Religious freedom and contraception

[Neally]

No (it's more complicated than that I'll get to that later), but let's accept your premise for one moment.

Error #1: Let's assume an employer purchased a BC plan without sterilization as an option? You are saying that we would have to make up sterilization figures on the one side to compare to non-sterilization on the other? Nonsense. Apples to oranges.

I don't follow what you are saying here, so let me restate what the model does and doesn't do.

First the model purports to show a comparison of the net cost of a health plan that offers contraception vs a plan that doesn't offer contraception coverage. In fact it doesn't do that. It compares a plan with full contraception coverage to a plan that only offers sterilization. If an employer only had those two plans available to choose from, they'd be better off going with the plan that offers full contraception coverage.

Their average cost per employee would be $562 for full coverage vs $659 for a plan that only offers sterilization. A savings of $97 per employee.

If instead they had an option to go with a plan that offered no contraception at all, their cost per employee would be $339. The math to arrive at that isn't complicated and I explained how it is derived from the model's own figures.

Error #2: Back to your assumption. Sterilization prevents pregnancies, right?

Right.

If you were to take away the coverage then the cost of unintended pregnancies WOULD go up, right?

It depends. Those people that would have had Sterilization done for free would need to choose how they wanted to handle birth control without it. If they all chose to use an Injectable or IUD instead, unintended pregnancies would in fact go DOWN, since those methods have fewer unintended pregnancies than sterilization. If they all chose to pay for sterilization there would be no difference. If they chose one of the other methods, unintended pregnancies could go up.

Did you factor those figures?

Nope. That would be an interesting study. The point is that people will take what's free, and if it's not free, they don't just throw up their hands and say, "I guess we have to fill the house with kids now!". They make other choices and find other ways to fund their birth control.

You thought you would get a free benefit?

You thought without free sterilization, people become proliferate breeders?

 

[RandFan]

It compares a plan with full contraception coverage to a plan that only offers sterilization.

Agreed.

If instead they had an option to go with a plan that offered no contraception at all, their cost per employee would be $339. The math to arrive at that isn't complicated and I explained how it is derived from the model's own figures.

But you are not comparing apples to oranges and it is important because of your error #2. If you are going to remove the cost of contraception on one side of the comparison without removing the cost of unintended pregnancy then you HAVE to do the same on the other side. Otherwise you are not comparing apples to oranges.

1. You take the benefit of sterilization without the cost of sterilization in column B
2. You take the benefit of sterilization but LEAVE in the cost of sterilization in column A

Neally, YOU CAN'T DO THAT.

You thought without free sterilization, people become proliferate breeders?

Straw man. I claim that without sterilization the cost for untended pregnancy would go up. Right? What are those costs?

See, you are playing a game of hide the costs that only benefit your conclusions.

1. Sterilization reduces pregnancy.
2. Sterilization costs money.
3. Unintended pregnancy costs money.

• Error #1 If you want to only consider the savings of sterilization and not the costs in column B then it is only fair to only consider the savings from sterilizations and the costs in Column A.
• Error #2 If you remove #2 then #3 goes up You haven't accounted for #3

 

[xjx388]

No one needs to have a specific contraceptive prescription, no matter what the patient's condition, they are interchangeable except for cost? There are no contraindications between them?

"Contraindications between them" is virtually meaningless. "Contraindication" is a medical term that means "should not take." So if a woman should not take an oral contraceptive that would apply to all of them. An exception is the "mini-pill" which contains only the progestin component. Women who can't take the estrogen component of regular OCs can take the mini-pill.

Every woman who can take an OC can take the generic one available for $9 (or $4 for the mini-pill). The other OCs available are more expensive but offer other benefits, mostly improved side-effect profiles. But it's not like there's a woman who is contraindicated to take the generic but can take a more expensive one.

And you learned that from what medical source?

I have a doctor sitting next to me who will answer any question I have as long as she's still awake. Or not mad at me, which happens from time to time . . .

Or is this yet another feeble attempt to dodge the question you've been running away from for pages now?

I only dodge questions that I think are irrelevant or repetitive. I've said very clearly that no religious views should be infringed unless there is a compelling public interest. That would apply to the Catholics, Muslims, Scientologists, Satanists, etc.

