Blog 6 - Response to Against the Odds: Oral Contraception

Blog Stage 6 Assignment

Commentary & Response to “Politics: Not Worth My Vote – Against the Odds: Oral Contraceptives”

For our stage 6 blog, I have chosen to critique this article written by my peer. My background includes an Associate’s Degree in Emergency Medical Services Technology and 13 years of practicing prehospital emergency medicine. My interpretation of the article is the author’s opinion is the basic premise that President Obama and his staff are wasting resources and focus on the wrong problems. The author makes a few anecdotal and hollow comments about how there are greater problems with far larger social mores than contraception and pregnancy.

Unfortunately, I must begin this critique with some more elementary problems rather than the content. There are some marked, basic grammatical errors throughout the document. It starts with the very first word of the very first line. While I can look beyond the grammar and look more for the meaning, these issues do make the document tough to read and take credibility from the argument.

“Examine what the world coming to when our president and government is mandating oral contraceptives to be part of the preventative medicine in health care plans.”

As I said, the first word of the first sentence should be “Imagine”, not examine. But, let us imagine what the world must be coming to when our government has to mandate oral contraceptives in health care plans and family planning. There must be some inherent failure of a capitalist economy. I have written about this before. See my blog entry here. Moreover, much of this governmental intervention stemmed from pressure from a very large, very wealthy, and very influential lobbyist – the Catholic church. President Obama’s mandate stated that insurance companies must pay for preventative services, not the Church itself. This makes one wonder what dog the Church even has in the fight, other than fundamental beliefs.

Consider this: Obama received 79% of the Latino Catholic vote and 44% of the Caucasian Catholic vote. So, if the majority of the majority of the Catholic Church voted for someone who was trying to institute mandates contradictory to the Church’s tenets, what does THAT say about what the world is coming to… Moving along…

“There are better means of making other drugs or treatment free of charge than preventing future pregnancies.”

This sentence doesn’t really make much sense to begin with either. To be more specific, the above sentence doesn’t make sense - at all. I tried, really hard, to see the forest from the trees but I just could not understand what the author was trying to say.

“Pregnancy is not an ill ridden disease”

I agree fundamentally that pregnancy is not a disease but it is a significant medical condition that requires the care and oversight of a specialized physician. It also comes with complications that include a 25% spontaneous miscarriage rate for pregnancies under 12 weeks, hemorrhage, and eclampsia, all of which are a threat to the mother’s life.

“and sex is not a deadly medical emergency”

HIV and hepatitis are sexually contracted diseases that up to the last 10 years, were fatal. So actually, they are a deadly medical condition. Emergency, no. But, hypertension, hyperglycemia, dialysis, and thyroid conditions are not truly emergent in and of themselves.

“Our minds wonder why the president and the government express concern over the importance to support free birth control pills to insulin or medical equipment.”

No, my mind doesn’t wonder anything like the author stated. The government is not “expressing concern” of the importance of birth control pills over insulin and medical equipment. These are, in the most simple of terms, two separate arguments. The author may have made a more valid point by saying “the government is placing an excessive amount of concern regarding contraception; however, I feel there are far greater issues that deserve attention, such as insulin and necessary medical equipment”. Addressing the topic of insulin, medical devices, and other necessary drugs or interventions: Medicare and Medicaid both have extensive budgetary inclusions for thousands of medical conditions and medications. I have yet to meet any indigent patients who cannot receive their medications, except in the rare occasions where patients stated they could not meet their $5 deductible. Case in point: I had an 84 year old gentleman on medicare whose lymphoma chemo drug, Gleevic, cost $400/pill. That is $300,000/year. The man had to pay a $10/month copay. I have met thousands of patients over the years who are on Medicare and Medicaid and receive benefits for their conditions. His story is not unique. I can convey another person’s story whose dialysis and medications cost $610/day. He had to pay nothing because he was on Medicare. Before an attack is made on the cost of his treatment, remember this was a disabled, and i mean truly disabled man in his 30’s who could not work. The point is that most of the other interventions the author speaks of are inarguable far more expensive than oral contraceptives. My experience is that there is an exceedingly slim number of people who cannot receive what they need. Maybe they do not participate in the newest and greatest clinical chemo trials, but Medicare does not pay for clinical trials. It does pay for FDA-approved regimens.

Back to the topic regarding governmental involvement, let us remember the spirit behind the presidential mandate: the best way to prevent unplanned pregnancy is using contraception, ergo greatly reducing the chances of the mother having to even make the decision of having an abortion, which is a whole other topic.

