If Viagra is covered by health insurance, why not "The Pill"?


#1

I'm not sure if anyone at the CAF has covered this already or not. But after the new law requiring health insurance companies to cover birth control, I've had this point thrown at me several times now. It seems to be a popular line of argument that some people consider to be a show-stopper, so I thought this might be of some help to anyone who encounters it.

Perhaps there are other answers (and by all means, feel free to offer them), but I think the simplest answer is:

According to Webster's Encyclopedic Unabridged Dictionary, the definition of "medicine" is: "any substance or substances used in treating disease or illness; medicament; remedy." Viagra is designed to remedy a dysfunction/disease of the human body (erectile dysfunction); therefore, it is legitimately described as "medicine." Conversely, "the Pill" is actually designed to stop the body from functioning normally and healthily; therefore, it is not legitimately described as "medicine."

Certainly Viagra can be abused (as can pain killers or almost any drug). But its intended purpose is to remedy a dysfunction of the male human body. The same is not true of "the Pill."


#2

Quite right.

Viagra facilitates healthy human sexual activity. Chemical contraception disrupts healthy human sexual activity. Viagra corrects a disorder, while chemical contraception creates a new disorder.


#3

The human body stops ovulating as a natural process when there is a lack of food, stress etc. The pill helps the body when it malfunctions by not recognising inappropriate times to ovulate.


#4

[quote="Hokomai, post:3, topic:252495"]
The human body stops ovulating as a natural process when there is a lack of food, stress etc. The pill helps the body when it malfunctions by not recognising inappropriate times to ovulate.

[/quote]

The law is not specific towards people with health issues, in fact, the president called it "preventive" health, so it is not to correct an issue, but to prevent one (prevent the body from functioning normally). The body is not malfunctioning by ovulating when a couple wants to have sex without babies.


#5

Using Viagra can help fix a functional problem within the body. And as a bonus promotes life!

For the majority of the people using "the pill", it can cause a disruption of natural body functions and has been shown to have negative long term side effects. Granted there are some legitimate reasons to prescribe "the pill", it can balance chemicals that have become unbalanced, and other reasons. If it is the only or the safest treatment for the condition for which it is prescribed, it is acceptable. An unfortunate side effect is the disruption of the natural reproductive process. It is best to seek out an alternative if a safe and effective one is available. Catholic women should have good, practicing Catholic doctors that will help in finding an appropriate alternative. "The pill" is over-prescribed when there are other options.


#6

[quote="lifeisbeautiful, post:4, topic:252495"]
The law is not specific towards people with health issues, in fact, the president called it "preventive" health, so it is not to correct an issue, but to prevent one (prevent the body from functioning normally). The body is not malfunctioning by ovulating when a couple wants to have sex without babies.

[/quote]

True, the president treats pregnancy as a disease. He once said that if his daughters made a mistake he did not want them to be "punished with a baby".


#7

[quote="eegardner, post:6, topic:252495"]
True, the president treats pregnancy as a disease. He once said that if his daughters made a mistake he did not want them to be "punished with a baby".

[/quote]

Ugh, yeah, I remember that...

Yeah, for a healthy woman the pill stops the body from functioning as it was made to and increases the risk of other illnesses...


#8

if these insurance companies are forced to cover these two drugs, which on their labeled use do NOT treat medical conditions, why are they not also forced to cover life-saving drugs and treatments I and millions of others rely on including but not limited to cancer treatments,


#9

[quote="Michael_Forrest, post:1, topic:252495"]
I'm not sure if anyone at the CAF has covered this already or not. But after the new law requiring health insurance companies to cover birth control, I've had this point thrown at me several times now. It seems to be a popular line of argument that some people consider to be a show-stopper, so I thought this might be of some help to anyone who encounters it.

Perhaps there are other answers (and by all means, feel free to offer them), but I think the simplest answer is:

According to Webster's Encyclopedic Unabridged Dictionary, the definition of "medicine" is: "any substance or substances used in treating disease or illness; medicament; remedy." Viagra is designed to remedy a dysfunction/disease of the human body (erectile dysfunction); therefore, it is legitimately described as "medicine." Conversely, "the Pill" is actually designed to stop the body from functioning normally and healthily; therefore, it is not legitimately described as "medicine."

