NPR’s Julie Rovner asks an excellent question in her report today about the ongoing uproar over new federal rules that would require employers to cover contraception as part of an overall package of preventative care for women. She writes:
If health insurance plans offered by Catholic-sponsored entities refuse to cover contraceptives for women because of the religion’s moral teachings banning artificial birth control, do they cover Viagra for men?
She says she got several emails asking just that after her story on the Obama administration’s change in the initial rule mandating coverage of birth control. (As part of the change, Obama said that hospitals, universities and charities sponsored by religious groups could opt out of covering contraception if their insurance companies did offer it to employees.) Continue reading →
Breaking News Update: The New York Times reports: “Obama Administration Plans to Offer ‘Accommodation’ on Birth Control Rule, Officials Say.”
Leading Democrats in Massachusetts are pointing to contraception as the latest example of a flip flop from former Governor Mitt Romney.
Contraception, with an exemption for churches, became a required benefit in Massachusetts in 2002, the year before Mitt Romney was sworn in as governor. Phil Johnston, who held top state health care and Democratic party positions, says Mitt Romney never tried to repeal the mandate. “He never mentioned that it would infringe upon religious freedoms and during the four years that Governor Romney served, he was totally silent on that issue.”
Romney aides say his original health coverage bill proposed eliminating all insurance mandates for individuals and small businesses covered through what would become the Health Connector. Since most large businesses are self-insured, and thus not subject to state mandates, these aides say Romney planned to remove mandates for most residents.
Former Health Care for All director John McDonough echoes Johnston’s recollection that Governor Romney never singled out contraception as an objectionable mandate. “The poster child for bad mandates,” remembers McDonough, “was in vitro fertilization, because it is so expensive.” Continue reading →
It appears that Cardinal Sean O’Malley, the Archbishop of Boston, is gearing up for a fight.
Responding to the federal government’s recent ruling that most health insurance plans, even those provided to employees of Catholic hospitals, colleges and charities, must cover free contraceptives for women, O’Malley lashed out at the ruling calling it “an alarming and serious matter” that “strikes at the fundamental right to religious liberty for all citizens of any faith.”
In a letter dated January 2012 posted on his blog, O’Malley adds that “the federal government, which claims to be by, and for the people has just dealt a heavy blow to almost a quarter of those people — the Catholic population — and to the millions more who are served by the Catholic faithful.”
Then he issues this call to action:
…unless the rule is overturned, we Catholics will be compelled and must be prepared either to violate our consciences, or to drop health coverage for our employees Continue reading →
Despite the breathtaking turnaround by the Komen foundation today on funding for Planned Parenthood, the organization remains under attack, according to Judy Norsigian, co-founder and executive director of Our Bodies Ourselves, and Ellen Shaffer, co-director of the Trust Women/Silver Ribbon Campaign, a project of the Center for Policy Analysis. In a blistering blog post today, they describe another assault on Planned Parenthood, this one by the U.S. Conference of Catholic Bishops:
What Komen, and the evangelicals, and Republican Rep. Cliff Stearns, who launched the pointless political inquiry, and the U.S. Conference of Catholic Bishops are really mad at Planned Parenthood about is this:
Part of what they do is help people plan. Parenthood. You know. They support birth control. In some cases, they provide it. Like your corner drugstore, but better.
And this week, the bishops are howling about it because the Obama administration refused to grant a broad religious exemption to contraception coverage. Continue reading →
Bad news for all the people who were upset at the Obama administration’s decision earlier this month requiring that teenage girls have a prescription to get the “Plan B” emergency contraceptive:
New research suggests that the broader context for that decision is even more troubling than previously known. It finds that many pharmacy staffers are blocking teen girls’ access to the “morning-after” pill even when the teenagers have a legal right to it. And those barriers are particularly bad in poor neighborhoods, where unintended pregnancies are especially common.
Lead researcher Dr. Tracey Wilkinson
“There’s a lot of misinformation and misunderstanding regarding this medication, and that’s universal,” said Dr. Tracey Wilkinson, a general pediatrics fellow at Boston Medical Center and lead author of a research letter just out online in the Journal of the American Medical Association. “We have a really efficacious form of pregnancy prevention that might not be accessible because of misinformation that’s out there.”