Consider the usual women who consider having abortions. It is usually young women or women who were not planning on having children. It is logical that anyone actually planning on having children would not entertain the idea of aborting a fetus. Going back to the usual candidates, these women are unprepared to have children. Giving them an option to avoid making the decision of abortion just makes good sense, regardless of your personal beliefs. That is the entire flaw in the Catholic Church’s argument.

The reality is that people are going to do what they want. Women are going to have unprotected sex. There is also an exceedingly high correlation of pregnant women and lower socioeconomic class. We should not set them up for failure, and a really difficult decision, by not providing contraception. To remove contraception as an option, regardless of how it is paid for, is socially irresponsible.

Regarding who pays for the contraception, I will state this: if we assume tax dollars will pay for contraception, I am all for it. Why? Because the upfront cost of paying for contraception will greatly offset the long-term cost of raising a whole human on welfare. Granted, this assumes that once on welfare, always on welfare. However, that assumption is more of a generally accepted norm than a theory. Consider the long term cost to the tax payers of paying for 1, 2, 5, or even 8 kids per mother. If you think this doesn’t happen, you are exceedingly naive. I had a patient 2 days ago who was 39 years old, single mother, with 8 children. The entire family was on Medicaid, Food Stamps, and living in government housing.

You and I pay for that. Do you still think handing out birth control like candy, even at the tax payer’s expense is a bad idea? Nevermind the cost, consider the future of those children. Do you think those children have a stable, structured environment that is loving and nurturing? I am hard pressed to give you evidentiary proof, but I can tell you that I also called CPS (Child Protective Services) because of the squalid living conditions.

The last point I will make is this: consider if the woman is impoverished and a welfare recipient. How good of a chance do they have of improving their life through employment, education, public service, community service, or volunteerism if they are hindered by having unnecessary or unwanted children?

“They are just giving the green light to have tons of sex and no baby.”

This statement is rather silly but actually does make a point. The government is not sending any message saying “have all the sex you want”. But, if it were to, having contraception available to people would be a far smarter tactic than not, again regarding unwanted pregnancies.

“The citizens of the United States should not have to fund their promiscuous lives.”

I agree with the statement, but we already fund lots of promiscuity. I cite crooked politicians who abuse tax dollars, corporate tax loopholes and the outsourcing of jobs, and wildly out-of-control defense spending with zero oversight or accountability. That is far more pornographic than people having a good ol’ roll in the hay.

“What needs to happen with our health care is helping those who need high blood pressure medication, insulin for their diabetics’ needs or chemotherapy for cancer patients.”

I already addressed this issue earlier. This actually happens. A lot.

“These are the things that count because people can actually die without those types of medications and are costly.  A cancer patient will be more grateful for a free chemotherapy session to kill the cancer cells that consume their body”

Women can also die from lack of preventative medical care as I already addressed. The comment about cancer patients is speculative at best, but a logical and agreeable sentiment.

“I seriously doubt some young adult will die because she did not have sex or did not receive her dose of birth control pills.”

Again, people are going to have sex regardless.

“President Obama and the government seem concern that Horny Helen does not run out of birth control pills before she hits a fraternity house for a night of boozing and sex.  If that is their main concern, then the ill citizens of our county are in deep water.”

This final passage is hollow and speculative. If in fact we have to concern ourselves with Horny Helen’s romp at the frat house, pills and booze just increase the risk of accidental pregnancy, and ironically, the fun factor. However, if she is having unprotected sex, we also need to consider the real possibility of STDs. 1 in 4 college students have Herpes Simplex 2. If Horny Helen contracts that, she then needs to worry about receiving medication to suppress the viral contagion and sexual prophylactics to prevent spreading the disease. Lastly, we then have to worry about her contracting the HSV2 to her unborn child if delivered vaginally. Then we have a whole new set of problems.

Regarding the last sentence, our country is already in trouble. Oral contraceptives are a grain of sand on the shores of our country’s problems. We have far greater concerns. Perhaps if we educated our children on sexual awareness, health (both physical and sexual), and prevention (again, for both types of health) we can help direct their futures for a brighter, long-term future for our whole country. We need to reform our campaign finance laws. We need to decrease our national debt. We need to do a lot of things. What we don’t need to do is continue to facilitate babies having babies, the poor having more and more children, and we don’t need to arbitrarily involve ourselves in corporate decisions. However, this decision comes with a heavy price that affects a large demographic - women having sex.

I feel that Obama’s mandate was good and necessary. Thank you for reading.

Dear author - I hope you didn’t take this personally. I was awful rough on your piece but my assignment was to critique a peer’s work.