A Setback For Women....Viagra Yes, Birth Control, NO!

[babsbunny]

We want to alert you that yesterday women's health suffered a significant setback. The U.S. Court of Appeals for the Eighth Circuit issued a shameful ruling that limits access to birth control. It all started when Union Pacific, the largest railroad in North America, made a reprehensible decision to cover Viagra and deny coverage for birth control.

Birth control is basic health care and insurance plans should cover it — just like they cover other prescription drugs. Contraceptive coverage provides women with critical access to birth control they might not otherwise be able to afford. Yet, Union Pacific deliberately chose to exclude coverage of prescription contraceptives from its health care plan. And now, in a decision made public yesterday, the U.S. Court of Appeals for the Eighth Circuit has decided to let them get away with it.

Planned Parenthood has worked for years in Congress and the courts to advocate for this basic fairness issue. We know that access to birth control leads to healthier pregnancies, children, and families. Help Planned Parenthood continue its vital programs and fight back against this outrageous step backward for women's health.

Donate now. Planned Parenthood Federation of America must step up its Prevention First campaign making it against the law for health plans to deny coverage for prescription birth control.

Planned Parenthood attorneys helped win an earlier district court decision that rejected Union Pacific's unfair treatment of its women employees. That court refused to let Union Pacific get away with denying women coverage for prescription drugs and devices to prevent pregnancy, while providing coverage for a broad array of prescriptions to prevent other non-pregnancy-related conditions.

The court called it what it is — illegal "pregnancy discrimination."

But now, in a split decision, two judges (one appointed by George W. Bush, the other by Ronald Reagan) have decided that, in spite of this different treatment of women, Union Pacific is not guilty of sex discrimination.

This wrong-headed decision is binding on courts within the seven states in the Eighth Circuit — Arkansas, Iowa, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota. And it will have a deep and damaging impact on all unionized women employees of Union Pacific, wherever they live.

That's why we have to step up our efforts to undo the damage by urging Congress to pass the Prevention First Act. Donate Now!

The Prevention First Act advances a wide range of measures: expanding access to reproductive health care services and education programs, increasing access to family planning services, preventing the spread of STIs, and giving women the tools they need to make the best decisions possible.

If we can get this done, Union Pacific and the judges that have excused their reprehensible actions won't be able to disregard women's health any longer. Let's get to work. Let's win a big, powerful victory for contraceptive equity!

Sincerely,



Cecile Richards
President
Planned Parenthood Federation of America

P.S. Let's take our outrage at this court decision and use it to add new momentum for Prevention First. Please donate right now.

[mentalsolstice]

1. This is so wrong! K&R

Birth control pills particularly, have multiple medical purposes besides contraception. Viagra, as far as I know, has only one purpose. Yes, Viagra is important for those couples who would be unable to enjoy a physical relationship otherwise. And I don't disagree that it should be covered by health insurance. However, to say that contraceptives have no medically necessary purpose is wrong!

And it's blatant discrimination! Viagra, and like products enable a man to have sex. What about the woman who is enabled to have sex by use of reliable contraception...for example, a woman who has been warned to not get pregnant because of a health-related condition such as diabetes?

On edit: I forgot, women who do not desire to become pregnant, or have been warned against pregnancy by their health care provider, shouldn't be having sex at all. Truly "nice" girls have sex for procreative purposes only, and even then they do not enjoy it! :sarcasm:

[Alcibiades]

11. Actually, there are other uses for Viagra

It's used in treating pulmonary arterial hypertension, which is a rare and potentially fatal condition, and has recently been shown to be effective in treating Raynaud's Phenomenon, which is a much more common ailment.

I, however, use it so I can have a handy place to put my hat.

[phylny]

20. There are also other uses for birth control pills, including use for patients

with Polycystic Ovarian Syndrome.

[BearSquirrel2]

17. Quite ironic given ...

It's quite Ironic given that the right wing is so anti-sex that they would promote and drug whose sole purpose is sex. There is nothing in Viagra that short-circuits if the taker is not married. It's the same situation with condoms and birth control. The only difference is that one tends to limit the number of human beings on the planet and some people see this as an offensive. Typically it's the people who don't pay for those children.

