Thursday, March 15, 2012

The (other, other, other) flaw in the Arizona birth control bill

As anyone who's spent five minutes on the internet in the past few days knows, they're trying to pass a bill in Arizona requiring people who want oral contraceptives covered by their employer-provided health insurance to prove to the employer that it's being used to treat a medical condition rather than to prevent pregnancy.

Apart from the four or five layers of inherent problems, there's another problem: any oral contraceptive that is not unsuitable for the patient is providing medical benefits other than contraception.

All oral contraceptives help with dysmenorrhea, menorrhagia, and menometrorrhagia. Because diagnosis for these conditions has subjective elements (such as "interferes with daily activities"), any patient who finds that the pain, heavy flow or unpredictability of her period interferes with her life can rightfully seek this diagnosis. And any doctor whose patient states that her period is interfering with her daily life can rightfully give this diagnosis.

Furthermore, contraceptives are generally the treatment of first resort for patients with menstrual complaints for whom they are not contraindicated. It can even be a step in the diagnostic process - try this and see how you respond. Even if it ends up the cause of the menstrual difficulties is something completely unrelated that isn't treated with contraception, the patient will most likely end up taking contraception, at least temporarily.

In short, this bill will have no impact whatsoever on the amount of contraceptives legitimately and rightfully prescribed and billed to employer health plans, while introducing a needless layer of red tape that violates existing US health privacy standards. Even if the intention were worthy, this still wouldn't be a good use of resources.

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