the actual users of contraceptives are no longer the ones paying for them, at least not directly? This kind of cost-shifting is a bad idea for at least three reasons.
1. It doesn’t make economic sense.
2. It isn’t fair.
3. It forces people to violate their conscience.
Regarding point one, I refer you to John Cochrane's Wall Street Journal article from about a month ago, “The Real Trouble with the Birth-Control Mandate.” He argues that paying for birth control with insurance, the current preferred method of making it "free,” is a bad idea because it will raise the cost for whoever does end up paying for it. We shouldn't use insurance for regular expenses — car insurance doesn't cover gasoline, health insurance shouldn't cover toothpaste or birth control. If it did, those markets would become less competitive, and the cost of those products would rise. Furthermore, "The minute pills are 'free,' under insurance, the incentive for drug companies to come up with cheaper versions vanishes. So does their incentive to develop safer, more convenient, male-centered or nonprescription birth control."
Point two is more subjective, but there are questions we can ask to help us determine if cost-sharing is fair. One important question is — could most people afford contraception on their own? If the answer is yes, that makes the case against forced cost-sharing. If the answer is no, that at least helps makes the case for cost-sharing (though it would be a necessary, not a sufficient, condition).
The answer is yes. First, witness Charles Cooke's National Review article from a few days ago entitled "My Contraceptive Haul,” in which he found that there are 309 places he can obtain free condoms within 5 miles of his office. Some of these are provided by a government program, but others come from private charities and organizations. He found that even more expensive forms of contraception are freely available from the Children's Aid Society, for free, *if* one is below the federal poverty line. (Any proposal to make contraception "free" for all would mean that we all help pay for contraception for everyone, including that millionaire down the road.)
If you do have to pay for birth control out of pocket, the basic forms are quite cheap. There has been much ado of late about $9 birth control pills. And we shouldn’t miss that the most basic form of birth control is totally free.
Finally, point three — if your plan to make contraception "free" forces people with a moral objection to help pay for it, then that's another argument against it. A lot of ink has been spilled on this lately, so there is little I can add that hasn't already been said a hundred times. But I think this is a big problem with "free" contraceptives. And I agree with the Wall Street Journal that the “compromise” offered was an accounting gimmick that did absolutely nothing to alleviate the religious liberty problem.
So contraceptives should not be “free,” as making them “free” would raise their real cost and unfairly and unnecessarily force others to pay for them, including people with a moral objection.
Photo Credit: brains the head