Certainly Viagra can be abused (as can pain killers or almost any drug). But its intended purpose is to remedy a dysfunction of the male human body. The same is not true of "the Pill."

[/quote]

Whoever says your title is wrong. Both viagra and the pill may or may not be covered under various insurance plans (they are all different). Usually they both require a copay. Now, the gov't has mandated that contraceptives be given away for free.....no copay. Viagra still requires a copay.

AND the pill works by mimicking the hormones of pregnancy--endlessly. You don't have a true period, it is simply hormonal withdrawal bleeding. There are a very few things the pill can actually treat, one being endometriosis (and that may actually be the only one). Most things the pill "treats" it actually just covers up with a fake 'cycle'.

AND I agree with PuzzleAnnie. I don't understand why the pill is covered, but diabetic supplies are soooooo costly. They are preventative. Or life saving cancer treatements. Or a miriad of other drugs that actually SAVE lives and don't just let you have sex whenever and with whomever you would like.


#10

[quote="Jennifer_J, post:9, topic:252495"]
Whoever says your title is wrong. Both viagra and the pill may or may not be covered under various insurance plans (they are all different). Usually they both require a copay. Now, the gov't has mandated that contraceptives be given away for free.....no copay. Viagra still requires a copay.

AND the pill works by mimicking the hormones of pregnancy--endlessly. You don't have a true period, it is simply hormonal withdrawal bleeding. There are a very few things the pill can actually treat, one being endometriosis (and that may actually be the only one). Most things the pill "treats" it actually just covers up with a fake 'cycle'.

AND I agree with PuzzleAnnie. I don't understand why the pill is covered, but diabetic supplies are soooooo costly. They are preventative. Or life saving cancer treatements. Or a miriad of other drugs that actually SAVE lives and don't just let you have sex whenever and with whomever you would like.

[/quote]

And the thing is, making it "free" will just make health insurance more expensive for people like my family, who do not want this optional medication, and want to be able to pay for our own health care without having to resort to gov health care, but its getting harder and harder to pay for our own health insurance, because of gov intervention (although I do recall Obama suggesting he was going to take this route.) Our rates went up this June in order to be able to comply with the new regulations that had to start in June. The sacrifice would be more worth it if it were to add on medications like the ones mentioned by Annie and Jennifer, but it is not worth it for regulations like the one for "the Pill".


#11

[quote="puzzleannie, post:8, topic:252495"]
if these insurance companies are forced to cover these two drugs, which on their labeled use do NOT treat medical conditions, why are they not also forced to cover life-saving drugs and treatments I and millions of others rely on including but not limited to cancer treatments,

[/quote]

The real question is, why is the government involved in dictating to private companies and individuals the coverage of an insurance policy. Why isn't the market allowed to work and tailor options to attract and support it's customers? The feds are now going along the same lines as Massachusetts in dictating coverage most people don't want, driving costs up.

For example, between college and joining the service, I was working a temporary job as a consultant so had to provide my own coverage. I simply bought a policy which covered disastrous conditions i.e. car accident or severe illness like cancer etc, or conditions requiring treatment in an ER, no routine care or drugs. It was the perfect solution for me, I was in excellent health, able to pay for any routine care or drugs, but needed coverage for the unexpected.


#12

[quote="styrgwillidar, post:11, topic:252495"]
The real question is, why is the government involved in dictating to private companies and individuals the coverage of an insurance policy. Why isn't the market allowed to work and tailor options to attract and support it's customers? The feds are now going along the same lines as Massachusetts in dictating coverage most people don't want, driving costs up.

For example, between college and joining the service, I was working a temporary job as a consultant so had to provide my own coverage. I simply bought a policy which covered disastrous conditions i.e. car accident or severe illness like cancer etc, or conditions requiring treatment in an ER, no routine care or drugs. It was the perfect solution for me, I was in excellent health, able to pay for any routine care or drugs, but needed coverage for the unexpected.

[/quote]

I had one of those Major Medical policies when I was right out of College as well. We called it my "Blow Up" policiy because it only kicked in for really expensive things...Like blowing up....anyway people should be free to pick the plan that works best for them.

