Conference turris::womannotes-v2

     I am not convinced that it is Digital's responsibility to pay for
    birth control pills, condoms, diaphragms, sponges etc. It seems
    to me that if it is an important enough priority to you, you'll
    spring for the $10/month to cover the charge. Perhaps a better solution
    would be organizing a corporate wide buying effort to get the pills,
    etc at a group rate (discount).
    
    -E

Yes, I complained. I knew my personnel person was sympathetic, so I got her
promise to complain to the next level. And I left it at that.

On the one hand, I do miss the Health Maintainance aspect of my HMO. On the
other hand, I knew what I was getting into when I switch to John Hancock
(which, by the way, is being called Dec something-or-other now, but is still be
administered by JH). I needed the flexibility.

So, if you want the pill subsidised, join an HMO. But do discuss your needs
with a person in a position to give that feedback to the right people.
	Mez

    
    Please correct me if I am wrong, but doesn't John Hancock cover
    abortions?  
    
    I know they pay for tubal ligations!  80/100% coverage! I believe the 
    doctor would contact the insurance company, stating that the individual
    is emotionally unable to handle another delivery.  
                                            
    
    Maria

    I always thought that medical coverage wa to pay for fixing things
    that were broken. I did not think that being able to have babies
    was a medical problem (ie. A woman who can have babies is 'broken'?).
    
    			Alfred

    If men could get pregnant, would they then understand why it's
    important for birth control to be covered by insurance?
    
    

    
    I belong to the HMO connected with Southboro Medical Group
    (Mass).  I only had to pay $3.00 for my birth control pills.
    Five years ago when I joined HMO, the pharmicist told me
    that the above HMO was the only HMO to include Birth Control Pills.
    I'm not sure if that is the case now.
    
    
    That was one of the major reasons why I joined HMO.  The pills
    had gone up to $15.00 a month at that time (Just curious, 
    what are they now?).
    
    Kathi
    

    
    
    Re: .3  Abortion really isn't an ALTERNATIVE to birth control (!)
    so I think it's comparing to apples to oranges to say DEC covers
    one, why not the other. 
    
    On the issue of infertility, I agree with the point made that
    infertility is a medical condition that needs to be cured. I don't
    see why paying for this service means that DEC should pay for birth
    control. 
    
    Roberta
    

   As for the $10 a month, try $15 * 12 = 180/yr.  It wouldn't
   hurt me much, since I'm on the engineering pay scale, but
   I can imagine that it does hurt families on a more limited
   budget.  And if you're on a limited budget, reliable birth 
   control may be a necessity, not a luxury.

   Re .3  Even if the Digital plan does cover abortions, I 
   wouldn't consider abortion a form of birth control.
   (Please, let's not go down the garden path discussing
   whether it is or isn't.)

   Re .4  The Digital plan pays for other things that
   could be considered "preventative health maintenance."
   How about those physicals every 5 years -- up to $150
   dollars worth?  And now pap smears and mammograms 
   (at least they're in there finally!).  I know lots of 
   people who use their chiropractors on a regular basis to 
   keep their back in line -- I consider that preventative.  

   Whether or not Digital will pay for birth control
   doesn't effect me much personally.  However, I happen
   to believe Digital should cover it, and I've raised
   it as an issue to personnel.  I'm glad to hear that
   at least one other person has done the same!
   

    
    I belong to Harvard HMO and birth control pills are the only 
    medication I have had to pay full price $15.00 for.  Though
    the last time I got them the clerk only charged me $3.00.
    I think she messed up because she was new.
    It does seem strange that this medication is not covered.
    Does anyone know the answer why?
    
    Michele

    On the purely practical side, since insurance does pay for abortions
    and births, it is easy to make a case for birth control as
    "preventative maintainance" -- pay for pills now, or pay for a
    delivery later.  It's the same argument as covering regular dental
    visits -- it's cheaper than paying to have cavities filled.
    
    (On the other hand, I suppose they figure that a woman's decision to
    use birth control or not probably won't be influenced much by
    whether it's paid by insurance, so why spend the money.)
    
    	-Neil

    My HMO does cover the cost of all prescriptions including BC pills
    - it was one of the reasons I joined.

    
    re .8 about physicals being covered
    
    Physicals, as you said, are preventive health maintenance. Getting
    pregnant does not (generally) cause adverse health consequences.
    So I don't think the analogy holds.
    
