Religiosity

Tags

contraception, erectile dysfunction, mandate, politics, religion, women

I had a big twitter fight today with one of my friends.  He is Catholic. He does not think there is a war on women.  He thinks that Obama started the fight with the birth control coverage mandate.  I keep trying to explain to him that it is just a piece of the puzzle – the over 400 pieces of legislation around the country aimed at slashing women’s rights are what make this a war on women.

But let’s just focus on the religion excuse re birth control shall we?

I have said this before but it is worth repeating. If this were about religion then men should be feeling the heat too.  Erectile dysfunction drugs have ONE purpose.  To get a man erect – for sex. Catholics believe that sex is for procreation – only.  For me to believe for one second that the lack of contraceptive coverage is about religious beliefs I would need to see similar legislation connected to erectile dysfunction drugs.

Catholics believe that homosexuality is an abomination – yet no screening for sexual preference is in place prior to coverage of ED drugs.

Catholics think that sex outside of marriage is an abomination – yet no proof of marital status is demanded prior to coverage of ED drugs.

Catholics believe that sex is only for procreation – so where is the proof that the drugs will be used for procreative purposes prior to their being covered by insurance? This is pretty laughable since the majority of prescriptions are for men beyond the child rearing phase of life – their wives in fact might even be post menopausal.

Hormonal contraception has a host of other uses than contraception – treatment of dysmenorrhea (painful menses), menorrhagia (heavy menses), metrorrhagia (frequent menses), polycystic ovarian syndrome, luteal cysts, acne.  Additionally just being able to skip menses and/or schedule it is reason enough!  Hormonal contraception is protective against ovarian cancer.

According to the Guttmacher Institute 58% of oral contraception prescriptions are written at least in part for a reason other than contraception.  I would argue that number is higher when you consider convenience and cancer prevention.

So please stop the religious  rhetoric.  Until men are subjected to the same ridiculous constraints as women, I don’t believe it and neither do my colleagues.

Bad Medicine

Tags

abortion, doctor patient, ultrasound, war on women

Being a physician is a privilege. I am entrusted by my patients to care for them.  The doctor patient relationship is a unique and special one – and it needs to be nurtured and properly cared for – as any relationship.  I do not ever take this privilege for granted. 

When someone comes into see me whether for preventive care or with an issue, we discuss what tests should be done.  The patient and I. Already we have some intrusion into this space – insurance companies and their third party screening companies. And these intrusions erode that sacred space of my office.

So now, as I watch all over America state legislators are practicing medicine without a license.  They are ordering unnecessary tests on my patients and inserting themselves into the sacred space of the doctor patient relationship – tainting it.  The decision to have an ultrasound is one for doctors to make along with their patients –  the government should have nothing to do with it.  

They cloak these new laws around informed consent – well I learned about informed consent in my 4 years at Yale Medical School and my 3 years of residency at Oregon Health Sciences University – I am fairly certain my colleagues and I know the risks and benefits of procedures and tests.

Unnecessary tests are not without their own risks.  Ironically, ultrasounds have unknown effects on fetal development – with these bills’ endgame to be preventing abortion, they could well be harming these fetuses with potentially fatal consequences.

In an era where we are trying to rein in medical costs, adding unnecessary tests is irresponsible.  It is bad medicine.

Costs

Tags

contraception, cost, viagra, war on women

So the right wing pundits keep saying that oral contraception pills (ocps) are so cheap – that you can just go down to Walmart and get them for $9 a month.  Uhm no – that is IF you have insurance coverage and that is your generic copay.

The latest data available for Average Wholesale Prices (AWP) is from 2010.  From http://www.regencerx.com/docs/physicianRx/womens-health-natazia-1010.pdf:

The prices for AWP are $20-$180 – that is the WHOLESALE cost.  So double that number for what it costs women without insurance.

And last I have seen prices for drugs have gone UP not down so 2012 costs are likely higher.

I would again argue that the majority of time hormonal contraception is used it is NOT for birth control but for one of a myriad of medical reasons: dysmenorrhea, menorrhagia, metrorrhagia, polycystic ovaries, cycle regulation, endometriosis, luteal cysts, mittelschmertz etc.

I don’t see the same people asking men to pay for their Viagra out of pocket: AWP $8.75 per pill (http://content.healthaffairs.org/content/19/2/147.full.pdf) and erectile dysfunction is not a medical condition that will effect your day to day life. It does not cause excruciating pain, anemia infertility, cancer not any of the things that ocps are used to treat.