The new healthcare laws also require people to carry maternity insurance no matter who they are. My mom's small business now has to have a maternity insurance policy for each employee, including my 80+ year old Grandfather and his similarly aged wife, my mom and aunt (both over 50 and have had hystorectomies), the singe 60 year old maintenance guy, and the 30 something bookkeeper. Seems kinda stupid to me as only bookkeeper is actually even capable of getting pregnant.


#13

It's because it invovles the male reproductive organs.It's okay for men to run around andimpregnate everyone they see, but women can't keep from getting pregnant? There are women who take it because they may have hormonal problems.Womens plumbing has problems too. Why do you think no one has really tried to come up with any sort of male birthcontrol except for condoms, which are as old as the ancient greeks.
I get so sick of these ads on tv for Viagra ,I just want to hurl.I don't hate men, but i am so tired of this.There is more to a relationship between a man and woman than just sex.
I'm not married, took take of two seriously ill parents over the years.If i found out my husband and i could'nt have sex anymore, well then so be it.I didn't marry him cause i just saw him as ameal ticket with a penis attached.I married him because i love and care about him. Modren society is getting more and more like the ancient romans.


#14

[quote="HollyDolly, post:13, topic:252495"]
It's because it invovles the male reproductive organs.It's okay for men to run around andimpregnate everyone they see, but women can't keep from getting pregnant? There are women who take it because they may have hormonal problems.Womens plumbing has problems too. Why do you think no one has really tried to come up with any sort of male birthcontrol except for condoms, which are as old as the ancient greeks.
I get so sick of these ads on tv for Viagra ,I just want to hurl.I don't hate men, but i am so tired of this.There is more to a relationship between a man and woman than just sex.
I'm not married, took take of two seriously ill parents over the years.If i found out my husband and i could'nt have sex anymore, well then so be it.I didn't marry him cause i just saw him as ameal ticket with a penis attached.I married him because i love and care about him. Modren society is getting more and more like the ancient romans.

[/quote]

The pill doesn't cure any hormonal issues, just covers them up. They are a bandaid at best. There are other treatments for female issues, that actually help/cure the problems.


#15

[quote="Michael_Forrest, post:1, topic:252495"]
I'm not sure if anyone at the CAF has covered this already or not. But after the new law requiring health insurance companies to cover birth control, I've had this point thrown at me several times now. It seems to be a popular line of argument that some people consider to be a show-stopper, so I thought this might be of some help to anyone who encounters it.

Perhaps there are other answers (and by all means, feel free to offer them), but I think the simplest answer is:

According to Webster's Encyclopedic Unabridged Dictionary, the definition of "medicine" is: "any substance or substances used in treating disease or illness; medicament; remedy." Viagra is designed to remedy a dysfunction/disease of the human body (erectile dysfunction); therefore, it is legitimately described as "medicine." Conversely, "the Pill" is actually designed to stop the body from functioning normally and healthily; therefore, it is not legitimately described as "medicine."

Certainly Viagra can be abused (as can pain killers or almost any drug). But its intended purpose is to remedy a dysfunction of the male human body. The same is not true of "the Pill."

[/quote]

I work in health insurance so I can help you with this one. It is a matter of perspective and one that I think a lot of people don't understand...health insurance companies are businesses and must make more in premiums paid in than costs they pay out. So, in making the determination of what to cover (outside of what government regulates) they typically must ask the question "Is this medically necessary?". In all cases (I have yet to see one that is an exception) Viagra is NOT medically necessary. Yes, it helps someone with a medical situation have a more enjoyable life, but they are not going to be affected medically if they don't get Viagra. On the other hand, while birth control is not medically necessary it can prevent pregnancy. The cost of someone being on birth control is MUCH cheaper to an insurance company than paying for a doctor's care during pregnancy, the various tests needed and an expensive hospital delivery/stay.


#16

[quote="Jennifer_J, post:9, topic:252495"]
I don't understand why the pill is covered, but diabetic supplies are soooooo costly. They are preventative. Or life saving cancer treatements. Or a miriad of other drugs that actually SAVE lives and don't just let you have sex whenever and with whomever you would like.