 

[theprestige]

It was the result of multiple studies that was the impetus for this policy.

Originally Posted by Guttmacher, Brookings, Business Group.
The Case for Insurance Coverage of Contraceptive Services And Supplies Without Cost-Sharing

RandFan, even assuming this study says what you claim it does, why does it follow that the government should get involved?

Why is it so important that in this particular situation, regarding contraception coverage, employers cannot be permitted to review the data and decide for themselves what choice makes the most business sense to them? Why is it so important that the government simply cannot allow them to make the "wrong" business decision?

ETA: I mean, "because it's cheaper for employers" doesn't really wash. It's not like we think it's a good idea for the government to conduct a cost-effectiveness audit of every possible business decision, and pass laws mandating the government's idea of the best decision in every case.

So either someone needs to explain quite clearly and convincingly why this particular business decision requires government intervention...

Or we should probably kick the "cheaper for employers" excuse to the curb as totally irrelevant to the real justification for government intervention in this situation. And then somebody needs to explain the real justification clearly and convincingly.












I mean, seriously. Costs for employers go down? Then we should probably make offshoring a federal law, shouldn't we?

 

[Neally]

But you are not comparing apples to oranges and it is important because of your error #2. If you are going to remove the cost of contraception on one side of the comparison without removing the cost of unintended pregnancy then you HAVE to do the same on the other side. Otherwise you are not comparing apples to oranges.

1. You take the benefit of sterilization without the cost of sterilization in column B
2. You take the benefit of sterilization but LEAVE in the cost of sterilization in column A

You are still confused. Again, we want to compare a plan with everything included (column A) with nothing included (column B). The benefit of sterilization won't "disappear" without coverage, just as the benefits of other forms of contraception don't disappear just because they aren't covered in a health plan. People pay for them out of pocket.

Straw man. I claim that without sterilization the cost for untended pregnancy would go up. Right? What are those costs?

I already explained - IT DEPENDS.

1. Sterilization reduces pregnancy.
2. Sterilization costs money to the company.
3. Unintended pregnancy costs money.
4. People pay for birth control if #2 is taken away.

Error #1 If you want to only consider the savings of sterilization and not the costs in column B then it is only fair to only consider the savings from sterilizations and the costs in Column A.

The costs from B don't necessarily change. They could even go DOWN, as I already explained. It depends on what choices people make if they don't get free sterilization. They will either pay for it themselves or choose an alternative method of birth control. It's pretty safe to say they won't just do nothing and fill the house with kids.

Error #2 If you remove #2 then #3 goes up You haven't accounted for #3

#4 Covers that.

 

[RandFan]

You are still confused. Again, we want to compare a plan with everything included (column A) with nothing included (column B). The benefit of sterilization won't "disappear" without coverage, just as the benefits of other forms of contraception don't disappear just because they aren't covered in a health plan. People pay for them out of pocket.

Again, you want the cost savings that result from reduced unwanted pregnancy that results from sterilization but don't want to pay for it.

I already explained - IT DEPENDS.

1. Sterilization reduces pregnancy.
2. Sterilization costs money to the company.
3. Unintended pregnancy costs money.
4. People pay for birth control if #2 is taken away.

The costs from B don't necessarily change. They could even go DOWN, as I already explained. It depends on what choices people make if they don't get free sterilization. They will either pay for it themselves or choose an alternative method of birth control. It's pretty safe to say they won't just do nothing and fill the house with kids.
#4 Covers that.

Utter nonsense. We know that sterilization reduces pregnancy. You want the benefits of reduced pregnancy without accepting the costs for those reduced pregnancies.

Column A has:

• The benefit of reduced costs of unwanted pregnancies due to sterilization.
• The cost of sterilization.

Column B has:

• The benefit of reduced costs of unwanted pregnancies due to sterilization.
• The cost of sterilization.

You want to remove the cost of sterilization and keep the benefits for column B. You are failing your algebra.

Doesn't work. No "depending" about it. You want to compare apples to oranges. Nonsense.

 

[RandFan]

Neally,

If we take away sterilization from plan B why can't we remove sterilization from plan A? You are asserting by fiat that it is impossible. BS, if you can have a plan with only sterilization then you can have a plan with only non-sterilization BC.

