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What Ocasio-Cortez and Cruz get right about birth control

Kyle Varner, MD
Health Policy
July 18, 2019
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I think we can all agree that women have a lot more hoops to jump through when it comes to contraception. If a woman wants to go on the pill, she has to go through the bureaucratic process of seeing a doctor and getting a prescription.

This is why I am so happy to see Alexandria Ocasio-Cortez and Ted Cruz agreeing to support a bill to make oral contraceptives available over the counter. I agree with them and the other 101 countries where contraception is available over the counter, but rent-seekers won’t. Rent seekers like Planned Parenthood and religious groups.

Why? Simple. Groups like Planned Parenthood profit from the medical visits associated with oral contraception. While religious groups who see sex as only something that is meant to occur for pro-creation deem contraception as amoral.

This is thus a classic example of the bootleggers and baptists phenomenon; where groups ideologically opposed from one another join forces, as they both benefit from an industry that’s being tightly controlled.

It’s thus vital we learn to ask important questions around public debates in health care — like, who benefits? Does this give me less choice to make my own decision? And is this group merely lobbying for more money from my pocket?

We should realize an interested party like Planned Parenthood only makes its bad-faith arguments about public safety because it financially benefits them. Ocasio-Cortez and Cruz, however, are making it because they have run the numbers, they know it’s what the people want. And Ocasio-Cortez and Cruz are interested in being re-elected.

The self-interest by medical groups like Planned Parenthood is nothing new. Doctors routinely attack the expansion of nurse practitioner’s independent practice rights on the grounds of patient safety even though multiple high-quality studies indicate care delivered by mid-levels is just as good as the care delivered by doctors.

Pharmaceutical companies also routinely discuss patient safety when proposals to allow the importation of foreign drugs are brought up. This is all public choice theory in action: regulators and big businesses act in their own best interests. They may speak in terms of public safety, but they are thinking in terms of their own benefit. It is just how politics work.

That means when we look to the political advocates to solve problems in our economy or our daily lives, we are bound to be disappointed with the results. Interested parties will always sell us “safety” if they can reach a little deeper into our pockets.

The solution in health care is simple: Stop mixing medicine with rent-seekers. A woman should have the ability to gain access to medications like birth control on her own terms and according to her own judgment. She shouldn’t be forced to pay a guy like me or a group like Planned Parenthood for a permission slip.

If we want to stop this kind of bad faith nonsense we need to decentralize decision-making processes. Rather than having centralized decision-making power with bureaucrats who will pursue their own self-interests at the expense of individuals, let individuals pursue their own self-interest directly.

Some will, no doubt, make poor decisions and suffer personal consequences. But that is dramatically preferable to a system whereby interested parties gain the power to exploit and make their decisions for the entire population.

Kyle Varner is an internal medicine physician who blogs at his self-titled site, Dr Varner, He can be reached on Twitter @Doctor_Varner.

Image credit: Shutterstock.com

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What Ocasio-Cortez and Cruz get right about birth control
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