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    Choices of the Heart: the Margaret Sanger Story (True Stories Collection)
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    Rated: NR

    The movie tells the story of Margaret Sanger (Dana Delany, China Beach) fight for women’s health through family planning and sex education in the early 1900s. The story takes place in New York City where despairing, women are forced mainly by economics to end unwanted pregnancies themselves.

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    Margaret Sanger: A Life of Passion
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The War on Women’s Health , Part 4: Contraceptive Coverage Economics

The War on Women’s Health

Part 4: Contraceptive Coverage Economics

Penny wise and pound foolish

By Truthmonk
November 2, 2012

The Economics of Premature Babies

Born too soon

The costs for a premature baby are very much greater than are the costs for a full term healthy newborn. A healthy full term newborn’s cost is $3,325 while a late term is $13,621 (32-36 weeks) and an extreme preterm $190,467 (<28 weeks).[1, page 411]

Average Annual Total Medical Care Costs
Average Annual Total Medical Care Costs by Gestational Age and Year of Life, United States, 2005

Medical care costs are $16.9 billion (or about $33,000 per baby) and maternal delivery costs are another $1.9 billion (or about $3,800 per baby). Continuing costs include early intervention services costs at an estimated $611 million (or about $1,200 per baby), special education services costs at $1.1 billion (or roughly $2,200 per baby), and lost productivity costs of $5.7 billion (or about $11,000 per baby).[1, page 400]

Table 4-2. Estimated Cost of Preterm Birth, United States
Table 4-2. Estimated Cost of Preterm Birth, United States, Aggregate and Cost per Case

The medical, special education services, lost productivity costs are from only four developmental disabilities (DDs) — cerebral palsy, mental retardation, vision impairment, and hearing loss.

“The annual societal economic burden associated with preterm birth in the United States was at least $26.2 billion in 2005, or $51,600 per infant born preterm.”[1, page 398]

The estimate doesn’t includes costs for lost productivity, medical, or special educational services outside of the four DDs. Nor does it include any caretaker costs. Further only maternal medical costs associated with delivery are included. Therefore the costs should be considered a floor, or minimum.

Contraceptive Coverage Economics

Win Win — Save money and prevent unplanned pregnancy

“Debates over improving insurance coverage of contraceptives invariably touch on the issue of cost. Research and experience now suggest that contraceptive coverage does not raise insurance premiums and that employers providing such coverage can, in fact, save money by avoiding costs associated with unintended pregnancy.”2

Multiple studies from 1987 to 2010 have found contraceptive coverage does not cost more but saves money both for public Medicaid and private insurers.

Cost Savings of Contraception Graph
Cost Savings of Contraception

Results varied from a National Business Group on Health study that had results of $0.16 for the private insurers to a Business and Health study finding of $28.57 also for private insurers. Public Medicaid savings were about $3 to $4.2.

Business and Health in a 1993 special report for employers, found the average costs associated with the birth of a healthy baby was $10,000 (prenatal care, delivery and newborn care for one year following birth). It also reported that the cost for oral contraceptives was $300–350 per year. Avoiding the cost for unintended pregnancies was a major factor in the savings for an insurer.

The cost looked at in the studies are only the easily determined direct cost “associated with normal live births (vaginal and cesarean), abortions, miscarriages and ectopic pregnancies.”2 There is also the saving of indirect costs which “include wages and benefits associated with employee absences, maternity leave, and pregnancy-related sick leave, as well as costs associated with reduced productivity during an employee’s pregnancy and with replacing employees who do not return to work after a pregnancy.”

Business employers not covering contraceptives in their employee health plans pay at least an additional 15 – 17% more than if they had coverage.

Providing contraceptive coverage does not increase the bill an employer is required to pay. And may in fact reduce the bill.

High Costs of Birth Control

This isn’t any place for sticker shock

Center for American Progress stated in a February 15, 2012 briefing3 that:


“Many people seem to think birth control is affordable, but high costs are one of the primary barriers to contraceptive access. It is for this reason that the Obama administration recently followed the recommendation of the Institute of Medicine to ensure that birth control will be covered as a preventive service with no cost-sharing beginning August 1, 2012.

“Although three-quarters of American women of childbearing age have private insurance, they still have had to pay a significant portion of contraceptive costs on their own.

“High costs have forced many women to stop or delay using their preferred method, while others have chosen to depend on less effective methods that are the most affordable.

“Women are struggling to pay for birth control at a time when they need it most.”



Table 4-3. The High Cost of Birth Control
Table 4-3. The High Cost of Birth Control

While many people seem to think birth control is affordable, high costs have forced many women to stop or delay using their preferred method.

Ø | The High Costs of Birth Control, It’s Not As Affordable As You Think | Center for American Progress | February 15, 2012 | http://www.americanprogress.org/wp-content/uploads/issues/2012/02/pdf/BC_costs.pdf

The missing health insurance industry outrage

Really. It’s no biggie

Robert Zirkelbach
Press Secretary Robert Zirkelbach

Press Secretary Robert Zirkelbach for America’s Health Insurance Plans, the trade association for health insurers, while expressing apprehension about the precedent the contraceptive coverage rule may set, acknowledged “Health plans have long offered contraceptive coverage to employers as part of comprehensive, preventive benefits that aim to improve patient health and reduce health care cost growth (emphasis added).”4

Child rearing costs

Penny wise and dollar foolish

The USDA stated in their annual report on Expenditures on Children by Families found that a middle-income family with a child born in 2011 will spend about $295,560 for food, shelter, and other necessities to raise that child.5

Expenditures on children
Expenditures on children

The conservative Republicans in their fantasy realm believe low income families will miraculously be able to have the money for these children.