The Dec. 7 Obama administration decision concerned over-the-counter access to Plan B for girls under 17, but the research by Dr. Wilkinson’s team found that even for young women 17 and up, and even for teen girls who have a prescription, getting hold of emergency contraception can be a problem. The administration’s decision was disappointing, she said, but the study found that “even the way things stand is not working.”
The researchers called 943 pharmacies in five different cities — Nashville; Philadelphia; Cleveland; Austin, Texas; and Portland, Oregon — in late 2010, a solid year after the FDA had lowered the age of permission for over-the-counter access to 17. (Younger girls can also obtain emergency contraception but need a prescription.) Continue reading →
I know they say that the brain’s planning areas tend to develop particularly late in teen boys, but the latest figures from the CDC on condom use are highly heartening: The number of teen boys who used condoms “at first sex” rose 9 percentage points between 2002 and 2010.
Clearly, when it matters, they’re planning ahead.
The full release from the CDC is below — including the latest snapshot of teen sex nationwide — and the full study is here.
More teen males using condoms
The percentage of teen males aged 15-19 years in the United States who used a condom the first time they had sex increased between 2002 and 2006-2010, according to a report from the Centers for Disease Control and Prevention.
The report, “Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2006-2010 National Survey of Family Growth,” from CDC’s National Center for Health Statistics, found that 8 in 10 teen males used a condom at first sex, an increase of 9 percentage points from 2002. The study also found that 16 percent of teen males used a condom in combination with a female partner’s hormonal method, a 6 percentage point increase from 2002.
Other findings include:
In 2006-2010, about 43 percent of never-married female teens (4.4 million), and about 42 percent of never-married male teens (4.5 million) had had sexual intercourse at least once (were sexually experienced). These levels of sexual experience have not changed significantly from 2002, though over the past 20 years there has been a decline in the percentages of those who were sexually experienced. Continue reading →
After being out of style for decades, IUD use has been rising rapidly among American women in recent years, spurred by strong endorsements from birth-control experts. IUDs are by no means for every woman, but top women’s health authorities are saying they’re a good option for most women — unlike the old days when, because of the risk of infection, they were recommended only for women who’d already had children. This post is not numerically balanced because birth control experts are not balanced: They argue that the IUD is under-used. But let’s start with some downsides:
1. IUDs don’t protect against sexually transmitted infections. A reader who’s happy with her own IUD points out: “An IUD is an effective form of birth control NOT a way to practice safe sex.”
2. Though current IUDs have caused nothing like the 1970s fiasco of the dangerous Dalkon Shield, complications still do arise. As Judy Norsigian of Our Bodies, Ourselves noted: ““Like every method, it has its downsides. There’s a remote risk of embedding and perforation, but it’s small. And some women have a lot of pain, others don’t. Some women expel the IUD, others don’t.”
Two IUDs are in use these days: The copper Paragard and the hormone-emitting Mirena. Each has some minuses:
3. The copper Paragard can lead to heavier periods.
4. The Mirena makes periods diminish or disappear, which some women don’t like.
5. Also, though their levels are very low, the hormones that the Mirena emits can affect some women. A friend of mine just had her Mirena pulled because of nasty, depressive symptoms. It’s a well-trodden path for women to replace the hormonal Mirena with the copper Paragard.
This is not an exhaustive list. But as our IUD-using reader said, “One great thing about needing a procedure to get this type of birth control is that it will allow you to have conversations with your ob-gyn and have an honest discussion about what kind of birth control suits your lifestyle.” That conversation should also include a run-down of the risks. A helpful IUD fact sheet is here.
Now for the upsides:
1. “Just one act“: It takes a doctor’s visit to have an IUD implanted, but then your birth control is likely set for years.
2. Effective: Once that “one act” is done, the device is close to 100% effective.
3. Cost: The IUD is also considered one of the most cost-effective forms of birth control; though it costs several hundreds dollars up front, that cost is spread out over years, and… Continue reading →
To get you in the mood for the weekend, here’s another inspired Stephen Colbert video. This time he’s targeting the Obama administration’s new mandate that private insurers cover preventative health services for women, like contraceptives, breast pumps and lactation support.
