In 1998, Congress passed, and then-President Clinton signed, the Women’s Health and Cancer Rights Act, which required that health insurance companies which pay for breast cancer also pay for reconstruction.
Fourteen years later, almost all insurance plans pay for reconstructive surgery after breast cancer, but almost none pay for women to get boob jobs. It’s not hard to see why: not liking one’s breasts is not an insurable risk, but losing one’s breasts to cancer is.
Sandra Fluke and her ilk would do well to understand this distinction and apply it to birth control. Health care plans that cover prescription drugs should cover the use of the Pill for medical reasons (e.g. cysts or endometriosis), as it is outside of a person’s control whether or not she develops those medical conditions.
Voluntary use of contraceptives, however, hardly falls under this rubric. Fertility among young women is not a medical condition or a disease; in fact, it is the normal, healthy operation of a young woman’s body. Likewise, the choice to use contraceptives qua contraceptives is entirely voluntary and in response to non-medical events in one’s life. Finding a boyfriend with whom one wants to be intimate is neither a medical condition nor an insurable risk. A risk is a chance, probability, or a hazard, not a certainty, nor an event conditioned entirely upon the insured’s desires.
Using insurance for doctor’s visits is often compared to having car insurance pay for oil changes. In that vein, using health insurance to cover contraceptives is akin to having your car insurance pay to detail your car and buff out any scratches in the paint. The end result is to increase the costs for people who just want to be able to buy another car if the one they are driving is destroyed in an accident. Likewise, having “free” contraceptives makes it more expensive for people to insure themselves against the costs associated with cancer or heart failure – which is hardly a “compassionate” result.