    Roberta
    

    The question  here  is  what  John  Hancock  is providing. If it's
    insurance  (i.e. coverage for costs that I don't plan and couldn't
    afford  to  handle myself), then there is no reason to cover birth
    control, as it is planned, and having JH cover it just adds to the
    cost  by  adding  one layer of paperwork. Insurance can reasonably
    cover  Pap  smears,  mamograms, and the like because it saves them
    money in the long run.

    If on the other hand, JH is providing "Health Care" then one could
    reasonably  expect  them to provide birth control. But should they
    provide  spermicide and condoms or just bc pills? I also need food
    to maintain my health, but I don't expect JH to pay for it.

    My feeling  is that an HMO should provide birth control as part of
    health maintenance, but insurance need not provide it, as bc is an
    expected cost, and shouldn't be insured against.

--David

    ps. To  answer Liz's concern, I have habitually shared the cost of
    birth control.

    The underlying question appears to be this: do you view insurance
    as a safety net, to provide protection against disasters you
    can't anticipate or afford?
    
    Or do you view it as an alternate source of income?
    
    The same question applies to automobile insurance, home insurance,
    etc. If everybody who could afford to pay $1000 to fix their
    cars had a $1000 deductible, overall insurance rates should come
    down substantially.

RE: .13, .14
    Those  notes  were  entered  independently, interesting since they
    agree strongly.  I wish my note was worded as well as Paul's.

Re: .12
    Pregnancy  is  risky.  Until  this  century some large fraction of
    women  died in childbirth (1/3, 1/2, I don't remember exactly.) It
    is still somewhat risky, but much less so.

--David

    
    re .15
    
    I am aware that pregnancy is risky, but not getting pregnant cannot
    be considered maintaining good health the way getting a checkup
    can. Getting pregnant does not directly effect your health.
    Diagnosing disease early DOES effect your health directly. At
    least JH believes so or they wouldn't pay for physicals.
                      
    Roberta
    
    

    re: .7 and .12
    
    I view medical conditions as 'needing' to be cured as ones that
    impact a person's health.  Infertility is not life-threatening or
    debilitating, and most of the fertility 'experts' are using very
    expensive and heroic efforts that they full well know have a remote
    chance of producing pregnancy.  I'm not talking about fixing blocked
    tubes or saving sperm via freezing to then use in a concentrated
    dose to increase chances of fertilization.  The heroic measures
    such as repeated attempts at in-vitro fertilization and transplanting
    embryos, etc. at $5,000+ an attempt, over and over again.  Being
    able to produce one's own biological children is not an inalienable
    right, and these heroic efforts drive up the cost of health insurance
    for everyone, even when the cost rarely produces the intended results.
    
    So the analogy not holding up in comparing not paying for birth control
    but paying for physicals works in the same way re: infertility
    treatment.  There are no adverse effects from not being able to
    conceive, and I would imagine that the risks are greater, even today,
    in carrying a pregnancy to full-term.
     

	re .4

 	JH pays costs associated with births, and I don't think most
	folks consider a woman who is having a baby as "broken".

	If DEC decides to cover costs of BC pills, I hope they will
	also cover costs of other forms of BC as well.

							Tom_K

    BC pills are a perscription medication. Insurance does not
    pay for non perscription medications so I see no reason for
    it to pay for non perscription contraceptives.
    
    Bonnie

    RE: .19 There are various non prescription drugs that Doctors
    tell people to use. Some of them are costly especially in large
    doses and over long terms. I would like to see JH cover some of
    those things. Especially for people with large families and small
    budgets. While I don't think that insurance should pay for
    contraceptives if they must then funding less expensive non
    prescription contraceptives sounds like a good idea. Having Doctors
    prescribe (for example) prescription strength pain killers when
    double doses of Advil would do just so that insurance will pick up the tab
    is not always a good idea. Likewise for contraception. Especially
    when the long term health impact of BC pills may be so much more
    severe then say condoms.

    			Alfred

    re .13 (by david w)
    
    > Insurance can reasonably cover  Pap  smears,  mamograms, and the like
    because it saves them money in the long run.
    
    hmm. i would think that paying for birth control would save money
    in the long run too. not only is raising a baby expensive (medically)
    but think of all the time that parents ordinarily take off from
    work!
    
    and the concerns i raised earlier were actually not monetary in
    nature. the attitude that i detected (and perhaps i misinterpreted)
    was that preventing pregnancy was not really an important issue because
    it's a woman's issue.
    
    liz

more on tangents:

I believe doctors can perscribe non-perscription things like humidifiers,
dehumidifiers, and so on, and then health insurance will pay some percentage.
	Mez

  It seems to me that it would work to both John Hancock's
and DEC's advantage (financially apeaking) to pay for birth control (either
presciption or non-prescription).

