Recently, Rush Limbaugh and a bunch of other rich, old, white men got a lot of people all riled up about “having to pay for Sandra Fluke to have sex.” There are too many things wrong with that statement to count, and you can’t fix stupid. So let’s not argue sexual morals, first amendment rights, or religion. Let’s talk money and math to consider why these people should be looking to pay for the sexual health needs of more Sandras and fewer Rushes.
Insurance is a game of odds. It’s also a for-profit business. (Go Capitalism!) As even the simplest among us must surely know, the insurance industry model is based on a lot of people paying for coverage that most will never use. Who doesn’t question their decision to buy travel insurance at the end of a safe and uneventful vacation? But we convince ourselves the alternative would have been worse. Our fear of the unexpected translates directly into profits for the industry.
Premiums–what we pay for coverage we will hopefully never use–are based on statistics. To get to your premium, insurance companies consider not only your age, health, income, and lifestyle, but also the age, health, income, and lifestyle of everyone they have to cover. Then they estimate the number of claims they expect to pay out, add in big fat profits and executive bonuses, and divide that number by their customer base. They base their estimates on historical data, and the more risky their customer base, the more claims they expect, and the higher the premiums; it’s simple math with a little Las Vegas thrown in. The house always wins.
But the beauty of statistics is that, unlike politicians and talk show hosts, numbers don’t lie. Numbers aren’t affected by emotion or religion, and numbers don’t change because you yell louder.
So why do we want more Sandras and fewer Rushes in the mix?
The operative word here is risk. Educated, childless, thirty-something women, like Sandra Fluke, are pretty much at the bottom of the risk pile. They are generally healthy, fit, and intelligent enough not to ride a motorcycle without a helmet. They are among the safest drivers on the road and are physically at the top of their game. They can even smoke or be a little overweight, because these factors will not translate into costly health issues for decades. I would venture to guess that the only prescription medication in Sandra’s medicine cabinet is birth control. And, if nothing changes, it will stay that way for a couple more decades.
On the other hand: rich, fat, angry, old men like Rush Limbaugh are a statistical time bomb at risk for heart attacks, type 2 diabetes, high blood pressure, strokes, and limp dicks, among other things. At this time in his life, Rush’s daily regime probably does or should include several prescription medications not including that whole Oxycontin thing he reportedly has(d) going on. If he continues on this path, and his head doesn’t explode first, his insurance company can expect lots and lots of claims from Rush. A catastrophic sudden exit from this world is the best that his insurance company can hope for; more likely, Rush will decay in a slow, drawn-out, expensive decline, which will include many years of medical procedures, prescription meds, and insurance claims.
So just on these basic lifestyle and health risk factors alone, insurance companies expect to pay very little for their Sandras and quite a lot for their Rushes. If you are a fat, old, angry smoker like Rush, you need lots of happy healthy Sandras in the insurance pool to keep your premiums down. If you are among the Sandras, statistically, you are paying a lot more to prop up Rush’s sex life than he is to support yours. If anyone owes us free videos of sexscapades on YouTube, it’s Rush.
What will change this risk scenario dramatically is pregnancy. From a risk perspective, pregnancy is total crap shoot. Even if all goes storybook perfectly (and it rarely does), the number of doctor visits and procedures a pregnant Sandra requires will multiply. She may require other drugs to maintain her health, and finally, she will rush to the hospital and rack up a big fat invoice for the privilege of pushing a seven-pound melon through her wahoo. Then there is the expense of raising a healthy melon. What if it’s not a perfect melon?
And what if it’s not a perfect pregnancy?
According to the American Pregnancy Association, of six million pregnancies a year in the U.S., only four million end in live births. That means a third of pregnancies will end prematurely due to miscarriage, ectopic pregnancy, stillbirth, and termination. Annually, 875,000 pregnant women experience one or more complications, and almost half a million babies are born prematurely. Another 150,000 have birth defects and almost 30,000 die in the first year.
Complications, premature babies, and birth defects cost insurance companies money, and this cost is transferred directly to premiums. The house always wins. When you consider the alternative, paying two or three thousand dollars a year for the Sandras to have lots of sex–er, use birth control–is good not just for the Sandras, but for everyone who buys insurance.
Insurance companies choose to cover birth control because it makes good business sense and translates into lower costs and increased profits. It has nothing to do with religion or moral judgment. In a truly freedom-loving, market-driven, capitalist world, no one would mess with the right of insurance companies to minimize costs and maximize profits without interference from church or state. And anyone who pays insurance premiums is a self-defeating idiot to push for them to do anything else.