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Should We Pay for Sandra Fluke's Contraception?

Should we pay for Sandra Fluke's birth control?


  • Total voters
    64
  • Poll closed .
I'm sure that whatever you pay for your policy and deductables wouldn't begin to cover your healthcare costs if you had to pay out of pocket. So whose footing the bill for the rest of your healthcare? Unless you're on Medicare it isn't the public, it's the insurance companies.

Where do the insurance companies get the money to pay these costs?
 
I know more than you think, and am not a fan of industry outsiders condescending to me. Pregnancy is a limited expense if covered considering a woman can get pregnant a maximum of once a year, yearly pregnancy is going to be rare. Birth control according to Ms. Fluke was around 3K a year, the average full term delivery is around 7,600, using Fluke's math if a woman has two kids in five years that's around 15,200 but if she has NO kids due to birth control in the same period of time it's 15K. So by that model without childbirth the savings are a whopping 200 dollars to the insurance company, BUT here is the problem you don't understand, and neither does Time magazine, the risk class for multiple consumers using the 3K/yr birth control are weighting the drug coverage UP which means increased premiums within the prescription pool.

Thanks for playing.
I actually forgot to weight in the deductible and OOP, let's say the couple having a child covered by maternity has a 5K maximum OOP. This would be 2,500 deductible, + with a 85/15 maximum OOP of 2,500. For the pregnancy to birth they would pay on a 100% claim 5K, the insurance company would then pay 1,600 for that pregnancy that year. Using Ms. Flukes math the BC regimen would cost 3K minus a 10, maybe 20$ copay so that's a whopping 120-240$ subtraction from the 3K, meaning the company would be on the hook for over 2K.

Of course that is using a 100% model when max. OOP is an immediate factor, but if that 5K has been reached on the year the company would be on the hook for more on the pregnancy, and still probably come out ahead in a five year birth period versus birth control.
 
I'm sure that whatever you pay for your policy and deductables wouldn't begin to cover your healthcare costs if you had to pay out of pocket. So whose footing the bill for the rest of your healthcare? Unless you're on Medicare it isn't the public, it's the insurance companies.

Where do the insurance companies get the money to pay these costs?

Where do most private companies get their money?

They get it from their customers, in exchange for whatever goods or services they are selling. In the case of insurance companies, they get it in the form of the premiums paid by their policyholders.

Any insurance company, in order to stay in business, must take in at least as much revenue in the form of premiums as they pay out on claims, plus whatever other expenses they incur as part of running the business. On average, the customer will pay significantly more in premiums than he receives in claims. It is mathematically impossible for it to be otherwise. So, on average, your statement that “I'm sure that whatever you pay for your policy and deductables wouldn't begin to cover your healthcare costs if you had to pay out of pocket.” is flat-out wrong. Some policyholders may very well receive more in claims than they pay in premiums, but the difference is made up by other policyholders who receive less in claims than they pay in premiums.

Insurance is actually, as I said before, a form of gambling. As with any casino or other organized gambling business, the odds are slanted in the house's favor, and the customer can, on average, expect to get less out than he pays in.
 
They get it from their customers, in exchange for whatever goods or services they are selling. In the case of insurance companies, they get it in the form of the premiums paid by their policyholders.
Very good, so what are we arguing about?

Any insurance company, in order to stay in business, must take in at least as much revenue in the form of premiums as they pay out on claims, plus whatever other expenses they incur as part of running the business. On average, the customer will pay significantly more in premiums than he receives in claims. It is mathematically impossible for it to be otherwise. So, on average, your statement that “I'm sure that whatever you pay for your policy and deductables wouldn't begin to cover your healthcare costs if you had to pay out of pocket.” is flat-out wrong. Some policyholders may very well receive more in claims than they pay in premiums, but the difference is made up by other policyholders who receive less in claims than they pay in premiums.
The policyholders who make less claims are still insuring against the risk that they might get sick or hospitalized. The one certain thing about life is that it's uncertain.



Insurance is actually, as I said before, a form of gambling. As with any casino or other organized gambling business, the odds are slanted in the house's favor, and the customer can, on average, expect to get less out than he pays in.
Yes, I suppose you could look at that way. One of the first to use insurance to gamble was Lloyd's of London insuring cargo ships (mostly in the slave trade) and betting that more ships would arrive to their destinations with cargo than would sink.
 
I actually forgot to weight in the deductible and OOP, let's say the couple having a child covered by maternity has a 5K maximum OOP. This would be 2,500 deductible, + with a 85/15 maximum OOP of 2,500. For the pregnancy to birth they would pay on a 100% claim 5K, the insurance company would then pay 1,600 for that pregnancy that year. Using Ms. Flukes math the BC regimen would cost 3K minus a 10, maybe 20$ copay so that's a whopping 120-240$ subtraction from the 3K, meaning the company would be on the hook for over 2K.