It's much less expensive for JH to pay for the pills (and I'm
sure _they_ don't pay the retail price we pay), than to pay
for a pregnancy test, pre-natal care, an obstetrician's fees,
delivery room fees, hospital room room-and-board fees, anaesthesisa, 
pain-killers, pediatrician's fees, the new-born's hospital fees, 
mom's short-term disability, etc., etc.

And for DEC, the money they lose in people not working on their
projects because they're out at the doctor or recovering from
giving birth, or on parental leave must be greater than the cost
of getting JH to cover birth control costs.

I've always assumed that it's because they (JH and DEC) think people will be
upset if they "condone" the use of birth control. It's the only
semi-logical reason I can come up with.

RE: .23 (and a few others)

    The assumption  here  is  that  if  JH  (or  DEC)  doesn't pay for
    contraception,  all  the  women  in  the company will get pregnant
    tommorow. I don't buy it. I think that (almost) everyone here will
    choose when to have kids, and that the cost of birth control won't
    enter into that decision. The disinction between bc and pap smears
    is  that  one  can  argue that many women won't get pap smears (or
    mamograms)  unless there is some support, and that offering to pay
    for  pap  smears  will  increase the number of women who get them,
    while  offering to pay for birth control won't decrease the number
    of  women  who  get  pregnant.  Among professionals, I believe it.
    Among  high  school  girls,  I  believe  that  offering free birth
    control   really   will  reduce  the  number  of  pregancies.  The
    differences  are the amount of disposable income and the change in
    maturity.

--David

.9�< Note 414.9 by BPOV06::MACKINNON >

    Michele, 
    	I'd double check with your pharmacy.  I belong to Harvard as
    well, and only pay $3.00.  This was true at the Medford center
    (which had its own pharmacy) and at Acton Medical Assoc (which is
    on the network prescription plan).  Mine were prescribed for medical
    reasons, but the pharmacists never knew that...all they saw was
    a piece of paper with a prescription.
    
    AbG

    If you don't think that they should pay for such "optional" items
    such as birth control, you might want to reconsider why they should
    provide health insurance at all.  After all, if they didn't, how
    many of us would really be without medical care?  We could buy our
    own insurance or choose to be self insured.  Most of us have enough
    money to pay the non-catastrophic medical expenses we run across.
    Besides, they do pay for such optional proceedures as nose jobs
    and face lifts.
    
    The economic reason for it is simple - they can get it at a group
    rate, we don't have to pay taxes on it since it's a benefit, and
    most of us will want it.
    
    You can use this same reasoning for birth control.  Most women want
    to use some form of birth control, it could be paid for at the group
    rate, and not be a taxable part of our salary.  But I guess this
    isn't important enough to worry about...
    
    Elizabeth
    

    It could be argued that the use of birth control is primarily a
    lifestyle decision, rather than a medical decision.
    
    The "just about everyone uses it so they should cover it" argument
    doesn't convince me.  The same argument could be used for including
    soap, toothpaste, bandaids and any number of things.
    
    Finally, Digital and health insurance companies are primarily in
    the business of making profits, not making life's road smooth and
    cushy for employees/subscribers.

    
    As with most things covered by health insurance, the more likely it is
    that members of a group will want or need it, the less it will be
    covered.  Why do you think that most dental coverage is so skimpy?
    As the likelihood of people electing a certain treatment approaches
    near certainty, coverage drops for that treatment approaches (and
    reaches) zero.  It also true that, when so many people want it a
    treatment, it is usually quite inexpensive.  Fifteen bucks a month is
    chicken feed.  I currently take medication, which, if I had to pay for
    all of it, would cost me hundreds of dollars per month.
    
    Unless they are being used to deal with some health condition, birth
    control pills are an "elective" treatment.  The only reason that
    they're prescription medication is that they cannot be safely used
    without medical supervision.  This argument that they should be covered
    by health insurance is pretty lame.
    
    							-- Mikey

    But they *do* pay for other elective treatments - as I brought up
    before, face lifts, nose jobs, chiropractic adjustments.  They will
    also pay for smoking cessation, drug and alcohol rehabilitation,
    sterilization, fertility treatments, adoptions, abortions, and normal 
    births.
    
    Why not ordinary birth control when they will pay for these other
    elective and lifestyle oriented treatments?
    
