Rush Limbaugh is under fire for responding in trademark fashion to the congressional testimony of Georgetown law student Sandra Fluke, who wants you to pay for her contraception. If the rest of us are to share in the costs of Ms. Fluke’s sex life, says Rush, we should also share in the benefits, via the magic of online video. For this, Rush is accused of denying Ms. Fluke her due respect.
But while Ms. Fluke herself deserves the same basic respect we owe to any human being, her position — which is what’s at issue here — deserves none whatseover. It deserves only to be ridiculed, mocked and jeered. To treat it with respect would be a travesty. I expect there are respectable arguments for subsidizing contraception (though I am skeptical that there are arguments sufficiently respectable to win me over), but Ms. Fluke made no such argument. All she said, in effect, was that she and others want contraception and they don’t want to pay for it.
To his credit, Rush stepped in to provide the requisite mockery. To his far greater credit, he did so with a spot-on analogy: If I can reasonably be required to pay for someone else’s sex life (absent any argument about externalities or other market failures), then I can reasonably demand to share in the benefits. His dense and humorless critics notwithstanding, I am 99% sure that Rush doesn’t actually advocate mandatory on-line sex videos. What he advocates is logical consistency and an appreciation for ethical symmetry. So do I. Color me jealous for not having thought of this analogy myself.
There’s one place where I part company with Rush, though: He wants to brand Ms. Fluke a “slut” because, he says, she’s demanding to be paid for sex. There are two things wrong here. First, the word “slut” connotes (to me at least) precisely the sort of joyous enthusiasm that would render payment superfluous. A far better word might have been “prostitute” (or a five-letter synonym therefor), but that’s still wrong because Ms. Fluke is not in fact demanding to be paid for sex. (Not that there’s anything wrong with that.) She will, as I understand it, be having sex whether she gets paid or not. Her demand is to be paid. The right word for that is something much closer to “extortionist”. Or better yet, “extortionist with an overweening sense of entitlement”. Is there a single word for that?
But whether or not he chose the right word, what I just don’t get is why the pro-respect crowd is aiming all its fire at Rush. Which is more disrespectful — his harsh language or Sandra Fluke’s attempt to pick your pocket? That seems like a pretty clear call to me.
I think the main fallacy is that the “benefits” of someone else having sex is our being able to watch it. I would pay not to watch most people having sex.
Ms Fluke is demanding that society subsidise her having sex, in the same way that society subsidised her education. I.e., that her sexual activity is a public good with benefits for society as a whole, and that she would normally under-consume, if it were allocated according to a normal pricing mechanism.
Or, closer to bodily functions, vaccination. Society wants people to be vaccinated, because of the public health benefits, in terms of the lower burden on the health system. But people don’t perceive those benefits, nor they feel them, so without public intervention, vaccination is under-consumed and under-produced.
The issue is a fairly straightforward public health cost-benefit analysis – will the cost of subsidising Ms Fluke’s contraception, in terms of the morning-after pill or condoms provided, outweigh the benefits to society in terms of not having to support her children, or treat her sexually-acquired diseases?
Forest for the trees. It looks like her letter would be better used as an argument for moving the USA away from a reliance on private insurance, towards a system proven by example to provide healthcare at lower cost.
Ugh. Sometimes, SL, you have me shaking my head in admiration, for example when you compared ‘buy American’ provisions to racism: a brave stand based on economic reasoning.
Other times, you appear to almost purposefully miss the point. ‘Slut’ isn’t anything but a cheap, high school pejorative. Imagine a man were to call your wife or daughter a ‘slut’. Would you argue that he was merely conveying the fact that she expresses “joyous enthusiasm” for sex “that would render payment superfluous”? Of course not.
But larger point is economic: the case for subsidised birth control hinges on exactly the externalities that you assume away (“absent externalities”).
If a stationary bandit asks me to pay a higher premium to him in taxes to increase the policing of my neighborhood in response to more gang violence, I regard this as a reasonable trade.
If public sponsorship for birth control increases its use (demand curves slope down), then I’ll gladly subsidise birth control if it reduces the costs to the public fisc- ultimately borne by me- of what would otherwise be higher rates of pregnancy.
My prior is that those women who benefit most from cheap or free birth control are those that would otherwise not use it; by introspection, this Georgetown student probably isn’t the marginal beneficiary.
Rush obviously struck a nerve. Calling Fluke a slut is no worse that what Google calls Santorum.
@Mike H:
“Forest for the trees. It looks like her letter would be better used as an argument for moving the USA away from a reliance on private insurance, towards a system proven by example to provide healthcare at lower cost.”
Lower than 6 dollars per month at target?
Her numbers are completely bogus, generic oral BC costs six dollars at target for a one month supply.
The word is “moocher” or “sponger” or “leecher” since there is no implied threat which would make it extortion.
Well, maybe comparing those 6 dollars with the 3000 dollars she mentioned and calculating her implied consumption levels was exactly what led mr. Limbaugh to call her what he did?
Haha, this was a well-written post.
I don’t think Rush’s antics serve the debate, but I’m at a loss as to how to make Landsburg’s point without resorting to “ridicule, mockery, and jeering.” Maybe Landsburg is right – maybe that is the only way to address positions like this.
I’m not a big fan of Rush Limbaugh. I’m not even a small fan of him for that matter. However, his point about benefiting from the sex life that we’re being asked to subsidize is excellent even if it is crass. If people don’t see the truth behind his over the top statement, it’s only because they’ve put blinders on.
While I appreciate the logic, her testimony makes it sound like there’s an actual need for insurance:
“For my friend, and 20% of women in her situation, she never got the insurance company to cover her prescription, despite verification of her illness from her doctor. Her claim was denied repeatedly on the assumption that she really wanted the birth control to prevent pregnancy. She’s gay, so clearly polycystic ovarian syndrome was a much more urgent concern than accidental pregnancy. After months of paying over $100 out of pocket, she just couldn’t afford her medication anymore and had to stop taking it. I learned about all of this when I walked out of a test and got a message from her that in the middle of her final exam period she’d been in the emergency room all night in excruciating pain. She wrote, “It was so painful, I woke up thinking I’d been shot.” Without her taking the birth control, a massive cyst the size of a tennis ball had grown on her ovary. She had to have surgery to remove her entire ovary. On the morning I was originally scheduled to give this testimony, she sat in a doctor’s office. Since last year’s surgery, she’s been experiencing night sweats, weight gain, and other symptoms of early menopause as a result of the removal of her ovary. She’s 32 years old. As she put it: “If my body indeed does enter early menopause, no fertility specialist in the world will be able to help me have my own children. I will have no chance at giving my mother her desperately desired grandbabies, simply because the insurance policy that I paid for totally unsubsidized by my school wouldn’t cover my prescription for birth control when I needed it.”