But lets not get our hackles up until we hear from Newt Gingrich or Rudy Guiliani or Mitt Romney (governer of (M)Assachusetts) some other Republican front runner for 2008. Or perhaps we can talk to John McCain who apparently has to phone all his questions into Bob Jones University before responding.

Seriously, does anyone else see that the path to the Republican nomination is 100% clear for Pat Robertson???

[Lisa0825]

2. Kick to the Greatest page!

:kick: :mad:

[Honeycombe8]

3. Not meaning to stir up trouble here, but I disagree (I think).

I may be wrong, but birth control pills are prescribed for reproductive control, not to aid a medical ailment or condition. I believe the pills are probably still going to be covered if they are prescribed for an ailment, like hormone imbalance or something?

The coverage of all sorts of things may be one reason that cost of insurance has skyrocketed. It's also because there are more treatments available now, plus cost of services and pills is much higher than used to be. But the majority of women in a certain age range take birth control pills on a long-term basis. That's a HUGE expense, and it's not really for a medical ailment or condition.

If it were me taking them, I'd want them covered. But looking at it from a distance, I see the logic. Unless it's for some other reason.

(I don't think Viagra should be covered, either, unless it's prescribed for an ailment. But even if it is, I hate to admit it, but it IS to treat a medical condition of sorts, isn't it? Like hormone therapy for middle aged women?)

[Solo_in_MD]

4. Could this be handled in the union contract?

I am of mixed feelings here...I have issues with the state telling private companies and insurers what to cover or what benefits to offer. Every health plan I have ever been under, going back to the 70s covered BC pills.Not to see it covered 35 years later seems odd. Your point about ailment vice natural state is a good one, that may be how it is being parsed. I had always believed that the cost of the pills was much less than a pregnancy or abortion so insurers would offer it.

[spooky3]

5. several good arguments here

http://writ.news.findlaw.com/colb/20010103.html

snip

"An analogy is necessary because benefit plans do not literally deny women coverage for the same exact prescription that they cover for men. In other words, if a male employee were to somehow to get a prescription for female birth-control pills, then the benefit plan would refuse to cover the cost of that prescription, just as it would for a female employee. The policy is formally gender- blind: Anyone who wants birth control pills is denied coverage.

Nonetheless, this formal gender blindness only thinly veils an obvious gender difference as to who, in practice, receives coverage. And just as a plan covering treatments for testicular cancer but not ovarian cancer would represent sex discrimination, the failure to cover birth-control for women may also represent sex discrimination if an analogous prescription for men is covered. But what "male" prescription should be considered analogous?" (more at the link)


***

Another point is that it is probably a stupid managerial decision from a cost-effectiveness standpoint. The cost of unwanted pregnancies and women's health complications resulting from some of them (i.e., reactive measures) are likely much greater than the cost of covering birth control (i.e., preventive measures). It only takes a few hospitalizations to offset the "savings" from hundreds of women's birth control. And if this differential coverage policy is symbolic of other policies and the culture in the org., it probably has a negative effective on the recruitment of highly qualified women (and I hope, men). See this link for some data:

http://www.suite101.com/article.cfm/birth_control/76456

[China_cat]

6. What 'medical' condition is going to result

if a man can't get a hard on? None.

What medical conditions can arise if a woman doesn't get the contraceptives prescribed for her? All the side effects of pregnancy, which include death. Look them up some time. Pregnancy isn't the safest condition.

Oh, and the pill is also used for things, like helping to prevent ovarian cancer;

Menstrual Cramps

For girls who experience severe menstrual cramps and over-the-counter medications do not help, oral contraceptive pills may be the solution. Oral contraceptive pills can help to decrease menstrual cramps. Because oral contraceptive pills prevent ovulation, they also get rid of pain that you experience with ovulation in the middle of your menstrual cycle.



Irregular or Absent Menstrual Periods

For girls whose menstrual periods are irregular (too often, too late, or not at all), oral contraceptive pills can help to regulate the menstrual cycle to every 28 days and provide the body normal amounts of estrogen to help protect the bones. Oral contraceptive pills also can reduce the amount and length of menstrual bleeding.