    The "The more likely you are to use it..." statement really doesn't
    hold here, especially on the maternity benefits.  The majority of
    employees will either have or adopt children sometime during their
    career.  The majority of employees will have a certain amount of
    cavities filled.  For that matter, sometime during our lives, we
    will probably all have a broken bone.
    
    And I agree, that many people (including myself) need glasses in
    order to do our jobs, which should be a higher priority than any
    problem not directly related to our ability to work.  I really don't 
    understand how they decide what to cover and what not to.
    
    Elizabeth                  

Does anyone _really_ know how our (DEC) health insurance is determined? (I
don't mean to stop the speculation - go right ahead! But I hope folks with real
knowledge will so indicate).
	Mez

    When I first read this note I was puzzled, because John Hancock USED
    to pay for contraceptive pills; unless my memory is extremely flaky.
    When Hancock changed from the method of submitting prescription
    receipts to PCS, ANY prescription medication could be purchased
    with the PCS card.  Am I remembering correctly?  If so, when did
    this change?
    
    I would also be curious to learn if the PCS card could be used to
    buy Rogaine (minoxidil), prescribed to restore hair to balding men.
    If so, and if contraceptives are disallowed, I'd say there's a 
    serious breach of fairness here.
    
    In my view, contraceptives should not be treated differently from
    any other prescription medication, especially since in many cases,
    such as Beth's, they are prescribed for purposes other than
    birth control.
    
    				Steve

Thanks for bringing up this subject, Beth.  It answered the question to which
I wanted an answer.

I have been covered through the Harvard HMO (or whatever their name is now) for
the past nine years.  I remember in the beginning it was only $1 a month, and
they would even give you 12 months worth at a time (saved trips if you were far
from the center (where you had to go for your prescriptions) as I was.  Now it
is up to $3 a month and you have to go to a neighborhood pharmacy, and can only
get a month at a time.

So much for history.  I am changing over to Digital insurance (or whatever
they call THAT now!) for "other" reasons, and now have my suspicion confirmed,
that, at least for now, I/we will have to pay "full price" for my pills.

As much as I would love to save the extra $12 a month, and as much as I agree
with those (like Elizabeth) who would like some consistency in what Digital
will and won't cover, and as much as I might complain about this and that
expense whereas everything was nicely paid for under the HMO, I am grateful
that we have as good insurance (and choices) as we do have.

Jill, who's been going through a lot of this lately!

	 To my knowledge (please correct me if I am wrong), but John
	 Hancock (the insurance company in question here, i believe)
	 services other companies/people besides Digital.  Please
	 don't call this 'Digital's Insurance'...DEC offers us many
	 options.  I, for one, get my pills at $3 a month, just like I
	 would any other prescription--as part of my HMO.

	 Not paying for BC pills and other things are not 'Digital
	 policy' but John Hancock policy and should be taken up with
	 them.

	 kathy

    	RE:  .34
    
    	Kathy, we are not insured by John Hancock, but rather by
    	Digital itself (as a company.)
    
    	They only use John Hancock to help with the paperwork (insurance
	forms, collecting money, etc.)
    
    	The real insurer is Digital.
    

    re last several, esp, "whatever its called now"-
    
    "Benefits Bulletin", January 1989
    "For US Employees of Digital Equipment Corporation"
    
    "...
    On April 1 the name of our medical program will change from the
    John Hancock Medical Plan to the Digital Medical Plans (Plan 1 and
    Plan 2).  This new name reflects the fact that Digital's and your
    contributions fund our program and that it has changed.  John Hancock
    Mutual Life Insurance Company will continue to administer the Digital
    Medical Plans."                                    
    
    This thing came in the mail a few days ago from Corporate Compensation
    and Benefits, CFO2-3/C17, Managing Editor Agnes Buchanan.  I suspect
    everybody will see it soon, but if you don't go to your local personnel
    rep...it has 6 pages of descriptions of the changes, and will affect
    EVERYBODY who doesn't use an HMO.
    
    DougO
    

    	RE:  .36
    
    	Thanks, Doug!
    
    	Although the name is changing in April, we (Digital) have
    	been "funding" it for some time (I forget how long.)
    