Again, thanks to Our Bodies Our Blog for noting this clip in a recent post, which reports that news of the new health coverage mandate “rankled some conservatives:”
Take, for instance, Sandy Rios, a FOX News contributor and vice president of the Family-PAC Federal, a conservative political action committee, who likened women’s health needs to beauty services: ”We’re $14 trillion in debt and now we’re going to cover birth control, breast pumps, counseling for abuse? Are we going to do pedicures and manicures as well?”
[Colbert responds with equal outrage] for instance, he notes that “a woman’s health decisions are a private matter between her priest and her husband,” and insurance companies should be in the business of covering only “necessary medical expenses — like boner pills.”
(Above: A 7-minute IUD show-and-tell by a leading expert, Dr. Eve Espey)
Full disclosure: I had an intra-uterine device implanted soon after my second child was born, and in my own experience, using an IUD for birth control is something like what Churchill said about democracy: It’s the worst system around — except for all the other ones.
My first few months with a Mirena — an IUD that emits tiny levels of the hormone levonorgestrel — were rife with unpredictable spotting. That certainly got very old very fast. But then the spotting ended, and my periods blessedly all but disappeared, a common Mirena effect. It’s been nearly seven years now, and I’ve been both problem- and pregnancy-free. I even re-upped for a second device when the first one hit its five-year limit.
So that’s my bias when I report that in recent weeks, I’ve noted a striking convergence of signs pointing to a new era of far greater popularity for IUDs. There’s even talk of an IUD “renaissance” — once all but unthinkable after the debacle of a 1970s device called the Dalkon Shield.
The "Mirena" hormone-releasing IUD
In the not-too-distant future, getting an IUD, which costs several hundred dollars, will be universally covered and co-pay-free under new federal insurance rules. The latest numbers suggest IUD use among American women has risen dramatically in the last decade. And the IUD’s safety record is looking so good that recent research finds that the devices can even be implanted right after an abortion or a birth.
“The message is finally getting out there that IUDs are a great option — that they’re highly effective, that they’re long-acting, and they provide reversible, highly effective contraception with just one act,” said Dr. Alisa Goldberg, director of clinical research and training at the Planned Parenthood League of Massachusetts. (That “one act” is having the IUD implanted, a quick office procedure.)
Among the first 2500 women who enrolled in the study, 56% — that’s right, more than half — chose to get IUDs.
“And the message is finally getting out there that the old days — the days of the Dalkon Shield — are long behind us,” Alisa, who’s also director of the division of family planning at Brigham and Women’s Hospital, said. “There are increasing amounts of data showing the safety, the efficacy and the increasing popularity of these methods.”
In a country where nearly half of pregnancies are accidental, “This could have a huge impact on public health,” she said.
No, she’s not in the pay of the IUD makers. She sounds just like many other evidence-based experts on contraception who have been pushing for greater IUD use for years. In fact, it was because I’d read some of their research that I opted for an IUD seven years ago, despite a lingering sense of past disaster.
We hear a lot about how health care prices need to be more transparent, about how patients and doctors need to know more about price tags as they make medical decisions. And we hear a lot about how the state is gathering the information — but we aren’t seeing a whole lot of it yet. Sounds like a job for….crowdsourcing!
What if there were a site that would gather in reports of prices from patients themselves, and share them to cast light on what’s really going on in the health care system? Our friends over at ClearHealthCosts are doing just that. Sadly, they’re doing it in New York for now. But they clearly have national ambitions — witness this nationwide project they just launched, gathering what’s being charged for birth control pills. Please pitch in here — it might make paying for pills a bit less painful if you get to drop a dime on the pharmacy’s pricing at the same time. And let’s put Massachusetts on the map!
From the ClearHealthCosts blog:
So we got curious—what are women paying for those pills? Thus the Price of Birth Control Map was born.
There’s a lot of interest in this topic these days. On Aug. 1, the Department of Health and Human Services approved a recommendation from the Institute of Medicine, an arm of the National Academy of Sciences, saying all insurers should cover contraceptives for women free, as one of several preventive services under the new health care law. That recommendation is to become standard practice–but not until 2013. It will not affect uninsured women.
We dug around, and identified some of the top-selling oral contraceptives. Then we looked at the out-of-pocket cost for a one-month supply. The results—which are still admittedly anecdotal—surprised us. The price of your pill might just depend on the block on which you choose to buy it. Continue reading →