Acne

Oral contraceptive pills also improve acne. For moderate to severe acne, which over-the-counter and prescription medications can't cure, oral contraceptive pills may be prescribed. The hormones in the oral contraceptive pill can help stop acne from forming. Most types of oral contraceptives can be used to treat acne. Be patient though, since it takes several months for the oral contraceptive pills to work.



Other Medical Benefits
Because there is less menstrual bleeding with the use of oral contraceptive pills, you are less likely to get anemia (low number of red bloods, which carry oxygen from the lungs to the tissues). Oral contraceptive pills decrease your chance of getting endometrial (lining of the uterus) cancer and ovarian cancer, and ovarian cysts. So the pill has lots of health benefits!

[jberryhill]

9. It's not about the "result" - It's about the "illness"

First, IMHO the insurance plan should cover birth control.

These decisions turn on short-sighted insurers that cover drugs prescribed to treat, diagnose, or cure an illness. When BC pills are prescribed for those other conditions, they are usually covered even when the insurance plan does not cover them for contraceptive purposes.

The insurance policy logic is that erectile dysfunction is a disorder. A drug is prescribed to treat it, and that is covered.

Pregnancy is not a disorder, and neither is the condition of not being pregnant. The policy does not cover a prescription to a person not having an illness for the purpose of preventing another condition which is also not an illness.

I don't agree with it, but that's the argument.

[mentalsolstice]

12. But what if a pregnancy...

...would result in a serious or deadly health condition for a woman. For instance, she's diabetic, or has pulmonary/cardiac condition. What about other medicines that are prescribed and covered that are preventative?

[jberryhill]

14. Like I said..

"These decisions turn on short-sighted insurers"

[spooky3]

19. why don't you read other legal reasoning on this if you

really do want to understand and perhaps even support a different line of reasoning and outcome? I posted some links above.

You may also be interested in the opinion of the Equal Employment Opportunity Commission regarding whether this policy would violate the Civil Rights Act and the Pregnancy Discrimination Act.

http://www.eeoc.gov/policy/docs/qanda-decision-contraception.html

For example:

"How is the PDA relevant to coverage of prescription contraceptives?

* Because the PDA prohibits discrimination against a woman based on her ability to become pregnant, it necessarily covers a health plan's exclusion of prescription contraceptives since they are a means by which a woman may control precisely that ability to become pregnant. The PDA does not require that all employers provide contraceptives to their employees through their health plans. It does require, however, that employers provide the same insurance coverage for prescription contraceptives that they do for other drugs, devices, or services that are used to prevent the occurrence of medical conditions other than pregnancy."

and

"Did the Commission consider arguments by the Respondents that their exclusion of prescription contraceptives is lawful?

* The Respondents advanced four reasons as to why their exclusion of prescription contraceptives did not violate the law. The Commission carefully considered these arguments but found them without merit
o First, the Respondents asserted that their insurance plan covered only abnormal physical or mental conditions and therefore they had no obligation to cover contraceptives. However, this argument does not hold up since the plan covers numerous preventive drugs and services, as discussed above. In addition, it covers surgical sterilizations and Viagra where patients complain about decreased sexual interest or energy.
o The Respondents also stated that the exclusion was permissible because it was based on cost considerations. However, Congress explicitly rejected a cost defense for pregnancy and sex discrimination; in any event, the Commission Decision cites studies that show that the cost of coverage of prescription contraceptives is, in fact, very low and is certainly less than the cost of childbirth.
o The Respondents argued that the exclusion of prescription contraceptives does not constitute sex discrimination. However, because prescription contraceptives are available only for women, the exclusion amounts, by definition, to sex discrimination.
o Finally, the Respondents argued that the charging parties' claims are preempted by the Employee Retirement Income Security Act (ERISA). However, while ERISA does preempt certain state laws that regulate insurance it explicitly exempts federal law from preemption. As a result, this argument is without merit."

There is much more there and at the other links I included in my prior post, that argues against your points.

It is not at all clear to me that this Appeals court decision would be upheld if the plaintiffs appeal it.

[jberryhill]

23. "argues against your points"

I have a better idea. Why don't *you* read what I posted originally, and not call a position with which I *disagree* to be "your points".

What's really irritating is that I bracketed the insurance companies' position with TWO count 'em TWO statements that it was not my position, and you still managed to jump down my throat.

