By Mike Causey
Washington Post Staff Writer
Monday, May 4, 1998; Page B02

Some readers are amused (or bemused) about the flap over who pays for Viagra.

The federal employee health program is the nation's biggest. And it covers about half the people in the Washington area. Most participating HMOs will cover prescriptions for the anti-impotence pill. Most fee-for-service plans, however, won't. Not yet, anyhow,

Viagra sells for about $10 per pill, and the market in the federal health program -- which covers 10 million people -- is potentially huge.

Many current and retired male feds want a decision on Viagra. They hope the government will require all health plans to pay for it next year -- if not sooner.

But demanding quick action on the pill for men has struck a nerve with some women. They had to wait more than a decade -- until this year in most plans -- to get coverage for birth control pills, and they are less costly.

The issue of who pays for Viagra -- or any drug or service -- is a big deal. Taxpayers foot about 72 percent of the total premium for federal workers and retirees. And because of its numbers and who is in it (such as members of Congress), the federal health program is a trendsetter.

Breathless news coverage of Viagra -- and the fact that most decision makers are men -- leads many female feds to believe men won't have to wait as long for coverage of their pills as women did for theirs. Here's what folks are saying on the subject:

"Isn't it interesting, this mad dash to doctors for Viagra prescriptions. This is indicative of the selfish behavior of men in our culture. Did these same men rush out to buy the male birth control pill? Of course not!

"It wasn't until this year that my health plan agreed to pay for oral contraceptives that cost about $1 each.

" . . . It took a dozen years to get approval for federal health plans to pay for birth control pills. Why is Viagra apparently 'so ready'? It looks like approval for it is going to happen almost overnight."

– Katherine Schneider

A male government worker, who asked not to be identified, has another view of the issue of who pays. He says: "I'm in my early fifties and have had problems functioning sexually since I had a liver transplant. There are many men in my situation. But we don't talk to each other about it. Maybe more of us need to 'come out of the closet' about our problem, but meanwhile it is still a problem. I tried to tell the lady at my health plan, GEHA, that this is a bona fide medical condition . . . that it is a genuine health issue with me and I wish my plan and others would cover it. I'm going to pay for the drug myself, but I hope insurance companies adopt an enlightened approach to this very serious problem."

Last word goes to "Mr. In Between." He says he wants the pill, "and I will get a prescription for it, and I will pay for it myself. This isn't a life-or-death medical necessity. Let the user pay for this one and save medical coverage for a genuine medical necessity."