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Why is contraception “health care”?

by Greg Krehbiel on 12 February 2012

“Health care” seems like it ought to mean things like recovering from injuries, preventing disease and keeping your body functioning the way it should.

Providing contraception stretches the definition considerably, I think. Requiring health insurance policies to provide free gym membership would be ridiculous, but it would be less ridiculous than requiring them to provide contraception, sterilization, and abortifacient drugs.

As the USCCB say in their response to Obama’s “compromise” on his latest health care diktat, pregnancy is not a disease.

-- 2012-02-12  »  Greg Krehbiel

Talkback x 24

  1. RootCzar
    18 February 2012 @ 4:32 pm

    My inaugural post here … There will be more! Excellent!

    Women actually take ‘the pill’ for a whole host of reasons … and I submit that many would satisfy your ‘healthcare’ definition.

    Taken from Planned Parenthood web site, verbatim:

    “Women who do not need birth control often choose to take the pill for the other benefits it offers. Combination and progestin-only pills
    reduce menstrual cramps
    make periods lighter
    offer some protection against pelvic inflammatory disease, which often leads to infertility when left untreated

    The combination pill offers many other benefits, including some protection against
    acne
    bone thinning
    breast growths that are not cancer
    ectopic pregnancy
    endometrial and ovarian cancers
    serious infection in the ovaries, tubes, and uterus
    iron deficiency anemia
    cysts in the breasts and ovaries
    premenstrual symptoms, including headaches and depression
    bad cramps
    heavy and/or irregular periods”

    Fodder for thought.

  2. smitemouth
    18 February 2012 @ 5:28 pm

    I know someone who took birth control pills to prevent ovarian cysts. Maybe that’s not healthcare.

    Other women take BC pills to regulate their hormones because they swing too much. Maybe that’s not healthcare.

  3. DSM
    18 February 2012 @ 8:08 pm

    @smitemouth: as always — or close enough to always — I fail to see your point. Is it your belief that to be consistent, if something can be used for one purpose which you approve of, then you must support its use for purposes that you don’t? Does recreational use of meth become “health care” because it can also be used to treat obesity?

    I’m scarcely an expert on Catholic moral thinking, but I think Catholics would argue that abortifacient birth control drugs shouldn’t be taken for hormone regulation purposes by women who might get pregnant. That doesn’t seem unreasonable to me.

  4. RootCzar
    18 February 2012 @ 8:28 pm

    Whoa …

    I’d submit that the wielding of the term “abortifacient” here is perhaps both incorrect and incendiary. That seems to be a new ‘dog whistle’ term that’s being bandied about … and I don’t know that it places well in this particular conversation.

    If I may speak briefly on my behalf, and that of smitemouth …. Birth control pills regulate hormones to inhibit the release of eggs ergo preventing a fertilization from ever occurring. They don’t cause abortions. That’s another host of drugs, and not the ones I (or maybe we) was referring to.

    I’m a man, and I tread lightly in these waters …. But I think that clarification needed to be made.

    Personally, I think any reference to ‘Catholic moral thinking’ is a demonstrative train wreck waiting to happen. Not exactly a population that has led well, by example.

  5. Greg Krehbiel Greg Krehbiel
    18 February 2012 @ 8:39 pm

    Can we agree that “health care” is something aimed at preventing or curing sickness and disease? So a treatment for ovarian cysts might be health care. I don’t see how trying to prevent a pregnancy is health care.

    Of course the question gets more complicated in the case of a treatment that helps with a sickness and also prevents births. But plain old birth control, used for the sole purpose of preventing a pregnancy, does not seem like “health care” under any reasonable definition.

  6. RootCzar
    18 February 2012 @ 8:46 pm

    Greg – google around … and seek the % of women who take it exclusively for preventing pregnancy. It’s low, lower than you might think. So …. the other benefits to the pill are very much in play. Should an employer be asking women WHY they might be taking the pill? If any given woman’s health is at risk with pregnancy … then, would this not be ‘healthcare?” Again, who has the right to ask WHY a woman takes the pill? I’d also point out that Viagra is commonly covered … Shall we delve into this issue, for that? :-)

  7. Greg Krehbiel Greg Krehbiel
    18 February 2012 @ 9:01 pm

    Okay, so let’s google the percent of people who smoke medical marijuana for health reasons. Right? Should we believe that?

    I don’t care if people use birth control or not. It’s a complete non-issue to me. But “preventing pregnancy” is not “health care” any more than binding your feet to keep them from getting too big would be “health care.”

