About That “Pre-Pregnant” Thing

Amanda points out that, if you actually read the CDC report cited in that godawful WaPo article “Forever Pregnant” (which Jill discussed here), you can easily discern that the Post has an anti-female autonomy agenda (reflected also in stories such as the one about how they sorta heard that college guys are losing erections because college girls are too easy) and that the CDC’s report itself is fairly neutral (or as neutral as an agency that changes the lineup of a panel on STDs to placate the abstinence-only crowd can be) and the advice it gives sound.

Leaving aside the still-icky implications in the argument that the guidelines can actually be viewed as a fairly progressive effort to increase health care and access to contraception for poor and minority women by using the Trojan horse of treating women as the walking womb-ed, I’m still uncomfortable with the long-term implications of these guidelines, and how they’ll be used.

What I’m concerned about is that the guidelines will provide more cover for doctors who already do things like withhold effective treatments from their non-pregnant patients on the grounds that the treatments are harmful to a hypothetical fetus, even when the alternative, fetus-safe treatment does not adequately control the condition or has more severe side effects for the patient than the fetus-harming treatment. To wit:

But the words “federal guidelines” and “pre-pregnant” are not just sending up red flags, they’re sending out a fireworks show and a marching band.

I have been unable to obtain adequate medical care for my epilepsy because I am what they’d call pre-pregnant. As my neurologist puts it, I am a woman of child-bearing age. As such, they flat-out refuse to try me on any medicines other than the ones proven least likely to affect a fetus (read: the ones that are paying off my neurologist). Despite the fact that I have declared my belly a no-fetus zone.

My neurologist does not trust me to not get pregnant. My neurologist puts a potential fetus’s potential health over my health.

And now the government wants to officially sanction that.

Oh HELL no.

I should not have to get my fucking tubes tied in order to not have seizures and/or get medication that at least doesn’t have me dropping weight. (90.5 on the Craftsman’s bathroom scale; even taking into account that it’s a different scale from my doctor’s, it’s a significant enough difference that I have to look at it. I’m 89 on my scale right now. Which slips, but – still.) To get off a medication that’s caused what’s essentially a whole-body crash.

Pre-pregnant? Hell no. I am post-pregnant by 11 years. Pregnancy and me do not belong in the same sentence.

Screw that noise.

EDIT: When I first posted this, I was writing just for myself and my friendslist, so I didn’t put in a whole lot of background. Now this post has been linked all over LJ and in DailyKos. So. Background for people who have not been reading me since the dawn of time, quick-and-dirty version: I was diagnosed with epilepsy in October 2003. My first neurologist put me on Lamictal, which caused some pretty untenable side effects, including the first 2/3 of what became a catastrophic weight loss – 50 pounds in total, to a low of 85 pounds.

She tried me on Keppra, which was worse – then gave up for the sake of the potential fetus. I switched neurologists and medications, trying Topomax and Trileptal, the latter of which (plus Zonegran) I’m still on. The weight loss continued. Uncontrollably.

There are medications that have, as their side effects, weight gain. I have begged for these medications, but been refused. Direct quote from my neurologist: “You’re a newlywed. You’ll want a baby.” I’m a newlywed with an 11-year-old daughter and a body that’s falling apart. Trust me. I do not want a baby. But my stated desires are irrelevant – I cannot get prescribed a medication that will keep me from losing weight and may control my seizures better than the one I’m on now, due entirely to increased risk of birth defects.

Bolding mine, italics in original.

Let’s unpack that doctor’s attitude, shall we? We have here a patient who says that she’s done having children, but the doctor not only doesn’t trust her, but has the gall to tell her that because she’s a newlywed, she’ll want to provide her new husband with a baby, since the old one isn’t his.

She’s lost weight, way too much weight, so much it’s unhealthy and highly distressing, but the doctors won’t give her drugs that can treat her condition and cause weight gain. Probably because she’s a newlywed (and she might ruin her looks if she got fat!) and we need to please the husband, not the patient.

But more importantly, the doctors are choosing to place the potential health of a potential fetus (and to cover their asses in the event of a malpractice suit based on fetal defects) over the current health and treatment of the existing patient. Why they are unworried about a malpractice suit from a patient who’s being undertreated based solely on her childbearing potential probably has to do with the idea that prevailing medical standards are to undertreat such patients for that very reason. And, hey, once the CDC starts formally recommending such a course of action, there’s nothing to worry about!

As Bitch, Ph.D. shows us, the guidelines do specifically address the epilepsy drugs that are teratogens, and do NOT recommend that epileptic “pre-pregnant” women be treated as such.

Isotretinoins. Use of isotretinoins (e.g., Accutane®) in pregnancy to treat acne can result in miscarriage and birth defects. Effective pregnancy prevention should be implemented to avoid unintended pregnancies among women with childbearing potential who use this medication (65–67). . . .
Anti-epileptic drugs. Certain anti-epileptic drugs are known teratogens (e.g., valproic acid). Recommendations suggest that before conception, women who are on a regimen of these drugs and who are contemplating pregnancy should be prescribed a lower dosage of these drugs (74–78).

Shadesong’s problem is that her doctor is refusing to even give her the drugs which are teratogens, even though she has made it clear that she is NOT contemplating getting pregnant. The danger is that the doctor will seize on the “treat all women as pre-pregnant” part of the guidelines and ignore the “with epileptics, treat as pre-pregnant only if they’re contemplating pregnancy and work with them not to have unplanned pregnancies” part. The doctors’ attitudes certainly reflect cultural biases rather than sound medical practice already.

45 comments for “About That “Pre-Pregnant” Thing

  1. May 18, 2006 at 12:12 pm

    Wow. I had the WaPo article but didn’t notice that the effing TITLE IS “FOREVER PREGNANT.” I mean… My. God!

  2. May 18, 2006 at 12:13 pm

    Wow. I had the WaPo article but didn’t notice that the effing TITLE IS “FOREVER PREGNANT.” I mean… My. God!

  3. May 18, 2006 at 12:17 pm

    Sorry about that multiple posting thing. Total web faux pas. And I even skipped a word. “I had READ…”
    Sheesh.

  4. May 18, 2006 at 12:22 pm

    This doctor deserves a malpractice suit.

    Not to mention to have their license revoked for pure incompetence, if they think a 90-pound woman whose medications are still causing significant weight loss would somehow be in any position to carry a baby to term healthily in any case! Not only would there be insignificant nutrients and so forth for the baby, but as pregnancy tends to put the baby first, it could seriously jeopardize her own health. Not that the doctor in question gives a damn about that, of course. I mean, they’re her doctor; it’s not like giving her own health any priority is anything like their job or anything.

