Vice Admiral, US Navy (retired)
Recently a Georgetown University law student testified before a congressional committee about the high cost of contraceptive services. She stated that contraceptives would cost her $3,000 during the three years she was in law school and so she supported the recent administration mandate that all health insurance programs provide contraception at no cost. Georgetown is a Catholic university, so her testimony drew the immediate attention of the Church, the administration and the media. She even received a phone call of support from the President after he saw her televised comments. This delicate issue rapidly became more polarized and enflamed.
Birth control (BC) pills can cost nearly $1,000 per year or well under $100 per year, depending on the brand. They all work pretty much the same and have similar ingredients, efficacy and safety. The difference in cost is in the packaging and advertising and depends on whether the formulation is still on patent. The most expensive ones are on patent and are advertised in slick, full-page color adds in magazines widely read by sexually active young women. The women talk with each other about this, believe the advertising and demand the brand name prescription from their doctor — and most of them get it. I checked with a large local health care group that provides birth control pills at no cost as part of their program, and they do provide the highest-cost pills to women who demand them. They do this because they got so many complaints from patients when they tried to provide the less costly variety, it just became easier to give them what they demanded than to try and educate them. The provider just spreads the costs between all of their program enrollees.
Individual providers in this program want to give these same young women the HPV Vaccine to prevent them from acquiring this ubiquitous virus that causes nearly all cervical cancer. But some rules and regulations prevent them from giving it to an emancipated minor without parental consent. Many of these underage girls have not told their parents they are sexually active and, for various reasons, don’t want them to know. So, unless they are also using effective barrier or virucidal protection, they are at risk of acquiring HPV.
Another problem is the risk of acquiring STDs. Many young people just becoming sexually active don’t understand that BC pills offer no protection from STDs, and perhaps give them a false sense of security about sex. Most people have heard of gonorrhea, syphilis and HIV and know that the first two are curable and the third manageable if detected early enough. The most common STD, though, is Chlamydia. This less well-known infection can later on in life cause inability to conceive because of scarring in the fallopian tubes. A young woman may not want to get pregnant now, but some day most of them will. When they get to the time they feel their biologic clock is running out, they get desperate. Unable to get pregnant the “natural” way, they resort to artificial methods that may work but are very expensive, tens of thousands of dollars per pregnancy.
Many doctors caring for young, sexually active women with multiple partners advise the use of condoms also to prevent getting an STD or acquiring HPV. There is a lot more to the BC pill issue than just making them available to women at no cost.
