What To Say To People Who Think Men Shouldn't Have To Pay For Prenatal Care In Their Insurance
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On Thursday, Republican Congressman John Shimkus very publicly wondered why cisgender men have to pay for prenatal insurance costs when they don't have a uterus. Aside from demonstrating a surprisingly shallow understanding of the American health insurance system, considering he's a lawmaker speaking on that very subject, his remarks left out the fact that women pay for health insurance that benefits men, too. Such a convenient blind spot, don't you think?  

In case you missed it, Republicans have finally unveiled their plan to replace the Affordable Care Act (ACA), and Shimkus made his comments during a markup session in the House Energy and Commerce Committee. When asked by Democratic Rep. Michael Doyle to provide specific reasons why Republicans are so aggressively, petulantly unhappy with the ACA, Shimkus pointed to the mandate requiring individual and small-group plans to include maternity coverage. "What about men having to purchase prenatal care? ... Should they?" he said.

Doyle was (understandably) taken aback, because it's not actually possible to pick and choose insurance coverage in such a way. Insurance plans, including health insurance, work because you share risks with other people on the plan, so healthcare costs are spread out among everyone. As Consumer Reports explains, "Most people are mostly healthy most of the time, so their premiums help pay for the expenses of the small number who are sick or injured." Or, say, pregnant — having a baby is astronomically expensive.

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Even if they can't get pregnant (if they're cisgender), are sociopathically uninvested in the fate of the next generation of children, and fail to acknowledge that their parents needed prenatal care in order for them to be born, men pay for maternity care because that's simply how health insurance plans work. On the flip side, women pay into all kinds of healthcare costs that don't apply to them, and nobody's complaining so far.

Take, for example, screening and treatment for prostate cancer. According to the U.S. Preventative Services Task Force, prostate cancer is the second most common cancer in men in the United States, and the Centers for Disease Control (CDC) reports that more than 176,000 men were diagnosed with the disease in 2013. Most states have laws requiring coverage for prostate cancer screening, especially in high-risk men. It's not a problem most women (mainly cisgender ones) have to deal with, but they still pay the costs because that's how insurance works. (Rep. Shimkus, are you paying attention?)

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Similarly, men are at a much higher risk for hypertension and heart attacks. Heart disease is the leading cause of death for men in the United States, and the American Heart Association reports that more than one in three men have some form of cardiovascular disease. Furthermore, nearly 70 percent of heart transplant patients were men in 2011, and around three-quarters of people receiving coronary bypass surgery were men in 2010. Just like childbirth, surgeries are expensive, and while men comprise the bulk of cardiovascular patients, women help pay for these costs.

It's also worth noting that men are more likely to smoke than women. Perhaps unsurprisingly, they're also more likely to get lung cancer as they age.

Finally, many heath insurance companies covered erectile dysfunction (ED) services long before they added contraception or maternity coverage. According to ABC News, more than half of Viagra prescriptions were covered by heath insurance within mere weeks of hitting the U.S. market in 1998, while many women still paid for their own birth control. Some private insurance companies also cover the cost of penile implants, a more drastic treatment for ED.

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To be fair, things have changed since then. In 2016, CVS dropped Viagra and Levitra from its list of covered medications; meanwhile, under the ACA, women finally accessed free and low-cost contraception. However, the fact remains that women have to fight for coverage of traditionally female health risks and procedures, while it's often a matter of course for men.

None of this is to say that insurance shouldn't cover these aspects of healthcare; that's the point of insurance. But it goes all ways. Women pay for male healthcare costs, men pay for female costs — "fairness" doesn't come into it. In the end, we all support each other. Isn't that what society is about?