What would the result be? Higher pregnancies, right?

If we can take sterilization from B then we MUST take it from A to have an equivalent comparison (especially if you don't account for the reduced pregnancies in B).

That's your fatal error. You continue to refuse to factor the reduced pregnancies resulting from sterilization.

 

[RandFan]

Neally, you want to pretend that getting rid of BC costs (in red) won't affect unwanted pregnancy costs (in blue). Nonsense. Did you happen to notice that both plans are similar in cost/benefit analysis (both have similar BC costs and unwanted pregnancies but according to you sterilization will have zero or near zero affect). Really Neally?

Given that the failure rates are as follows:
Sterilization .5%
Pill 6%

You want me to believe that eliminating sterilization would not increase unwanted pregnancies? Sterilization is the same as no sterilization?

 

[crimresearch]

This thread is long, I haven't seen them, but I've seen no evidence that contraceptives are not affordable. Hell, you don't even appear to be willing to make that claim.



Oh please. Now you're just making **** up. What medical conditions require only the use of the most expensive birth control pills? Please, do tell us.

So in other words, you've created yet another strawman argument.

And you are the one making the extreme assertion that there is no difference between the prescriptions except for price, so the burden is on you to prove that, instead of running away from facts that were posted long ago.

 

[crimresearch]

"Contraindications between them" is virtually meaningless. "Contraindication" is a medical term that means "should not take." So if a woman should not take an oral contraceptive that would apply to all of them. An exception is the "mini-pill" which contains only the progestin component. Women who can't take the estrogen component of regular OCs can take the mini-pill.

Every woman who can take an OC can take the generic one available for $9 (or $4 for the mini-pill). The other OCs available are more expensive but offer other benefits, mostly improved side-effect profiles. But it's not like there's a woman who is contraindicated to take the generic but can take a more expensive one.

I have a doctor sitting next to me who will answer any question I have as long as she's still awake. Or not mad at me, which happens from time to time . . .

I only dodge questions that I think are irrelevant or repetitive. I've said very clearly that no religious views should be infringed unless there is a compelling public interest. That would apply to the Catholics, Muslims, Scientologists, Satanists, etc.

So your proof of the claim that every single prescription oral contraceptive is exactly the same except for price, and that there are zero medical considerations where one would be better for the patient, is... that you have no proof, but you'll move the goalposts to 'mild side effects' anyway.

 

[xjx388]

So your proof of the claim that every single prescription oral contraceptive is exactly the same except for price, and that there are zero medical considerations where one would be better for the patient, is... that you have no proof, but you'll move the goalposts to 'mild side effects' anyway.

Strawman. I never said that every single OC is the same. I said that they are made of the same ingredients: progestin and estrogen. If you are contraindicated from these ingredients then you can't take any OC even if they use different synthetic forms of these two ingredients.

I'm sorry if you don't understand this basic fact of OCs, but it's the simple truth.

What you are referring to is the fact that some women can tolerate certain OCs better than others. But this is a different issue than contraindication.

ETA: Just to emphasize, you originally said stuff like "contraindicated from each other." Which is really nonsense. You are moving the goalposts now from "Contraindicated" to "Zero Medical Considerations." Two different things.

 

[RandFan]

Strawman. I never said that every single OC is the same. I said that they are made of the same ingredients: progestin and estrogen. If you are contraindicated from these ingredients then you can't take any OC even if they use different synthetic forms of these two ingredients.

I'm sorry if you don't understand this basic fact of OCs, but it's the simple truth.

What you are referring to is the fact that some women can tolerate certain OCs better than others. But this is a different issue than contraindication.

Should doctors have a say? I'm not trying to be difficult and I concede that I've not followed this sub thread. But it seems like you are saying that a doctor's opinion is irrelevant. Sorry if that is not the case.

 

[Ziggurat]

So in other words, you've created yet another strawman argument.

And you are the one making the extreme assertion that there is no difference between the prescriptions except for price, so the burden is on you to prove that, instead of running away from facts that were posted long ago.

You're accusing me of creating straw men? That's rich.

