The US healthcare reform bill that recently passed the House only did so after a controversial amendment was inserted banning any insurance plan which pays for abortion from accepting any federal subsidies, a clause that will probably eliminate abortion from most or all health plans if it goes into law. One reader at TPM had the following thought experiment:
What would happen if a few female members of the House put in (or merely proposed) an amendment to the health care bill which stated that men would be barred BY LAW from purchasing health insurance which covered Viagra, all hair-growth medications or procedures or transplants, etc.?
This thought experiment reminded me of the well known case of the birth control in Japan. Actually, I say well known, but when I checked to confirm the dates, the details were rather more complex than the simplistic version of the story that I had thought I knew, in which the pill was simply never legalized in Japan until a decade ago.
The first birth control pill was approved for that use by the United States FDA in 1960, but was rarely used in Japan until recently. The pill was not approved at all in Japan until 1972, but this was the high-dose formulation that was already being replaced in other countries with a low-dose version of the drug due to safety reasons. Because the safer, low-dose pill was never approved in Japan, oral contraceptives remained little used. Even after the original high-dose formulation was removed from the market in the US in 1988, the low-dose pill remained off the market in Japan.
This changed in 1999, after Viagra was fast-tracked for approval. Viagra first went on sale in the US in March 1998, and only a few months later was already being studied for approval in Japan, where it went on sale in March 1999 – only one year after the US. Feminists complained about a double standard that allowed a drug whose primary purpose is allowing recreational sex for old men to be approved almost immediately, while the safe low-dose birth control pill was still not approved after four decades. At the time, Yoshiaki Kumamoto, president of the Japan Foundation of Sexual Health Medicine, was quoted as saying that viagra was approved so quickly because old men in parliament “want to have that drug.”
The modern pill was finally approved in September of 1999, although women taking it are required to have pelvic exams four times a year, as opposed to once or twice in most countries, and there is still a widely held association with the dangerous side effects of the old formulation. According to a late 2006 study, only 1.8% of Japanese women were using the pill for their birth control needs. This compares with, according to UN figures for the year 2005, 7.5% of women worldwide, and 15.9% of women in developed countries.