Commentary: Birth control should be as easy to buy as cold medicine
As early as 2014, the National Campaign to Prevent Teen and Unintended Pregnancy called counties where underprivileged women do not have reasonable access to state-funded birth control “contraception deserts.” While health care for those in need is a critically important issue, there are other forms of contraception deserts that haven’t received the appropriate attention.
Across large swaths of the United States, even women with the financial means to obtain contraceptives cannot easily do so, thanks in part to bad public policy. This is especially true in Texas, where the consequences have been severe. The Lone Star State has the nation’s seventh-highest teen pregnancy rate. Moreover, nearly 60 percent of Texas’ total pregnancies were unintended in 2010, resulting in 298,000 unplanned pregnancies — far higher than the national average.
Every unplanned pregnancy places an incredible burden on mothers and taxpayers, forcing many lawmakers to seek solutions. While reproductive health care often gets mired in partisan bickering, the answer to this problem lies in a commonsense solution: freer markets and less regulation.
Sen. Borris Miles, D-Houston, seems to agree. He recently sponsored legislation that would allow women to bypass doctors and get their birth control directly from a pharmacist under a standing medical order from the state government. Such a measure would greatly benefit Texas.
According to the current law, if a woman wants to obtain hormonal contraceptives, she must set a doctor’s appointment, where her physician will check her blood pressure and ask her about her medical history to identify any contraindications. Only after doing so can she receive a prescription, which she must subsequently take to a pharmacist to fill.
One of the primary problems with this outdated model is that it forces women to rely on expensive and increasingly hard-to-find intermediaries: doctors. This poses a problem for a variety of reasons. First, doctors aren’t always easy to come by in Texas. The state has the 10th-lowest physician-to-population ratio. In fact, 147 Texas counties have no OB-GYNs and 35 have no physicians of any kind. What’s more, the doctor shortage is getting worse. Requiring women to visit physicians, who might be many miles away, for a time-tested medication discourages them from obtaining birth control.
Second, physicians’ visits aren’t cheap or quick. This is a serious concern because Texas has a 15 percent poverty rate, meaning many women cannot pay for a doctor’s appointment. Others simply do not have the time or cannot afford to take time off from work to visit with a physician.
The consequences of limited access to hormonal contraception are unplanned pregnancies. Unsurprisingly, the women who cannot afford doctors’ visits to obtain birth control cannot afford the medical costs associated with pregnancy. As a result, the government frequently foots the shockingly large tab for their medical care. In fact, in 2010, Texas pregnancies cost taxpayers $2.9 billion.
Like so many others, Sen. Miles has recognized the need for smart health care reform. That’s why he’s advocating an innovative solution that removes unnecessary obstacles from the equation and allows pharmacists to directly prescribe contraceptives to women. This eliminates the time and cost of a doctor’s visit for women seeking birth control. Moreover, the level of care that women receive would not suffer under Sen. Miles’ proposal; women would still be required to consult with pharmacists before receiving medication.
Indeed, hormonal contraception has long been shown to be both effective and safe. Even the American College of Obstetricians and Gynecologists advocates for over-the-counter access to birth control.
Meanwhile, numerous red and blue states have enacted this model with great success in the last several years. Knowing this, Texas is at a crossroad. The state currently requires women to clear unnecessary hurdles to obtain basic birth control, and the consequences of these requirements have been devastating. Texas could maintain this status quo to the detriment of its residents, or the Legislature could adopt a new paradigm that will reduce unintended pregnancies and the taxpayer burden. Objectively speaking, the answer seems clear.
Image credit: i viewfinder
