In the wake of the discussion about contraception and whether insurers should have the right to deny coverage based on religious or moral beliefs many newspapers and bloggers have jumped on the cost of generic birth control pills at Target and Wal-Mart: $9 a pack. Someone even posted, in reference to Sandra Fluke at Georgetown, that $9 is cheaper than two beers in most D.C. pubs.
Yes it is true that Target and Wal-Mart have the best price in the country for oral contraceptives. As of yesterday they both carried two pills: Sprintec and Tri-Sprintec (the generics of Orth-Cyclen and Ortho-Tri-Cyclen). Both fine pills, although why anyone would want to take a tricyclic pill is beyond me (they were a marketing invention of the 80’s, not born of and medical breakthrough, and that is true insider information).
So there is a limited choice of relatively inexpensive generics. However, many women desire other forms of highly reliable contraception. Some like the Depo-Provera shot, there is also Implanon, and IUDs never mind the option of tubal ligation and vasectomy. So while the pill will work for some, getting your contraception at Target leaves many women without their contraceptive of choice. It also leaves many women without the option of the most effective contraception as the birth control pill has a pregnant rate of 8.7/100 women/year but with a copper IUD the pregnancy rate is 0.3/100 women/year and with a Mirena it is 0.1/100 women/year.
The other issue is cost efficacy. Contraception is a sound investment. Period. Every dollar spent on contraception saves $1.40 in maternal and reproductive health costs. Put another way, contraception keeps the costs of a health plan down.
Finally, so what if you can get the pill at Target? What if someone finds paying for high-blood pressure medications for a patient who refuses to lose weight, start exercising and quit smoking morally and religiously offensive? Target has $4 blood pressure medications. If health plans can opt out of contraception on moral or religious grounds, then of course they should be able to opt out of covering any other medication.
And then who decides what is morally acceptable medicine and what isn’t?