Is there “moral hazard” in free contraception?

Last updated on: July 8, 2014 at 12:34 pm by Jane the Actuary

Is there “moral hazard” in free contraception? 2014-07-08T12:34:00-06:00 Jane the Actuary

LOGO Patheos Explore the world's faith through different perspectives on religion and spirituality! Patheos has the views of the prevalent religions and spiritualities of the world.

That is, will the availability of free contraception through health insurance cause women to spend more than they otherwise would, now that it’s Other People’s Money?

I had observed the other day that the actual goal of declaring all contraception Free! Free! Free! seems to be to move more women onto the IUD and implants because of their lower risk of user failures.

Are these methods actually cost-effective, over time? In principle, if the Mirena IUD costs approximately $1,000, and lasts for 5 years, then that’s $200 per year, or $17 per month, which is, from what I understand, a good deal. Only if IUDs become the norm, even for women who are not good candidates and seek to have them removed early in the five-year period does it become expensive.

What about brand vs. generic? I came across guidelines from a major insurer, in looking for details the other day, which indicated that they will only provide brand-name pills if a doctor certifies that a patient has unacceptable side effects in using the generic. (Whether doctors do this for any patient who requests it, I don’t know.)

What about barriers vs. hormonal methods? My guess is that people choose one or the other based on personal preference rather than cost. Will there be women who aren’t in sexual relationships but want to keep their options open, or are in a long-distance relationship, who will choose a pill now, even if they hadn’t before, because it’s free (and perhaps because of desirable side effects, like regular or no periods)? It seems likely to me.

Here’s the irony: the one set of users who could potentially take advantage of the Free! Free! stuff in a moral-hazardly sort of way are fertility-awareness method users. There are a number of devices which have been approved and are in use in Europe, such as the Persona fertility monitor, on Amazon for GBP 55, plus GBP 10 for an 8-pack of refill test strips. The concept here is similar to the ovulation test kits that couples can buy when they’re trying to conceive, but with, of course, the reverse guidance, and is certified, in the UK, as 94% effective at avoiding pregnancy.

Why this hasn’t been approved by the FDA isn’t clear to me; I don’t know whether the manufacturer simply never thought it would be worth the effort, or if the FDA’s guidelines mean that it wouldn’t meet some criteria or another (such as being idiot-proofed) for contraception.

But if it were approved, this would be a significant market, and a potential movement from low-tech charting to an ongoing expense every bit as high as the pill.

Second question: is there a risk that contraception manufactures will determine that they can now increase their prices as much as they wish, especially for single-source drugs and devices, like the Mirena or the implants? After all, if the insurer is required to cover Mirena, then they’d be trapped, right? I suppose time will tell, but I wouldn’t be surprised if the pricetag starts increasing, with, as seems to be the case often enough, special price reductions for the uninsured, to soak up as much of the insurance premium as possible.

Uncategorized

Previous Post

July 7, 2014

Time for some neo-colonialism?

Next Post

July 9, 2014 You watched the World Cup game last night, didn't you?

Browse Our Archives

Select a Category Actuarial/Retirement Issues Politics Uncategorized

Select a Month September 2026 August 2026 July 2026 June 2026 April 2026 March 2026 February 2026 January 2026 December 2025 November 2025 October 2025 July 2025 June 2025 May 2025 April 2025 March 2025 February 2025 January 2025 December 2024 November 2024 October 2024 September 2024 August 2024 July 2024 June 2024 May 2024 April 2024 March 2024 February 2024 December 2023 November 2023 October 2023 September 2023 August 2023 July 2023 December 2022 September 2022 August 2022 July 2022 June 2022 May 2022 February 2022 January 2022 December 2021 August 2021 June 2021 April 2021 February 2021 January 2021 December 2020 November 2020 October 2020 September 2020 August 2020 July 2020 June 2020 May 2020 April 2020 March 2020 February 2020 January 2020 December 2019 November 2019 October 2019 September 2019 August 2019 July 2019 June 2019 May 2019 April 2019 March 2019 February 2019 January 2019 December 2018 November 2018 October 2018 September 2018 August 2018 July 2018 June 2018 May 2018 April 2018 March 2018 February 2018 January 2018 December 2017 November 2017 October 2017 September 2017 August 2017 July 2017 June 2017 May 2017 April 2017 March 2017 February 2017 January 2017 December 2016 November 2016 October 2016 September 2016 August 2016 July 2016 June 2016 May 2016 April 2016 March 2016 February 2016 January 2016 December 2015 November 2015 October 2015 September 2015 August 2015 July 2015 June 2015 May 2015 April 2015 March 2015 February 2015 January 2015 December 2014 November 2014 October 2014 September 2014 August 2014 July 2014 June 2014 May 2014 April 2014 March 2014 February 2014 January 2014 December 2013 November 2013 October 2013 September 2013 August 2013 July 2013

TAKE THE

Religious Wisdom Quiz

Why was Jesus' eating with tax collectors controversial?

Select your answer to see how you score.

They were healthy They were viewed as sinners They were famous They were wealthy