I do not have a problem with other people using contraception or getting it paid as part of their health plan. I do have a problem with me paying part of it. The simple solution is for contraception to be a benefit of the Affordable Care Act’s “Gold” plan or as an extra cost item for the Essential Benefit’s option. Sex is a choice not an “Essential Benefit”. As part of my health insurance I can pay extra for dental coverage. I think benefits like dental coverage and contraception should be extra cost options.  Our policy wonks seem to be locked into thinking that health care must be locked into a fairly rigid structure. The plans must be follow a “Bronze”, “Silver”, and “Gold” structure with no exceptions. A “cafeteria” style plan is a more flexible and logical alternative and is the more typical offering in the real world. It would at least show that the policy wonks were not asleep in Marketing 101. This is a pretty common practice in the insurance industry.

The fundamental question is whether society is better served with heath care under the tax model or the insurance model. Since most of our health care is paid for by a third party system, it works and feels like a tax. For people purchasing health care insurance directly it works and feels like an insurance policy. The interesting irony is that ACA realizes that the third party payment system is not affordable or sustainable and their first act is to make individual health care insurance unaffordable and not sustainable. This is not a strategy to lower health care costs. In a previous post I compared Ohio health care insurance to Massachusetts. The cost of “Essential Benefits” in Ohio was $305 per month and the cost in Massachusetts was $1,296. To put this in perspective I purchased a two year old car last year for what I would have paid for “Essential Benefits” health insurance premiums in Massachusetts. I could have bought a new car with the cost of a “Gold” plan. In my entire 35 years of paying health care costs for my family, we have not spent what the average Massachusetts person pays in one year for their “Gold” plan. Our health care costs do not make sense so our first attempt at fixing the health cost problem is to model a national system after Massachusetts! With Massachusetts as our model why do we expect health care costs will slow down? It is a sign of insanity when you keep doing the same thing and expect different results.