  5. May 18, 2006 at 12:38 pm

    Shadesong points out that she shouldn’t have to get her tubes tied in order to prove to the doctors that she’s not planning on having any babies–of course, that’s if she can find a doctor who’d be willing to perform a tubal ligation. Assuming she’s of child-rearing age, and a newlywed and everything, the doctor will probably want to her to bring a permission slip with her husband’s signature on it.

  6. Katie
    May 18, 2006 at 1:07 pm

    Grrr with a side of GRRRR. Shadesong, I’m royally pissed on your behalf! I wish I was surprised – but after hearing several doctors explain to me why I need/want brain surgery to one day be able to have children, I can’t say I’m shocked by this “it’s all about the babies” attitude. (I have a benign hormone-producing pituitary tumor that has no symptoms other than inhibiting ovulation and conception.) My situation in *no* way compares to Shadesong’s because I’m not ill, but I hear ya on the doctors and their insistence on forcing their own expectations onto patients…

  7. Dennis
    May 18, 2006 at 1:20 pm

    Quiet down, people. This is all part of some ingenious plot for nationalized health care. First, we give it to the women of child-bearing age, because the righties want healthy fetuses for war. Then, we extend it to all women, because the government has no right to pry into a woman’s fertility status (4th amendment). Then, someone gently points out that women have a benefit that men don’t. Explosion of rage, flurry of publications, masculinist backlash, and then: healthcare for all!!!

    I’m sure this is it. It has to be it. Please?

    No dice? Aw, shucks. What a bunch of bull-honkey. Next thing you know, birth control won’t be covered by employee health plans. *offstage whispering* Mein Gott!

  8. Pipingdude
    May 18, 2006 at 1:21 pm

    The CDC ???

    Hey ain’t these the same bozo’s who several months back in collabaration wih the History Channel made this Oh My God, Oh my Gosh, movie about the up-coming bird flu pandemic? Painting a picture of doom and gloom and a worse case secnario, billions dead world wide, tens of millions here in the USA, economic collapse etc, etc.
    To add hillarity to the matter just two weeks ago ABC did a purely fictional, made for TV bird flu pandemic and what does the CDC do, they issue a statement stating that its all fictional and for people not to worry and than they go on to say that getting a flu shot would be useless as there is no known vacine for this flu.
    BUT
    If my memory serves and my gray matter isn’t to mushy, didn’t these same educated fools recomend to the federal gov that they should be buying the flu vacine for a just in case this does happen.
    And you know what, our elected officials spent close to $1.5 billion doing exactly that.
    Now I ask you, how can any sane rational person, take any statement from them with any confidance?

    Pipe

  9. Oneiros Dreaming
    May 18, 2006 at 1:37 pm

    It sound’s like a brilliant idea, Dennis, until I realized one thing:

    Then, someone gently points out that women have a benefit that men don’t. Explosion of rage, flurry of publications, masculinist backlash, and then: healthcare for all!!!

    It relies on the masculine backlash deciding the proper course of action would be to apply healthcare to all to equalize. Of course, what would actually happen is that it would be used as an excuse to tear down women even further.

    I suppose we have to have our dreams though…

  10. Julie
    May 18, 2006 at 2:18 pm

    That story is really scary to me. I don’t have epilepsy, but working in the field that I do, I have a lot of experience with the types of medication used to treat it and the side effects and it’s beyond absurd that this doctor refuses to listen to her patient when she says “I do not want to have a baby”. I could see if this was a permanent decision based on a traumatic event (for instance, I was adamant after my son died that I would be having no more children ever and asked to have my tubes tied. My doctor said she would write the referral, but strongly cautioned me against making a spur of the moment decision. She was right and I ended up wanting to be pregnant again about 3 months later) because that really is just common sense advice… give yourself time to recover and then think about what you want to do. But to deny a woman who has a serious health problem drugs that can help her because of a potential fetus that the woman in question has no interest whatsoever in having? That doctor needs her head examined.

  11. May 18, 2006 at 2:35 pm

    I have a benign hormone-producing pituitary tumor that has no symptoms other than inhibiting ovulation and conception.

    Wow, what a totally cool tumor to have. I’m reminded of Emma Goldman, who also had some medical issue that made her infertile, which she chose not to correct.

    didn’t these same educated fools recomend to the federal gov that they should be buying the flu vacine for a just in case this does happen.

    I think there may have been more to it than that. We’ve had flu vaccine shortages in several recent years. In one recent year, a production problem was discovered in a single flu vaccine supplier that caused a serious enough shortage that everyone but the highest risk flu vaccine recipients was getting turned away (showing how easily problems at a single vendor can screw up our whole vaccination program). So stockpiling flu vaccine isn’t quite up there, in unreasonableness, with, say, insisting that Iraq had WMDs.

    The CDC is, in general, a useful organization, which usually comes up with medically sound reports. I trust the information coming out of the medically oriented parts of the government (CDC, FDA) considerably more than, say, the facts the government produces to support whatever its favored next military target may be, or anything the administration says about the state of the economy. At least, when it comes to medicine, you sometimes get a Surgeon General Koop. But on particular hot button issues (like anything related to sex), even the medically oriented parts of the government can get politicized, and you get stupid stuff like what’s been going on with the Plan B OTC application.

  12. Nymphalidae
    May 18, 2006 at 4:02 pm

    Since all us wimmins are pre-pregnant we’d better not do any hard labor, either. Or be in stressful jobs, or jobs that require us to work with hazardous materials. Pre-pregnant women shouldn’t be in the armed forces, since the uterus could be damaged in battle. In fact, it’s better if none of us enter the workforce at all. Pre-pregnant women shouldn’t take birth control, since the ads on TV say you shouldn’t take it if you think you might be pregnant. What else should we do/not do because of our potential incubator status?

  13. kate
    May 18, 2006 at 4:54 pm

    First, we give it to the women of child-bearing age, because the righties want healthy fetuses for war.

    Actually, this is where the arguement breaks down. The righties actually don’t really care about healthy fetuses, that’s why they don’t offer actual prenatal care at their pregnancy crisis centers (remember Amanda’s article). If a fetus or baby dies due to lack of proper healthcare that is “natural,” or maybe even “God’s will” and we must not mess with that. On the other hand, if a fetus dies because a woman does not avoid anything and everything that might harm it, no matter how much it might interfere with her living her life, that is “evil.” Understand now?

  14. May 18, 2006 at 9:27 pm

    zuzu:

    …you can easily discern that the Post has an anti-female autonomy agenda (reflected also in stories such as…

    I’m surprised you haven’t gotten any comments on what you said here. I mean, I’ve been reading Pravda on the Potomac since I was a little obsessive-compulsive reading mutant (we got the Star too, but only rarely have I read the moonie paper).

    I know that Katharine Graham has passed on, but come on! Does it only take two stories? In your opinion, has the WaPo shifted on it’s stand on Israel or “gun control” too?