Clearly, the only thing sensible to do is to require all men who want to have non-marital sex with women in their fertile years to pay into a contraception pool that shares the cost of contraception with the women they want to have sex with… or require such men to sign pre-sex affidavits in which they agree they’ll split the cost of any resulting pregnancy or childcare.
Heterosexual men are already getting benefits from having women on contraception – that benefit is sex. You are not just subsidizing women’s sexual behavior by paying for contraception – you’re subsidizing your own.
As for the more general argument on subsidized contraception – if you believe in health insurance at all, it is simply cheaper to pay for contraception than to pay for the healthcare costs associated with unintended pregnancies and childbirth. Being able to choose when to have children also allows women to be more productive in the workplace.
I suppose that any man who has never had sex with any potentially fertile woman with whom he doesn’t share an ongoing financial relationship could argue that he gets no benefits from subsidized contraception – but those men are few and far between. (At least among heterosexuals, and I don’t see a lot of gay men arguing against subsidized contraception.)
While I sympathise with Steve’s argument, I think he has not addressed one issue. Drugs which act as contraceptives also have other uses (such as treatment for ovarian cysts, endometriosis etc). Such women are not asking others to share in the costs of their sex life.
Of course this whole madness is due to employer mandated health care (though in this case it seems to be college provided health care — I have no idea of colleges are mandated to provide health care). And if some entity wants to provide healthcare plans to others, it should be up to them what they want to provide and let the consumers decide if they want such a plan or not.
Elizabeth:
it is simply cheaper to pay for contraception than to pay for the healthcare costs associated with unintended pregnancies and childbirth.
Yes, in the same sense that it is simply cheaper to fast than it is to buy food, and simply cheaper to live on park benches than in houses. It does not follow that it’s a wise policy to give up food and shelter.
More explicitly: When we pay for the healthcare costs associated with pregnancies and childbirth, we are *getting something in return* (namely a fellow citizen, a potential friend, potential lover, potential mate, potential collaborator, potential employer, potential employee, potential customer and potential Steve Jobs). When we pay for contraception, we’re not. Any argument that compares the costs while ignoring the offsetting benefits is no argument at all.
As for this:
Heterosexual men are already getting benefits from having women on contraception – that benefit is sex.
The question is whether the benefit is external. It seems pretty clear to me that it’s not, since birth-control makes women more attractive to men. Where is the counter-argument?
@Elizabth #10
Why can’t a woman just tell the man she is having sex with (or about to have sex with) to pay for her contraception? Or buy her a pack of pills before they consent to sex? Why distort the free market with taxes, mandated payments and subsidies?
Nobody is asking you or Rush to pay for her sex life. All they are saying is that some forms of contraception are considered “health care”, and insurance plans should cover “health care”. Now why would we consider contraception (via the pill) to be health care? Well, how about the fact that you have to go to a doctor to get it? It makes a great deal of sense to a lot of people to group the pill in with all of the other prescriptions we use.
Now why would we consider contraception (via the pill) to be health care? Well, how about the fact that you have to go to a doctor to get it?
More sensisble then to demand that contraception be available over the counter like tylenol.
If you disagree with this then it is YOU who wants to impose the high costs, not me or steve, or Rush limbaugh.
Elizabeth, a few problems with your argument:
1 – The BCP is not the only form of contraception available on the market. There are other, more affordable options. Yes they are less effective, hence the price premium for the most attractive form of contraception. You would not argue for the government to provide us all with BMWs as a form of public transportation, so why argue for the most luxurious form of contraception?
2 – Your argument that it is “simply cheaper” to pay for BCP is precisely the scope creep that opponents of public health care have made all along. Government medicine poisons the well by introducing public cost-cutting into private health care decisions. It is cheaper for public health to ban sugar, fat, alcohol, tobacco, etc. than it is to allow people to consume what they please and live with the health consequences. Government bureaucrats always want to turn the health care debate into one of “cost effectiveness” and public expenditure. For my money, this is perverse. Health decisions do not come down to dollars and cents, they come down to personal choice and health outcomes. I would expect someone who wants to exercise her personal choice to use the BCP to appreciate that.
3 – Any person with whom you associate, be it a friend, family member, romantic partner, or business colleague, may potentially end up costing you some money. Intercourse of all kinds is risky business. If you are a social being, you will occasionally confront the risks of associating with others. Conception is no accident; it is caused by one activity and one activity only. We may all enter into any contract or sign any affidavit we please. Your suggestion of withholding sex from anyone who does not sign such an affidavit – although hyperbolic – is well within your rights, and I doubt anyone who opposes this BCP mandate would oppose the limitations you impose on your own private romantic partners. I certainly wouldn’t.
Damn right: SLUTS! SLUTS, every one.
What a fucking SLUT.
Of course, it’s also widely known among people who aren’t Landsburg that birth control pills reduce cramps. Birth control pills work because they decrease the amount of prostaglandins — chemicals your body produces to make the muscles of the uterus contract. With fewer contractions, there’s less pain.
But why should we socialize such costs? (No, I’m not talking about socializing the pain of the cramps. Those are for women. That’s only natural; even a slut knows that. I’m talking about socializing the cost of mitigating the pain.) Sure, women experience cramps as a function of enabling the human race to continue. But if they didn’t want that burden, why did they choose to become women? After all, Landsburg didn’t! Let them bear the cost of their own decisions, or else we’ll create a moral hazard!
I mean, the burdens of cramps are not like the burdens of prostate issues. That’s entirely different; of course those should be covered. Even a slut would recognize that.
_________
A young woman — whose mother was lucky enough not to lose her overies to cysts – will someday come home from school and be surprised to find that grampa is visiting. “How serendipitous!” she exclaims, both because she’s delightful and because she likes words. “I just got a new assignment in social studies: Explain the causes of the collapse of the Republican Party in the early part of the century. Any theories?”
