Sandra Fluke and the Nature of Insurance

On Feb. 23, Georgetown Law student Sandra Fluke testified before the House Democratic Steering and Policy Committee about women's health and contraception. Ms. Fluke thinks that the health insurance program provided by Georgetown University, Premium Plan, should cover contraception. Her testimony warrants comment: 

First, although Georgetown U. does require that fulltime students have health insurance, the university does not require that students enroll in Premium Plan. A student can opt out, get a waiver and secure her own policy from another insurance provider not affiliated with Georgetown. Also, Georgetown does not stipulate that those other insurance plans not cover contraception. So, even though she can buy a policy that suits her, Fluke wants to change the whole insurance industry.

Second, Fluke relates the story of how one of her fellow students was embarrassed when she discovered that her health insurance didn't cover contraception. She should have read her description of benefits. For on page 29 under EXCLUSIONS AND LIMITATIONS (items 19-b and 21), one reads that "birth control and/or contraceptives" are not covered.

Third, the cost of Premium Plan for one calendar year is $1,895. The average annual premiums for health insurance in 2011 for a single person were $5,429. The reason Premium Plan is so cheap is precisely because it doesn't cover everything, including contraceptives. Ms. Fluke is moaning about not getting an Angus T-bone when she paid for hamburger. Perhaps Fluke thinks such a low-cost plan should also provide "free" daily therapeutic massages. What Ms. Fluke should resent more than the out-of-pocket expense of contraceptives (which, by the way, she has wildly inflated), is the cost of health insurance itself. Fluke's real beef should be with government policies that are responsible for the surge in health care inflation.

The price of Premium Plan illustrates what's wrong with ObamaCare, which is that everyone gets everything -- all insurance policies must cover everything for everybody. But that's not how insurance works. If it covers all possible health-related expenses, health insurance ceases to be insurance, and becomes akin to prepaying for food.

Fourth, Ms. Fluke conflates issues to make her case. Fluke is able to conflate issues because oral contraceptives have several applications not related to birth control, such as the treatment of endometriosis and polycystic ovarian syndrome, from which her fellow students suffer. But Fluke claims that her ill friends who suffer from these diseases need contraception -- not hormonal treatment nor even oral contraceptives, but contraception: "The contraception she needs for her endometriosis." If it were discovered that the steroid hormones in oral contraceptives also alleviated headaches, would one then say that a woman who suffers from headaches needs contraception?

Watch Fluke's opening statement here, or the entire hearing at C-Span here. It's amazing to see how glibly she blows off the religious conscience concerns that started this flap. But then, Fluke is only in her third year of law school and can't be expected to have gotten around to reading the First Amendment.

Jon N. Hall is a programmer/analyst from Kansas City.

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