McCain was recently asked about a point raised by Carly Fiona about birth control and Viagra. Unfortunately for McCain, he did not handle the situation very well.
Carly Fiorina has been employed by McCain to help him win the votes of women. She recently said that “there are many health insurance plans that will cover Viagra but won’t cover birth-control medication. Those women would like a choice.” Fiorina certainly seems to imply that she supports having insurance cover birth control medication. However, John McCain voted against a bill that would do just that.
McCain has been relying on the fact that many women do not know his actual voting record and positions on many key issues. However, this incident is wearing away that illusion and exposing the reality. It is rather ironic that Fiorina, who has been hired to sell McCain to women, has helped expose McCain’s actual record.
Of course, politics is the art of illusion. As such, it is hardly shocking that McCain is trying to be all things to all voters. What seems to be hurting him more is the way he handled the situation. Rather than acting in a decisive manner, he seemed baffled and confused about the matter. He claimed that he could not remember how he voted because he has voted so many times.
While people obviously forget many things, McCain should know his own principles and how he would have voted on such a matter-even if he cannot recall the bill in question. Even if he honestly had no idea how he voted, he should have been able to handle the question better.
Of course, everyone has bad moments and a single event should generally not be taken as defining a person. To use an analogy, it would be a mistake to judge a person’s abilities as a runner based on one really bad race. Similarly, McCain should not be judged solely on this incident. Of course, it does become another piece of information that should be used to assess his capacity to be a good President. After all, it would be good to have a President who clearly knows his own principles and can, at the very least, handle a surprise incident with skill and grace.
In addition to the matter of McCain, there is also the matter that started this: if Viagra is covered by insurance, then should birth control be covered?
The answer is clearly “yes.” One argument against covering birth control is that birth control is a matter of lifestyle choice and not (in most cases) a matter of health. Of course, this same argument could be applied to Viagra. Both Viagra and birth control seem to be lifestyle drugs. A person takes Viagra to be able to have sex and a person takes birth control to be able to have sex without becoming pregnant. In general, neither is needed for health. Unless, of course, one considers having sex to be important for health. If so, they are still on roughly equal footing.
It might be countered that Viagra is different because it simply restores a natural function that is lacking. In this regard it could be seen as analogous to a hearing aid or a pair of glasses. in contrast, birth control does not restore a natural function or correct a problem. It simply prevents a natural function from taking place.
This argument does have some plausibility. Naturally, the argument would justify covering birth control in the case of women who needed it for clear medical purposes rather than simply to avoid pregnancy. However, this would be a very small number of women.
It can be argued that insurance does cover treatments and medicines that are designed to enhance or preserve quality of life and that this would justify coverage of birth control. For example, a person might be on blood pressure medicine to keep her blood pressure from increasing further. In the case of birth control, it could be argued that it is a medicine that enables a woman to maintain a desired quality of life. As such, it would be a preventative medicine. Of course, this would seem to imply that pregnancy is in the same category as diseases and such.
Another argument that can be employed is this: if Viagra is covered and it is justified because men should be able to chose to have sex, then birth control should also be covered because it enables women to chose not to become pregnant. If men need to have sex and hence Viagra should be covered, then women can argue that they also need to be able to avoid getting pregnant and hence birth control should be covered.
I also think that running shoes and race entry fees should be covered by insurance on similar grounds.
Awesome story.! Much food for thought… It really made my day. Thank you.
You’re welcome. Thanks for reading.
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Krissy-well said.
Just seeing this thanks to torbydamskietrobydamskitorbiedamskie here, but I gotta ask, re “also think that running shoes and race entry fees should be covered by insurance on similar grounds. ”
I am increasingly unable to tell when you are joking, Mike. Without going into the tortured logic of the rest of this post, especially as it is past its significant relevance date, you were being facetious there, correct?
How would I dare joke about something as serious as running shoes?
Okaaaay…still not sure…
Then let’s look at this post. “politics is the art of illusion” indeed…Please read through this post again. Putting aside your dismissal of the function/malfunction reasoning in favor of a “quality of life”-oriented argument, do you not see the glaringly obvious factor that you overlook that makes your conclusion baseless? Or are you still “baffled and confused” yourself?
Are you perhaps using the illusion of philosophical objectivity to further a political view point? Of course, everyone has bad moments and a single event should generally not be taken as defining a person. But OTOH could this be another piece of information that should be used to assess your capacity to be a good philosopher?
“…do you not see the glaringly obvious factor that you overlook that makes your conclusion baseless?”
Since I think we’re taking contrary positions here, I’d like to respond to your critique but I’m not clear on what the obvious factor you mention is…could you explain it, or restate it if you already have?
