Contraception – again?!?!

2014 and we are still talking about contraception. Here in the United States where we were FOUNDED on the principal of separation of church and state.

“The Supreme Court on Friday extended a temporary order from Justice Sonia Sotomayor barring the Obama administration from enforcing the contraception coverage requirement of the Affordable Care Act against an order of Roman Catholic nuns.” NYT January 24, 2014

The  nuns object because they find the mandate offensive to THEIR beliefs. THEIR beliefs that are now being imposed on others who may not hold those beliefs.

Let us go back in time as to how the contraceptive mandate came about since that seems lost in all the rhetoric and companies discuss the mandate as though President Obama pulled it out of thin air.

July 19, 2011 The Institute of Medicine, an INDEPENDENT advisory board of the National Academies released a report “Clinical Preventive Services for Women: Closing the Gaps”  HHS had requested this report as the centerpiece of the 2010 ACA (Patient Protection and Affordable Care Act ) is its focus on preventive services rather than the reactionary health care system in existence. The idea behind the ACA is to foster optimal health and well –being.  While both men and women benefit from this, HHS recognized that women would stand to benefit more from expanded preventive services.  Thus tasking the IOM with reviewing which preventive services are important for health and well-being and recommend which of these services should be included in the guidelines.

“The IOM defined preventive health services as measures—including medications, procedures, devices, tests, education and counseling—shown to improve well-being, and/or decrease the likelihood or delay the onset of a targeted disease or condition. The IOM recommends that women’s preventive services include:

  • improved screening for cervical cancer, counseling for sexually transmitted infections, and counseling and screening for HIV;
  • a fuller range of contraceptive education, counseling, methods, and services so that women can better avoid unwanted pregnancies and space their pregnancies to promote optimal birth outcomes;
  • services for pregnant women including screening for gestational diabetes and lactation counseling and equipment to help women who choose to breastfeed do so successfully;
  • at least one well-woman preventive care visit annually for women to receive comprehensive services; and
  • screening and counseling for all women and adolescent girls for interpersonal and domestic violence in a culturally sensitive and supportive manner.


In the section on contraception they reviewed data on cost sharing and came to the conclusion that it should be available to women WITHOUT any cost sharing.

As a physician what I find most offensive about the arguments against contraceptive coverage is that the vast majority of time women are prescribed hormonal contraception for reasons that have nothing to do with contraception: dysmenorrhea, polycystic ovaries, menorrhagia, metrorrhagia, migraines, endometriosis, luteal cysts and to prevent ovarian cancer. “As the Ovarian Cancer National Alliance notes in its brief supporting the government’s position, “the contraceptive-coverage provision takes an important step forward toward increasing access to treatments that reduce the risk of ovarian and other deadly gynecologic cancers, but the position of the companies and shareholders challenging that provision jeopardizes that access for thousands of women nationwide.”  (

Dr. Nancy Stanwood, board chair of Physicians for Reproductive Health, said that hormonal contraceptives such as the pill, the patch, and the ring, “actually decrease the risk of cancers,” including ovarian, uterine, and colon cancers (ibid). IUDs reduce the risk of uterine cancer.  Cancer prevention is a reason alone to provide coverage.

Even if we strictly discuss the politics of women’s health, the surest way to reduce the abortion rate is readily available, reliable contraception.  From the Guttmacher Institute “access to the range of contraceptive methods without cost sharing can dramatically reduce the rate of unintended pregnancy, with profound consequences for women and society…reducing the rate of unintended pregnancy is by far the most widely accepted and effective means of reducing the need for and incidence of abortion.”

A law or regulation violates the Religious Freedom Restoration Act (RFRA), if it imposes a “substantial burden” on a person’s religious exercise. No one is going to force contraception on the nuns, nor the owners of Hobby Lobby nor anyone else.  Their objections to providing it as part of comprehensive preventive services is absolutely ridiculous and I find it incredulous that we are still having this debate in 2014 – IN AMERICA!.

If we allow corporations to opt out of this mandate what is next?  Chemotherapy? Surgery? Antibiotics?  Legislators need to get out of the exam room and let physicians perform their jobs. We have an extraordinary oversight body in the form of state medical boards in addition to hospital oversight, medical societies, and our colleagues.  Interfering with how we practice medicine without knowing the science as we do is dangerous.  Treatment decisions are between a patient and physician and no insurer or employer should be intervening with that.