    Regardless and back on topic, can you see how perhaps a Canadian style (universal, single-payer, socialized, take your pick) healthcare or a HMO plan might limit one’s choices compared to perhaps something like Health Savings Account (HSA) with a medical high deductible health insurance plan?

    Increased government regulation is gonna ooze it’s creeping crud between a doctor and his practice and take away any discretion of the course of treatment, no getting around it. That’s just what bureaucrats do.

    The other benefit is this. Medical records used to be between a doctor and the patient. Nowadays it’s between a doctor, the patient, and the HMO (still understandable, they have to pay out the expenses, of course they’ll want to see the records). Now the trend is a computerized standard defined by the government. How is that going to enhance your privacy? (You all are still big on medical privacy, right? I mean that was a cornerstone in Roe, right?)

    If you honestly think that politically well-connected congress-critters and their maggot minions won’t improperly traipse through other people’s medical record when it suites their purposes, you ought to take a look at the aids of Charles Schumer did to get ahold of Michal Steele’s credit report (I have to say though, Chucky did the right thing and promptly fired their asses) tinyurl.com/qj38e (WaPo)

    Need another example? tinyurl.com/epufz (fox news)

    Monday, November 22, 2004

    WASHINGTON — Congress passed legislation Saturday giving two committee chairmen and their assistants access to income tax returns (search) without regard to privacy protections, but not before red-faced Republicans said it was all a mistake and would be swiftly repealed…

    Heh, good thing they read those laws before they pass them, eh?

    With Health Savings Accounts (that are not the flexible spending accounts with the use-it-or-loose-it scheme that you are used to), the only thing that the government needs to know is that you did, in fact, spend money on medical care or supplies (because you or your employer fund the account with pre-tax money) You can even get debit cards to use solely on medical expenses to help ease the paperwork.

    When you are spending your own healthcare dollars and your doctor says you don’t get the effective treatment you want because of some mythical fetus, you fire that doctor’s ass and go elsewhere for the treatment you need. Problem solved.

  15. Dennis
    May 18, 2006 at 9:43 pm

    Shit, kate, you got me. I should have been more thoughtful in my post. I mean, they don’t even bother to give our soldiers armor, surely a healthy platoon also counts for nothing. So long as something crawls out of your womb, and they can find a place on it to hang an assault rifle and shove it across a foreign border, they’re satisfied.

  16. Dennis
    May 18, 2006 at 9:45 pm

    Nymphalidae,

    You know, too much exercise can trigger a miscarriage… I wouldn’t carry your line of logic too far, or Bill Frist might lock you up in a veal cage.

  17. zuzu
    May 18, 2006 at 9:51 pm

    I know that Katharine Graham has passed on, but come on! Does it only take two stories? In your opinion, has the WaPo shifted on it’s stand on Israel or “gun control” too?

    Did the “such as” elude you? This is also the paper that’s been hyperventilating over teenage girls giving blowjobs.

    Regardless and back on topic, can you see how perhaps a Canadian style (universal, single-payer, socialized, take your pick) healthcare or a HMO plan might limit one’s choices compared to perhaps something like Health Savings Account (HSA) with a medical high deductible health insurance plan?

    No, I don’t. You’ll have to come up with something better than Fox News as a source, too. Logically, if all doctors are being paid by the same payer, then any doctor is available under the plan; ergo, choice is not an issue. Under my current health care plan, I do not have a choice of every single doctor in the world, I have a choice of the doctors in my health care plan. The fact that I live in New York and belong to a large health-care network means that I have a meaningful choice.

    What, exactly, is so fantabulous about health-care savings accounts? All they do is shift all health care costs onto the individual, rather than spread those costs among all those covered. You do understand the concept of a risk pool, do you not? The young and healthy people who pay into the system yet do not make use of the system subsidize the older and sicker people.

    Also, current health care savings accounts are “use it or lose it,” meaning that there’s no incentive for people who don’t need to use a doctor to use their HSAs. Whereas, the people who need health care, especially those who need catastrophic health care, can’t possibly keep up with the costs of needed care.

    I suppose you favor individual retirement funds in place of Social Security, too.

  18. May 18, 2006 at 11:39 pm

    No, I don’t. You’ll have to come up with something better than Fox News as a source, too.

    Forgive me. I wrote about the story over a year ago and my link went dead. I just plugged the text in to google and pulled up a current cite. But since it’s fox news, and you think that somehow they pulled the story off the AP wire and totally rewrote the story as fiction, you are free to use your mad google skillz and plug the text I supplied in and find another source. They really did pass a law back in 2004 removing any pretense of privacy on tax returns. However, it’s up to you to decide if it was an honest mistake by congressional staffers or a bit of legislative standard mischief.

    Logically, if all doctors are being paid by the same payer, then any doctor is available under the plan; ergo, choice is not an issue.

    Ugh, yea, but they can decide to limit the number of opinion you are allowed to solicit to save costs. They can also limit the acceptable treatment choices to the most cost effective. If there’s a diagnostic test like a MRI that may be useful, but the is not essential, you may get put on a long waiting list (and you may decide to slip across the border to seek treatment on your own dime).

    You know, one of my first comments on a posting here (regarding EC) someone made a comment about how their healthcare plan did not allow them enough BC pills so they could skip a period. Do you honestly want some bean counter deciding if, and under what circumstances certain women will be alloted extra hormones so they can time their periods? Do you want to be put in a position of having to lie to your doctor to be able to qualify to be one of those women?

    Under my current health care plan, I do not have a choice of every single doctor in the world, I have a choice of the doctors in my health care plan. The fact that I live in New York and belong to a large health-care network means that I have a meaningful choice.

    Choices are good. More choices are better. If there was a promising new therapy on the left coast, would your plan cover it? Probably no, because they might decide it’s experimental, and probably not completely because that doctor would be out of their “system”

    What, exactly, is so fantabulous about health-care savings accounts? All they do is shift all health care costs onto the individual, rather than spread those costs among all those covered. You do understand the concept of a risk pool, do you not?

    I did mention the “medical high deductible health insurance plan” right? That’s the group insurance that kicks in when your expenses go over the “high deductible”. Except odds are, most people will never hit that ceiling. That’s why the rates are cheap, but if you ever have a medical catastrophe , your risks are spread out over others. It’s a safety net that does not get used as a hammock.

    The young and healthy people who pay into the system yet do not make use of the system subsidize the older and sicker people.

    Yea, we just gotta hope that birthrates don’t decline while the medical advances that help people live longer don’t tend to be developed elsewhere in the world where there’s still an free market reward for the creation of new therapies. Whoops.

    Also, current health care savings accounts are “use it or lose it,” meaning that there’s no incentive for people who don’t need to use a doctor to use their HSAs. Whereas, the people who need health care, especially those who need catastrophic health care, can’t possibly keep up with the costs of needed care.

