For years, drug companies sold birth-control pills and other contraceptives to university health services at a big discount. This has served as an entree to young consumers for the drug companies, and a profit center for the schools, which sell them to students at a moderate markup. Students pay perhaps $15 a month for contraceptives that otherwise can retail for $50 or more.
But colleges and universities say the drug companies have stopped offering the discounts, and are now charging the schools much more. The change has an unlikely origin: the Deficit Reduction Act signed by President Bush last year. The legislation aimed to pare $39 billion in spending on federal programs, from subsidized student loans to Medicaid. And among the changes was one that, through an arcane set of circumstances, created a disincentive for drug makers to offer school discounts.
The contraceptive prices offered to schools are now included in a complex calculation that determines certain Medicaid-related rebates that drug makers must pay to states. In this calculation, deep discount prices would have the effect of increasing drug makers' payments.
Colleges and universities say the change is having a significant impact on their health centers and the students they serve. Prices have begun skyrocketing for many popular brands of birth control. Health centers are having to reconfigure their offerings and write new prescriptions. And college students are making some tough choices, such as switching to cheaper generic brands or forgoing their privacy in order to claim their pills on their parents' insurance.
"Forgoing their privacy": that phrase caught my attention. I'm assuming that it means that a co-ed thinks that it would be a violation of her privacy if her parents were to discover that she was sexually active. I would challenge that assumption. After all, the student knows her parents are having sex -- where's their right to privacy? Heck, not only my parents, but my in-laws, and my siblings, and all my friends and acquaintances and even people I see on the street know I'm sexually active, and that I've had sex at least THREE times. The government knows.Now, I'm all for people seeking privacy when they're having sex. (It's not something I want to watch other people doing.) But I don't think there's some right to privacy regarding whether one is known to be sexually active, because sex is an act that has social ramifications. It creates a bond between the actors (whether acknowledged or not). It's the cheapest, most efficient way for societies to obtain new citizens, so in a sense I find it rather odd that the government should have been subsidizing this in the first place. If anyone should be subsidizing birth control for female college students, it's the guys who benefit from it.
College Guy: Hey, you wanna hook up Friday night?
College Girl: Sure. That'll be $50 upfront.
College Guy: WTF? That's prostitution!
College Girl: No, that's economics.
Perhaps the objection is that students forfeit their medical privacy if they use their parents' insurance to obtain birth control. Guess what? If someone else is paying for your medical care, they have a right to know what they're paying for. It's basic. You get as much privacy as you pay for. Simply being a college student doesn't entitle to you no-strings-attached, child-free, privacy-protected sex. In fact, contrary to the unwritten assumptions of the WSJ article, being a college student doesn't entitle you to have sex, period.
But for all the college girls out there who can't afford birth control, here's my tried and true method for avoiding pregnancy in college: Keep your pants on.*
*Like all birth control methods, this only works if you use it every time.