[spooky3]

27. No one is jumping down your throat.

And providing information with links is not "arguing." Perhaps the following additional information will spell it out more clearly.

You indicated that you disagreed, but you didn't provide a refutation of the argument with which you said you disagreed. Not only that, but when another DUer raised a legitimate question, you said "like (sic) I said..." but offered no response to the question content, and no argument against the appeals court decision. Hmm.

I provided information both before and after two posts of yours, that provided evidence that the argument is not a very good one. If I take you at your word about your "disagreement", I would think you would welcome the additional information and that you seem not to welcome it seems rather strange.

So kindly do not "jump down (my) throat", and please follow your own advice about reading posts, and think about what you are doing that leads to the replies you are getting. And please bear in mind that other people posting here who disagree with either the Appeals Court decisions or statements about the company's arguments may want the info in the links. Thanks.

[China_cat]

15. You would think, though, that an employer

providing insurance would INSIST on birth control coverage. A lot cheaper than paying for prenatal and delivery care, not to mention lost productivity and the inconvenience of having to provide maternity leave.

[jberryhill]

24. Yup

That's why I don't understand the larger logic.

[Arkansas Granny]

41. There probably isn't going to be a big upswing

in the birth rate if contraceptives aren't covered by insurance. Most women affected by this ruling will just pay for it themselves if it's not in their policy, rather than take a chance on an unwanted pregnancy.

[spooky3]

22. the plan also covers Rogaine. Is hair loss a "disorder"?

http://feminist.org/news/newsbyte/uswirestory.asp?id=10205

Does the plan limit Viagra to only those cases where men simply cannot ever have sex? If not, some medical people might argue that the Viagra is for the patient's convenience, not to treat an illness. In fact, since sex is not necessary to live, I could see someone making the argument that all Viagra use is an unnatural intervention simply for the patient's convenience. Not saying I agree or disagree, but rather, saying that the situation is not nearly as black-and-white as you depict it.

Further, although I am not an attorney, it may WELL be about the "result." Other cases of discrimination have been decided on the basis of disparate impact. Disparate treatment is not the only theory of discrimination. In disparate impact cases, differential adverse consequences for men vs. women may well be illegal if they cannot be justified on the basis of business necessity. Here it would be difficult to see the business necessity if it is in fact cheaper to cover contraception than to pay for childbirth expenses. And EEOC (see my other posts with links) specifically rejects a cost defense in this case.

[jberryhill]

25. Please find someone who disagrees with you and argue with then.

Thank you.

on edit: Incidentally, I haven't had any health insurance for two years, as I am self-employed and haven't been able to find reasonable coverage. So this is sort of like listening to the first-class passengers complain about the food from here.

[Igel]

7. Most likely.

My wife had BC pills prescribed for years. Endometriosis.

Insurance covered them when it didn't cover birth control.

[mentalsolstice]

16. Unfortunately my BCPs were not covered

I was taking them to control excessive menstrual periods (I'd have one about every 2 weeks), cramping and bleeding, due to fibroids. Fortunately, my gyn would give me three months of free samples (that's how often she would switch brands and dosages to see if we could find one that worked). She said there was no point of my paying $30-40 per month for something that could prove to be useless. Funny, the insurance did pay for the hysterectomy I ultimately had to have. :shrug:

[SharonAnn]

10. Not true. Birth Control pills are prescribed for conditions that involve excessive bleeding

during menstruation. Also used in treatment of endometriosis. Also used in treatment of some endocrine diseases.

I know, because I had to get a prescription for it filled when I was 50 and the doctor had to verify to my insurance company that it was for a medical condition and not for pregnancy prevention. Interestingly, my insurance would've covered the most expensive delivery, C-section, and post-natal care. A complicated pregnancy, delivery and premature baby hospitalizations can easily exceed $500,000. That would cover a lot of birth control.

I don't understand their "Risk management" logic

[phylny]

21. The coverage of birth control pills is nothing compared to the coverage

of prenatal care, delivery, and 21 years of health coverage for a baby born due to lack of birth control. Talk about a HUGE expense. No logic there.

And, as I stated upthread, BCPs are used for things other than contraception.

[alarimer]

26. Bullshit

Covering birth control pills is a lot fucking cheaper than pregnancy.