    I did mention that “Health Savings Accounts” that were nothing at all like the “use-it-or-loose-it Flexible spending accounts”, right? If you don’t quite understand the difference, google is your friend.

    Basically it lets you bank excess funds between years. Since the money is *always* yours, there’s an economic incentive to control costs that simply does not exist with the average HMO where all your prescriptions are $5 a pop. (Did I say $5 each, well, for some strange reason prescriptions drug costs are soring, so now they are $15 a refill. Wait, they are still going up, so OK, now the ones that are on our specific list are $20, but only if you mail the order in, if you are in a rush, generics cost $25, and brand names cost $30. Oh, and we get to decide what is on the generic list and what is not.)

    I suppose you favor individual retirement funds in place of Social Security, too.

    Gee, zuzu, we’ve never met, but you know me so well. Yea, I’m generally against non-optional ponzi-like schemes that depend on sustaining high birthrates and expect Seniors that tend to die at 55. People saw the Social Security train wreck coming before I was born, and did nothing.

  19. May 19, 2006 at 8:46 am

    Surely shadesong’s neurologist is incompetent, right? I mean, the general idea of the practice of medicine is to hela the patient, isn’t it?

    Ah, fuck it. I’ll just throw health care into my invisible knapsack.

  20. May 19, 2006 at 9:22 am

    But since it’s fox news, and you think that somehow they pulled the story off the AP wire and totally rewrote the story as fiction, you are free to use your mad google skillz and plug the text I supplied in and find another source.

    OK, I Googled, and here’s the CNN story. The tax return provision was added to a massive budget bill, which both houses of Congress passed, but was then caught by “Democratic Senate staffers” before the bill got signed by Bush. Then both houses had to go back and fix the bill before Bush could sign it.

  21. May 19, 2006 at 9:50 am

    Standard Mischief:

    You know, one of my first comments on a posting here (regarding EC) someone made a comment about how their healthcare plan did not allow them enough BC pills so they could skip a period. Do you honestly want some bean counter deciding if, and under what circumstances certain women will be alloted extra hormones so they can time their periods? Do you want to be put in a position of having to lie to your doctor to be able to qualify to be one of those women?

    Yea, I’m, quoting myself, anyway, I reached deep in to the archives and found this: [www.feministe.us/blog/archives/2006/02/01/women-sue-wal-mart-over-ec/]

    Lauren Says:
    February 2nd, 2006 at 9:51 pm

    I intended to use my birth control to skip periods on purpose, but every fourth week I tried to refill my scrip they wouldn’t let me. Why? Insurance company, one, and two, the pharmacy would not let me use any medication for off-label purposes. To further add to the fire, I tried this at three different pharmacies before giving up.

    So much for that free market.

    And someone named zuzu said this:

    zuzu Says:
    February 2nd, 2006 at 9:25 pm

    Um, do you have insurance? Because mine won’t pay for extra doses of medicine until it’s time for renewal. So I couldn’t pick up extra to hoard unless I was paying out of pocket…

    That’s another advantage, normally the HMOs and PPOs that I have experience with don’t want to let you get too far ahead in stockpiling medicine. I’m unfamiliar with Canada style healthcare, but I doubt that they are very, uh, liberal with letting their subjects “hoard” the critical medical supplies they need.

    When it’s your money, it’s your choice.

  22. zuzu
    May 19, 2006 at 10:17 am

    You know, one of my first comments on a posting here (regarding EC) someone made a comment about how their healthcare plan did not allow them enough BC pills so they could skip a period. Do you honestly want some bean counter deciding if, and under what circumstances certain women will be alloted extra hormones so they can time their periods? Do you want to be put in a position of having to lie to your doctor to be able to qualify to be one of those women?

    How, exactly, is that different from the current situation in America?

    You pull out a quote from me about my health plan. I live in America, and I’m insured (on my own dime). There *is* some bean counter deciding how many pills I can have a month. My other option is to be uninsured so that I can pay out of pocket. Oh, yay for choice!

    I’m unfamiliar with Canada style healthcare

    Yet you feel compelled to pontificate about all the disadvantages of it and the limitations and lack of choice and the sneaking across the border and how they won’t let you have an MRI and OH NOES you’re going to die!!!

  23. Dianne
    May 19, 2006 at 10:55 am

    If there’s a diagnostic test like a MRI that may be useful, but the is not essential, you may get put on a long waiting list (and you may decide to slip across the border to seek treatment on your own dime).

    Arggh! The old “but you can’t get an MRI in Canada” argument again. Well, this is total anecdote, of course, but I’ve actually occasionally seen people go over the border to the north to get MRIs because their choices here were limited to a) waiting for months to get an MRI at a competent but way overscheduled MRI at Belleveue or b) pay more money than they had to get an MRI that was so poorly done that it was meaningless at a storefront radiology center or c) pay orders of magnitude more money than they had to get a reasonably good MRI at a nearby private hospital. The Canadian MRI wasn’t speedy, but it was adequate in both time it took to obtain it and quality. And let’s not even get into the cost of prescriptions in the US versus Canada…

    Which is not to say, of course, that the Canadian system is by any means perfect either. It has its problems, too.

  24. Dianne
    May 19, 2006 at 11:07 am

    I live in America, and I’m insured (on my own dime). There *is* some bean counter deciding how many pills I can have a month.

    From the other side of the equation, I’ve worked in a private office that took several of the more common HMOs and I’ve worked at a VA with the government bureaucracy behind it. Of the two, I’d rather deal with the govt’s bureaucracy than the HMOs any day. Two major reasons for this: One, every HMO has slightly different rules and trying to remember which ones require (for a real example of different tests allowed by HMOs for patients presenting with sore throat) a rapid strep test before culture versus culture only versus allowing only the rapid strep test and never paying for culture versus allowing only one particular RST to be used and refusing payment for any other can drive you insane very quickly. Two, HMO bureaucrats have a strong motivation to deny coverage for any expensive tests. The VA bureaucrats really don’t care as long as you’ve got the proper forms filled out and bring them a nice shrubbery. On good days they’ll even help you find the right forms. Indifference is MUCH easier to deal with that active obstruction.

  25. May 19, 2006 at 12:06 pm

    SM: I’m unfamiliar with Canada style healthcare, but I doubt that they are very, uh, liberal with letting their subjects “hoard” the critical medical supplies they need.

    zuzu: Yet you feel compelled to pontificate about all the disadvantages of it and the limitations and lack of choice and the sneaking across the border and how they won’t let you have an MRI and OH NOES you’re going to die!!!

    You know, i could say something about you selectively quoting me without even the decency to add ellipsis, but instead I’ll ask anyone who truly knows about Canada healthcare to chime in and tell us whether or not they can get, within system, 6 months or so of medicine in advance.

