The press and President Barack Obama have been all over Rush Limbaugh for the words he used to criticize a Georgetown Law student, Sandra Fluke, who spoke on Feb. 23 at a meeting of the House Democratic Steering and Policy Committee.
There’s been less attention paid, alas, to the details of Ms. Fluke’s testimony, which, when you get into them, help explain why Mr. Limbaugh was worked up about the issue.
Here is some of what Ms. Fluke said:
"Without insurance coverage, contraception can cost a woman over $3,000 during law school. For a lot of students who, like me, are on public interest scholarships, that’s practically an entire summer’s salary. Forty percent of female students at Georgetown Law report struggling financially as a result of this policy."
For feminists, the Georgetown chapter of Law Students for Reproductive Justice sure have a non-egalitarian view of who should pay for birth control.
Here are a few ways Ms. Fluke and her friends might get their contraceptive costs down below that $3,000 level:
• They could have men pay half. Modern men do half the parenting work or pay at least half the child support. Why shouldn’t men pay for half of the contraceptive costs?
• Ms. Fluke and her friends could use condoms instead of prescription birth-control pills. One Georgetown student group reportedly handed out 4,500 “free” condoms during a recent semester. Or the law students could buy condoms online at $40.25 for a package of 100. At about 40 cents a condom, the Georgetown students could have sex twice a day, 365 days a year, for all three years of law school, for just $881.
• Ms. Fluke and her friends could go to Walmart or Target, whose lists of inexpensive drugs include the oral contraceptive Tri-Sprintec, priced at $4 for a 28-day supply. Total cost, assuming continuous use for three full years (including the summer after graduation from law school or before starting): about $150.
Under Obamacare, though, if you have health insurance, contraceptives have to be not just inexpensive, but free. That’s right, as President Obama himself explained it on Feb. 10: “As part of the healthcare reform law that I signed last year, all insurance plans are required to cover preventive care at no cost. ... We also accepted a recommendation from the experts at the Institute of Medicine that when it comes to women, preventive care should include coverage of contraceptive services such as birth control. … We know that the overall cost of healthcare is lower when women have access to contraceptive services … we decided to follow the judgment of the nation’s leading medical experts and make sure that free preventive care includes access to free contraceptive care.”
This idea that something which costs money to make can really be “free” to taxpayers or to anyone else is a deeply held left-wing belief. The New York Times columnist Maureen Dowd over the weekend faulted Mr. Limbaugh for saying that insuring contraception would represent another “welfare entitlement.” That, Ms. Dowd insisted, “is wrong — tax dollars would not provide the benefit, employers and insurance companies would.”
Yet Ms. Dowd’s own newspaper reports that Obamacare “seeks to extend insurance to more than 30 million people, primarily by expanding Medicaid and providing federal subsidies to help lower- and middle-income Americans buy private coverage,” at a cost of “about $938 billion over 10 years, according to the nonpartisan Congressional Budget Office.” If Ms. Dowd is correct and “tax dollars would not provide the benefit,” what’s the need for those “federal subsidies”? And if Mr. Obama is correct and dispensing “free” contraceptives really reduces healthcare costs, why is it even necessary for the government to step in and force insurers to do something that will save them money?
To some degree, the tax-funded contraceptive horse is already out of the barn. A study conducted in 2007 and 2008 by the Kaiser Family Foundation and George Washington University School of Public Health and Health Services found that at least 39 states and the District of Columbia covered oral contraceptives under Medicaid, the healthcare program for the poor whose costs are split between state and federal governments. That was back during the George W. Bush administration, which is something to remember the next time a Democrat claims that once Republicans come into office they are going to take away access to birth control pills.
Another interesting aspect of Ms. Fluke’s testimony is that so much of it — about a third — concerned the use of birth-control pills not as contraception but as a treatment for polycystic ovarian syndrome. The Polycystic Ovarian Syndrome Association lists birth-control pills as one treatment for PCOS, but it lists a lot of other treatments, too, including in-vitro fertilization, anti-androgens, and insulin sensitizers. The birth-control pills are the only treatment for the syndrome that the government wants to make free to consumers, or that Ms. Fluke emphasized in her testimony. It’s not clear why that treatment should get preference over other ones.
There are a lot of questions here that go right to the heart of Obamacare. Why is the president getting involved in setting prices for prescription drugs in the first place? Where in the Constitution does he get that power? Why should people past reproductive age who are paying copayments for their heart or arthritis medication be paying taxes to subsidize free prescription contraceptives for law students?
No wonder a lot of people would prefer, instead, to discuss Rush Limbaugh’s word choices.
Ira Stoll is editor of FutureOfCapitalism.com and author of Samuel Adams: A Life.
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