Contraception, Again.

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It seems a bit odd arguing about contraception in 2012. After all, the matter seemed to have been large resolved some time ago.  While it is tempting to say that Contraception 2012 is a manufactured conflict, there do seem to be some points worth addressing in this context.

One talking point that has been presented by some folks, such as mainstream American media personality Rush Limbaugh, is that insurance coverage of contraception is the same thing as paying someone to have sex.

In the case of people who are prescribed contraceptives because of medical conditions (such as ovarian cysts), this is obviously not the case. In cases in which the person is simply using the contraception as contraception, she is still not being paid to have sex any more than the coverage of Viagra and comparable medicine for men is paying men to have sex. At most, what is being paid for is the means to have sex (Viagra) and the means to avoid getting pregnant (contraception). True, these are connected to sex, but covering either is not the same thing as paying people to have sex.

Another common talking point is that the plan to cover contraception will be “using people’s money” to pay for something they do not approve of.

One obvious reply to this is that for most folks insurance coverage is either paid for by the individual or as part of a benefit package for a job. Either way, the person is earning her coverage. To use an analogy, my insurance covered my quadriceps tendon repair (mostly). This was not using some other people’s money since I pay for my insurance. Likewise, if a woman get contraception covered by her insurance, she is paying for that (either directly or by getting benefits as part of her compensation).

It might be countered that some women get coverage from the state, so tax dollars could go to pay for birth control. Since some folks are against contraception or do not want to pay for it, this should not be done.

The stock reply to this is that our tax dollars are routinely used to pay for things that we might not want to pay for or that we might even oppose. For example, I’d rather not have my tax dollars pay for subsidies to corporations and I certainly don’t want to be paying for other dudes’ Viagra.  This is the way democracy works-provided that the spending is set up through due process, by agreeing to the legitimacy of the state we also give our consent to the spending-even for things we would rather not contribute to.

Naturally, it can be argued that we should not be required to pay for anything we oppose and this has considerable appeal (see Thoreau’s arguments about civil disobedience for an interesting look at this matter). However, if we adopt this principle for contraception, it must also apply across the board. So, for example, folks who are against war can insist that war should not be paid for using tax dollars and so on. It seems likely that for every proposed spending there will be a person who opposes it-thus the state should not spend money on anything. While this would solve the deficit problem, it would seem a rather absurd solution.

A third talking point is that contraception should not be covered because it does not treat a condition. This is most often brought up when defending the coverage of Viagra (which restores a natural function).

The easy reply to this is that some forms of contraception are used to treat medical conditions (such as ovarian cysts). As such, this use should be covered. But, of course, this would not warrant the coverage of contraception as contraception.

One reply worth considering is that the framing of the debate begs the question against women. After all, the claim is that anything that is covered must treat or prevent a harmful condition and this would exclude contraception (except in cases in which a women would be medically harmed by being pregnant). However, this framing tends to be simply assumed rather than being argued for, which is rather unfair to women in this regard. After all, the matter of pregnancy seems to be unique (and limited to women) and hence it seems questionable to insist that it must automatically fall under the framing in question. It can, of course, be argued that it does-but an argument is wanted here to show that is the case.

While some might be tempted to cast pregnancy as the harmful medical  condition that is being prevented by contraception, the idea of casting pregnancy as a harmful medical condition has rather limited appeal. After all, while pregnancy puts considerable strain on the woman, it seems rather difficult to cast it as an illness that needs to be prevented or treated as if it were comparable to measles or cancer.

A more fruitful line of approach is to argue that contraception provides medical control over a woman’s quality of life. That is, it enables her to chose whether to be pregnant or not. Doing this clearly falls under the domain of medicine and women do seem to have a legitimate claim to this right. After all, much of medicine deals with maintaining a desired quality of life and women would seem to have as much right to that as men.

Naturally, it might be countered that I am treating pregnancy as a disease (which would be some major rhetorical points against me). But this is not the case. All I am claiming is that given that pregnancy can be rather challenging for a woman and, of course, a child is a major consumer of resources a women has a legitimate right to use medical means to maintain her desired quality of life-just as a man has a legitimate right to use Viagra and its ilk to maintain his desired quality of life. Just as Viaga is covered as a quality of life drug, so should contraception.

A fourth, somewhat uncommon,  talking point is that contraception is on par with abortion, so covering contraception is covering abortion.

One stock reply is the obvious fact that contraception lowers the number of unwanted pregnancies and this lowers the number of abortions. As such, folks who are worried about abortion would seem to have a good reason to favor covering contraception.

Of course, some folks contend that contraception is like abortion in that it prevents a possible person from becoming an actual person. While this does have some philosophical interest, it would seem to entail that every moment I am not out and about impregnating women, I am engaged in acts comparable to abortion. After all, by not impregnating as many women as possible, I am preventing some possible people from becoming actual people. Put a bit less absurdly, if I am practicing abstinence, then I am effectively engaged in abortion since all those possible people will never become actualized.

It could be countered that this only applies to cases in which I am actually having sex (and presumably that I should only be having sex with a woman I am married to). That is, every time I have sex, there should be a roll of the dice to see whether or not the woman gets pregnant. Presumably if either of use chooses to use any method that lowers the probability of pregnancy, then this would be on par with attempting an abortion.  As such, the only acceptable family planning would be to decide to have sex only when one plans on a pregnancy since intentionally preventing it would be unacceptable. I would be interested in seeing some arguments for this that do not involve an appeal to theology.