How can conservative Republicans make any type of argument for bringing in more children into the world when there are already over 16 million children in poverty (21.9 percent)6 and 7.6 million (9.7 percent) without health insurance.7

They aren’t willing to take care of existing children. They certainly would not take care of any additional children. Only delusional, incoherent, drivel will come out of their mouths on this issue.

In addition this doesn’t even count the costs associated with the use of the natural and societal resources, use of governmental services, overtaxing the existing public and private infrastructure, stressing the social cohesion, and increasing intangible demands on society such as traffic congestion and additional pollution.

Preventing abortions by funding contraceptive services

Win Win — Save money and prevent abortions

The IOM report8 on page 105 asserts “as the rate of contraceptive use by unmarried women increased in the United States between 1982 and 2002, rates of unintended pregnancy and abortion for unmarried women also declined.”

The report notes that “increased rates of contraceptive use by adolescents from the early 1990s to the early 2000s was associated with a decline in teen pregnancies” in several studies and any “periodic increases in the teen pregnancy rate are associated with lower rates of contraceptive use” as published by Santelli and Melnikas in 2010.

National publicly funded family planning services are responsible for preventing almost two million unintended pregnancies in 2006.9 Nearly a million abortions, including natural and induced, are prevented each year by giving women the contraceptive services that they need.

Two-thirds of U.S. women who practice contraception consistently and correctly account for only 5% of unintended pregnancies.9

A positive side effect is the almost $7.5 billion is saved each year with family planning and contraceptive services by not needing to fund the $10,0002 average cost associated with the birth of a healthy baby.

Unintended Pregnancies
Unintended Pregnancies

ObamaCare would prevent 320,000 abortions from taking place. Many liberals believe that preventing 800,000 unintended pregnancies is good but not those on the right.10

The IOM said in their report,8 “In a study of the cost-effectiveness of specific contraceptive methods, all contraceptive methods were found to be more cost-effective than no method, and the most cost-effective methods were long-acting contraceptives that do not rely on user compliance. … Cost barriers to use of the most effective contraceptive methods are important because long-acting, reversible contraceptive methods and sterilization have high up-front costs.”

They concluded, “that contraception is highly cost-effective” in preventing pregnancies.”


Next: The War on Women’s Health, Part 5 – Women’s Economics

Previous: The War on Women’s Health, Part 3: Maternal Fetal Medicine

Caring for Your Baby and Young Child, 5th Edition: Birth to Age 5 (American Academy Of Pediatrics)

From the most respected organization on child health comes this essential resource for all parents who want to provide the very best care for their children. Here is the one guide pediatricians routinely recommend and parents can safely trust, covering everything from preparing for childbirth to toilet training to nurturing your child’s self-esteem. Whether it’s resolving common childhood health problems or detailed instructions for coping with emergency medical situations, Caring for Your Baby and Young Child has everything you need.



1 Behrman, Richard E. and Butler, Adrienne Stith (Editors) | Chapter 12: Societal Costs of Preterm Birth ⊂ Preterm Birth Causes, Consequences, and Prevention | The National Academies Press (Washington, DC, USA) | 2007.
2 Dailard, Cynthia | Special Analysis: The Cost of Contraceptive Insurance Coverage | The Guttmacher Report on Public Policy | Guttmacher Institute, New York, NY, USA | Volume 6, Number 1 | March 2003.
3 Ø | The High Costs of Birth Control, It’s Not As Affordable As You Think | Center for American Progress | February 15, 2012 | http://www.americanprogress.org/wp-content/uploads/issues/2012/02/pdf/BC_costs.pdf
4 Zirkelbach, Robert | Statement on contraceptive coverage | America’s Health Insurance Plans | February 10, 2012 | eptember 18, 2012@
5 USDA Office of Communications | A Child Born in 2011 Will Cost $234,900 to Raise According to USDA Report, Release No. 0197.12 | U.S. Department of Agriculture | June 14, 2012 | Accessed September 18, 2012@ http://www.cnpp.usda.gov/Publications/CRC/2011CRCPressRelease.pdf.
6 Ø | Poverty: Income, Poverty and Health Insurance in the United States: 2011 – Highlights | Social, Economic, and Housing Statistics Division ⊂ U.S. Census Bureau | Last Revised: September 12, 2012 |
Accessed September 18, 2012@ http://www.census.gov/hhes/www/poverty/data/incpovhlth/2011/highlights.html.
7 Ø | Newsroom: Income, Poverty and Health Insurance Coverage in the United States: 2011 | Public Information Office ⊂ U.S. Census Bureau | Last Revised: September 13, 2012 | Accessed September 18, 2012@ http://www.census.gov/newsroom/releases/archives/income_wealth/cb12-172.html.
8 Committee on Preventive Services for Women | Clinical Preventive Services for Women: Closing the Gaps | IOM (Institute of Medicine), The National Academies Press; Washington, DC | 2011.
9 Ø | In Brief: Facts on Unintended Pregnancy in the United States | Guttmacher Institute, New York, NY USA | January 2012 | Available @ http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.pdf.
10 Gold, Rachel Benson; Sonfield, Adam; Richards, Cory L.; Frost, Jennifer J. | Next Steps for America’s Family Planning Program: Leveraging the Potential of Medicaid and Title X in an Evolving Health Care System | Guttmacher Institute, New York, NY, USA | 2009.


3 Responses

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