And grandpa Landsburg will stroke his beard and reflect. “You know, that’s one of those ineffable mysteries. An F-able, ineffable mystery….” And the girl will smile, because she likes words, and because she likes naughty words. She’s even grown accustomed to her grandfather’s peculiar epitaph for her….
@nobody.really: Then why don’t you want to reduce the total social cost of the pill? I know you don’t because your fulminations are about who damn well ought to pay for it for the love of god!!!! not about making it cheaper.
Polevaulter Donkey,
You’ve been duped. The question is not about whether employers should be required to pay for medicine that is also effective as birth control. To my knowledge, no employer or insurer really does that (I’m assuming that if they did, somebody would have pointed it out rather than talking about Catholic institutions).
If you have an issue with medicine being denied that should be covered under your insurance contract, that’s a legal issue that should be addressed with complaints and then, if necessary, legal action. This doesn’t change if you suspect you’re being denied because the medicine you need is effective as birth control. You have a contractual right, you enforce it. You don’t require that employers provide “free” birth control, anymore than the answer to denials of payment for surgery is to mandate employers to provide “free” surgeries.
“The question is not about whether employers should be required to pay for medicine that is also effective as birth control. To my knowledge, no employer or insurer really does that (I’m assuming that if they did, somebody would have pointed it out rather than talking about Catholic institutions).”
Should have proofread. The point I was trying to make is that no employer to my knowledge refuses to pay for medicine simply because it is also effective as birth control. I’m sure there may be an employer out there that does this, but forcing employers to pay for birth control is an idiotic response (at least if the goal was to address such a problem, and not to use a non-problem to score cheap political points).
Dmitry Kolyakov:”Well, maybe comparing those 6 dollars with the 3000 dollars she mentioned and calculating her implied consumption levels was exactly what led mr. Limbaugh to call her what he did?”
She clealry stated the $3,000 was the number for the law school program (3 years is the norm). So she is talking $83 a month (but, of course $3,000 sounds makes the point she wants). I have no idea if the generic $6 per month number is more accurate.
More broadly, I want people to make their choices and absorb the costs. So, how many Georgetown women are “forced” to pay $83 (or $6 or something in between) pay more than that for cigarettes. Well, every one that smokes. Which is cheaper, the prorated share of that months birth control or the cost of the cigarette after? See, this is where “looseness” becomes important.
@johnson85
Isn’t that what I have said? I did say that 1. Emploers should not be mandated to provide healthcare plans; and 2. If they do, then what they include is their choice (subject to any contract with the employee).
My issue is with Rush’s phrasing. Is he against govt mandated employer provided health plans? Is he against not-giving equal tax treatment to employers who buy health plans for their employees and people who buy their own health plans? If not, then what is his principled opposition to not providing birth control pills to women who need them to treat cysts and endometriosis?
“We expected that when 94% of students opposed the policy…” I conclude from this that 6% of the students take economics.
As to the cost, Wikipedia says the method cost is $15-50 / month. So Flukes $3000 for a 5 year college career is feasable, at the top of this range.
The testimony is rather confused. Much of the argument is based on insurance companies not paying for medical needs other than contraception, but for which the treatment is the pill. This is really a separate issue, as others have said, and probably not best solved by giving the pill to everyone.
Oral contraception is a cost that only falls on women. When it was largely men who were responsible (via condoms), the cost would depend on how lucky you were. At the top end, $50 a month would be good going, but $15 a month would not be unreasonble for those in a stable relationship or with very good chat up lines.
There are of course many programs issuing free or subsidised condoms. These also have the disease prevention benefits, and I think it is at these externalities that the programs are aimed.
I do not agree that contraception makes women that much more attractive to men – I think the overwhelming factor is more available. Whilst men do bear some of the cost of unwanted pregnancy, it is mostly borne by the women. Without contraception, the woman will decline sex – so both men and women do without. With contraception, the woman agrees to sex, with benefit to both, but only paid for by the woman. The man surely gets an external benefit.
The crux is here: “absent any argument about externalities or other market failures” I think that advocates of the policy think that this is meaningless in the real world, although they are not able to express this coherently in economic terms. I am probably unable to do so also, but I will have a go.
Sex is great. We mostly enjoy it very much. It is also driven by one of our most powerful natural urges. Who can say that they have always acted rationally when sex is in the offing? A choice that is not rational is a mistake. When people make mistakes, Steve often asks how we can know in which direction they will make it. They are just as likely to overestimate as underestimate, for example. Well, in this case I think we can make pretty reliable predictions about which direction the mistake will be. The powerful sex drive will override rationality, and result in indulgence in sex where a rational choice would be to abstain, or wait until contraception is available.
I am not sure what economic theory has to say about correcting irrational choices. The bottom line is, if we make contraception free, then for pregnancy, we will be getting closer to the position a rational world would provide. This will come at a cost in other areas which may or may not be worth it.
Will I have to pay for your Viagra? That’s covered, is it not? Are you a extortionist?
Concerned female: I think it’s nuts for insurance to cover Viagra, but as far as I’m aware, nobody’s talking about making that mandatory.
Steve, the word you are looking for is contraceptive sponge.
Joker: You are a genius.
Prof. Landsburg:
Suppose Rush were to say, “If we are going to provide free education for poor kids, they should be required to work for 2 hours a day at a local workhouse with all their wages going to the state so that tax rates for tax payers can be lower.”
Would you say:
If I can reasonably be required to pay for someone else’s education (absent any argument about externalities or other market failures), then I can reasonably demand to share in the benefits.
Steven,
I am extraordinarily disappointed, if not terribly shocked that you would defend Rush Limbaugh. I have been reading your blog for a while, and while I often disagree with your opinions, I have often found that you teach well.
But I am done with your blog.
In your close-minded economic approach to the world, you can only see Rush’s comments as economically related, which is just damned STUPID. Do you not understand that nothing of what Rush said was a reasoned argument? Calling a woman a slut and a prostitute has, for centuries, been a way to demean a woman’s opinion to the point that her existence as a sentient being no longer matters? There are certainly reasoned arguments, something you profess to hold dear, to be had against Ms. Fluke, but simply dismissing her as a slut is no reasoned argument.
you are simply engaged in the same misogynistic idiocy as the House Republicans, who I am sure you agree with wholeheartedly. In these eyes of these Republicans, women do not need to even be involved in the conversation about the birth control mandate. Whether you agree with the mandate or not, how can you have a full conversation about the issue without even including women? Instead, these women are dismissed as sluts, sex-crazed, emotional, etc. All words that have been historically used to dismiss the opinions of women in their entirety as irrelevant. If women are so irrelevant, why don’t you just advocate overturning the 19th Amendment?