Insurance companies understand that even when used solely as contraception, ocps are cost effective.  For every $1 spent on contraception, $4 are saved.  Abortion, pregnancy and raising a child cost a lot more. Insurance companies do not have an issue with the contraceptive mandate.  It is solely religious fundamentalists.  Separation of church and state means this is a personal choice. It means if you do not believe in birth control nor abortion you do not need to use them.  It does not mean you have a right to inflict that on others – that is religious persecution.

Stop the War on Women

Farm Animals

It is bad enough that all around the country new legislation is added (it seems daily) that restricts women’s healthcare – whether her right to terminate a pregnancy or her right to obtain and have her insurance cover medication –  now male lawmakers are comparing women to cows and pigs.

And like the barnyard animals, in Georgia, legislation is pending to prohibit women from obtaining an abortion after 20 weeks even when the fetus has died.  State Representative Terry England explained why women would be forced to carry a dead fetus (or a nonviable fetus) by explaining how he had delivered dead pigs and dead cows – that life gives us experiences: http://thinkprogress.org/health/2012/03/12/442637/georgia-rep-compares-women-to-animals/

Georgia House Bill 954 passed 102-65.

I cannot imagine the horror of carrying a dead or non viable fetus around for up to 20 weeks.

I lost a child late in pregnancy due to a cord accident – around 20 weeks actually.  It was bad enough to lose her,  to endure labor (I was induced) and bury her.  But to imagine walking around for months with a dead fetus, looking visibly pregnant, having people  ask me when I was due?  This is so monstrous I cannot believe any human being could be so cruel as to imagine this is ok – but apparently in Georgia 102 of them think so!

And dead tissue is an infection risk – how many women would die from sepsis if this becomes law?

Do none of the 102 who voted for this horrific law have wives? daughters? sisters? mothers?

Perhaps the men writing these laws should just stick to sex with farm animals – that way the women will be safe from  the cruelty they might have to endure.

Mobilized

Tags

feminist, NARAL, NOW, planned parenthood, rights

I never really considered myself particularly political nor truly a feminist but these last few weeks have changed that.   As Barbara Grufferman so eloquently states in today’s Huffington Post piece I am mad and taking action.

In the last 24 hours I have donated to Planned Parenthood, NARAL, NOW and added numerous feeds to my twitter account – all around the issues of women.

So yes, I am embracing the word feminist.  No longer complacent, no longer so sure that in America I will always have rights  - I am on the bandwagon.  I will speak, I will vote, I will donate and help try to stop the madness that has embraced this country.

The owner of the uterus is the only one with a say as to what happens in it and around it.

Stop the war on women.

 

The GOP War on Women

Tags

contraception, GOP, men, religion, women

If the Catholic Church is so opposed to contraception that they need to deny insurance coverage (even when used for medical conditions – the vast majority of prescriptions I would argue) then why not an equivalent furor over erectile dysfunction drugs (Viagra, Cialis, Levitra – all PD-5 inhibitors)?

The Church regards homosexuality as an abomination, yet there is no screening men for sexual orientation prior to covering the cost of PD-5 inhibitors.

The Church regards sexual intercourse outside of marriage as adultery  - yet there is no requirement of proof of marital status of men prior to covering the cost of PD-5 inhibitors.

The Church regards sex as a means for procreation ONLY – therefore PD-5 inhibitors should only be covered for men who are having sex to procreate.  Where is the demand for men to prove their intentions?

The whole GOP argument that requiring religious institutions (and face it we are talking about Catholics here as no other group has refused coverage of selective medications) to cover contraception is a violation of religious freedom is a fallacy.

It is an attack on women.  An attack on women’s health.

If this were about religious freedom then PD-5 inhibitors would not be covered by Catholic institutions.

And as long as we are talking about attacks on women’s health, what about the requirement for vaginal probe ultrasounds prior to pregnancy termination?  The arguments given for this procedure are to protect women, to fully inform women – well where is the equivalence for men?

Erectile dysfunction can be an early sign of cardiac disease.  It can be a sign of a tumor.  So should we not equally protect men?

There should be a cardiac workup – minimally an exercise stress test.

There should be screening for colon cancer – a colonoscopy and there should be screening for prostate and bladder issues  - cystoscopy (yes that means a probe and camera up through the penis).

The GOP arguments would not sound so hollow if  these arguments were equally applied to men.

The reality is that there truly is a war on women.  How sad is it that 100 years after Margaret Sanger women are still fighting for control of their own biology.  How sad is it that these rights are so threatened that rather than use my vote for ALL the issues I need to vote on protecting women.  I thought these rights were secure.  I thought former President Bush sent troops to Afghanistan to help women there have rights when the Taliban has kept women suppressed. Apparently the United States will fight for women abroad but not at home.