Inoculate Yourself, ObamaCare is Working

The Affordable Care Act (ObamaCare aka ACA) is 3 years old – and we are now getting to some of the biggest provisions – including the insurance exchanges.  Enrollment in the exchanges is to begin in October for coverage that starts on January 1, 2014.  Not unexpectedly there has been a media campaign to try and undermine all the advances the ACA has brought.  Critics have spent $400 MILLION in negative (and often misleading) ads ( This exceeds the educational ads on what the ACA actually does 5 fold (

House Republicans have formalized this negative campaign: House Obamacare Accountability Project  (HOAP). This campaign is an attempt to instill anxiety and uncertainty as the exchanges roll out.  Ironically they are reaping the benefits of ObamaCare as they denigrate it ( They are requesting grant money from  the ACA for their districts as they publicly decry it and try to repeal it (

These are the same law makers who have wasted tax payor money voting to repeal the ACA 37 times, at an estimated operating cost of $1.75 million EACH TIME.  $64.75 million wasted.  Since that tactic failed, now they are trying this new method. As HOAP claim ObamaCare has a negative effect on health care costs, Kaiser has released a new study on the benefits of the Medical Loss Ratio provision of the ACA. ( This is the provision that explicitly states insurers must use premium dollars for actual health care  – something most of us assumed was the point of paying health insurance premiums.  Not only are reimbursement checks being sent to consumers, but premium costs are lower – the exact effect being sought by the provision.

What SHOULD be promoted, instead of the negative attack ads, is that the revealed exchanges have even lower premium rates than predicted ( for better coverage than consumers were paying for (thanks to the ACA’s provisions of minimal coverage).  Rate Shock is a crock as are the other doom and gloom predictions about the ACA’s effects.  Don’t be fooled. Inoculate yourself with the actual facts.  Rates are stabilizing or going down, more people will have access to care, no one can be turned down or have their care rescinded, lifetime caps are gone. ObamaCare is working.


There has been a lot of chatter recently on new taxes that the ACA imposes – specifically the 3.8% capital gains tax – this is a tax on UNEARNED income – ie from stocks and real estate. Pardon me if I do not cry.  Capital gains tax rates are currently 15%. This is far below the over 30% paid in earned income at the level mostly affected. Increasing capitol gains tax to help pay for increasing coverage to over 30 million Americans makes sense.  The same people complaining will also likely  get tax credits for supplying coverage to their employees – for small businesses this is a 35% credit increasing to 50%.  ( It strikes me that the complaining is just obstructionist.


The ACA is law of the land. Rather than sticking heels in the sand and pouting we need to get to work to ensure that ALL Americans have access to affordable, quality healthcare.  That means having the coverage to get preventive services – now supplied without cost sharing.  It means we, as physicians, can intervene BEFORE a health condition warrants a visit to the emergency room. It means we can potentially avoid costly care.


I am tired of seeing fighting for fighting sake.  This latest tact of complaining about taxes is just not warranted.  The actual tax provisions are laid out by the IRS:  The doom and gloom talk is really unwarranted.  What is more laughable is that some of the uncertainty around insurance  – cost increases due to aging employees – existed long before the ACA and is in fact one of the reasons we need the ACA – now thanks to the new law insurance companies cannot:

-rescind care

-put lifetime caps on benefits

-spend more than 20% of premiums on administrative overhead, including executive salaries

-refuse to cover due to pre-existing conditions (children already have this provision and adults will as of 2014. Meanwhile there is a high risk pool to buy into).

-raise rates without justification.

We need the ACA for sentiments such as this “The company is particularly concerned about having to offer health benefits to about 400 employees who work more than 30 but less than 40 hours per week, as the law stipulates it must do beginning in 2014”


The idea that companies have their employees work more than 30 hours but less than 40 hours per week to AVOID paying benefits is why we have the situation that we do.  It is not entitlement mentality to want benefits for the hard work being done – rather denying benefits is a direction this country has taken that must stop.  We have lost compassion in our society. The ACA seeks to help put that back.