Finally, I do hope that this article doesn’t make any news, because I would be horrified if such demeaning attacks on women were to become associated with my alma mater, which I adore. I am already embarrassed enough that you are associated that a misogynist such as yourself is associated with the university, I hope it doesn’t get worse.
See how easy it is to disregard someone in their entirety with just one demeaning word?
Goodbye. I’m sure you won’t miss me.
This whole discussion completely misses the point. It is quite accurate that it doesn’t make economic sense for insurance to cover any forms of repetative prescriptions: birth control pills, blood pressure medicine, anti-depressants. However, current policy and practice is to cover repetative prescriptions, and it does not make sense to exclude birth control pills from that practice.
If Rush wants to demonize Ms. Fluke, he should also announce that he is going to stop submitting his blood pressure medication for reimbursement.
Also, employers have a motive for covering those types of medications – all of them. Just like covering birth control is cheaper than covering pregnancy, covering blood pressure medication is cheaper than covering heart attacks.
And I have to add that I’m disappointed that Steve is endorsing Rush’s misleading and distracting attack. If you want to make the argument that insurance shouldn’t cover any form of repetative prescription, make that argument, not a spurious attack on a single form of prescription.
Really? This is what you want to describe as a bit of “spot-on” analysis:
RUSH: What does it say about the college co-ed Sandra Fluke, who goes before a congressional committee and essentially says that she must be paid to have sex, what does that make her? It makes her a slut, right? It makes her a prostitute. She wants to be paid to have sex. She’s having so much sex she can’t afford the contraception. She wants you and me and the taxpayers to pay her to have sex. What does that make us? We’re the pimps. (interruption) The johns? We would be the johns? No! We’re not the johns. (interruption) Yeah, that’s right. Pimp’s not the right word. Okay, so she’s not a slut. She’s “round heeled.” I take it back.
let’s unpack this, shall we? Sandra Fluke is not a “co-ed,” she’s a law student. Her testimony before Congress concerned a fellow student who was prescribed birth control pills for non-contraceptive reasons – ovarian cysts. That student’s university-provided health insurance wouldn’t cover the pill, no matter what the reason for the prescription.
So, for the temerity of advocating a public policy with which you and Rush Limbaugh disagree, Sandra Fluke deserve public humiliation and gendered, misogynist insults? Really? That is exactly what I expect from Rush Limbaugh. Can you really not imagine a way to disagree with her without a tired appeal to sexism? I understand that that would be impossible for Rush Limbaugh, who is an unrepentant asshole. But you Steve?
One more thing to add: I agree that it doesn’t make sense to cover repetative prescriptions. I have asked my employer if I can opt out of pharmaceutical coverage, but they will not allow me to.
Umm….yeah.
I’ve pretty much lost all respect (what little I’ve already had) for S.L. after this post.
I could go on and debate the medical benefits for women at large by just taking the pill not for contraceptive purposes, but nobody.really beat me to it. Further, the argument S.L. stated…
When we pay for the healthcare costs associated with pregnancies and childbirth, we are *getting something in return* (namely a fellow citizen, a potential friend, potential lover, potential mate, potential collaborator, potential employer, potential employee, potential customer and potential Steve Jobs). When we pay for contraception, we’re not. Any argument that compares the costs while ignoring the offsetting benefits is no argument at all.
…is fallacious because not having sex at all prevents those benefits. It’s similar to the Great Beethoven Fallacy. Also, statistically speaking, society bears a high cost for an unintended/unwanted pregnancy, which is more likely to outweigh the benefit because the child is more likely to become a delinquent.
Anyways, so long bigquestions.com.
Has anyone here who claims that men are being subsidized by women’s birth control use ever had sex? If so, were you single? As far as I know, every one of my friends and I use condoms, and I’ve met a large number of women (and had sex with some of them) who don’t use birth control. Who is subsidizing whom?
@nobody.really, thanks for your comment. My 19 year old daughter takes birth control pills. Not because she is a slut, as Steve implies, but because otherwise her montly periods are so debilitating they cause her to miss school.
Al V.: “However, current policy and practice is to cover repetative prescriptions, and it does not make sense to exclude birth control pills from that practice.”
When a bad policy is in place is it preferable to restrict it with loopholes, minimizing the damage it causes, or to apply it consistently, minimizing damage to the legal system?
Wait, isn’t the policy in question to leave employer-provided benefits untaxed, and isn’t repetitive care coverage by insurance companies an unintended consequence of that policy? Now I don’t know what I’m talking about.
Hemeili: “spot-on analogy” not “spot-on analysis”.
Richard:
I realize you said you are leaving the bigquestions, but, in case you return . . .
Nothing Steve said endorses stopping a person from using contraception. He made a statement about requiring the public to pay for it.
Are you aware of any law that requires the public or a private organization to pay people to not have sex at all?
Thomas Bayes: This distinction between allowing and paying for has eluded Richard and many others on this board for several threads now. I’d say you are not adjusting your priors …
SL: ” I think it’s nuts for insurance to cover Viagra.”
How so? I realize I am picking nits here but I see no reason why one might not want to buy insurance against needing this sometime in the future. I can see a case against requiring the tax-payer to pay for it of course.
@All: If you re-read the original post you’ll see that SL says Limbaugh’s “harsh” (i.e. misogynist) language is misplaced. He prefers “extortionist” which seems pretty gender-neutral.
My question – especially if many/most agree that predictable, recurring expenses are not what insurance is really for — is why isn’t this precisely the type of issue organizations like Planned Parenthood *are* for: so like-minded people can support those truly in financial need while respecting the fact that others may not agree? The analogy to vaccinations (a true ‘public health’ issue) is strained. Ironically, as others have pointed out, subsidizing certain types of birth control can possibly increase actual communicable disease.
A thought experiment: An organization (Catholic, whatever) is considering starting a hospital. They are then told if they do that they will have to include services they don’t want to offer. So they scrap their plans. Is anyone better off?
