Arkansas has the nation’s highest teen pregnancy rate. It also has one of the country’s highest unintended pregnancy rates among women of all ages. Each one of these pregnancies strains mothers and families, and can also increase the taxpayer burden. But it doesn’t have to.
Many of these pregnancies stem from a lack of contraceptive usage, which can be attributed in part to burdensome hurdles that women must clear to obtain birth control. This is a considerable problem in Arkansas, but one that lawmakers could easily resolve by adopting a new paradigm that red and blue states alike have been increasingly enacting: the pharmacy access model.
In fact, it appears that there is momentum within Arkansas to do just this. State Rep. Aaron Pilkington, R-Clarksville, recently introduced House Bill 1164, which would permit women to bypass physicians and safely obtain oral contraceptives directly from a pharmacist. Rep. Pilkington’s primary rationale for his legislation is to “encourage better healthcare decisions, lower teen unintended pregnancy rates, and expand birth control availability — thereby reducing the number of abortions.” Regardless of one’s stance on controversial life issues, the benefits of Rep. Pilkington’s proposal are immense.
Currently, to acquire hormonal contraceptives, women must schedule a doctor’s appointment usually consisting of the physician obtaining the patient’s medical background, checking her blood pressure and discussing any birth-control preferences. Only after completing this process can women receive a prescription for hormonal contraception, which they must fill through a pharmacist.
While these requirements may seem innocuous at first blush, they are unnecessary, cause far more harm than good and, as Rep. Pilkington put it, are “a huge hassle.”
For one, Arkansans have limited access to medical care, thanks in large part to a massive doctor shortage throughout the state. In fact, Arkansas has one of the lowest physician-to-population ratios in the country. But even when doctors are available, medical care can be cost-prohibitive for many Arkansans — especially given that the state has one of the highest poverty rates in the nation.
In addition to this issue, doctor’s visits can be time-consuming — especially because of the low physician-to-population ratio — and some women simply do not have the time to travel to the nearest physician and wait in a doctor’s office. The combination of these factors discourages women, especially those without insurance, from visiting a doctor to obtain birth control.
Indeed, every hurdle placed before women seeking birth control makes it that much more likely they won’t get the care and medicine they need. However, being able to obtain a prescription from a pharmacist, rather than a doctor, and filling it in the same visit eliminates a major impediment to women receiving health care.
Removing barriers to contraceptive access is an issue on which many doctors agree. The American College of Obstetricians and Gynecologists — America’s largest organization of women’s health specialists — advocates even going a step further and permitting over-the-counter birth control access. After all, women are able to safely assess their own birth control needs. While it would take federal action to permit over-the-counter availability to hormonal contraceptives, pharmacy access is the closest available option for state policymakers.
Moreover, many view hormonal contraception as simply a family planning tool, but birth control is also used to treat women’s ailments, including endometriosis and polycystic ovary syndrome, which affect 11 percent and 10 percent of women, respectively. Given how safe hormonal birth control is, women shouldn’t be required to visit a physician merely to get a prescription to provide relief from one of these illnesses.
While women bear the brunt of these unnecessary medical regulations, the costs associated with the current birth-control policy weighs heavily on taxpayers, too. In 2010, the public funded the medical expenses associated with over 72 percent of unplanned pregnancies in Arkansas, which cost taxpayers over $328 million — nearly $62 million of which was funded by Arkansans. Considering that many of these unintended pregnancies could have been prevented with easier birth-control access, Rep. Pilkington describes the current system as “fiscally irresponsible.”
The simple truth is that women shouldn’t have to visit a doctor to obtain basic birth control. “I trust women to adequately take medication, and so should others,” says Rep. Pilkington. “Many countries even permit women to obtain birth control over the counter. It’s simply a nonissue in those places.” Indeed, pharmacists are capable of safely and competently completing the same activities that doctors perform before prescribing hormonal contraceptives — namely, listening to a patient’s self-reported medical history and taking her blood pressure.
The pharmacy access model shows great promise in the United States, where it has been successful in many states. It reduces regulation, expands consumer choice, provides women with better health-care access, and has the potential to save millions of taxpayer dollars. Most importantly, it does all of this without increasing any risks. Indeed, it’s a solution in which everybody benefits.
Image credit: V_L