Patient Over Politics


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I spent last week in Tampa, yes at the same time as the Republican National Convention was occurring. I brought my sons to be part of the Patients Over Politics bus tour – truthfully they had no choice but to come as it also coincided with my 50th birthday – nothing like a little maternal guilt.   The purpose of this tour (still ongoing now at the Democratic National Convention) is to educate.  It is a plea to politicians to stop the rhetoric, stop politicizing, and help us to take care of patients.

Dr Cat in the hat with her 2 sons: Thing 1 and Thing 2


The Affordable Care Act was passed by congress. It was then deemed constitutional by the Supreme Court. Yet the political discussions continue as though it is still under discussion.  And it is patients who are suffering.  There is now so much confusion of what the truth is about the ACA that we found people eager to learn.  Of course many were further perturbed that they had not heard the facts – and wanted to know why.

While the majority of the people we encountered were open to learning, and hearing facts, we of course had hecklers. There was the guy who ran through, and hearing that we support the ACA told us to move to Canada. The ACA is in no way a government takeover of healthcare. In fact it strengthens the private market and has room for innovation.  Tufts University in Massachusetts just received a grant to start a consumer owned health plan (

We hear about $716 billion.  Some of the rhetoric claims that it is being “robbed” from Medicare – though Politifact called that a “mostly false” claim ( There are savings being built into Medicare – mostly through cuts in payments to private insurers through Medicare Advantage –  that over the next 10 years result in $716 billion in savings.

Hecklers aside, it was fascinating watching people learn. Those that stopped by our booths often started out against the ACA – but really had no actual data to back up this opinion. By the time we finished speaking with them many signed a Declaration of Support (  Minimally they took a fact sheet and clearly were interested in knowing the truth.

One of the best moments of the week was during our march on the last day of the RNC. Tampa was filled with police and barriers (the previous RNC in Minnesota had over 10,000 protestors and 300 arrests – including reporters and in 2004 over 1800 were arrested). As we marched we were suddenly surrounded by police in formation – they blocked traffic so we could continue! And as we marched they were behind and to the side of us as a police escort. At the end of the march they handed us all cold bottles of water – yes you read right, the police gave Doctors for America water.  Some of them spoke with us at different points over our time in Tampa – clearly they were supportive.


There were many foreign reporters present and universally they could not understand the opposition to expanded access to healthcare.  Since they came from Europe, Australia – countries with single payer systems – they were mystified that anyone would want to repeal a law designed to increase basic health care.  Frankly so are we.

 marching in Tampa on the last day of the RNC



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I am employed by a hospital, and have health insurance through my job (pretty good coverage) the has an employer contribution and employee contribution.  I still get confused, though I have the hospital’s own plan, about what is covered and what is not – I can only imagine how hard it must be for my patients.

The prescription plan that comes with this insurance is pretty straight forward – $40 for brand name pharmaceuticals, and $10-$15 for generics.  Some exceptions but this is pretty straight forward.

I switched pharmacies recently, and had prescriptions transferred to the new big chain pharmacy.  One a generic medication, one a brand name (old medication been around a long time).  The new pharmacy did not yet have my insurance information so I was not surprised that when I received an email that my prescriptions were ready I did not see the copays I listed above.  Instead, 30 pills of the generic medication were $68 and the branded $148.

When I went to pick the medications up, my 14 year old son was with me – he wanted to know if it was for some new chemotherapy agent as he was shocked at the cost being so high – then I explained that actually those prices are low – that new drugs could be thousands per month.

I was, however, a bit surprised at the cost – so I looked it up and the sticker price of the one that this big chain wanted to charge me $148 is $84.97 for 90 pills.  The generic that they wanted to charge me $68? $15 for 30 pills.

How can we possibly reign in medical costs when our pharmaceutical costs exceed that of any other nation (the excuse being funding research and development but that does not explain why we pay for the whole world’s drug supply) and further pharmacies are raping us?

I understand profit but this is seriously out of hand.

Right now, prescription drug costs are only 11% of healthcare spending however with an aging population that is shifting and with the obesity epidemic, spending on hypertension, diabetes and other complications are only going to go up, with medications the mainstay of therapy.