@Harold: one thing I’m pretty certain of is that if you presume to treat people as though they are irrational, you will get more seemingly irrational behavior. And in this case possibly more pregnancies too. I believe SL actually wrote a book (I haven’t read) suggesting this is in fact an area where despite the “powerful, natural urge”, people may actually underinvest in it (for reasons the pill would not address).
@Al V.: Whether covering birth control or blood pressure medication is cheaper is an empirical issue; it depends on how much is spent on prevention vs. how often it in fact prevents something. Some might add that if things are evidently cost-effective insurers need no mandate.
@Martin, I’m not clear if you are agreeing or disagreeing with me. You are 100% correct, that it does not make sense to legislate through loopholes. That was exactly what I was trying to say.
@polevaulter donkeyman,
I failed to make my point again. You say, “If not, then what is his principled opposition to not providing birth control pills to women who need them to treat cysts and endometriosis?”
To my knowledge, nobody anywhere (except for those people deliberately trying to mislead people and those people that are actually mislead by them) is talking about refusing to provide medicine to people for conditions such as cysts and endometriosis or refusing to provide insurance that pays for such medicine. If somebody needs medicine to treat cysts and endometriosis, whether such medicine can also be used as birth control is irrelevant to whether the insurance policy covers it. If there is a covered medical reason for wanting the drug, insurance will pay for it, even if it’s also effective as birth control.
Ignoring the big issue of whether gov’t should be mandating insurance coverage at all (or mandating which drugs and procedures must be covered by any insurance offered), the issue is whether the gov’t should be able to force employers to pay for birth control used for the purposes of birth control, i.e., when it is not being used to address an issue such as cysts or endometriosis.
I know a lot of that is basically repeating the same statement, but I can’t think of a way to make it any clearer.
Al V: It is quite accurate that it doesn’t make economic sense for insurance to cover any forms of repetative prescriptions: birth control pills, blood pressure medicine, anti-depressants.
This is wrong in detail. If I worry about a future risk it can make perfect sense for me to buy insurance against it, at a premium an insurer is willing to offer it to me at. ALS sufferers may in the future benefit from a repetitive prescription or repetitive spinal injections. Insuring agisnt that can make sense.
It might also make sense for my insurer to offer me at low cost coverage of some drugs that are cheap enough to be effective preventatives. If they are on the hook for my heart attack blood pressure pills can be a good investment for the insurer.
What does not make sense is to mandate that A pay for B’s item, knowing full well that most B’s will want it, that the cost is not high, and calling that insurance. Which is precisly what Fluke did, and she did it to play upon feelings of guilt and obligation properly attendant to what real health insurance covers, like ALS treatments. That is her ploy, you’re like the hearltess HMO denying me life-saving medicine.
I find the sentence “Without insurance coverage, contraception can cost a woman over $3,000 during law school” in Fluke’s testimony to be amusing. It’s just like when Obama talks about saving $40 billion over ten years by eliminating oil and gas subsidies. That’s $4 billion a year, a pathetically small number (well, $40 billion is too but at least it sounds bigger). If law school is 3 years, then $3,000 over 3 years is about $83/month, or roughly the cost of a smart phone and data plan subscription. How many of these struggling law students have those? I like the word “can” in that sentence too. That’s like saying “the flight I’m taking to Asia “can” cost $10,000.” It probably won’t, but it can, so give me $10,000 damnit!!!
@iceman, which is exactly why insurers will willing to cover birth control without any increase in premiums.
@Ken B, what is the difference between my daughter’s birth control medicine, and my blood pressure medicine? In both cases, we need a medicine to address a medical issue, and in both cases we are calling something “insurance” that is really a subsidy from you to me (since I pay for her insurance). And in both cases the insurer and my employer don’t mind paying for the medicine, since prevention costs less than the alternative. Either both should be covered, or both should be excluded.
Ken B:
SL: ” I think it’s nuts for insurance to cover Viagra.”
How so?
Because Viagra is a pretty minor expense, and it’s nuts to be insured against minor losses.
Al V:
Why should you set the rules for inclusion as you want to do in the last sentence?
As for the rest you need to read Johnson85’s comments. You are doing something sneaky here: your daughter takes a chemical for reasons unrelated to contraception; that chemical also serves as a contraceptive; you persistently conflate these.
Imagine your daughter took a DIFFERENT pill for her condition. If it were an effective preventative, which you stipulate, your insurer would cover it. Totoally orthoganl to the contrception debate. Make it the same pill, same considerations apply.
This distinction between allowing and paying for has eluded Richard and many others on this board for several threads now. I’d say you are not adjusting your priors …
LOL…I won’t take criticism from someone who claims I fail to make a distinction between allowing and paying (which I haven’t), yet makes elementary economic errors between demand and quantity demanded and cannot seem to be able to read the sources he sites. Cat got your tongue it seems in those other posts, Ken B.
^Come to think of it, Fluke shouldn’t worry about criticism from Rush Limbaugh either. He’s a fat #$%@ drug-addict who should have the public stop paying for his blood-pressure medications.
SL: “Because Viagra is a pretty minor expense”.
Sorry, I forgot you weren’t Canadian! :> But it’s a fair point …
The only thing that comes to mind is an old Russian saying. Roughly translated:
Loving downhill sledding means loving uphill sled pulling.
This simple life lesson was first taught to me by my mother when I was a lazy 4 year old (and involved an actual sled). It’s time to pass this wisdom on to Ms. Fluke at her rather more advanced age.
(I know I said I was leaving but I can’t help but pointing out this irony…)
Didn’t Steve write a book titled “More Sex is Safer Sex.”? It seems to me that if we subsidize birth control this will lead to more women considering having more sex, which is safer…thus a much bigger net benefit for society.
Richard: If you’ve read beyond just the book title, you’ll know that the externalities of sexual activity are negative among the most promiscuous and positive among the least promiscuous. So to make your pro-subsidy argument work, you’ve got to argue that birth control is used disproportionately by the least promiscuous. You might in fact be able to argue exactly that, in which case you’ve got a respectable argument for subsidizing birth control. Note that Ms. Fluke made no attempt at any such argument.
I might add (not directly relevant to your comment, but relevant to others) that if you tried to make a similar argument along the lines of population control, your argument would fail. First, my own estimate is that the externalities of population growth are, on balance, positive, but let’s put that aside and assume they’re negative. You still can’t use that as a very good argument for subsidizing birth control, because there’s a far more direct way of attacking this problem, namely taxing childbirth.