    

     Like every company, Digital apportions some percentage of its
    operating budget for employee compensation. Whenever a new benefit
    is given to the employees, an amount corresponding to the cost of
    this benefit is no longer available to be used for the weekly
    compensation we all get that comes in a blue envelope. Would all
    of you be willing to have your next pay increase lowered by the
    amount necessary to offset the increase in benefit costs caused
    by Digital paying the bill for you? This is what would happen, ven
    though no one is going to tell you about it come review time. In
    addition, all other employees would also be affected. I'd rather
    see Digital pick up the cost for eyeglasses (non-gender specific).
    I also don't see any reason why the cost of hair replacement, etc
    should be borne by the company (read us). That is a personal decision
    about how you live your life.
    
    The Doctah

    What I can't understand is, why would DEC pay thousands of dollars
    to have a baby, pay for all the medical cost (okay, 80% of it) of
    raising a baby, but won't help in the cost of preventing the baby?
    
    In the realm of dollars and cents, it just doesn't make sense...

I don't know exactly what the cost ramifications are, but consider the cost
of adding 100,000 employees times $144/year to the budget. It seems  like
a big cost. As to whether it costs more or less than supporting the medical 
costs of a child, I am not sure. Perhaps if you could show a savings to the 
company in terms of dollars spent, it would be easy to get company supported
birth control adopted as a standard benefit.

The Doctah

	 thanks for the clarification...I didn't realize DEC was the
	 insurer.  NOW the situation raises quite a few more questions
	 in my mind.

>>    "Why doesn't Digital pay for birth control?"  ...


	 has anyone called to ask about why they don't or are we just
	 making guesses?  I'd call but I don't know who to call, and
	 it doesn't affect me anyway (HMO).

	 it seems to me that DEC is 'supporting birth control' by
	 allowing my HMO to cover it.  Isn't that a round-about way of
	 supporting birth control?

	 My BC Pills are prescribed for a medical condition...BC is a
	 mere side affect of them.  Shouldn't  DEC at least cover this
	 situation?

>>	100,000 employees by $144/yr

	 i don't think the impact is that high...there aren't THAT
	 many on BCPills are there?  BC Pills are a prescription only
	 drug, its understandable that DEC won't buy your condoms or
	 your sponges, but BC Pills should be treated as
	 any other prescription drug, shouldn't they?	     

>>	supporting building a family

	 some DEC sites have day care centers as part of their
	 facility.  Other DEC sites arrange for outside day care
	 centers to give DEC employees discounts.  At least at our
	 site it is like this...

	 kath

    I asked my pharmacist what wasn't covered by Matthew Thorton.  The
    only things she could think of off hand were BCPs and insulin syringes.

    To answer my earlier question, I asked my pharmacist about what was
    and was not covered by PCS.  There is a code on the PCS card next
    to the letters PCS that indicate what "plan" you are in.  We are plan
    143, and indeed the first "not covered" item listed is contraceptive
    pills, whether or not prescribed for medical reasons.  I did not
    see any reference to drugs such as Rogaine, but the pharmacist told
    me that none of the medical plans she was familiar with would pay
    for Rogaine, the general opinion being that it was not a medical
    necessity (and I agree).
    
    
    Regarding the earlier comment about "100,000 employees times
    $144/year", well I and probably most other men wouldn't bother trying
    to collect for birth control pills. If they want to pay for my condoms,
    though, that's another story...
    
    You can argue the point about DEC "supporting" any part of a range
    of beliefs, depending on where you stand.  Consider the whole
    idea of medical benefits as viewed by a Christian Scientist,
    for example.
    
    
    You can argue cost benefits all you want, but the sad truth is that
    logic and rationality flies out the window when questions relating
    to "controlling" sex come into play.
    
    				Steve

    My BC pills are covered, because they're prescribed for a
    medical condition.  I have to fill out a form, the pharmacist
    has to sign it each time, etc.  But it does get paid for.
    (BTW, my pills cost $19.40/4-week period, or ~$250/year...) 

    Muddying the waters...a handful of insurance carriers will
    pay for a portion of glasses.  But DEC's is the *only* policy
    I've ever seen that covers hearing-aids. The hearing-aids
    most useful to me cost $450 apiece (I wear two), have been
    increasing at 5-15%/year, and need replacing every 5-10
    years, about as often as glasses.  Guess it just shows
    insurance carriers, like everyone, are in business for $, not
    out of the goodness of their hearts--or our wishes.  Sigh.

    -- Linda 

    In reply to .28
    
    
    Dec does cover our eyeglasses in this plant.  As a matter of fact,
    every Friday we have an eye doctor come in for 2 1/2 hours.
    
    Our plant is a factory.  And it is mandatory that when you are
    out on the floor, you must wear safety glasses.  Henceforth,
    the reasoning behind the prescription eyeglasses.