    Also, I think the problem with health care is that employers have anything to do with it at all. Do you know the history of this? The only reason employers are in this business is because of government meddling with wages and prices during WWII.

    The government froze wages. So in order to attract talent, employers had to offer non-wage benefits. That’s how it became customary for employers to offer health care.

    But it’s completely stupid. My employer doesn’t have anything to do with my car insurance. Why should he have anything to do with my health insurance? Why should my options for coverage depend on who I work for? Why should my boss get to choose my policy options? And why should I be placed in jeopardy of losing coverage (for a pre-existing condition) if I change jobs?

    The whole system is stupid, and “health care reform” didn’t fix the problem at all.

    So my answer to your question is that a woman should buy the health care coverage that she wants. If she wants a package that covers contraception, she can buy that. Her choice should not be governed by her employer, or by Washington busy bodies.

  8. RootCzar
    18 February 2012 @ 9:15 pm

    LOL! I think … we need some women to chime in on this one! STAT!

    Funny …. I scoffed for a long time at the notion of medicinal marijuana … I enjoyed it recreationally for years; I still do.

    However …….

    I’ve now first-hand found it to be convincingly and effectively medicinal. Nobody was more shocked than me, but it really is true. Just thought I’d mention that! :-D

  9. RootCzar
    18 February 2012 @ 9:26 pm

    OK … my finale on this one. But I felt that I needed to bring in, a ringer.

    http://www.cancer.gov/cancertopics/factsheet/Risk/oral-contraceptives

    i.e.:

    “How do oral contraceptives affect ovarian and endometrial cancer risk?

    Studies have consistently shown that using OCs reduces the risk of ovarian cancer. In a 1992 analysis of 20 studies of OC use and ovarian cancer, researchers from Harvard Medical School found that the risk of ovarian cancer decreased with increasing duration of OC use. Results showed a 10 to 12 percent decrease in risk after 1 year of use, and approximately a 50 percent decrease after 5 years of use (5).”

    Ta-da! Now … What does Viagra do again? ;-)

  10. pentamom pentamom
    18 February 2012 @ 10:01 pm

    Woman chiming in here — I agree with Greg.

    And I don’t think the point is that medicinal marijuana (or health-related hormones that are currently only available in the form of contraceptives) isn’t a real thing, it’s that when you say that something has legitimate medicinal uses, suddenly all the people who want to use it magically claim to have a “medicinal” need, so that there’s no way to get an honest stat on it. It’s not that the medicinal needs aren’t real, it’s that they get overstated when it becomes a legitimate way to get a desired but non-medicinal benefit that would otherwise be (in the case of marijuana) legally unavailable or (in the case of contraceptives) paid for by someone else.

  11. pentamom pentamom
    18 February 2012 @ 10:07 pm

    “and seek the % of women who take it exclusively for preventing pregnancy”

    When you frame the question that way, assuming it has any side benefits at all, of course the % who take it “only” for one reason gets low.

    The real question is how many would take it if they weren’t *primarily* interested in preventing pregnancy.

    Analogously (though not to claim they’re closely comparable) you could ask how many women eat chocolate *exclusively* because it tastes good.

    Probably not many, with all the news out about how it stimulates endorphins which helps mood, and contains healthful anti-oxidants. Few people are going to claim they don’t also take for *any* of those other reasons. But those side benefits are not really the primary motivation, and if it tasted like sauerkraut but stimulated endorphins and contained anti-oxidants, you’d amazingly have fewer people using it.

    It’s not a perfect analogy because there are real hormonal benefits for a small percentage of women that aren’t currently available in other forms, but narrowing it to “exclusively” ignores the fact that women *like* to have regulated cycles and more balanced hormones and better weight control and skin and all those other things. So of course they’d say, “Sure, I also use it for those reasons.”

  12. RootCzar
    18 February 2012 @ 10:38 pm

    I’d submit that there are ‘real hormonal benefits’ for veritably all of the women that take OCs. My laundry list of benefits appears above in other posts. All denote a direct link to ‘healthcare’ regardless of WHY a woman exercises her right to take them. Catholics and others on the right, seem to want the right to ‘inquisition’ and determine a woman’s reason for taking them, and then allow or disallow in accordance with their self aggrandizing rectitude. I think that’s fundamentally wrong.

    I would also submit that most women would likely agree with me on this one … perhaps outside of this particular forum.

    Fact – there are health benefits to taking OC’s

    Wasn’t that the criteria being sought after in this blog? If you want rights to determine who can take them and for why … it ain’t Obamacare that’s interfering between women and their doctors.