I suggest that Fluke supporters get together and immediately form a huge charity to get these women the contraception they deserve. There is so much passion here that I am surprised they haven’t done this already. In a way, the contraception would still be subsidized because your charity would be tax deductible. What are you waiting for? It’s a free country.
The Catholic Church doesn’t wait.
Two observations.
1. In discussing the Blunt Amendment, many commenters conflate the idea of taking contraceptives for contraceptive purposes and taking contraceptives for non-contraceptive purposes.
2. The Blunt Amendment also conflates these two propositions. Specifically, S. 1813 would amend 42 U.S. C. Sec. 18022(b) to say that insurance meets the requirements of ObamaCare even if the insurer —
There Landsburg goes again – won’t tax capital, but always happy to tax labor…..
@nobody.really
The Blunt Amendment reads as if it is a general exception for conscientious objection. In theory it looks like it could be used if an employer decided that they had a moral conviction that say, treating heart attacks is wrong. If you think that’s a bad idea, you can legitimately argue that the language of the Blunt Amendment should be revised.
But what people are doing is arguing that because some medical treatments are also effective as birth control, employers that already will pay for such treatments should also pay for people to use birth control for non-medical reasons, because some people use medical treatments that are also effective as birth control.
It a completely illogical argument unless you are trying to trick people into believing that employers (say employers affiliated with the Catholic church) are trying to avoid including insurance coverage for medical treatments simply because the medical treatments are also effective as birth control. As far as I know, nobody has proposed doing any such thing, and if they did, it seems the reasonable thing would be to address that issue.
God damn right. If that was Fluke’s concern, why didn’t she talk about how certain institutions might withhold contraception from people who have a medical need for it, unrelated to any need for suppressing pregnancy? Why couldn’t she talk about the amendment’s failure to provide language addressing this problem? Why couldn’t the slut simply say something like this?
@Al V.:
I was trying to suggest that you’re making assertions and predictions about an empirical issue, but they do not seem to be supported by the actual behavior of insurers.
@All: Can we please stop using misogynistic terms that no one on this blog has endorsed? It’s not scoring you any points.
1. I dare say, even if subsidizing birth control is a second-best solution, Congress would have an infinitely easier time passing such legislation (or killing the Blunt Amendment) than passing anything called a tax. Some religions you dare not cross!
2. Would a tax be a more effective way to deal with the negative externalities of child birth? It’s not clear to me that the externalities arising from wanted births are the same as the externalities arising from unwanted births. And a tax on births would discourage both wanted births and unwanted births, while subsidies for birth control would have a much more targeted effect on unwanted births.
As I’ve noted previously, the Freakonomics guys found a correlation between the date abortion was legalized in any given jurisdiction and the subsequent fall in the crime rate. This suggests to me that unwanted births may generate more negative externalities than wanted births. I’d be curious to hear Landsburg’s (and others’) thoughts on that.
(And, ok, I’ll try to be on good behavior and drink decaf before responding….)
@nobody.really
If a lady was denied coverage for medicine she was contractually entitled to under an insurance policy, the solution is to enforce her contractual rights, not require employees to pay for birth control.
Also, I question Fluke’s credibility regarding the issue since she says “Under many religious institutions’ insurance plans, it wouldn’t be…” I would have liked her to name at least one such institution since there are so many of them. What religious instutions’ would have insurance plans that won’t cover medicine just because they can be used as birth control? I wouldn’t think there’d be many out there or that they’d be particularly big employers.
Even if there were a lot of religious institutions that fit that description, why wouldn’t you address it by providing that qualifying plans can’t fail to cover a medicine approved for treatment of a condition simply because it also can be used as birth control. Except to score political points or for the fun of being mean spirited, it’s pointless to needlessly trample on an employer’s moral convictions when there is a much less intrusive way to address the issue.
@ iceman:
If you re-read the original post you’ll see that SL says Limbaugh’s “harsh” (i.e. misogynist) language is misplaced. He prefers “extortionist” which seems pretty gender-neutral.
Which is why SL says:
A far better word might have been “prostitute” (or a five-letter synonym therefor), but that’s still wrong because
This 5 letter word is of course whore which in my mind is not really gender-neutral.
The term for you iceman is impotent nose picker, but that’s still wrong because that would imply that you could figure out how to put your finger in your nose.
And before you get upset with me for calling you an impotent nose picker, read closer and you will clearly see that I corrected myself and said the term didn’t apply to you.
So there is no reason for you to assume that I am using pejorative terms against you.
@johnson85
I think we agree on mostly everything (of relevance in this thread). I think what we disagree on is Rush. Did Rush differentiate between birth control pills taken for the purpose of contraception and birth control pills taken for a non-contraceptive purpose (such as ovarian cysts and endometriosis)? I don’t think so, which is why I have faulted him. Is my reading of Rush wrong, and if so why?
@nobody.really
From my reading of Steve, he is happiest in taxing consumption (but I do get your pun), he would rather not tax labour and least of all capital and nothing wrong in that.
@iceman
If you are referring to the word “slut” — I fail to see the misogyny in the word. I agree with Steve that “slut” connotes joyous enthusiasm. And as for “prostitute” and “whore”, again I fail to see the misogyny in words which essentially mean honest self-employed professionals; we should be celebrating prostitutes as we celebrate other self-employed professionals.
Is anyone bothered by the fact that it is wrong to commit extortion, even in the name of a public good or reduced externalities?
BTW, why are women complaining about paying for birth-control? I am middle-class and have never had to pay for my pills. There are many organizations in almost every city/town that give free birth-control and that are not subsidized by government. If we live far away, they can prescribe 3 months worth at a time to eliminate long travel distances that many would attribute to issues of difficult access.
It really isn’t that hard to have safe sex without direct or indirect government assistance.
I think this women has been raised to feel entitled to get everything she wants and a lot of other people like her agree.
@iceman. I think the key is predictably irrational. If you know people behave irrationally, then it surely makes no sense to act as though they were rational. This cannot be the basis of good policy. You may decide that trying to compensate for irrationality would lead to poor policy, but it should be an informed descision, not based just on an assumption of rationality.
Being called a slut by Rush Limbaugh has to be the holy grail of feminism.
