In yesterday’s Globe, there were two stories that made me kind of mad, for reasons that are, in a strange way, related.
One was about a federal government panel’s recommendation to require all insurance plans to ”offer female patients free coverage of prescription birth control, breast-pump rentals, counseling for domestic violence, and annual wellness exams and HIV tests,” as well as ”screening for gestational diabetes in pregnant women; more sophisticated testing for a virus, known as HPV, that is associated with cervical cancer; annual counseling for sexually active women on sexually transmitted infections; and multiple visits to obtain preventive services if they cannot be provided in one annual examination.”
Supporters of these recommendations say that they will improve people’s health, prevent unintended pregnancies, and possibly prevent large expenses in the long run. But what people really need to think about is what is fair. None of these services will be truly free, of course. Requiring insurance companies to cover them with no co-pays or deductibles equals requiring everyone, regardless or whether or not they use them, to pay for them. This is simply not fair. Contrary to what many people seem to think, sex is not something that people need to live; it is an activity that people can choose to participate in, or not, just like playing sports, reading, blogging, or buying a house, for example. It is unfair for everyone to be required to subsidize some people’s choices. These recommendations would force people who do not have sex (who may be a tiny minority but do exist) to pay higher insurance prices with no added benefits.
It is also worth mentioning that because the U.S. Preventive Services Task Force “has historically paid less attention to gender-specific recommendations, the law’s drafters required that the Department of Health and Human Services issue a supplementary list for women.” This is extremely sexist. Men and women should be treated equally in all respects, and giving women special treatment and attention is both unfair and insulting. Would men have to pay for contraception and STD treatment under the new recommendations, while women wouldn’t? That is precisely the kind of thing feminists should oppose.
The second article in the Globe that made me mad was Jeff Jacoby’s column arguing in favor of population growth. He writes that ”the birth of virtually any baby is cause to rejoice” because ”human beings…usually create more than they destroy” and “when human beings proliferate, the result isn’t less of everything to go around.” He quotes economist Bryan Caplan, who said, ”The world economy is not like a party where everyone splits a birthday cake; it is more like a potluck where everyone brings a dish.”
While possibly true about some things, for the world’s most important resources this is completely false. No matter how inventive, hardworking, and talented people may be, they cannot create more land, more water, more oil, or more coal. There is simply a finite amount of these things, and it is a mathematical fact that the more people there are, the less of these things each person will have. I have seen with my own eyes houses being torn down to make way for condominiums, more people packed into the same amount of space. The Earth is not merely full, as Thomas Freidman at the New York Times wrote, it is beyond full. Although Jacoby calls opposition to population growth a “persistent and popular superstition,” I believe it is unpopular but right. He may call people like me “churlish” and “misanthropic,” but he is the real misanthrope for wanting people to be condemned to a world with inadequate space, nutrition, and fuel.
This might seem like an odd pair of beliefs for one person to have: opposing making birth control free but also opposing population growth. But it really isn’t. I thought of two ways to solve the problem of overpopulation which may not be practical or popular, but which I believe are truly fair:
- Health insurance should only cover medical services that are necessary and that were not directly caused by a person’s own actions. Some of the things mentioned in the recommendations, such as domestic violence and STD counseling, are not exactly health services. Others, such as contraception and pregnancy-related services, are not needed to live, because the decision to have sex and/or have children is a choice. And others, like STD testing and treatment, are only needed as a result of certain decisions that people make. The purpose of insurance is to cover large, unexpected expenses. Covering things that are discretionary or that are predictable and preventable results of people’s actions, is unjust to all of the people who pay into the insurance pool.
- If making birth control more easily available is unfair, how can the world solve the problem of overpopulation? In my opinion, the best solution is simply to enact a tax on having babies. Creating a new person is not a fundamental right; it is a choice that has negative externalities because it reduces the available amount of land, water, and fuel. Internalizing this externality is a perfectly fair way to get the world’s population under control.
July 22 update: The L.A. Times has an op-ed about exactly this topic, arguing that population growth is a huge problem that the public and the media ignore. I really like most (but not all) of it; check it out!