    SM: You know, one of my first comments on a posting here (regarding EC) someone made a comment about how their healthcare plan did not allow them enough BC pills so they could skip a period. Do you honestly want some bean counter deciding if, and under what circumstances certain women will be alloted extra hormones so they can time their periods? Do you want to be put in a position of having to lie to your doctor to be able to qualify to be one of those women?

    zuzu:How, exactly, is that different from the current situation in America?

    Umm, OK, it’s like this. You have a “Health Savings Accounts” and you know you want to skip periods. You go to the doctor and get the government mandated permission slip. Because you are a cost-aware consumer, you call around to three pharmacies for price quotes. You then go and have your prescription filled with the pre-tax money that you and maybe your employer put in your account. That’s it. You will probably want to keep the receipt to show that you did, in fact, use the pretax money for medical purposes, but there’s not HMO rules that limit your choices to how many pills you can get a month. There’s no pretext for some snoopy government agent looking through your medical records looking for fraud, in fact the records go back to being private between a doctor and the patient, where they should be.

    If you chose to participate in some medical study regarding some experimental treatment, you could offer to allow your records to contribute to the study. You could even get some scratch for the data you chose to provide, that could go back into your Health Savings Account.

    The important thing here is that you, and not some administrator, or bureaucrat, gets to decide what’s covered and what’s not. Choice. I’m pro-choice.

    background info:
    http://www.usatoday.com/money/perfi/taxes/2003-12-04-mym_x.htm
    http://www.treasury.gov/offices/public-affairs/hsa/

  26. hp
    May 19, 2006 at 12:15 pm

    You know, I actually left a GP’s practice after the office sent out a letter basically saying: since you’re in our records as a female of fertile age, you should always manage your health as though you’re pre-pregnant and here’s how to do so. (This was maybe 5 years ago?) The primary point of the damn letter seemed to be to convince women to order vitamins from a company that the office was probably getting some type of kick-back from. (Vitamins of the type more cheaply available OTC at your local Wal-mart or Target.)

    Then, I went to another GP, who was shocked that I hadn’t been sent to a specialist for a particular condition, then I went to the specialist, who was shocked at the medication I’d been placed on (by the first GP’s office) for that condition. The only reason the new GP and the new specialist could find for use of that (known to be fairly ineffective, and ineffective for me) medication was that it was often advertised as the medication “safest” during pregnancy. I was dumping medicine in my body that wasn’t doing shit, because the more effective medicines that might have HELPED had minor (and I mean minor–the specialist told me that he wouldn’t hestitate to prescribe them even to a pregnant woman if they were needed) risks associated with pregnancy.

  27. May 19, 2006 at 12:16 pm

    Dianne Says:
    Arggh! The old “but you can’t get an MRI in Canada” argument again…

    Raincitygirl had some interesting comments on this. The deep link is right here:
    http://www.feministe.us/blog/archives/2006/05/11/denying-military-women-medical-care/#comment-45382

    Which is not to say, of course, that the Canadian system is by any means perfect either. It has its problems, too.

    Agree 100% here.

  28. Marian
    May 19, 2006 at 12:30 pm

    Do you honestly want some bean counter deciding if, and under what circumstances certain women will be alloted extra hormones so they can time their periods? Do you want to be put in a position of having to lie to your doctor to be able to qualify to be one of those women?

    This is interesting. My cousin-in-law (in india) was able to obtain pills to delay her period past her wedding day and honeymoon, when it was due. From what I gather, she went to the dr., said I’m getting married and I need these, and she got them. She was not on the pill otherwise. They didn’t lecture her about aborting potential babies that could occur on the wedding night.

    I wonder if this can still happen in America or not. Would be interested to know.

  29. May 19, 2006 at 12:40 pm

    hp Says: …Then, I went to another GP, who was shocked that I hadn’t been sent to a specialist for a particular condition, then I went to the specialist, who was shocked at the medication I’d been placed on (by the first GP’s office) for that condition. The only reason the new GP and the new specialist could find for use of that (known to be fairly ineffective, and ineffective for me) medication was that it was often advertised as the medication “safest” during pregnancy. I was dumping medicine in my body that wasn’t doing shit, because the more effective medicines that might have HELPED had minor (and I mean minor–the specialist told me that he wouldn’t hesitate to prescribe them even to a pregnant woman if they were needed) risks associated with pregnancy.

    Get yourself a PDR (Physician’s Desk Reference). Get yourself Current Medical Diagnosis and Treatment. Use your library, Use your Internet. Take notes. Walk into the doctors office with an agenda.

    HMOs and PPOs negotiate block rates for visits. For the doctor to make enough to pay off his medical school loans, s/he’s got to see a patent every 15 minutes, and that’s not counting the time taken away by the drug pushers (drug company sales maggots) You can’t get effectively taken care of in your 12 alloted minutes unless you go in prepared. My doctor gives me extra time because I’m not an ignorant cow with a pulse.

    I would gladly go to a pay-by-the-hour system. I would insist on more doctoring and less diagnosis tests (only necessary tests).

    This is from personal experience. Do you know I’ve been tested 5 times in two years for Lyme’s disease? Neither did I until I went around to all the specialists and got my all records. (That itself was another fun story. Everyone thought I was getting ready to sue them. Not fun) No doctor ever got sued for requesting more tests, but that’s not really practicing medicine.

    And I’m not even gonna go in to the ones that like to play drug roulette. (Doctor: I’m not sure what you have, but take this prescription and try it for 30 days. Come back in another month for the exact same blood tests)

  30. zuzu
    May 19, 2006 at 12:46 pm

    I wonder if this can still happen in America or not. Would be interested to know.

    I’m sure doctors are hooking up their patients with sample pill packs because it’s to the benefit of the new husband to not have to deal with all that icky blood on the honeymoon.

    You know, i could say something about you selectively quoting me without even the decency to add ellipsis, but instead I’ll ask anyone who truly knows about Canada healthcare to chime in and tell us whether or not they can get, within system, 6 months or so of medicine in advance.

    Don’t be passive-aggressive. If you could say it, say it. However, nothing in the part of the sentence following “I’m unfamiliar with Canadian-style health care” changes the fact that you’re unfamiliar with Canadian-style health care and that any suppositions you have about whether they make their patients wait for drugs or allow them to buy them in advance are just that, suppositions. Pulled out of your ass, like the “can’t get an MRI in Canada” thing.

    Nor does your citing Raincitygirl’s comment on the Canadian health care system support whatever point it is you’re trying to make. She acknowledges that the system is not perfect, but it won’t bankrupt you and you can get needed emergency care quickly.

  31. Dianne
    May 19, 2006 at 12:51 pm

    For the doctor to make enough to pay off his medical school loans, s/he’s got to see a patent every 15 minutes,

    Ha. I’ve never had to go to the 15 minutes no matter what system* and my loans are paid off. Ok, so I can’t afford to buy a condo in Manhattan yet, but that’s hardly a sign of dismal poverty.