Of course that is using a 100% model when max. OOP is an immediate factor, but if that 5K has been reached on the year the company would be on the hook for more on the pregnancy, and still probably come out ahead in a five year birth period versus birth control.

What if there are complications during the pregnancy that require special treatment? Does that include the costs of the actual delivery of the infant and hospital stay for the mother and infant? All of these expenses and potential expenses have to be included too, don't you think?
 
No, it is those who pay for these policies who will be paying for the birth control pills. It is those who pay—whether through premiums or taxes. In other words, the public.

The difference here is that private insurance is exactly that; private. And as such you actually have the choice to go sign up with whatever company you want and even have a choice among plans. Thus you can choose what you support. Now tax driven insurance is another matter as that comes out of tax dollars and there is much less say in what your money supports. When it is tax dollars then it is the public that pays as all are (in theory) taxed. When it is a private company then no it's not the public that pays because not all or even most are included. Only those that elect to purchase that policy pay.
 
What if there are complications during the pregnancy that require special treatment? Does that include the costs of the actual delivery of the infant and hospital stay for the mother and infant? All of these expenses and potential expenses have to be included too, don't you think?

I probably should add to this because it's not very clear. I know the insurance company would pay for these things, but that would drive up the cost of paying for a pregnancy as opposed to paying for birth control, IMO. I am really thinking about ways to reduce the number of abortions in this country and other horrible things like abandoned babies and beaten children. Not that this would be a cure-all, but it COULD help to make BC very easy to access.

Just as a side, I wonder about sterilization too. Is that a procedure covered by insurance? I do medical transcription, so I type doctor reports and type about women having tubal ligations, but I am unfamiliar with the insurance aspect.
 
I've never denied that there are some companies that engage in unethical practices, but your father getting denied coverage is not equal to an elective treatment being mandated for this argument. I can just as easily state that the rate of denials went up with the amount of mandates, when the risk pool has more to cover the providers will find ways to cut costs.

You're right it's not equal, but the fact that such practices are not only out there, they are apparently common, does open the door for such mandates. Especially when the "elective treatment" being discussed happens to be one that is often not covered even when deemed medically necessary by a doctor due to those practices.

As far as the mandate goes, I'm relatively agnostic, to be honest. My biggest issue in this debate is the nonsense about having to pay for other people's contraception based on that mandate. The money that goes into the pool is not your money anymore. You are paying for something you receive, which is healthcare coverage, not for what others receive. That's just a fact of life.

For example, if I gave you $20 for a service that you provided me, I can't say that I paid for whatever you spend that money on. I spent my money on the service which you provided me. End of story. It's no longer my money, it's your money.
 
Here are some statistics re unplanned pregnancy and BC use just as an FYI.


Statistics : American Pregnancy Association

Reproductive Health:
Every year in the United States, there are 60,000,000 women in the childbearing years of 15-44 :

70% of these women are sexually active
64% use a form of contraception
3,000,000 use NO contraception, accounting for 47% of unplanned pregnancies
 
It's not a strawman, you are using a media group article to argue with a former professional in the field. I couldn't care less what their opinions are.

I'm using a media group to bring up polling data. Both your opinions and theirs are irrelevant. You still haven't addressed any of my arguments.
 
Well for one, if it isnt medically indicated, then insurance companies shouldnt be forced by mandate to pay for it ... it should be elective coverage.

Um... did you actually read the sentence you were responding to? I said the prescription was medically indicated. So, like, the opposite of what you just said.
 
Birth control = less or no babies, you are the one saying "birth control is a benefit to society", well guess what, we are in a negative birth period in U.S. history right now, IOW we are not replacing ourselves at a sufficient rate. I don't think that it's my business to tell people whether or not they should start a family but I am NOT responsible for the direction they choose, nor for funding it.

Not necessarily...it could equal the same amount of babies just raised in the right environment for the to succeeed.

There is a cost to you and society for any decision made. The thing about this policy requiring INSURANCE companies to cover the cost of birth control pills....just like they do for limp dick pills....is that it provides an added amount of control and makes it easier for women to decide when the right time for them to have a child. Our biology isn't keeping up with the advancement of modern society. Sure when you worked at a farm and got married at 15 popping out 10 kids before the age of 25 was pretty useful.

Now not so much!
 
You're right it's not equal, but the fact that such practices are not only out there, they are apparently common, does open the door for such mandates. Especially when the "elective treatment" being discussed happens to be one that is often not covered even when deemed medically necessary by a doctor due to those practices.
Most companies will not deny coverage when a physician makes the case correctly, however there are unethical companies. That said denying critical care coverage is not an argument for mandating electives. Not even close to in the same ballpark.

As far as the mandate goes, I'm relatively agnostic, to be honest. My biggest issue in this debate is the nonsense about having to pay for other people's contraception based on that mandate. The money that goes into the pool is not your money anymore. You are paying for something you receive, which is healthcare coverage, not for what others receive. That's just a fact of life.
Tucker, it is not nonsense. The nonsense is the claim that it is cost neutral, it is not, the numbers do not hold up which is why it isn't covered by every company to begin with.

