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The Free Lunch Is Back
The birth-control mandate is emblematic of the Democratic party’s philosophy.


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Mona Charen

Leaving aside the blatant assault on religious liberty that the Obama administration’s contraceptive mandate represents (a number of commentators have ably elucidated the assault on free exercise), the edict ought to offend all sensible Americans for its sheer economic and moral fatuousness.

In this case, “moral” refers to moral hazard — i.e., unintentionally encouraging bad behavior. But first, consider the economic argument the administration has advanced for forcing insurance companies to offer contraceptives and abortifacients free to all women.

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Health and Human Services Secretary Kathleen Sebelius explained that forcing insurance companies to supply a product for free would actually save the companies money:

This is a no-cost benefit, that the National Business Council on Health, that       our actuaries, a variety of people in group plans say having contraception as part of a group insurance plan actually lowers the overall cost, doesn’t increase it, because, on balance, preventive services around family planning, avoiding what may be unhealthy pregnancies, avoiding the health consequences of that actually is a cost reducer.

Perhaps Sebelius should become a business consultant. Obviously the insurance industry was missing a chance to save itself money! But wait, maybe most of the women who will use birth control are already using it and paying for it either out of pocket (a month’s worth of condoms is about $15, and generic pills can be had for $9 a month) or through a co-pay. Assuming that this group consists of the vast majority of potential contraceptive users, the insurance company will certainly lose money by providing for free what had previously been paid for.

As for those women who don’t now use birth control but will if contraceptives are provided for free, we can guess that the potential “savings” in the form of avoided pregnancies will be very small. Some percentage of these women will have unintended pregnancies anyway, because the reason they didn’t use contraceptives was not that they couldn’t afford them, but that they were irresponsible. According to the Alan Guttmacher Institute, only 12 percent of women cited cost or availability as the reason for not using contraception. And even that figure is suspect. Considering 1) the price of condoms; 2) that Americans spend $110 billion on fast food every year; and 3) that no one who winds up unintentionally pregnant wants to admit that she was careless or stupid, the 12 percent figure deserves skepticism.

In any case, according to the Journal of the American Medical Association, 53 percent of unintended pregnancies are among women who do use birth control and report “contraceptive failure” (which often means failure to use them properly). So Sebelius’s fond prediction of insurance companies saving money on all those avoided pregnancies is unsound.

Additionally, when anything is free, demand for it will increase. So insurance companies will be shelling out more money for products that people may use — or simply stock in their medicine cabinet. To cover their added expenses, insurance companies will have to raise premiums — until the secretary of HHS decrees that they may not, in which case they will become unprofitable and go belly up. Presumably the HHS secretary will then forbid that as well — becoming King Canute.

The anguished cries of leading Democrats notwithstanding (Barbara Boxer declared that Republicans are trying to “take away women’s rights . . . their medicine”), pregnancy is not a disease. There are lots of real diseases, though, for which medicine probably does save money on net: anti-seizure drugs come to mind, insulin, blood-pressure-reducing medicines, and blood thinners. Come to think of it, why would a doctor prescribe any drug if not to ward off a serious illness or condition? When drugs reduce the incidence of serious diseases, it’s good for everyone, not least the patient himself. By the logic of the Obama administration, all drugs that reduce illnesses should be provided “free” by insurance companies. Before you knew it, insurance companies would be making so much money by providing free drugs that they’d be able to provide all other services for free as well. Poof! The solution to our health-care crisis.

This is the governing philosophy of the Democratic party: top-down mandates, “cramdowns” of renegotiated mortgages, creating an infinite cornucopia of newly discovered “rights” such as the right to birth control, forcing individuals to purchase private products, and forcing private companies to supply products free of charge. This is the world that Democrats build. It’s misconceived, uneconomic, unconstitutional, and doomed to failure.

It isn’t just Obamacare that must be repealed, it’s Obamaism.

Mona Charen is a nationally syndicated columnist. © 2012 Creators Syndicate, Inc.



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