    *In the interests of full disclosure, though, I should admit that I’ve never actually run my own practice. In fact, I’m paid on salary and the only incentive I’ve ever had to move patients through quickly is that I have to see all of them no matter how long it takes.

    and that’s not counting the time taken away by the drug pushers (drug company sales maggots)

    They can be and are ruthlessly blown off.

  32. hp
    May 19, 2006 at 1:08 pm

    Get yourself a PDR (Physician’s Desk Reference). Get yourself Current Medical Diagnosis and Treatment. Use your library, Use your Internet. Take notes. Walk into the doctors office with an agenda.

    The letter was a last-straw type of situation: while I was of the opinion that the condition (fuck it, high blood pressure in a 25-year-old of good weight, with a good diet, who exercised regularly) deserved a referral to a cardiologist (and pos. endronologist), the GP’s office refused to refer me. They were insistent that all I needed to do was take the med they’d prescribed me and shut up.

    I was already considering finding myself a second opinion, at the least, and then the letter showed up. So, I found myself a new GP instead, and went to her with the intention of getting a referral. She was quite willing to give me one.

    And the end result was that I was diagnosed with white coat hypertension (possibly made worse by various experiences at the first GP’s office), removed from all medications, and set up to do daily home monitoring, which I’ve been doing for 4 years. I do run “high” for my age (up to 130/90, resting, at times), have a family history, and will probably need to go back on medication at some point. Now that I am preggers, I still do my daily home BP monitoring and home urine protein tests, JIC, since I might be at higher risk for preeclampsia.

    When I can find docs who want to work WITH me–which my current GP and OB are quite willing to do–things just go so much more smoothly. But I find it very worrying that had I just gone along with the doctor-knows-best attitude of the first office, I’d still be on medicine I didn’t need, and still under the care of a doctor who apparently placed possible fetal risk over my health without even telling me.

    (And since I’m in a fairly liberal urban area, it makes me wonder how many practices are like that.)

  33. Julie
    May 19, 2006 at 1:17 pm

    I don’t know, I have health insurance and I used my pills to skip my period the week of my wedding… I didn’t want to deal with it, I had enough on my plate. I don’t think it’s a big deal if you only do it once in awhile, my insurance didn’t flinch anyway. But again, I live in NY and have decent health care options.

  34. hp
    May 19, 2006 at 1:27 pm

    I’m sure doctors are hooking up their patients with sample pill packs because it’s to the benefit of the new husband to not have to deal with all that icky blood on the honeymoon.

    I think it depends on the practice, the typical insurance coverage of the patients who go to the practice, and the economic area the practice draws from.

    Back when I was on the pill, I went to a couple of different GYNs. The ones in the economically challenged areas were very generous with the free pill packs: I usually got one mail-order size fill from them for free (3 months) and a full year’s written prescription. The GYNs in the whiter suburban areas usually figured their patients had good prescription coverage, wrote for 13 months of fills, and didn’t give free packs or gave a single free pack.

    Personally, I’ve come to prefer OB/GYNs whose practices draw from more economically challenged areas. It seems easier to find practices that are more open to discussing all reproductive/birth control choices without prejudice.

  35. Kat
    May 19, 2006 at 1:28 pm

    Wow, what a totally cool tumor .

    Yikes. No tumor is a cool tumor to have. I have a prolactimona, which may be the same thing Kate has, not sure. Mine is in the pituitary gland and causes an excess secretion of prolactin. And if I do not treat it, I stop ovulating and menstruating.

    I actually had a doctor once tell me this would be a great form of birth control. Ya know, cause I wouldn’t ovulate. Which he considered to be the only requirement of birth control. The fact that the side effects made me NOT want to have sex to begin with didn’t bother him (leaking milk from my breasts and loss of libido caused by high levels of prolactin). Or perhaps that’s what he meant by birth control? To leave me with no sex drive? Huh.

    Other side effects of this type of tumor, in some patients, is that the abnormal level of hormone can adversely affect bone growth (which is not good before 35), the tumor can grow and press against the optic nerve causing loss of peripheral vision and headaches.

    In my case, this tumor is a pre-existing condition which makes private insurance companies hang the phone up on me. My medication, without insurance, costs $600 for each refill. And, because the condition’s side effects are not life-threatening (one doctor told me when I complained about the leaking milk that that was a “cosmetic” concern), some insurance companies don’t like to pay for the meds even if you are insured.

  36. Marian
    May 19, 2006 at 2:07 pm

    When I can find docs who want to work WITH me–which my current GP and OB are quite willing to do–things just go so much more smoothly. But I find it very worrying that had I just gone along with the doctor-knows-best attitude of the first office, I’d still be on medicine I didn’t need, and still under the care of a doctor who apparently placed possible fetal risk over my health without even telling me.

    I just left a GP too because of this reason. He was wonderful to my husband when he got sick, so I thought I’d see him too for my physical. Apparently this guy acts a bit different to his male patients vs his female ones. I was diagnosed with “irregular excessive heart beats” because I was in a hurry getting to his office and was at aerobic heart rate when I got in. I tried explaining that I had just hiked it from Manhattan to Hoboken on 4 trains and lots of stairs, and he wasn’t buying it.

    On top of that, he tried to talk me into cholesterol meds, which ironically are WORSE for a fetus (I’d think). He almost had me on heart meds I don’t need AND cholesterol meds (when diet is just as good), and thyroid as well until that turned out to be a false positive. The guy just likes to prescribe, and give his pharma sales guy some commissions. He could give a flying fuck about fetuses, which I find ironic in the face of all this.

  37. Dianne
    May 19, 2006 at 2:18 pm

    high blood pressure in a 25-year-old

    hp: I know that this is seriously none of my business, but have you been worked up for secondary causes of hypertension? Even with a family history and a serious white coat hypertension component, this scares me a little.

  38. hp
    May 19, 2006 at 6:25 pm

    Dianne: it was after kidney and abdomen CTs to check on the arteries (veins? I can’t remember which can be the source of hypertension), a stress echocardiogram, 24-hour Holter monitor, 24-hour blood pressure monitor, and multiple 24-hour urine protein analyses, that the cardiologist declared it to be mainly white coat hypertension for now. I also do yearly TSH tests for thyroid function as part of my standard blood work (which I think can be linked to hypertension too? the maternal side of the family has a history of Grave’s disease as well). It was in fact the Holter and 24-hour blood pressure that convinced him to pull me off the medication (or at least change it)–I was on the lowest dosage they prescribe and my heart rhythms were showing signs he’d only seen with an overdosage (and not just an overdosage of the medication, but an overdosage delivered via IV–there’s nothing more amusing than hearing that the rhythms WERE associated with an overdosing of the particular medication, but he’d never heard of them occuring when it was taken orally).