For example, if I gave you $20 for a service that you provided me, I can't say that I paid for whatever you spend that money on. I spent my money on the service which you provided me. End of story. It's no longer my money, it's your money.
Not a proper analogy. Tucker, let me explain it again, when you join a risk pool you agree to covered/not covered and you also agree to whatever conditions are contained in the policy. This means you pay to be risked with everyone else agreeing to be in the pool and you pay for the pool, meaning whatever liabilities the company incurs. So no matter what Obama and Sebilius claim YES you do pay for a birth control mandate.
 
What if there are complications during the pregnancy that require special treatment? Does that include the costs of the actual delivery of the infant and hospital stay for the mother and infant? All of these expenses and potential expenses have to be included too, don't you think?
Not the same thing. Complications are going to be a smaller risk and covered whether there is a maternity rider or not.
 
Not necessarily...it could equal the same amount of babies just raised in the right environment for the to succeeed.

There is a cost to you and society for any decision made. The thing about this policy requiring INSURANCE companies to cover the cost of birth control pills....just like they do for limp dick pills....is that it provides an added amount of control and makes it easier for women to decide when the right time for them to have a child. Our biology isn't keeping up with the advancement of modern society. Sure when you worked at a farm and got married at 15 popping out 10 kids before the age of 25 was pretty useful.

Now not so much!
Necessarily, not entertaining this anymore because you aren't even listening.
 
I'm using a media group to bring up polling data. Both your opinions and theirs are irrelevant. You still haven't addressed any of my arguments.
I worked in the industry, they didn't. Could care less how you weight my opinon.
 
Plenty. It's called risk tables.

And risk tables show that fewer than 58% of women using birth control use it for reasons other than birth control? Do you have a link?
 
Tucker, it is not nonsense. The nonsense is the claim that it is cost neutral, it is not, the numbers do not hold up which is why it isn't covered by every company to begin with.

I didn't say it was cost neutral. The cost you pay for services could certainly increase (although in this particular case, not all that significantly), but that just means that the cost of the services you receive has increased. It's been happening at an alarming rate without this mandate anyway, and this mandate will not have a large impact on the cost either.

As far as complaints about rising costs of health insurance go, mandating BC is WAY down on the list.

Not a proper analogy. Tucker, let me explain it again, when you join a risk pool you agree to covered/not covered and you also agree to whatever conditions are contained in the policy. This means you pay to be risked with everyone else agreeing to be in the pool and you pay for the pool, meaning whatever liabilities the company incurs. So no matter what Obama and Sebilius claim YES you do pay for a birth control mandate.

You pay a pittance for the BC mandate, but you do not pay for others BC (just like you don't pay for anyone else's cancer treatments). You pay for the services you are receiving.

Saying "My costs for health insurance could increase slightly because of the BC mandate" is very different from saying "The BC mandate means I have to pay for other people's birth control".

One is an honest and accurate statement, the other is saying you pay for other people's birth control.
 
And risk tables show that fewer than 58% of women using birth control use it for reasons other than birth control? Do you have a link?
You know what, do your own homework. It should be painfully obvious what the main usage of contraceptives are, it's in the name. Realistically you are trying to be difficult here and when I left the industry I got rid of all my info due to burnout issues, I'm not digging again. There isn't even a copay requirement in the law so companies are on the hook MORE for birth control pills than statin drugs, my numbers hold up.
 
I didn't say it was cost neutral. The cost you pay for services could certainly increase (although in this particular case, not all that significantly), but that just means that the cost of the services you receive has increased. It's been happening at an alarming rate without this mandate anyway, and this mandate will not have a large impact on the cost either.

As far as complaints about rising costs of health insurance go, mandating BC is WAY down on the list.



You pay a pittance for the BC mandate, but you do not pay for others BC (just like you don't pay for anyone else's cancer treatments). You pay for the services you are receiving.

Saying "My costs for health insurance could increase slightly because of the BC mandate" is very different from saying "The BC mandate means I have to pay for other people's birth control".

One is an honest and accurate statement, the other is saying you pay for other people's birth control.
Tuck, no one should be forced to pay for electives by law, period.
 
You know what, do your own homework. It should be painfully obvious what the main usage of contraceptives are, it's in the name. Realistically you are trying to be difficult here and when I left the industry I got rid of all my info due to burnout issues, I'm not digging again. There isn't even a copay requirement in the law so companies are on the hook MORE for birth control pills than statin drugs, my numbers hold up.

I already did my own research. You suggested that it was invalid, and now you can't be bothered to demonstrate why? That's pretty pathetic, dude.
 
I already did my own research. You suggested that it was invalid, and now you can't be bothered to demonstrate why? That's pretty pathetic, dude.
Your research is based upon third party information. I don't accept it based upon my recent work history in the industry, you make claims that the birth control mandate is a sum good, you have to back that up because frankly the real numbers suck in the aggregate.
 
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