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Stage set for debate over birth control
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WASHINGTON -- Fifty years after the pill, another birth-control revolution may be on the horizon: free contraception for women in the U.S., a result of the new health care law.
It could start a shift toward more reliable -- and expensive -- forms of birth control gaining acceptance in other developed countries. But first, look for a fight over social mores.
A panel of experts advising the government is expected to meet this month to begin considering what kind of preventive care for women should be covered at no cost to the patient, as required under health care reforms.
Sen. Barbara Mikulski, D-Md., author of the women's health amendment, said the clear intent was to include family planning. But is birth control preventive medicine?
For many medical and public health experts, there's no debate.
"There is clear and incontrovertible evidence that family planning saves lives and improves health," said obstetrician-gynecologist Dr. David Grimes, an international family planning expert who teaches medicine at the University of North Carolina. "Contraception rivals immunization in dollars saved for every dollar invested. Spacing out children allows for optimal pregnancies and optimal child rearing. Contraception is a prototype of preventive medicine."
But U.S. Catholic bishops say pregnancy is a healthy condition, not an illness. In comments filed with the Department of Health and Human Services, the bishops said they oppose any requirement to cover contraceptives or sterilization as preventive care.
"We don't consider it to be health care, but a lifestyle choice," said John Haas, president of the National Catholic Bioethics Center, a Philadelphia think tank whose work reflects church teachings. "We think there are other ways to avoid having children than by ingesting chemicals paid for by health insurance."
So far, most other religious conservatives have stayed out of the debate, though that could change. Some say they are concerned about any requirement that might include the morning-after pill, an emergency contraception that contains a high dose of a hormone found in birth-control pills and can stop pregnancy by preventing the implanting of a fertilized egg. The Food and Drug Administration classifies it as birth control; others see it as an abortion drug.
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