We need accountability – from insurers, pharmaceutical companies and pharmacies.

The Obesity epidemic – response to WSJ editorial


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“The Weight of the Nation” editorial is so blatantly biased and ignores the 462 page tome – clearly the writers did not bother to read it.

The writers admit: “No question the bulging U.S. waistline is a public health problem. Two-thirds of Americans are now overweight or obese, a trend that began in earnest only over the last 25 or 30 years. For the first time in history, more Americans are obese than smoke. The report estimates 20.6% of annual medical spending is attributable to obesity, much of it absorbed by taxpayers via Medicare and Medicaid.”

Indeed this is the issue and we need a multi system approach to help solve it. Obesity-related medical costs in general are expected to rise significantly, especially because today’s obese children are likely to become tomorrow’s obese adults – the nation will incur higher costs for disability and unemployment benefits, and businesses will face the additional costs associated with obesity-related job absenteeism and lost productivity

The editorial makes this accusation: “The institute’s panelists don’t come out for entitlement reform or new incentives for individuals to maintain a healthy weight through diet and exercise, “

This is blatantly wrong. The IOM report is a product of years of research and consensus building among our country’s most reputable obesity experts. As it states, causes of increased obesity in the United States—the influences that have led people to consume more calories (or energy) through food and beverages than they expend through physical activity—are multifactorial, ranging from cultural norms, to the availability of sidewalks and affordable foods, to what is seen on television.

If a community has no safe places to walk or play, lacks food outlets offering affordable healthy foods, and is bombarded by advertisements for unhealthy foods and beverages, its residents will have less opportunity to engage in physical activity and eating behaviors that allow them to achieve and maintain a healthy weight. Successful obesity prevention thus involves reducing negative and increasing positive influences on a societal level

THE IOM addresses the difficulty of maintaining energy balance when sedentary lives are the norm and high-calorie foods are ubiquitous. They determined this was best done by approaching in 5 ‘stakeholder’ areas:

1) integrate physical activity every day in every way

2) market what matters for a healthy life

3) make healthy foods and beverages available everywhere

4) activate employers and healthcare professionals

5) strengthen schools as the heart of health

Science is about embracing the rational, and it is irrational to watch our country’s medical bill rise above 2.9 trillion dollars, and our national obesity rate head toward 40%, and not do something. It is also irrational to expect people to be able to avoid obesity if the tools –healthy diet and daily exercise—are not available to them. What our free market system has done, by commodifying necessities, is to create food deserts (communities where poverty has limited food sources to corner bodegas selling junk food) and a transportation system that makes walking and biking hazardous to your health.

The solution of course is to make it easy to be healthy and hard to be unhealthy, and we know how to do that. First, we confront junk food as we did tobacco, and recognize it for the engineered, addictive combination of fat, salt and sugar that it is. It does not deserve the privileged tax free status that food enjoys, nor do its raw ingredients deserve the subsidies they currently have, and the tax income can go to subsidize small, local farms. Then, we invest in a public transportation system designed around walking and biking, since it has been shown that simply using busses and trains instead of cars gives people the 22 minutes a day of physical activity they need to stay healthy. This is what the IOM report does in its 462 pages. Take what we know and apply it.

The editorial states: “Others are more novel—zoning rules that encourage bike paths, parks and grocery stores (but not gyms and health clubs)“– who would pay for gyms in poor neighborhoods? Parks are free. In many parts of the United States, low-income individuals and families live, learn, work, and play in neighborhoods that lack sufficient health-protective resources such as parks and open space, grocery stores, walkable streets, and high-quality schools. The first step is to ensure that changes.

The editorial accuses: “But the most dangerous idea is the call to turn over a large part of fiscal policy to a scientific committee. “

How is it dangerous? You would rather religious zealots and politicians make policies that have failed? Some of which are dangerous? “The panelists want to expand farm subsidies—entitlements for plants and animals—to include fruits and vegetables.” This is bad why? One of the main issues is the cost of fresh fruit and vegetables. “They would have done far better to endorse an end to subsidies for row crops like corn, which become low-quality calories via refined starches and high-fructose corn syrup”. – ahh so take up the political mantel that HAS been tried and failed due to large lobby. This can happen when we stop compromising democracy and our future with unlimited political spending – which was NOT the point of this report.

