Women, not their employers, should pay for birth control

Perhaps the most anticipated case on the Supreme Court’s current docket concerns the Affordable Care Act’s requirement that private companies pay for their employees’ birth control. Regardless of the ruling, the losing side is going to be extremely upset. The court is confined to determining the constitutionality of a law passed by Congress while individual justices are not supposed to be inclined to interject their own moral views or engage in social activism. That said, there are at least two broader issues here that lie outside the purview of any court.

First the act of sex itself. Sex is not a fundamental human need on par with oxygen, water, food, sleep or shelter. Nobody has ever died from a lack of sex, yet many people have died from unprotected, high-risk sexual activity, and contraceptive pills or injections do nothing to protect against STDs. Pregnancy is not a disease, thus, contraception should not be considered preventive health like blood pressure checks, diabetes screening or colonoscopies. If women freely chose to engage in sex as a form of recreation rather than procreation, then they should pay for their birth control, not their employer.

Second is employer-based health insurance, an obsolete relic of World War II-era government-imposed wage controls. The United States is the only developed nation that lacks single-payer health coverage. This hodgepodge “system” is the least efficient in the world. In any other developed nation, the issue of employers paying to protect employees from the consequences of morally controversial behavior is nonexistent since all health care is paid by the government. But in America – where the corrupt alliance of obscenely profitable pharmaceutical and health insurance companies, and politicians, especially Republicans, protect the status quo – the employer-based health insurance system, and all its drawbacks, will be enshrined for the foreseeable future.

Peter McNeela, M.D.