  13. Greg Krehbiel Greg Krehbiel
    18 February 2012 @ 10:52 pm

    The whole discussion of oral contraceptives is a diversion.

    Even if we were to say that oral contraceptives are always wonderful for all women and have nothing but good health effects, that still wouldn’t resolve the issue because the health care law requires insurance companies to provide other forms of contraception that don’t have health benefits.

    IOW, you seem to be saying that insurance companies should provide oral contraceptives because they have beneficial health effects. So are you willing to live by that standard? Shall we judge all the contraceptives covered under the health care act by your rule? If some other contraceptive (maybe an IUD, or a diaphragm) does not have a health care benefit — if the only purpose is preventing pregnancy — are you willing to admit that it’s not “health care”?

    My basic point still stands. Contraception itself is not health care, even if some contraceptive methods have some health benefits in some cases.

  14. pentamom pentamom
    18 February 2012 @ 11:16 pm

    No, the Catholic organizations do not attempt to have ANY say over whether a woman will, or will not, use any form of contraceptives.

    They only wish to have a say over whether they will be involved in *providing* them.

    My husband’s employer does not buy gas for our cars. And yet, I would never imagine making the complaint that they are “denying” our ability to use a car, or even “making it harder” for my husband to get to work.

    Not providing something for someone else is not remotely related to exercising say over whether they use it. I don’t buy my neighbors their beer, either.

  15. RootCzar
    18 February 2012 @ 11:24 pm

    I disagree that it’s a diversion … i think its rather integral and essential. We agree to disagree.

    The new proposed law does seem to require access to all forms of contraception. Anecdotal cases can be made for an IUD or a morning after pill being important to protect the health and welfare of the woman, and pregnancy can in some cases he detrimental to one’s health. I know, anecdotal. But … I come back to who get’s to ask WHY without being invasive and potentially discriminatory.

    If the only reason for a contraceptive is to prevent pregnancy … then the case for it being ‘healthcare’ by your definition is thin. My point is …. you, or a church employer don’t get to ask the WHY question. Nobody has to use any means of contraception if they object to it.

    You know, the Catholic church endorses no cost Viagra in the insurance programs … because it promotes procreation. Isn’t THAT a rather grand naïveté?!? And a rather ironic one …

    They don’t even purport any health benefit. Whiffs of discrimination. Honestly, any time one makes an argument to literally diminish someone else’s rights … doesn’t that … not seem right?

  16. RootCzar
    18 February 2012 @ 11:59 pm

    Seems like … Many major Catholic academic and healthcare institutions are ok with it and have already had similar policies in place. Many (28) states have had this requirement in place for some time … Most Americans are ok with it … Most Catholics are ok with it …

    So who’s fighting it, and why?

    http://publicreligion.org/research/2012/02/january-tracking-poll-2012/

    Looks like mostly white male congress members and white male bishops. ;-) Not sure that’s a good stratagem.

  17. DSM
    19 February 2012 @ 12:16 am

    @RootCzar: “Birth control pills regulate hormones to inhibit the release of eggs ergo preventing a fertilization from ever occurring. They don’t cause abortions. That’s another host of drugs, and not the ones I (or maybe we) was referring to.”

    They most certainly do. The birth control pill does frequently suppress ovulation, but not always (if it did, no one on the pill would ever get pregnant!), and when it doesn’t there’s a high likelihood that the pill-induced changes in the endometrium will prevent the implantation of the the fertilized ovum. If you’re talking about Catholic views of contraception, it behooves you to at least know why they object.

    I will grant that many people use the word “contraception” to mean “prevent implantation” instead of, er, “prevent conception”. I find this use Orwellian, and I refuse to go along with it; if this refusal constitutes use of a dog whistle, then Hweeeeeeeeeeeeeeeeeeeeeeeeeee, I suppose.

    Incidentally, you seem particularly interested with the race and sex of people who make an argument. Do you believe that truth comes in colour and gender?

  18. DSM
    19 February 2012 @ 12:18 am

    [And I suppose I should be clear; Catholic objections to "contraception" fall into two categories, depending on whether it really does prevent conception or not, i.e. whether or not it brings about the death of a human being. So the use of a condom and the use of a birth control pill fall into different moral categories.]

  19. RootCzar
    19 February 2012 @ 1:17 am

    @DSM – no going easy on the newbies, huh? ;-)

    In my posts, I tried to use ‘LOL’ and various emoticons to denote and/or evoke some sense of humor, levity or tongue-in-cheekiness … but maybe not well enough. The crack about the congress members and the bishops … was intended to be cheeky.