“I expect there are respectable arguments for subsidizing contraception (though I am skeptical that there are arguments sufficiently respectable to win me over)”
There’s the argument from eugenics: Women for whom getting free contraceptives makes the difference between getting pregnant and not getting pregnant are probably not ones whom we want to be passing on their genes.
I heard Rush’s show on this, and I had the impression he used the word ‘slut’ not because she wanted to be paid but because, to use enough condoms to approach spending $1,000 a year, she’d have to be having sex at least five times a day, with guys who weren’t willing to share the expense. The point wasn’t to insult her but to make fun of her inflated cost estimate.
Philo: Thanks for this. I didn’t hear the show, but this does sound both Rush-like and far far less offensive than what’s being reported.
Gosh Steve, I had thought that the term “slut” was insulting, and that insulting people was wrong, and if anyone had called my wife or daughter a slut I previously would have been upset, but now you’ve shown me that I was just confused. Thanks.
Not in general the highest quality discussion but two superb quips: Joker’s “contraceptive sponge” and nobody.really’s “There Landsburg goes again – won’t tax capital, but always happy to tax labor”.
It sounds like Mr. Limbaugh was just engaging in a little hyperbole and humor in order to emphasize the salient point. Did not Walter Bagehot say that to tell the truth “you must exaggerate much and you must omit much.” Seems to me he is thinking like an economist.
n.r:” about how certain institutions might withhold contraception from people who have a medical need for it”
First nobody has a medical need for contraception. They might have a medical need met by a drug used as a contraceptive. This is not the same.
More importantly no institution is denying anyone contraception; some are declining to pay for it. This is not the same. No-one but me pays for my aspirin; I am not denied access to aspirin.
Chris writes: “I find the sentence “Without insurance coverage, contraception can cost a woman over $3,000 during law school” in Fluke’s testimony to be amusing” and he makes some good points. But he misses one: these are future LAWYERS. We are asked to subsidize future LAWYERS because they won’t be able to pay off their enormous contraceptive debt later on.
Harold:”The bottom line is, if we make contraception free, then for pregnancy, we will be getting closer to the position a rational world would provide.”
We cannot make contraception free, just as we cannot make anything free. Your point though is about net social costs. We can reduce the net social cost of the pill by making it OTC.
Matt shrewdly notes “Mr. Limbaugh was just engaging in a little … humor in order to emphasize the salient point. ” Indeed, as did Steve. This is why it is being treated as such a crime. This isn’t just laughter, it is laughter at. Laughing at people who cannot be laughed at.
You might recall an old joke:
How many feminists does it take to screw in a lightbulb?
THAT’S NOT FUNNY!!!!!!!!!
Thought I would check in one last time and see how far the conversation had descended.
It amazes me that the economists and many of the other readers of this blog seem to miss the point that NOT EVERYTHING IS BASED ON ECONOMICS. Sometimes, an insult is just insulting, and no matter how you might try to rationalize it with economic principles, it is still just purely demeaning.
You might think its fun to play with calling a woman a slut or a “five letter word” (whore), but really its not, because you are not just having fun. You are trying to invalidate her opinions by defining Ms. Fluke as a (in your opinion) sexual deviant. Why can you not read the actual testimony given by Ms. Fluke and critique that, WITHOUT resorting to denigrating her sexual activity. We can talk about whether women need subsidized contraception without calling her a slut. If you think she is having sex too much, say so, and don’t forget about the men that she is having sex with. It takes two, and if you are going to call her a slut, you should very well be calling him a slut as well, because if there are 50 straight women having sex more than you would like, there are most certainly 50 straight men having sex more than you would like.
Words like slut, whore, and prostitute are not the neutral terms that Steven apparently wants you to believe that they are. A slut is not a woman who has sex too much. A slut is a denigrating term for a woman who, in the estimation of the society as a whole, has sex too much. But this is lost on an economist, and I don’t even know why I bother trying.
Didn’t hear the show? Guys, Limbaugh publishes transcripts. And no, I find no reference to condoms in the transcript. Instead, I find this:
And here’s what Landsburg said in response to a show he never heard:
Now, I have no knowledge that Fluke has ever used birth control, or ever intends to; she makes no mention of her sex life, or anyone else’s, in her statement. Instead, she advocates a policy position.
I surmise that Limbaugh and Landsburg know more about her sex life than I do, because they talk about it freely. But pershaps people of their ilk feel no compunctions about making public statements about a young woman’s sex life, with or without evidence.
They may want to gather some evidence in support of their accusations, however, because truth is a defense against the charge of defamation. Common law elements of defamation include 1) communication to at least one other person 2) when the subject of the communication is detrimental to the victim’s reputation. Classic examples of messages deemed per se detrimental are allegations of criminal activity – prostitution or extortion, for example – and allocations of unchastity.
Fortunately for some people, context matters. A defendant can present evidence that he has a reputation for bombastic statements and is not generally regarded as credible. How hard would it be to find witnesses to testify on behalf of such a proposition? Time may tell.
@ Beth:
I’m not bothered by the fact that people lobby congress to pass legislation that is in their interest. Whether this is oil companies lobbying for government subsidies or paranoid parents lobbying to have buses stop at rail road crossings.
To a certain extent a representative democracy is all about extortion in that people in essence say to their representatives, if you don’t do what I want, I’m going to do everything I can to get you fired.
Also, thanks for your honesty. I mean a middle class person getting free pills would really make a person question whether or not he should donate money to an organization that distributes contraception. Good job.
It takes a special skill to get people so blind with fury they cannot hear what you say and so ‘beclown’ themselves screaming at you. Steve Landsburg has that skill, for her never called Fluke a slut, a whore, a prostitute, a round-heels, the town bicycle, or indeed anything but a Georgetown law student and an “extortionist with an overweening sense of entitlement”.
As much as I am enjoying the fulminations and the posturing, and am looking forward to more screaming this time aimed at me, I probably should clarify a few things. I think RL is over the top here; I think he should have made his point without zeroing in on Fluke as he did. I’d say he should apologize; a skilled rhetorician could combine a mea culpa with a fairer bit of derision. I think the substantive point, which SL emphasizes, is right, and that much of the outrage is a way to avoid answering the argument. Most of it is just because the mockery hits home and some.people simply cannot abide being laughed at. Steve’s assessment, extortionist, is harsh but not unreasonable; I think she is an emotional blackmailer with an overweening sense of entitlement.