Think about it. What does Viagra enable a man do that, for whatever reason, he can no longer do. Why does a woman need birth control, and especially implied here a specific form of birth control, to achieve the female equivalent. To not be able to answer this question for yourself implies a conscious or subconscious desire to not see it. Either that or you live a very sheltered life for this day and age. Even if none of the women you know have arms.
Also, on a different tack from my above implication…From what I see on the ‘net, Viagra costs about $20 a pill. A condom is what, a buck? Birth control is something like $30/month? I don’t know for sure about these costs as I am out of the market for all three, but surely the relative financial costs should also be a consideration that is also overlooked here. Unless the people involved are only interested in once a month.
Not that I think any of this should be mandated to insurance companies, though it is worthy of debate vis-a-vis Viagra.
On reflection, I agree with you that insurance companies have no obligation to cover birth control except when used as part of a medical treatment.
Although I think Mike is right that health insurance exists to protect quality of life for those covered, it seems legitimately limited to quality of life threats in the form of illness or injury — which erectile dysfunction is surely a species of. So, Viagra does make sense in a way that birth control doesn’t
That said, any woman who wants birth control should have access to it — as I see it, this is important enough to warrant government subsidy to ensure; social equity seems to require such access.
While I agree with the desire to remove any barriers to birth control access, the only barrier I see is cost. And it’s not much of one at $30/month or the price of a condom.
From a purely abstract observation it seems a no-brainier given the cost to society due to unplanned pregnancies. However we should also examine the costs, financial and moral, of taking responsibility for a person’s sexual behavior. Do we not erode their sense of responsibility and thus also their ability to develop self-esteem, to some degree, in the process? And regardless of financial cost, many will still fail to take their pill as necessary or even bother to make an appointment to get the prescription.
Perhaps the money involved would be better spent on an ad campaign to encourage people to take responsibility for themselves. Maybe we could create a special tax on the entertainment industry to pay for it. Or maybe some kind of cap-and-trade where those who pollute our sense of responsibility could buy credits from those who promote a sense of responsibility. Of course I’m joking. I think.
Funny, when I originally responded to this post I wanted to discuss the difference between health care and health insurance.
I think people should be responsible for their behavior. However, I am also a “realist” in that I am well aware of how people generally tend to behave. As such, I would support using some public money to subsidize birth control. If people are less likely to have unwanted children if the birth control is cheaper, then it would be money well spent. After all, unwanted children have a sad and unfortunate tendency to end up costing society. Note: I am NOT advocating that the state should force people to use birth control. I am just claiming that subsidizing it could be a prudent investment of tax dollars.
Ideally, of course, each person would assume full responsibility for his/her own life and act rationally, prudentially and ethically. Failing that, the state usually gets the task of dealing with such citizens be they actively causing trouble (criminals) or merely failing. Of course, there are situations in which people end up in dire straits despite doing what they should and acting in a responsible manner. The state should also help out such people.
You are right that Viagra and birth control have different functions. The question is whether the functions are relevantly different in a way that would justify insurance covering viagra and not covering birth control.
On the one hand, it could be argued that both are quality of life medications. One allows men to have sex, the other allows women to have sex without getting pregnant. If we assume that people do not need to have sex, then neither should be covered. If we assume that people do need to have sex, then viagra restores functionality whereas birth control “merely” allows a woman to have a choice as to whether or not she gets pregnant from engaging in sex. A such, this could be a relevant difference-after all, a woman does not need birth control in order to have sex, just to prevent pregnancy.
Also, as you point out, people can just buy condoms and they are fairly cheap. It is hard to imagine that medical insurance should cover condoms, so it could be argued that the same would apply to birth control. Unless, of course, it has a medical necessity some birth control medications do more than just prevent pregnancy).
Yeah, Mike, I am right about another relevant factor that you either dance around or are too obtuse to pick up on. Let me spell it out for you. Birth control does not ““merely” allow a woman to have a choice as to whether or not she gets pregnant from engaging in sex.” A woman has a choice as to whether or not she gets pregnant by choosing the manner of sex she will engage in. Birth control is not required. If you are unfamiliar with this option, there are web sites freely available for your education. Ask your students, they can point you in the proper direction. A man who requires Viagra, requires it for any form of sexual gratification whatsoever.
As to whether or not insurance companies should cover this, shouldn’t that be left up to the insurance company and the individual purchasing the insurance?
Also, note that you ARE advocating that the state should force people to pay for other peoples’ birth control. That is what “subsidizing” really means, whether or not it could be a prudent investment of tax dollars.
Other medical necessities would be other medical necessities. Just because a tool has various uses should be irrelevant to the discussion. Unless of course people were to fraudulently claim one need for the purpose of another.