    I was also suffering fainting spells on the medication. It was a curious position to be in–despite the medication, my blood pressure was high whenever taken in a doctor’s office, and I was becoming dizzy and graying out when going from a sitting to standing position when not in the doctor’s office.

    I need to repeat the CT scans after the sprog is born, to make sure that pregnancy didn’t cause any damage and that there wasn’t undetectable but advancing damage when they were first done.

    The only possibility that I wasn’t screened for was a pituitary tumor. That was going to be the next step, but when I showed that my at home blood pressure was within norms, (and, for some reason after going through all this shit, I came to trust my GP enough that I did start to exhibit normal blood pressure in her office), they decided not to for the time being.

    Looking at that list, I’m glad I have good insurance . . . even if they’re jerking me around and making me cry right now.

  39. Standard Mischief
    May 19, 2006 at 11:25 pm

    Don’t be passive-aggressive. If you could say it, say it. However, nothing in the part of the sentence following “I’m unfamiliar with Canadian-style health care” changes the fact that you’re unfamiliar with Canadian-style health care and that any suppositions you have about whether they make their patients wait for drugs or allow them to buy them in advance are just that, suppositions. Pulled out of your ass, like the “can’t get an MRI in Canada” thing.

    But I learned how to be passive-aggressive from the very best! Although I’ve never been under the care of Canadian-style health care, I know bureaucracy firsthand, having battled it all my life. I’m sure it’s substantially similar up north. By the same standards, you are unqualified to talk about first-waver feminists, having not been around about that time.

    I’ve found the stats, BTW, on raw numbers of MRI machines. I’d link, but it seems to give your anti-spam fits. I was surprised to learn that as late as 2002, there still was not a single MRI machine in all of Prince Edward Island.

    Nor does your citing Raincitygirl’s comment on the Canadian health care system support whatever point it is you’re trying to make. She acknowledges that the system is not perfect, but it won’t bankrupt you and you can get needed emergency care quickly.

    Read it again, but without your rose colored glasses. I see a national government monopoly on healthcare that is not properly funded, where there’s no choices. I see people with painful, but not dangerous problems suffering while they wait for healthcare rationing. I see all of her upsides vs. HMOs, being solved by the Health Savings Accounts I advocate. Most of all I see a barely serviceable healthcare system that might be OK for day to day uses, but would fall far short in a true emergency (terror attack, earthquake, Katrina, etc)

    You pull out a quote from me about my health plan. I live in America, and I’m insured (on my own dime). There *is* some bean counter deciding how many pills I can have a month. My other option is to be uninsured so that I can pay out of pocket. Oh, yay for choice!

    Well, If you happen to take the low dosage non-tri phase type of BC, you might ask your doctor about paying cash for a high dosage cycle, and then using a pill splitter to split the three weeks in half. That should yield 6 weeks of “fill-in” replacements. I found Ogestrel®, at Safeway for $40.99, which makes the additional out-of-pocket cost of $6.83 to not have a period that cycle. You might make that up in sanitary napkins alone. Of course, just like I don’t “know anything” about Canadian healthcare, I also don’t “know anything’ about BC or sanitary napkins, so perhaps you ought to talk to a pro first.

    Actually I know a bit about sanitary napkins, because I have some in my first aid kit. They’re clean, individually wrapped, and they are designed to absorb blood. I take a few with me when I backpack, along with some vet-wrap. I also know quite a bit about pill splitters, having used one to save myself a bunch of cash in the past.

  40. May 20, 2006 at 1:13 am

    Standard Mischief, do you understand fucking ANYTHING about the Canadian medical system? Because I live here, and the stuff you’re saying bears no relation to the system I’ve been getting my health care from since 1978.

    First of all, most extended health care plans (i.e. when your employer covers the cost of precriptions, pays for dental care, and pays all or part of user fees for semi-covered services like massage therapy or physical therapy) won’t let you get more than three month’s worth of the Pill at a time, even if your prescription is for a year. You can only get 13 packs (at 28 days per pack) paid for in one year. However, when I wanted to skip my period because I was going on vacation, and thus went through my 13 pack prescription in slightly less than a year, my doctor came up with a very logical solution. She gave me two different prescriptions, one for 13 packs to cover the upcoming year and which I would have the pharmacy charge to my workplace health plan, and one scrip for 1 pack which I bought without going through my health plan, and paid cash for. If memory serves, it cost about $25. I know other women who’ve elected to not have their period every so often, and they did the same thing.

    Prescriptions are handled by pharmacies, not by the government. If you have an extended health plan, often times you can get the co-payment taken off when you get your meds, and thus, if the plan covers %80 of the cost of a prescription (pretty average, although some really fancy health plans cover %100) you just have to pay the 20% to the pharmacy directly, rather than paying for the whole thing and then sending in a claim form with your receipts. If people have no extended health plan and they fall below a certain income level, they can get their meds covered by the government (yeah, birth control too). If they have no health plan but fall above that cut-off, then they pay cash. Oh, and if somebody has a private health plan but that plan will only cover prescriptions up to a certain financial ceiling, there is a mechanism for the government to step in and top up the payment so the person can get their very expensive meds.

    I have a fair bit of choice in terms of which doctor I see, certainly much more than an American whose HMO will only allow him to see certain doctors. Possibly because universal healthcare is like one big HMO, but where NOBODY doesn’t have coverage. Yes, there are problems with the damn system, yes there are waiting lists for non-emergency care and non-lifethreatening surgeries, but if your doctor pisses you off you can go to another one without being restricted to the doctors of whom the HMO approves.

    And if you are diagnosed with cancer or another serious illness when you go to a doctor, you will always get care. In the US, if you’re unlucky enough to be diagnosed with a serious illness at your first trip to the doctor when you sign onto a health plan, that’s a pre-existing condition, and they don’t have to pay. Which means you’re probably mortgaging your house to get treatment. I have many complaints about Canada’s health care system, but I’d take living in a country where getting seriously ill doesn’t also mean you may end up bankrupt over living in the US any day. Mainly BECAUSE I am appalled that the richest country int he world, which put a man on the moon and spends billions on fighter jets, doesn’t have a public health care system.

    If poor women in the US could afford the regular “well woman” check-ups which are a huge part of preventive medicine, and catch medical problems before they become very serious,and maybe if uninsured pregnant American women could go to the OB/GYN on a regular basis over the course of their pregnancy, the US might not have a higher infant mortality rate than Cuba. Fucking Cuba, which, may I remind you, is considered by many to be Third World country. You know which developed country on that list had the highest infant mortality rates: Latvia. That’s the only industrialized country in the entire fucking world where more babies die in infancy than in the US. And I had a roommate from Latvia. Trust me, being able to say you’re better at something than Latvia is pretty pathetic. Like an American bobsled team saying they’re better than the team from Jamaica.