[/quote]

I agree with you about the diabetic supplies because they ARE medically necessary. I am not quite sure why diabetic supplies aren't always covered 100% but I am going to guess that cost (at least for a type 2 diabetic) could be considered a "motivating factor" for a patient, at least that's how an insurance company could view it. My sister is diabetic and is motivated to avoid getting to a level where she is insulin dependent (which is VERY expensive) and has, at least, some control over her diabetes (some exercise, some diet modification) by taking medication (which is less expensive for her and the insurance company). My diabetic father just lost a lot of weight and exercises regularly and is now medication free as he has his diabetes under control. Obviously his lifestyle changes affect what he pays and what insurance must pay for him. So, I am making a good guess this is a reasoning of the insurance company. Unfortunately, for type 1 diabetics, that is not the same so I cannot guess on that one...however, there are far more type 2 than type 1's.

Regarding cancer treatments, the insurance company must always look at the success rate of methods out there. Some newer (and typically expensive) treatments have not been around long enough to prove themselves effective so an insurance company will likely not cover them unless they see years and years of good results, otherwise, they will prefer putting their resources towards methods that have been proven. "Risk" is the key factor here. An insurance company has limited money to work with and they have lots of people to cover. Emotional decisions could put them out of business and hurt lots of people.


#17

[quote="styrgwillidar, post:11, topic:252495"]
The real question is, why is the government involved in dictating to private companies and individuals the coverage of an insurance policy. Why isn't the market allowed to work and tailor options to attract and support it's customers? The feds are now going along the same lines as Massachusetts in dictating coverage most people don't want, driving costs up.

[/quote]

I absolutely agree! I understand government regulation of insurance companies to keep them honest, but dictating coverage? That's preposterous! The market should be able to decide what is covered and what is not. Insurance companies, in many cases (unless a group is small), can usually design packages based on what employer groups desire based on their employee needs and what the employer is willing to do on their end. Government sticking their nose in to force companies to cover certain items only forces insurance companies to have to raise premiums to everyone.


#18

[quote="Slinger, post:16, topic:252495"]
I Regarding cancer treatments, the insurance company must always look at the success rate of methods out there. .

[/quote]

then the same standard should apply to contraceptives. The insurance company should be able to balance risk vs benefit vs cost, which they no longer can do because it will be mandated, raising my premium, even though hormonal treatment I need is not covered.

get the gubmint out of the health care business because they don't know what they are doing. if you question this ask anybody involved in the VA medical system.


#19

[quote="Slinger, post:15, topic:252495"]
I work in health insurance so I can help you with this one. It is a matter of perspective and one that I think a lot of people don't understand...health insurance companies are businesses and must make more in premiums paid in than costs they pay out. So, in making the determination of what to cover (outside of what government regulates) they typically must ask the question "Is this medically necessary?". In all cases (I have yet to see one that is an exception) Viagra is NOT medically necessary. Yes, it helps someone with a medical situation have a more enjoyable life, but they are not going to be affected medically if they don't get Viagra. On the other hand, while birth control is not medically necessary it can prevent pregnancy. The cost of someone being on birth control is MUCH cheaper to an insurance company than paying for a doctor's care during pregnancy, the various tests needed and an expensive hospital delivery/stay.

[/quote]

Thanks for your reply. I had a couple of thoughts:

1) I'm not sure where you live/work, but what you stated about Viagra coverage isn't universally true, Slinger. Viagra is generally covered in my state by health insurance companies...as long as it is being prescribed for a documented dysfunction like ED.

2) The point about birth control is well taken from an economic/business perspective. It's financially beneficial to insurance companies to cover birth control because it's cheaper than pregnancy. (Also, at least in my state, birth control actually is typically covered). As a Catholic, of course, I look at the purely financial reasons for covering birth control as further proof that capitalism can too easily become an engine for evil if it is not governed by solid, Catholic morality/ethics. Insurance companies are willing to cover it, even though it violates the precept of "medical necessity" (by and large it doesn't cure anything that could be classified as a dysfunction or disease) - pretty much solely because it saves them money.

I find it troubling that pregnancy is often seen as a negative, or as a disease to be avoided. Contraception is a large part of that mentality that feeds into the abortion culture - abortion often being back-up contraception. And again, abortion (at least when done relatively early on in pregnancy) is cheaper than carrying to term and delivering.

I posted in another place about the unfortunate (but not unforeseen) effect that IVF is having on our collective mentality:

forums.catholic.com/showthread.php?t=590594


#20

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