Much ado about rubbers?

In this post, I wrote why I think cost benefit analyses suck.  Here HHS bureaucrat Kathleen Sebelius gives a great example of a bad cost benefit analysis.

She explains:

The reduction in the number of pregnancies [from forced contraceptive coverage] compensates for the cost of contraception.

First, I think it’s silly that we are fighting over rubbers. Seems like we have more important things to concern ourselves with than whether Georgetown law students can afford their apparently rich tastes in contraception.

Rubbers are cheap and effective. If you can afford to buy a drink and McDonald’s you can afford a rubber.

But, that’s not why Sebelius’ CBA is bad.  It’s bad for a few other reasons.

First, she doesn’t appear to offer any evidence. Last I checked, a large majority of sex-having-folks in our country already have figured out arrangements for their birth control. If they don’t want pregnancies and want to have sex, they have strong incentives to figure this out.

It’s not clear that government-mandate-health-insurance-contraceptive coverage will increase the number of people who actually use contraception properly. I’d venture to guess that a big portion of unwanted pregnancies stem from contraceptive mistakes like forgetting to take the pill or improperly mounting the rubber, which government-mandated coverage will not solve.

Second, no alternatives are considered. A good CBA always consider alternatives so you can at least get some idea of opportunity costs.

For example, if there are some poor people who do not get contraception because they are poor, why not try a more targeted approach, like having an organization that addresses their needs? One is called Planned Parenthood. I heard a caller on a radio show this evening that works at a clinic that offers a range of contraceptive methods, free.

So, one alternative is a more targeted approach to address the folks, apparently like Georgetown law students, who can’t afford rubbers.

A third reason I don’t like this CBA is that it doesn’t consider potential unintended consequences. There are ways this could lead to more unwanted pregnancies and/or sexually transmitted disease.

I’ll mention one.

Perhaps, contraceptive coverage enables budget constrained folks to trade-up from condoms to the pill, which leads to more unprotected sex and spreads more VD’s.

Also, it’s probably a bit easier to forget to take a pill than it is to forget to put a condom on.

The fourth reason I don’t like it is because it presumes such low expectations of us to not be able to take care of basic functions. Folks, there are some things we should be expected to do on our own. Take out the trash. Pay our bills. And buy rubbers. They cost about as much as hand sanitizer.

Are we going to mandate that health insurance buy hand sanitizers and soaps too? How about tap water? Think about how much money insurance companies could save from reduced disease and sickness transmission if they did that.

How about toothpaste, floss and toothbrushes? These have the same CBA’s. And they’re silly because ultimately we should be smart enough to decide for ourselves that the personal benefits of these things are well worth the price, so we choose to buy them.

And those who don’t buy them probably won’t use them even its free.

Take note. Obamacare is not in full effect and we’re already fighting over rubbers as if not having to pay a buck for one directly is an inalienable right. I didn’t expect it would get this silly, this fast.

Steven Landsburg also has a good post on the subject.

Update:  Commenter Mike M asks (and was mentioned on W.H. Heasley’s blog, The Last Embassy):

 If the Obama administration sees “access” to (which they have defined as having in place a mandate that someone else has to pay for it) contraceptives as a “basic human right”, why do they prohibit me from using money from my Health Savings Account to purchase condoms?

Mike, I’m sure if you get Donna Fluke to argue for your case, the administration will grant you an exception soon.

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