I'm sure there are differences between different prescriptions. For example, some of them have anti-acne properties, to name just one difference. But that's not the issue. The issue is whether or not contraception is affordable. You have not shown, or in fact even tried to show, that it is not. All you have done is take umbrage at me for pointing out that nobody has demonstrated this.

 

[Ziggurat]

So your proof of the claim that every single prescription oral contraceptive is exactly the same except for price

Nobody made that claim. So again, for you to accuse me of creating strawmen is really the height of hypocrisy on your part.

 

[daenku32]

Am I anti-food because I want you to buy your own damn meals?

Are you one of those people do directly barter with their farmers for their food items? Just wondering. Because if that's not the case, the society is doing quite a bit to make sure the food you get doesn't kill you.

 

[xjx388]

Should doctors have a say? I'm not trying to be difficult and I concede that I've not followed this sub thread. But it seems like you are saying that a doctor's opinion is irrelevant. Sorry if that is not the case.

A doctor's opinion is important. You can eliminate the contraindications with a thorough history. Once you do that, the BC choice really comes down to what's important to a woman, what the budget is, etc. For a woman without coverage who wants OCs, I'll bet 9 times out of 10 the recommendation will be to try the generic versions first and go from there. But if OCs are contraindicated, then the discussion will be about alternatives.

 

[RandFan]

We evolved to be a social species. We live in a society. Sometimes it's in the best interest of all to provide social services.

Is that really so difficult to understand?

If feeding the disadvantaged would help everyone then why the hell not?

 

[RandFan]

A doctor's opinion is important. You can eliminate the contraindications with a thorough history. Once you do that, the BC choice really comes down to what's important to a woman, what the budget is, etc. For a woman without coverage who wants OCs, I'll bet 9 times out of 10 the recommendation will be to try the generic versions first and go from there. But if OCs are contraindicated, then the discussion will be about alternatives.

Thank you. So shouldn't we simply leave it up to the doctor and patient?

We know that A.) contraception is cost negative and B.) Title X provides for public funding for contraception. So why all of the hang wringing?

 

[crimresearch]

Strawman. I never said that every single OC is the same. I said that they are made of the same ingredients: progestin and estrogen. If you are contraindicated from these ingredients then you can't take any OC even if they use different synthetic forms of these two ingredients.

I'm sorry if you don't understand this basic fact of OCs, but it's the simple truth.

What you are referring to is the fact that some women can tolerate certain OCs better than others. But this is a different issue than contraindication.

ETA: Just to emphasize, you originally said stuff like "contraindicated from each other." Which is really nonsense. You are moving the goalposts now from "Contraindicated" to "Zero Medical Considerations." Two different things.

Tappity tappity tapptity tap.

The claim was that no one needed to use the more expensive medicines, that it was simply a choice.

But it is about this because this is the example used in the relevant testimony. How many women actually spend $1000/year on contraception? A few that choose to use the very highest cost ones, perhaps. But no one needs to spend that much.

Did you seriously believe that was just going to vanish down the memory hole?

Fluke's testimony was that there was a range of prices for contraceptives that could go as high as $1K a year, and that testimony has been proven true with the links provided.

This is relevant in that it counters the argument about it being no burden at all for any given woman to pay for her own prescriptions instead of having them covered by the health insurance she is already paying into.

Now some people seem to think that a doctor might prescribe a specific contraceptive due to medical conditions where a certain type might be contraindicated because of potential *harm* to the patient.

The two recently published studies looked at whether there is a higher risk of blood clots in women taking birth control pills containing the progestin drospirenone when compared to similar women taking birth control pills containing a different progestin called levonorgestrel. These two new studies reported that there is a greater risk of VTE associated with birth control pills that contain drospirenone. This risk is reported to be up to 2 to 3 times greater than the risk of VTE associated with using levonorgestrel-containing pills

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601050.html

And you say they don't know anything, based on 'sleeping doctor testimony'.




Do you have anything at all that is either correct or useful?

 

[xjx388]

To get back on track, no one has demonstrated that a compelling government interest exists in mandating birth control coverage.

1. The mandate only helps women with insurance.
2. Govt programs already to help every woman get contraceptives.
3. Contraceptives are nowhere near as expensive as people like Sandra Fluke would like you to believe.