Caustic and curmudgeonly P.J. O'Rourke, warns us not to sit and wait for accidents to happen. He says: "No, you have to go out and cause them yourself. That way you're in control of the situation."

Speaking of unintended consequences (and unintended pregnancies), the 109^th Congress included language in the Deficit Reduction Act of 2005 (DRA) that deprived pharmaceutical companies of the ability to provide low cost drugs to campus health centers and "safety net providers." Drug companies quickly cut campus health centers off from low-cost contraceptives which forced them to increase prices to their students.

We recognize the public policy system is, at times irrational, but before we cause another accident trying to recover from this one, we should try to make sense of:

• how we came to need The Prevention and Affordable Access Act (HR 4054);
• how we're going to get it passed and signed;
• and whether it will make a meaningful difference if we succeed.

Family planning advocates aren't gamblers. In the same way that the consequences of limiting access to affordable contraceptives to students and low-income women is predictable, the consequences of relying upon the good will of pharmaceutical companies and Health and Human Services Secretary Leavitt to provide us with access to contraceptives is foreseeable. For risk-averse family planning advocates, it's a bad bet.

Drug companies, Congress, the NY Times Editorial Board, and our advocates all agree on the correction that needs to be made and we all know that the consequences of inaction will be borne by women in a far more personal and potentially devastating way than any threatened decrease in drug company profits.

Representatives Maloney and Crowley, and Senators Obama, McCaskill, and Clinton have introduced legislation to take control of the situation and restore the ability of drug companies to offer discounted pricing to campus health centers. In Wisconsin, our family planning association is wisely lining up behind the American College Health Association to help push the bill forward, but we must push deliberately or we might push ourselves into another collision with reality.

Restoring drug pricing regulations to what they were prior to the DRA still leaves student health at risk. Regulations to provide access to public sector drug discounts were deeply in need of repair long before the DRA.

In its current form, H.R. 4054/S. 2347 has neither a requirement nor an incentive to insure the pharmaceutical companies offer low prices to campus health centers or safety-net providers. Without a definition of ‘safety net provider' or an application process, the central question of access remains entirely up to the drug companies.

At the same time we push for this legislation, we must tell our elected officials and advocates that we need a clearly defined process to obtain ‘safety net provider' designation (to prevent another example of O'Rourke's theory).

"Go out and cause them yourself":

1. Use the ‘contact us' link at the House Energy and Commerce Committee Subcommittee on Health's website and the Senate Finance Committee website to make your voice heard. Let the committees know that HR 4054 and S 2347 should be passed with a clear definition and process to follow.
2. Let your own representative and your senators know that you support HR 4054 and S 2347 and that you would like his/her support for these bills. Visit the ‘Write Your Representative" website and the "Find Your Senator" website.
3. Tell friends and supporters contact their legislators and advocate for a strengthened HR 4054 and S 2347. Ask them to make the congressional contacts above and help you spread the word.

Visit our website at www.FPHS.org if we can be of help or to learn more about us. If you do contact your legislator, let us know at [email protected]. Thanks for your help!