“”The Weight of the Nation” also comes out for using the tax code to promote social policy via “substantial and specific excise taxes on sugar-sweetened beverages,” aka a soda tax.” No – it is VERY clear that this is not just soda, but energy drinks, flavored coffees and teas which have been the issue. The wording: excise taxes on sugar-sweetened beverages (e.g., cents per ounce of liquid, cents per teaspoon of added sugar), with the revenues being dedicated to obesity prevention programs “This option will grow more appealing to the political class as federal and state balance sheets continue to deteriorate, but one thing it won’t do is improve public health.” Wrong again: both California and Boston school programs clearly show decrease in consumption of soda with incentives. By reducing calorie intake among students, even modestly, it will result in 16 fewer pounds gained per year. Cigarette taxes have dramatically reduced teen smoking rates so why do you doubt its application to sweetened beverages (which of course gets at the underlying corn subsidy since much of corn ends up as High Fructose Corn Syrup)?

It comes down to: whom do you believe? We choose to believe the dedicated scientific experts of the Institute of Medicine rather than the Wall Street Journal Editorial Board. We will let you judge who has partisan motivations and who has ambitions to better the health of our nation.

(this post was written with generous help from Chris Lillis, MD and Becky Jones, MD)

Uninsured affect the care of those insured


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We are a month away from hearing the Supreme Court decision regarding the Affordable Care Act, and this week 2 studies highlight the need for the ACA.

We know that being uninsured is detrimental to one’s health, resulting in worse health outcomes, but a new study by a healthcare economist shows that high rates of uninsured mean worse outcomes even for those with coverage.  From 1999 to 2006, California had a 19% reduction in mortality from heart attacks. Across the state there was a large variation: San Francisco and Los Angeles had decreases between 26 percent and 30 percent, while in Sacramento, the drop was just 13 percent.

The author compared outcomes for insured heart attack patients in these cities, controlling for basic demographic information, as well as preexisting conditions.  He found that in cities where more uninsured patients are treated there were worse outcomes for insured patients.

The author estimates that, if uninsurance were eliminated, there would be 3 to 5 percent fewer deaths among those who already had coverage.

He describes this phenomenon as “negative spillover”.  Hospitals that treat more uninsured patients have a higher rate of uncompensated care which takes away resources that could be used to upgrade medical equipment, improve staffing or other investments that improve health outcomes. This results in worse care for ALL patients treated at the facility.  Conversely, increasing insurance coverage might have “positive spillover” effects – improving the quality of care for the already insured.  The author concludes that policies aimed at addressing the uninsured may have additional benefits to insured patients in the same communities.

The other study, by the Urban Institute, shows that access to care is eroding for millions – even those with insurance. The findings suggest that more privately insured Americans are delaying treatment because of rising out-of-pocket costs, while safety-net programs for the poor and uninsured are failing to keep up with demand for care. Overall one in five American adults under 65 had an “unmet medical need” because of costs in 2010, compared with one in eight in 2000.

People with private or public health insurance have significantly better access to care than the uninsured. If the ACA is overturned or scaled back, “we would be likely to see further deterioration in access to care for all adults — uninsured and insured alike,” it concludes.

While the Affordable Care Act does not solve the US healthcare paradox of both overtreatment and undertreatment it is certainly a first step in the right direction.  Quality healthcare for all Americans starts by covering all Americans.

Reproductive Slavery


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What do you call it when you force someone to do something against their will? Slavery.  Yet this is exactly what the anti-choice movement wants to do – force women to stay pregnant even when they do not want to be.

Nearly half of all pregnancies in the United States are unintended. This is one of the reasons that contraception is included in the Affordable Care Act.  Contraception sometimes fails. Rape and incest happen. For all these reasons and more abortion needs to be safe and legal.  Doctors who practiced before Roe v Wade passed remember women dying from illegal abortions.  For those who need a reminder:

The flurry of anti choice legislation that has appeared around the country is predominantly (if not exclusively) the work of AUL (Americans United for Life) – ALEC’s antichoice ‘cousin’’s_equally_despicable_anti-choice_cousin_?page=1

AUL is present at ALEC’s meetings.  They even exhibit.  Their styles are identical.  Clearly they are connected.  What I find offensive (apart from co-opting the entire democratic process that is supposed to define this country) is their insidious use of rhetoric.

