A bitter pill

Last summer, the reproductive freedom of American women was very nearly eviscerated.

Ortho-McNeil, the primary manufacturer of oral contraception in the United States, approved an 1,800-fold increase in the price at which it sold birth control to family planning clinics. While Ortho-McNeil had once charged clinics around a penny a pack, under its new pricing scheme clinics would have to pay up to $18 for a month's supply of birth control per person. Under the old price, clinics like Planned Parenthood could distribute pills to women who lacked health insurance for next to nothing. The cost hike forced clinics to raise their own prices beyond the means of many of the poor and uninsured women that the clinics catered to. Thankfully, women's health groups lobbied Ortho-McNeil to reconsider, and in August the company announced that it would cut prices to "only" 320 times the original cost, with pills maxing out at $3.20 a pack. While the compromise comes as a relief, the 320-fold increase has put pressure on the already underfunded clinics to cut costs, and some clinics say that they will be forced to lay off staff and reduce their hours in order to make ends meet.

Of course, we at Princeton are protected against such arbitrary market forces by our health insurance, right? Wrong. The Princeton University Student Health Plan does not cover oral contraception, and at the new "discount" price, many undergraduates may find themselves unable to purchase it for themselves. Even without considering the recent price hike, there is no adequate justification for University Health Service's refusal to pay for oral contraception for insured students.

Oral contraception allows women to have complete control over their bodies and their future. It gives women the sexual freedom that men have always had, and there's the rub. UHS considers oral contraception to be a "lifestyle" drug that isn't medically necessary. In the 2006-2007 Student Health Plan Benefits Summary, oral contraception is excluded from coverage in the same clause in which "drugs used for cosmetic purposes or for weight loss" are excluded. This is patently unjustified. First of all, UHS covers athletic injuries, though playing on a sports team is a "lifestyle" choice that no one is forced into. Secondly, an unintended pregnancy can have disastrous consequences for a female undergraduate. Just as UHS covers immunizations and other preventative medicines, so too should it protect students from an unwanted fate that may involve dropping out of school and relinquishing career plans. Thirdly, oral contraception's benefits extend beyond avoiding pregnancy. Doctors prescribe oral contraception to lessen cramps, regulate menstrual cycles and combat anemia. Oral contraception is not just a medical convenience; many women use it to protect their health and to maintain their quality of life.

Even the Anscombe Society should support the coverage of oral contraception. Whether or not one is in favor of a woman's right to choose, almost everyone would agree that reducing the number of abortions that occur is a good thing, if only because abortions can be dangerous and traumatizing for the mother. Studies have repeatedly demonstrated that increased access to birth control leads to fewer unintended pregnancies and hence fewer abortions. Abortions among Princeton students are rare but not unheard of. In 1999, the last year for which data is publicly available on the Internet, there were 55 reported pregnancies on campus (including undergraduates, graduate students and their dependents). Fourteen of these were referred for abortions. Insurance coverage of oral contraception can help decrease that number.

Some may say that this reform is not needed. With pills on sale at UHS for under $10 a month, does anyone really need insurance to cover it? Unfortunately, yes. Over the course of a Princeton education, a woman may have to spend hundreds of dollars on the pill, which not everyone can easily afford. Furthermore, as happened over the summer, its price can fluctuate rapidly, making continued access to the pill more difficult. Princeton students should not have to worry about these issues in order to maintain their bodily freedom and integrity. The Princeton University Student Health Plan ought to cover oral contraception. Jason Sheltzer is a molecular biology major from St. Davids, Pa. He can be reached at sheltzer@princeton.edu.