Contraceptives should be classified as preventative health care for insurance coverage

Hi Beverlee! Thanks for accepting this debate. I just want to clarify that the scope of this debate is strictly on whether all contraceptives should be classified as preventive care, not preventive care in general nor reproductive health, which has a larger scope than just contraception.For the purpose of this debate, I am defining preventive care as "a pattern of nursing and medical care that focuses on disease prevention and health maintenance. It includes early diagnosis of disease, discovery and identification of people at risk of development of specific problems, counseling, and other necessary intervention to avert a health problem. Screening tests, health education, and immunization programs are common examples of preventive care."(1)Preventive care consists of two basic functions:1. disease prevention 2. health maintenanceSome common methods of attaining said functions are:1. Screening and early diagnosis/identification2. Education and counseling3. Proactive prevention methods such as immunizationsAs you can agree, that is a pretty broad definition and there are definitely some aspects of contraception that can fall into preventive care. However, contraceptives as a whole does not meet the definition of preventive care. FDA-approved methods of contraceptives are "hormonal (e.g., birth control pills), barrier (i.e., diaphragms), emergency contraceptives (i.e., "morning after" pills) and select over-the-counter (OTC) contraceptives."(2) "Certain OTC contraceptives for women are covered at 100 percent including female condoms, emergency contraceptives (Next Choice", Next Choice One-Dose", Plan B One-Step"), and contraceptive film, foam and gel."(3) I will structure my argument around the function of preventive health care and relate it to the 3 FDA-approved functions of contraceptives (as OTC contraceptives fall into one of those three categories).A. Disease PreventionOne type of barrier contraceptive (condoms) does assist in preventing the spread of Sexually Transmitted Diseases (STD). However, that is just a secondary function. I will argue that STD prevention is not a critical objective for preventive health care, the primary purpose of contraceptives is not disease prevention, and the decision to have sexual relations is a privilege, not a right.Point 1: STDs are not considered a critical objective to preventive health careI would like to highlight some diseases on the CDC website for Preventive Screening recommendations by the U.S. Preventive Services Task Force (USPSTF):(4)1. Alcohol Misuse2. Chlamydial Infection3. Hepatitis B only for pregnant women4. HIV only for high risk persons5. Obesity in Adults6. Tobacco UseHep B and C are on the list but the USPSTF only recommends Hep B screen for pregnant women and does not recommend or is neither for nor against screening for Hep C. Also, there is a distinct absence of other STDs, such as gonorrhea, meaning that STDs, in general, are not considered part of the preventive care regimen. Point 2: The primary purpose of contraceptives is not disease prevention but pregnancy preventionSee definition of contraceptive. Also, the majority of FDA-approved contraceptives (hormonal, barrier other than condoms, and emergency) do not prevent disease. "The condom is the only form of birth control that also protects against sexually transmitted diseases, including HIV (the virus that causes AIDS)."(5)Point 3: Sexual activity is a choice, thus the use of condoms is a responsibility, not privilegeThe decision to be sexually active is a privilege, not right. In fact, abstinence is the only way to prevent the spread of STDs.(6) Just like purchasing care insurance, the cost of condoms for the purposes of STD prevention is the responsibility of the individual. While I fully agree that counseling for obesity or tobacco use should be included as preventive health care, the cost of tools such as gastro-bypass surgery and Nicotine patches are NOT covered by most preventive health care insurance nor required by ACA as preventative coverage. Review the Cigna Preventive Drug List and there is no category for weight loss or tobacco cessation.(7) Therefore, counseling and education on STDs should be covered by preventive care but not contraceptives such as condoms.I do not support full coverage of condoms under the guise of preventive health. Like the cost of maintaining a healthy lifestyle (gym membership, more expensive organic foods), using a condom is a personal responsibility.B. Health MaintenanceThis will probably be a greater point of contention in this debate as there are direct health benefits to the use of some contraceptives for specific individuals. I will argue that contraceptives as a whole do not promote health maintenance because only a few hormonal contraceptives help regulate health in specific circumstances and the use of contraceptives may actually be a health detriment.Point 1. Contraceptives used for health maintenance is limited to specific circumstances and typesOral birth control pills can help regulate numerous issues such as acne(8), premenstrual dysphoric disorder (PMDD) (a debilitating form of PMS)(9), ease menopausal symptoms/discomfort(10), and even help prevent osteoporosis(11). However, each of these are only representative of a select group of hormonal contraceptives and health situations. Not all hormonal contraceptives are helpful in each of these specific cases. Other contraceptives have no bearing on an individual's health whatsoever. For the sake of clarity, becoming pregnant is not a health maintenance issue for a normal, healthy woman.Point 2. Use of contraceptives can actually be a health detrimentAccording to the World Health Organization, "the birth control pill increases a woman's risk for cancers of the breast, cervix and liver, but it decreases risk of endometrial and ovarian cancers."(12) Additionally, hormone imbalance is an issue where women may experience "anxiety, loss of appetite, insomnia and lack of concentration...sudden weight gain, a reduced sex drive, hot flashes and night sweats"(13) While there are several factors that can contribute to hormonal imbalance, "more commonly, medication such as birth control pills can also throw off your body's chemistry."(14) Other potential side effects of oral contraceptives "may include severe abdominal pain, chest pain, unusual headaches, visual disturbances, or severe pain or swelling in the legs"(15) as well as "sexual, metabolic, and mental health consequences."(16)Contraceptives were never designed to be a health maintenance tool. I would support the limited use of certain oral contraceptives to assist in regulating hormones as a preventive health resource, but not all contraceptives in general.(1) http://medical-dictionary.thefreedictionary.com... (2) http://www.uhc.com..., Page 1(3) ibid.(4) http://www.cdc.gov...(5) http://medical-dictionary.thefreedictionary.com... (6) http://www.webmd.com...; last bullet: Consider that not having sex is the only sure way to prevent STDs.(7) http://www.sjcme.edu...(8) http://www.webmd.com...(9) http://www.mayoclinic.com...(10) http://www.lifescript.com...(11) http://www.aafp.org...(12) http://www.abortionbreastcancer.com...(13) http://www.sheknows.com...(14) ibid.(15) http://health.nytimes.com...(16) http://www.medicaln...