No Winners in Birth Control Debate

Universal health care would ensure all women's reproductive rights were covered

The birth control controversy of the past few weeks has focused our nation's attention on an issue most of us would prefer to avoid.

Not because birth control is an uncomfortable topic-for the vast majority of Americans, birth control is supremely uncontroversial.

It's the fact that birth control is so ubiquitous that makes the two-week kerfuffle we've all been subjected to even more surprising. It began when Kathleen Sebelius, secretary of health and human services, issued a rule that required employers to cover the cost of contraception for their female employees. Catholic institutions promptly declared that their religious freedom was being trampled.

President Barack Obama gave the religious right some time to work themselves into a frenzy-presidential candidate Newt Gingrich called it an "attack on the Catholic church" and Mitt Romney called it an "assault on religion."

Rick Santorum got into trouble when one of his prominent backers commented, "back in my day, they used aspirin for contraception. Gals used to put it between their knees and it wasn't that costly." This led to closer scrutiny of Santorum's statements on birth control, which include: "It's not OK. It's a license to do things in a sexual realm that is counter to how things are supposed to be."

In the second act of the drama, religious leaders got involved. Prominent members of the U.S. Conference of Catholic Bishops stated that Obama was "waging a war on religion."

As the rhetoric escalated, liberals fought back. They insisted that Obama support Sebelius and not back down. Leftists who hadn't thought about access to birth control for more than five minutes over the past five years were suddenly incensed, demanding that Obama throw himself under a bus for it.

But of course, he didn't. In the third act of this melodrama, Obama brokered a compromise: Catholic institutions will not have to pay for contraception, but women who work for those institutions won't see an increase in co-pays either. (The solution: insurance companies are required to foot the bill.It's so simple that you wonder if Obama and Sebelius may have been fully aware of how this would play out from the start.)

The result is that every Republican presidential candidate found himself on the wrong side of the issue. They went on record denigrating birth control, a product that has been used by 99 percent of American women.Another win for Obama, right?

Possibly. But before the curtain comes down on this highly entertaining spectacle, we should take a moment to more seriously consider the question of access to birth control. Who needs birth control the most? Women who are young, unmarried or poor. Most of them are not planning on getting pregnant and are unable to support a child.

What's another characteristic of the young, unmarried, working poor?They are the group most likely to lack health insurance.

There are currently 49.1 million uninsured people in the United States. Half of them are women, and nearly 75 percent are of reproductive age. That makes a grand total of 18.4 million women who couldn't go to the doctor last year. And when you can't see a doctor, you can't get your Ortho Tri-cyclen prescription.

During the two-year period 2007-2008, over 86 million Americans went without health insurance for some period of time. So we're talking about 32 million women whose lack of insurance affected their access to birth control.

I don't know how many women work for Catholic institutions, but it's a tiny fraction of 32 million.

Yes, the Affordable Care Act has provisions that will lower the number of uninsured women starting in 2014.But even the most optimistic estimate still leaves more than a million women without insurance and therefore without access to birth control.

During the birth control controversy, liberals fought for two weeks to protect access to birth control for a small number of women who work at Catholic institutions. Where is that rage when it comes to the millions of others?

Let's not cry over a drippy faucet while the water main is rupturing in the basement. If we truly care about reproductive rights, we should be fighting for universal primary care.

Cameron Page is a doctor at Beth Israel Hospital.