They frame ultrasound legislation as ‘informing’ the mother – yeah I think she knows she is pregnant and where that leads.  The crisis pregnancy centers position themselves near Planned Parenthood, then blatantly LIE to vulnerable women that they can get their new mandatory ultrasounds there (well yes they can get scanned but not the one that they need).  This is coercion. Plain and simple.  It is not a physician going through explaining things, it is an anti choice counselor brain washing. And yet  for all the ‘informing’ they have also introduced legislation shielding doctors from lawsuits for lying to patients about birth defects to discourage terminations – so is the mother to be informed or not?

Where are all these rabid anti choicers after the baby is born (for the ones they talk into staying pregnant). They label abortion, a legal medical procedure, “murder”.  They call the cluster of cells a “baby”.  Not only is this a lie from a scientific point of view,  some religions do not consider the fetus to be a person until it is born – so yes, this rhetoric is religious persecution.  Abortion is not murder no matter how many times that lie is repeated.  They use inflammatory pictures and hideous descriptions yet call the prochoice movement violent?

They have introduced legislation to legalize murdering a physician who has performed abortions!  They incite violence and  do not denounce the numerous bombings and murders that have occurred.  How is this “pro life” as they like to call  themselves?  This is not pro life.  It is anti choice.

For me it certainly brings to question what happened to Abby Johnson to make her such a woman hating, sanctimonious choice hater? And Charmaine Yoest?

I can understand not choosing for yourself, but for others?  To deprive other women dominion over their own bodies?

Motherhood is an important and difficult job ergo it should never be forced on anyone:

We need to respect each woman’s choice – to have children or not, to stay home or not. Most importantly we must make sure that everyone is free to choose of their own free will.  This country was founded on that principal.  We the people.

AUL and its clones should go start a theocracy somewhere else where they can feel free to spew their rhetoric and legislate at will.  78% of Americans believe that abortion should remain legal.  Let’s make sure that it does.


The latest bit …

The latest bit of propaganda is to simply deny that there is a War On Women – that it is made up by the Democrats. Really?

This is borrowed from a comment discussing Rachel Maddow’s coverage (Yes women notice when you try to take away our rights)

War on Women… what war on women?

– Every GOP Senator voted AGAINST Equal Pay for Women Act
– Every GOP Senator voted AGAINST Al Franken’s Anti-Rape Amendment

– Every GOP member vote FOR Anti-Safe Abortion Legislation

– Every GOP member vote FOR Blunt/Rubio Anti-Women’s Equal Health 
Coverage Amendment. While Blunt/Rubio Amendment does not allow employer 
to deny men employee health coverage for Vasectomy, the Blunt/Rubio 
Amendment allows Employer to deny female employees & female 
dependents: contraception, tubes tied, and hysterectomies.

– GOP Redefine Rape

– GOP write legislation to probe metal prongs up a woman’s vagina

– GOP change legal term for victims of rape, stalking, and domestic violence to “accuser”

– GOP write legislation that could make it legal to murder a doctor who provides abortion care. (South Dakota GOP)

– GOP write legislation to cut nearly a billion dollars of aid to low-income pregnant women, mothers, babies, and kids.

– GOP write legislation that would let hospitals allow a woman to die
rather than perform an abortion necessary to save her life.

– GOP write law cutting ALL funding for low-income kids saying “Women
should really be home with the kids, not out working (Maryland)

– GOP Cut Funding for Head Start, by $1 Billion.

– Two-thirds of the elderly poor are women: GOP write Bill to CUT 
funding for employment services, meals, and housing for senior citizens.

– GOP Candidates for President vow and pledge to Cut Funding for Planned Parenthood.

– GOP voted for a Amendment to cut all federal funding from Planned Parenthood health centers.

– GOP write Bill to eliminate all funds for Federal Family Planning Program.

– GOP Write Bill to Provide Contraception for wild horses but ENDS 
all Federal Funding for Family Planning, including contraception 
coverage. (Dan Burton(R))





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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.