A big step forward for women's health

Perhaps lost in the cacophony of the debt ceiling debate in Congress was news that the federal government will now require insurance companies to provide a substantial list of preventative care measures for women, including mammography, domestic violence counseling and breast-feeding support, without requiring a co-pay or a deductible.

If you heard anything at all about this, it was probably conservatives complaining that the list also includes birth control pills and the dreaded morning-after pill, which interrupts the fertilization cycle before a fertilized egg can attach to the uterine wall. Conservatives and those with strong religious points of view oppose the use of their insurance premiums to provide services to which they are morally opposed.

It is a shame that the objections focused on free birth control pills, to the exclusion of so many other medical services that will soon be provided to women without charge.

They include regular well-woman visits (much like the "well-child" visits to which we have taken our children for so many years), immunizations (of which there are several new ones for adults), colonoscopies, cholesterol checks, counseling for sexually transmitted diseases and flu shots, just to name a few.

But, as I said, the focus was on The Pill.

Birth control pills cost about $50 a month, an expense deemed prohibitive by many women who become unintentionally pregnant. The Guttmacher Institute says 95 percent of unplanned pregnancies are to women who report using contraception only occasionally or not at all, often because of the cost.

Granted, there is a personal responsibility component in these unintended pregnancies. Daily pill taking often falls through the cracks in the chaotic lives of teens and young women, and there is plenty of "it won't happen to me" out there, too.

But uncomplicated pregnancy and delivery can cost upward of $7,000. And that is just the down payment on the price of raising a child — or the social costs if that child is born into a poor or single-parent family, or to a teenage mother.

A year's worth of birth control pills is small change by comparison, so the argument that this service increases the cost of health care at a time when the nation is trying to cut those costs just doesn't add up.

What this list of services does do is send a very strong message that we value the health of women in this country and we recognized their pivotal role in the health of their families.

In the majority of families, women make most (if not all) the health care decisions for their children and even many of those decisions for their husbands. They are enormously influential in the health care decisions of their parents and their siblings. Even their neighbors.

It will be a while before these services are available to all women. The order from the department of Health and Human Services does not take effect until Aug. 1, 2012, and then it only applies to new policies or ones that are changed substantially. But in time, all insurers and all employers will be providing this preventative health care to women.

The key word here is preventative. You can provide free colonoscopies to women, or you can pay for colon cancer. You can provide free mammograms, or you can pay for advanced breast cancer. You can provide birth control, or you can pay for an unwanted child. You can provide STD and HIV counseling, or you can watch those diseases spread. You can provide domestic abuse counseling or condemn a woman and her children to remain in a violent household.

At the end of the day, this is more than just about making women feel loved and appreciated by providing preventative health care for them. It is about keeping the wives, mothers, daughters and sisters of this country on their feet and caring for the rest of us, or opening up a lot more hospital beds and maybe a few more graves.

Susan Reimer's column appears Mondays. Her email is