I am also a “realist” in that I understand that if you do not expect people to take responsibility for themselves and their actions, they generally will not do so.
I am curious as to why you seem to repeatedly accuse me of being obtuse and so on. Is it not enough to simply be critical of my claims without attacking me personally?
Yes, I am aware that a woman could have sex in various ways that cannot cause pregnancy. However, that seems to be on par with saying that a man would not really need Viagra either because he could also have sex in ways that do not require full functionality.
Insurance companies should have a role in deciding what they cover, however this does need to be supervised. After all, they would presumably tend to prefer to cover as little as possible. Of course, there must also be checks against putting excessive burdens on these companies.
Yes, I suppose that would be endorsing that the state force people to pay. However, since we are already forced to pay for the consequences of unwanted pregnancies, this could be a far more prudent expenditure.
People are more likely to act responsibly if this is made as easy as possible. Yes, people should be better than they are. But, as Donal R. might say, you go through life with the people you have.
You’re misreading Mike in a few places, there, WTP…
Anyhoo, although it’s literally true that “a woman has a choice as to whether or not she gets pregnant by choosing the manner of sex she will engage in”, using that as an argument against providing birth control trivializes the needs and desires of women by implying that it’s okay for them to be restricted by the lack of something that can be easily provided.
Such a position is destructive to social equity — I won’t call it sexist because I gather you would accept a parallel argument against men using condoms as well, though if that’s not true then it certainly is.
Well, to be fair, I think I only called you “obtuse” just this once. But also to be fair, perhaps I am the one being obtuse.
“Yes, I am aware that a woman could have sex in various ways that cannot cause pregnancy. However, that seems to be on par with saying that a man would not really need Viagra either because he could also have sex in ways that do not require full functionality.”
I was hoping to avoid the details. I will try to stay as clinical as possible. I am not sure how a man who requires Viagra for sex can have sex in a way that is “on par” with what a woman can do without the aid of birth control. Correct me if I am missing something here, but as I understand it Viagra and male sex work in the following way…
1) A man who requires Viagra, requires it because he cannot achieve an erection either 1-a) at all OR 1-b) one that is neither firm enough nor lasts long enough to provide for sufficient stimulation that will result in what is commonly referred to as an “orgasm”.
2) As I understand it, and from all of my personal experience, a full and complete erection is necessary to achieve orgasm. I am willing to guess that there are those out there that have maybe had once-in-a-lifetime experiences that might in some manner without having an erection, possibly in their sleep in what is known as a “nocturnal emission”. My guess is that most of these situations are not pre-planned and would be outside of our problem space.
3) Most men, and I assume women too, regard the orgasm as the climax of all of the sexual experiences.
Forgive me if I come across a little short-tempered today, as I have spent a considerable amount of the day trying to find a definition of the word “assigned” that some people in my company and I can agree upon.
“It can be argued that insurance does cover treatments and medicines that are designed to enhance or preserve quality of life and that this would justify coverage of birth control. For example, a person might be on blood pressure medicine to keep her blood pressure from increasing further. ”
So high blood pressure is a “quality of life” issue? I guess if you define “quality of life” as “staying alive” that could be true.
From Wikipedia:
Hypertension is the most important risk factor for death in industrialized countries.[74] It increases hardening of the arteries[75] thus predisposes individuals to heart disease,[76] peripheral vascular disease,[77] and strokes.[78] Types of heart disease that may occur include: myocardial infarction,[78] heart failure,[79] and left ventricular hypertrophy[80] Other complications include:
* Hypertensive retinopathy[81]
* Hypertensive nephropathy[82]
* If blood pressure is very high hypertensive encephalopathy may result.
“So high blood pressure is a “quality of life” issue? I guess if you define “quality of life” as “staying alive” that could be true.”
Well, quality of life is increased by pleasure and decreased by suffering…since it already assumes life, it can’t refer to staying alive — it’s not that quality of life is decreased by death, death renders it meaningless.
I think the charitable reading of Mike’s example is that the person is taking preventative care medication before their blood pressure rises to the point where it causes suffering or restricts their ability to enjoy life — although, it could just as easily refer to medication aimed at allowing someone with an advanced condition to more fully enjoy what time they have left. The point is that it doesn’t have to be about life and death.
It could be a quality of life matter in that having the blood pressure stay the same avoids problems that would be non-fatal, yet harmful. If the person is at the point that the elevation would be a quick kill, then it would be a matter of life and death rather than quality. To use an analogy, consider obesity. That won’t kill a person right away, but is a health risk and lowers quality of life in this regard. Of course, it can (like elevated blood pressure) lead to an early death.