HEALTH CARE/Joan Retsinas

Plan B Contraception vs. Laissez-Faire Economics

Teenagers have sex. Sometimes teenagers get pregnant. The headlines are not startling. But the brouhaha over levonorgestrel – also known as Plan B One-Step contraceptive – is startling. Conservatives throughout this endless season of campaign blather have vowed to restore America to an unfettered world of “laissez faire” economics.

They will pull Uncle Sam from the marketplace: no interference in energy, education, health, housing, commerce. Although Texas Gov. Perry forgot the precise cabinet departments he yearned to ax, he could have named anything except Defense (nobody has spoken out against that one) or State (a few candidates might not know much about the other countries on planet Earth, but they still wouldn’t ax the State Department). The healthy marketplace is free from Uncle Sam’s meddling ways. Thus goes the mantra.

So this tale of Plan B is baffling. Conservatives suddenly demanded that Uncle Sam tread clumsily into your local pharmacy. Walk down the aisles of those local stores. They showcase a hodgepodge of over-the-counter supplements, drugs, condoms, and elixirs, nestled beside batteries, toys, and, in some cases, alcohol.

Pharmacies also sell cigarettes – often behind-the-counter, because federal law restricts the sale to smokers over age 18 (I suspect conservatives would want to ax this federal meddling).

Plan B One-Step can prevent pregnancy. When a woman takes it within 3 days of unprotected intercourse, the pill will prevent an egg from attaching to the wall of the uterus. If a woman is already pregnant, it will not abort the pregnancy.

The medical wisdom has judged it effective: it does what it advertises. More importantly, the wisdom has judged it safe, certainly safer than an unplanned, unwanted pregnancy. The Food and Drug Administration Commissioner gave the pill a green light to go onto pharmacy shelves.

Initially the pill was available only by prescription, only in a few states. That kept sales low. Women – married or not, rich or poor, with or without children – often couldn’t get a prescription, plus the pill, within the requisite three days.

Then women’s groups, medical bodies, as well as manufacturers argued that the pill was both safe and effective. Eventually the federal government allowed pharmacies to sell it without a prescription. Conservatives fought back.

They won an age-restriction caveat: only women over age 18 could buy this pill without a prescription. So the pill stayed behind-the-counter, and customers had to prove their age.

From the vantage of the market, this age-restriction cut off potential customers: a lot of teenage girls have sex, and many of them do not want to get pregnant. After prodding, in 2007 the government lowered the age to 17. But that still barred easy access for thousands of sexually active girls.

The recent Food and Drug Administration Commissioner decision to drop the age-threshold re-opened the battle. The FDA opted to let Plan B join condoms, aspirin, and pain-killers on pharmacy shelves. Anybody, whatever the age, could buy Plan B without a prescription.

After all, teenagers can buy pain-killers and sleep aids. These pills are not narcotics; on the contrary, girls may suffer some cramping.

Nor are the pills, at about $50 a dose, inexpensive. Girls will buy the pills for the same reason their older sisters, mothers, and friends have bought them: to avoid pregnancy.

But conservative values – not laissez faire, but family ones – prevailed.

The secretary of the Department of Health and Human Services, Kathleen Sebelius, overruled the recommendation of the FDA. The pills remain restricted to customers over age 17.

Younger girls can get the pill with a physician’s prescription – as though young girls can easily schedule a visit within the minimal 3 days, with the anonymity that many girls need.

Ironically, conservatives cheered when Uncle Sam meddled in this marketplace.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, February 1, 2012

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