[ComerPerro]

29. try telling that to a woman with endometriosis

[kineneb]

36. been there, done that

wound up in emergency surgery at 19 for ruptured endometrial cyst on one ovary. BCP regulated my system for years, and kept me out of the hospital (and saved lots of $$$).

[Shallah Kali]

32. 1 pregnancy is more expensive than years of birth control. add in time off to give birth, etc.

also BC is helpful for some women who have severe problems with their periods that might otherwise keep them from work or at the very least inhibit their ability to do their job. Vigra isn't like hormone therapy for menopausal women. Males don't get hot flashes, inability to sleep at night, etc. BTW a british study showed that kegel exercises gave results equal to viagra in men:

http://health.yahoo.com/experts/sexderogatis/4131/can-kegel-exercises-help-men-with-ed
http://www.prevention.com/article/0,5778,s1-1-122-372-6804-1,00.html

[recoveringrepublican]

34. I use them to aid a medical ailment

without them I bleed constantly. They regulate my period so this doesn't happen. Without them I become very anemic and can not take care of the two kids I do have. They also protect against various cancers, clear up acne, and in many women shorten periods (and for me help with PMS).

[Quantess]

35. You see the logic?

:wtf:

Trust me, there's no logic involved. It's about religious hypocrisy.

[MsMagnificent]

40. Hormone therapy fights

osteoporosis, alzheimer's, helps in warding off heart disease, etc.

Is not Viagra for the "medical condition" of a man not able to get it up? Hardly (hmmm... : ) life-threatening!

[madfloridian]

8. This is the result of years of "pro-life" activism in both parties.

It is likely based, even if not admitted...on a religious concept of when life begins. Birth control should not be considered any differently than any other medication prescribed by a doctor.

It is the result in part of religious views on the subject.

Many Southern Baptists now even preach against any form of birth control. They never used to do that.

It took years for them to put women in their place. If God says you will be pregnant, you will be. :shrug:

[mentalsolstice]

13. And if God says

You shan't have an erection, then you shan't! :hide:

[BearSquirrel2]

18. Yes but ...

Yes but that would pre-empt the production of more little Christo-fascist syncophants. It's far easier to indoctrinate than it is to evangilize.

I lament that the world seems to be pushing for a HUMANS race between christians and muslims. We only need to look to China to see the error in this reasoning.

[Greyhound]

28. This is why the class action rules were changed.

This is the reason, they know they have at least a 10 year rule of the courts, no matter who is in Congress or the White House.
ETA; :kick: & R

[femrap]

30. Women should be the only

individuals permitted to fill prescriptions for Viagra.

I hate insurance companies.

[NDP]

31. This got me to thinking. I can't wait to get into an argument with a someone who

doesn't support birth control or family planning, so that I can ask them if they support allowing men to use viagra. If that man needs viagra, then apparently "God" doesn't want him to be having sex.

[HuffleClaw]

33. appalling

typical of a right-wing controlled court.

[orleans]

37. so it doesn't cover condoms but does it cover prescription birth control

pills?

i'm confused:

"The three judge panel of the Eighth Circuit voted 2 to1 to reverse the lower court decision with Judge Kermit Bye dissenting. Bye disagreed with the majority’s reasoning that an employer’s treatment of condoms was the proper legal comparator. “Union Pacific has not identified any health insurance policy which would provide coverage for non-prescription, contraceptive devices available in drug stores and gas stations nationwide.”
http://www.allamericanpatriots.com/m-news+article+storyid-21443.html

[ieoeja]

39. You're misreading.

The two judge majority said the plaintif is comparing apples to oranges when they compare birth control pills to Viagra. They say a more accurate comparison would be birth control pills to condoms.

Your quote is the one dissenting judge disagreeing with that logic. He points out that lots of health insurance policies cover prescription birth control. But that NOBODY covers non-prescription birth control, like condoms. So apparently nobody outside this trial has ever tried equating coverage for birth control pills to paying for condoms.

[Clark2008]

38. I really don't understand this as a business decision.

Isn't providing BC pills/implants MUCH cheaper than insurance for mulitple children?

:shrug:

[Bronyraurus]

42. It makes sense

Viagra remedies a real medical condition: the inability to get boners. Therefore, it is a medicine. Birth control remedies no medical condition, so it's not medicine.