  41. Sevyn
    May 20, 2006 at 1:22 am

    As a Torontonian, I’ll chime in and say that on insurance and off I’ve been able to easily obtain free sample packs and perscriptions of the pill to last 6 months to a year. Also, if a doctor ever asked me about my fiance or family plans, I’d probably laugh out loud, then wonder wtf was going on. This is definitely the first time i’ve heard of anything like this.

  42. May 20, 2006 at 10:01 am

    Raincitygirl Says:

    Standard Mischief, do you understand fucking ANYTHING about the Canadian medical system? Because I live here, and the stuff you’re saying bears no relation to the system I’ve been getting my health care from since 1978.

    Seems like I do, but hey, thanks for your input!

    .. You can only get 13 packs (at 28 days per pack) paid for in one year. However, when I wanted to skip my period because I was going on vacation, and thus went through my 13 pack prescription in slightly less than a year, my doctor came up with a very logical solution…

    Damn, looks like I was spot on here, zuzu. Thankfully, it’s no more restricted than your average HMO here in the states. I figured it was like this the same way most people figure out which way to flick the light switch when you walk into a dark room. You don’t even think about it, most of the time just from past experience, you flick it up.

    Prescriptions are handled by pharmacies, not by the government. If you have an extended health plan, often times you can get the co-payment taken off when you get your meds, [snip rest of interesting paragraph]

    So you are saying the all encompassing Canadian healthcare has not yet reached prescription plans? That’s interesting. I do know, however that the Canadian government has instituted price controls on pharmaceuticals, nationwide.

    I have a fair bit of choice in terms of which doctor I see, certainly much more than an American whose HMO will only allow him to see certain doctors. Possibly because universal healthcare is like one big HMO, but where NOBODY doesn’t have coverage. Yes, there are problems with the damn system, yes there are waiting lists for non-emergency care and non-life threatening surgeries, but if your doctor pisses you off you can go to another one without being restricted to the doctors of whom the HMO approves.

    For this very reason, I’ve had a PPO for years. I could got to any doctor I wanted, but if I stayed on a pre-approved list, I only had to pay the copay. I never needed a referral, I could just go to a specialist if I wanted. I even had a decent prescription program. However, even though I had the very best coverage available short of visiting heads of state from corrupt third-world countries who have near unlimited funds and pay for the very best care by the hour, I still got shafted. See below.

    And if you are diagnosed with cancer or another serious illness when you go to a doctor, you will always get care. In the US, if you’re unlucky enough to be diagnosed with a serious illness at your first trip to the doctor when you sign onto a health plan, that’s a pre-existing condition, and they don’t have to pay. Which means you’re probably mortgaging your house to get treatment. I have many complaints about Canada’s health care system, but I’d take living in a country where getting seriously ill doesn’t also mean you may end up bankrupt over living in the US any day. Mainly BECAUSE I am appalled that the richest country int he world, which put a man on the moon and spends billions on fighter jets, doesn’t have a public health care system.

    Look, I’ve already freely admitted that the way we tend to do healthcare here in the USA has serious problems. And I haven’t even touched on what happens when you don’t have coverage.
    In my case, I had just about the best coverage plan one could buy.

    My GP could not figure out my problem, so he sent me to a bunch of specialist. I saw a dozen specialist on my plan’s dime, but not a single one of them spent more than fifteen minutes on me. Frequently they ordered diagnostic tests, frequently the very same tests. Two of the doctors ordered a battery of blood tests before I even saw them. I don’t “know anything” about blood test “kickbacks”, but many of the doctors employed people who’s sole job was to take blood. I think that they received payment back from the lab for every vial they drew because as soon as I instituted a strict policy of only having my blood drawn at a lab, to prevent the doctors from receiving kickbacks, the blood test batteries stopped. They were pumping my excellent coverage for cash, which drives up costs for everyone else on my system. Also, in an effort to control costs, my plan would try to disallow coverage for shit, after-the-fact of course. Oh, and I already mentioned the “drug roulette” game
    .
    In the end, I went around to the dozen doctors, got all my records (got in to a few nasties here. a few asserted that they weren’t my records) and hit the books. I had to cross index my results, make lists of all the possible nasties I might have, and then I cornered my GP at my next visit. I got his full attention for about 40 minutes, and he sat down with me and we reviewed my records, and crossed out, one-by-one, the various things that I didn’t have.

    In the end I made the diagnosis, he merely confirmed it. Treatment was surprisingly inexpensive, the actual diagnosis saga spanned over two years and cost thousands of dollars, most of which was redundant and was paid by my PPO. The not-so-funny thing is if they had sprung for perhaps an hour of real doctoring and a small battery of focused tests, they could have saved thousands.

    If poor women in the US could afford the regular “well woman” check-ups which are a huge part of preventive medicine, and catch medical problems before they become very serious,and maybe if uninsured pregnant American women could go to the OB/GYN on a regular basis over the course of their pregnancy, the US might not have a higher infant mortality rate than Cuba. Fucking Cuba, which, may I remind you, is considered by many to be Third World country. You know which developed country on that list had the highest infant mortality rates: Latvia. That’s the only industrialized country in the entire fucking world where more babies die in infancy than in the US. And I had a roommate from Latvia. Trust me, being able to say you’re better at something than Latvia is pretty pathetic. Like an American bobsled team saying they’re better than the team from Jamaica.

    I’m with you 100% on the preventive care, but the rest of this may be cooking-the-books. See this (including the comments):

    http://www.saysuncle.com/archives/2006/05/10/the_feminine_mistake/

    Raincitygirl, thank you for commenting, you have added a bunch to the discourse here.

  43. May 23, 2006 at 10:11 am

    So now that you all are done chewing me out over my inexact, but apparently good enough grasp of the state of Canada’s healthcare, does anyone wish to comment of the big freaking elephant in the living room?

    That elephant, again, is the potential for government employees of all levels, including those of which like to freeze their bribe money, to snoop into other peoples’ private medical records.

    I mean, this is the blog that informs me about the Rethuglicans preventing military family members from getting Plan B

    Or those that think “Contraception is next issue after abortion. And pro-lifers must work it through.”

    Or how the NSA is data-mining all of our phone records.

    Or how AT&T is peering all it’s Internet data with the NSA.

    Or how perhaps the FDA might be swayed into keeping the HPV vaccine off the market.

    So what’s going on here? You all know that the anti-choice people would love to get the names of those who have had abortions or even BC, so they could send them all off to the re-education camps, so what gives?

    I can only guess that those who would support any kind of government controlled healthcare either think that medical privacy no longer matters, or that the moment we get socialized medicine in the USA, the horns will blow in the heavens; the United States will instantly turn into one of those enlightened European countries, except that it’s really freaking big, and has slightly less cool architecture; oh, and all the “fundies” will melt away like the Wicked Witch of the West.

    Am I missing a third option? Please, do tell.

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