Will A: You and I have traded more than a few barbs on this board, but until now I cannot recall anything nasty. The last part of your comment to Beth, a woman who will almost certainly live a less affluent and privileged life than Fluke, is nasty. I will of course deny saying this later, but I think you are fair enough to recognize this and apologize.
It doesn’t really matter at this point.
The left has managed to somehow make this about birth control… when that was never the issue.
They do this every time: If I am against government education subsidies, I must be against education. If I am against government jobs programs, I must be against people working. If I am against stimulus, I must be against the economy, and am doing it just so Obama will fail. If I am against food stamps I must want poor people to starve.
We we try to explain that its about freedom of conscience and not about birth control, they just repeat “birth control, birth control, birth control LALALA.” Somehow ignoring us and just yelling their idiocies at the top of their lungs has worked and shifted the debate. Why? Why has it worked? Because we didn’t mock them for being childish, instead we played into their hands and started talking about sex and birth control.
This happens in almost every debate, the left manages to frame the debate by co-opting the media, so they just want to ask questions completely irrelevant to the task at hand. I am tired of it, but I have no idea what to do about it.
Should we just point at them and laugh and then say: “Oh you are so clueless, you stupid person, you think this is about sex, don’t be so parochial. Its about much bigger things, which if you were a grown up you might understand.” Would that work?
Landsburg “if you tried to make a similar argument along the lines of population control, your argument would fail. First, my own estimate is that the externalities of population growth are, on balance, positive, but let’s put that aside and assume they’re negative. You still can’t use that as a very good argument for subsidizing birth control, because there’s a far more direct way of attacking this problem, namely taxing childbirth.” – why is this more effective than subsidizing birth control? What if someone refuses to pay the tax are you going to put them in prison or take the child away… probably not and if a tax can’t be enforced it’s not going to work.
Rush Limbaugh:
Doc Merlin:
Jakrs writes if there are 50 straight women having sex more than you would like, there are most certainly 50 straight men having sex more than you would like
That does not logically follow. Those 50 women could very well be having sex with the same dude. The median number of partners for men and women is the same, but the deviance varies greatly. This being a college setting, my scenario also makes more sense empirically.
ps: I think Landsburg was making fun of the argument made by Ms. Fluke, not her position (pun not intended). You guys are arguing over externalities when no such argument was ever raised.
Come on; Bill Clinton graduated back in ’68.
@nobody.really
So sorry the First Amendment threw a spanner in the works!
@Doc Merlin: Come to think of it, why DO you want to starve poor people? Is it because you see food as a positional good? :>
Excellent points. But in this case I think some mockery, and especially the wild reaction to it, has made several regulars here look intemperate, intolerant, unresponsive to argument, self-righteous and humourless.
Steve, Ken B, you guys are right. We’re being “dense and humorless.” We should lighten up. After all, this whole thing was pretty funny! Yeah, it’s funny when a prominent media figure hurls a demeaning slur at a woman.
Nobody.really makes an interesting point. Steve says “[Fluke] will, as I understand it, be having sex whether she gets paid or not.” Where did that understanding come from, Steve? What reason do you have to believe that she’s sexually active at all? Did you read her testimony?
A word of advice for Steve: It’s ok every once in a while to stop being an economist, and just be a man.
@ Ken B:
Beth described herself as a middle class individual (not poor).
If she had said, “Does anyone else have a problem with food stamps? I’m a middle class person who goes to food banks so that I could save up for a 70″ LED TV”, I would have made the same comment. Except substituting food for pills.
Joker and Landsburg thought the term “contraceptive sponge” was a genius term to describe someone who gets contraception for free. I must have missed your comment about how that is unfair.
I was questioning the intellectual integrity and motives of what she said. I did the same when I questioned Frank’s integrity about taxes causing clean air.
I mean this seriously, if you spotted something that implies that I have no concern for those less privileged than the American middle class let me know. This is something that I would want to avoid.
The main thing that this ordeal, including all the commentary, has proven is that most guys have no idea why girls use birth control. Yes, birth control helps avoid unplanned pregnancies. No, that a girl take birth control on Monday doesn’t mean that she’s having sex on Monday. Birth control is also used to regulate the menstrual cycle, amongst other non-sexual reasons.
“I mean this seriously, if you spotted something that implies that I have no concern for those less privileged than the American middle class let me know.”
Not no concern, just insufficient concern. If you had sufficient concern you’d favour more markets and less intervention, you’d want the pill OTC, and you’d take arguments against your positions more seriously.
I repeat, your comment to Beth was personal and motivated by spite and animus, that makes it nasty.
Ken B and Will A: I think that Will’s comments were pretty well within the bounds of respectful but spirited discussion. I think I understand why Ken disagrees. But I don’t think it would be a good idea for us to get sidetracked into a discussion of this. I’ll welcome one final word from Will if he wants to have it, but beyond that I hope we can avoid going off on this tangent.
Ken B:
A middle class woman who gets free contraception reads the threads in this discussion in particular the “contraception sponge” comment and what concerns her the most are the comments by people who defend Fluke.
I understand a middle class woman who pays for contraception being upset that others extort.
I also understand a middle class woman who doesn’t believe in the use of contraception being upset that others extort.
My attack was motivated by the fact that I don’t believe that Beth is being honest.
In this thread, I think I’ve taken 2 positions.
The first is that extortion against elected officials is OK on the condition that the extortionist threatens with the removal from office.
The 2nd is that making a statement like “Calling Tiffany a whore isn’t accurate because she does it for free” is really calling Tiffany a whore.
As it relates to being open to different positions, In the recent “Your President Hopes You’re Stupid” post, I think I pretty much slammed those on the left who fail to recognize that there is a legitimate case about liberty infringement in requiring someone to purchase something they are morally objected to.
Like Frank (re: recent posts), I believe that we should raise the income taxes on the wealthy. However, I will attack his statements if I feel he is being dishonest. If you remember I called Cochrane – different point of view from me – sloppy, but Frank – same point of view as me – dishonest.
Beth may attend the Evangelical Lutheran Church of American and be in favor of universal healthcare, however I feel she is being dishonest, I’m going to call her on it.
Beth of course can comment on this blog and say, “Actually Will A people lobbying for free contraction really does bother me more than someone calling me a contraception sponge.”