    Truth is truth … but everyone has a different perception of it.

    I would disagree with the notion that contraception in any form brings about the death of a human being. That is simply, my truth. I doubt that a Catholic bishop would see my truth, as such.

    Aristotle would have seen even a condom as a tool of violence in that it works against nature. I don’t see it that way, that’s not my truth.

    I appreciate your point on the OCs. I didn’t mean to imply that they were 100% effective in only one way. You were right to point out my flawed phrasing, and its important to offer clarity on how they actually can work.

    I’m pro-choice.

    I struggle to accept that men can really speak to power and truth on some of these subjects. Women’s healthcare, perceptions of contraception and the realities and personal truths involved … I just think that perhaps we men folk might take a more secondary role in such realms. Just my opinion. I thought that House panel was rather pathetic.

    Q for you. I don’t mean this in any kind of aggressive way …

    For you, OC’s … do they enact abortions or do they work towards preventing abortions? That seems to be a crux in the debate.

    Good debate to be having.

  20. Greg Krehbiel Greg Krehbiel
    19 February 2012 @ 8:13 am

    Root, I think you’re still avoiding the significance of the different kinds of contraception.

    Let’s make it simple and say there are only 2 kinds: A and B.

    A prevents conception, but can also be used to treat other health issues.

    B only prevents conception.

    If the health care law only mandated A, you could have a plausible case that it’s “health care.” But if it also mandates B, you have to answer the question why preventing conception is “health care.”

    It’s no good to say that pregnancies can be risky. Driving can be risky, but preventing driving is not “health care.”

    There may be certain situations where a particular person shouldn’t have a baby or shouldn’t drive. You might be able to call that “health care.”

    But preventing a pregnancy itself is simply not health care.

  21. DSM
    19 February 2012 @ 12:36 pm

    @RootCzar: I don’t know what OC means. Do you mean oral contraceptives?

    Assuming that, on the question of whether “they enact abortions or [] they work towards preventing abortions”, to the degree that they succeed in preventing conceptions among people who would otherwise abort the child, they may prevent some abortions. To the degree they fail to prevent conception and induce an abortion, they enact abortions, and depending upon statistics I’ll bet neither of us know offhand, they may make them inevitable.

    As for your struggles “to accept that men can really speak to power and truth on some of these subjects”, I can sympathize.

    In the case of abortion, I find many men seem attracted to ideas which make it possible for them to have sex with fewer consequences attached, and more generally anything which helps make sex a commodity. Moral questions about why it’s okay to abort a child we’d spend hundreds of thousands of dollars trying to save if the child were “wanted” are easily set to the side by those wanting power and control over the most defenceless of us. The old joke that if men got pregnant abortions would be free at the corner store has a certain dark truth to it.

    Speculating as to motives and accusing the other of having impure ones is a fun game, but since everyone can play and everyone can declare himself the winner, there’s not much point, really.

    In any case, I don’t understand this “my truth/your truth” stuff. I don’t get to kill a five-year-old girl because it’s “my truth” that her tricycle was in my way. Why should I be interested in “your truth” that it’s okay if she’s only seven months old? The fact that people have different opinions doesn’t mean they have their own truths, whatever that would mean.

  22. Brad Kitson
    19 February 2012 @ 9:09 pm

    You have point, but is it a point worth bothering about?

    BC is a regulated drug that when used has healthcare effects on the patient. It seems to me that it’s best taken under the direction of a doctor through a pharmacy. That fits into our healthcare system.

  23. Greg Krehbiel Greg Krehbiel
    19 February 2012 @ 9:31 pm

    Brad, I don’t care much about birth control one way or another. What I care about is the nationalization of health care, and the fact that the president can just issue diktats on what will be covered by whom, and who will pay for it.

  24. RootCzar
    19 February 2012 @ 10:06 pm

    I might disagree with that representation of this issue a bit …

    This requirement was a part of the healthcare plan passed by Congress in 2010. In January, the Obama admin announced it would not seek to expand the exemption to this requirement, to include religious institutions and organizations. More recently, a kind of compromise was tendered to have the services provided and paid for directly from the insurer; idea being it gives at least a modicum of separation for the religious entity.

    Back in the day, I heard a lot of whining about how obamacare puts govt bureaucrats between a patient and their doctor …

    Kinda seems like another terri schiavo debacle to me. Oh well.