Healthcare as Social Planning

Although I am an advocate of voluntary birth control, I am not happy about (1) the equation of this choice with healthcare – even preventative healthcare (as if pregnancy is a disease); and (2) the government mandating that health insurers must cover these expenses, without even a copayment.

A recent “non-partisan” committee has reported its recommendations for mandatory provisions in all health insurance.  This is part of the flowering of Obamcare regulations.

The list is from the New York Times article of July 20, 2011 which in the print edition was called, “Panel Calling for Free-Contraceptive Coverage.”

To reduce unintended pregnancies, the panel said, insurers should cover the full range of contraceptive methods approved by the Food and Drug Administration, as well as sterilization procedures and “education and counseling for all women with reproductive capacity.”

This recommendation would require coverage of emergency contraceptives including pills like ella and Plan B, panel members said.

In addition to contraceptive services for women, the panel recommended that the government require health plans to cover screening to detect domestic violence;… and counseling and equipment to promote breastfeeding, including the free rental of breast pumps.


Most private insurance provides contraceptive coverage, but co-payments have increased in recent years, the panel said.


The panel said insurers should be forbidden to charge co-payments for contraceptives and other preventive services because even small charges could deter their use.

And finally,

The chairwoman of the panel, Dr. Linda Rosenstock, dean of the School of Public Health at the University of California, Los Angeles, said, “We did not consider cost or cost-effectiveness in our deliberations.”

I believe that family planning is a good idea. In general, the more control people have over the consequences of their sexual activity the better. I do understand that pregnancy among poor teenagers pretty much ensures that they will continue to be poor, and that many will choose abortion.  (To what extent is this the statist-liberal answer to the conservative concern about abortion?)

However, must the government MANDATE all of this in health insurance which we have been told is so expensive?  Furthermore, must I pay to improve others’ life styles, however sensible?   By expanding the definition of healthcare to include the above the Obama Administration hopes to use the moral attractiveness of providing healthcare insurance for all in order to foist something more upon us. (A classic slippery slope mechanism is at work, I suggest).

Move away all the details. What is at work is clear. Healthcare reform is the wedge which will undermine individual autonomy in many forms:  what we eat, what life-choices we must financially support, the reduction of moral issues (contraception is a moral issue for some people) to healthcare and so forth.

But this is the tip of the iceberg. The key reason is in the statement by Dr. Rosenstock that the panel did not consider cost factors in their deliberations.

EITHER we allocate resources by the market (prices or cost-considerations, through direct payment or insurance costs) OR we allocate (“ration”) them by – well, panels. This is clearly either/ or.  All the Obamacare obfuscation in the world cannot change that.

The system is broken and the costs are out of control. The “solution” that is being prepared for us seems clear. We shall go on bended knee before a panel to ask for a little more than our allotment.  Maybe, if they cannot help us, they will give us some candy to calm us down. But, no, that will probably be forbidden.

About Mario Rizzo 75 Articles

Affiliation: New York University

Dr. Mario J. Rizzo is associate professor of economics and co-director of the Austrian Economics Program at New York University. He was also a fellow in law and economics at the University of Chicago and at Yale University.

Professor Rizzo's major fields of research has been law-and economics and ethics-and economics, as well as Austrian economics. He has been the director of at least fifteen major research conferences, the proceedings of which have often been published.

Professor Rizzo received his BA from Fordham University, and his MA and PhD from the University of Chicago.

Visit: Mario Rizzo's Page

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