Not the same thing at all.

[Lord Jim]

Meade and Oldr, I understand the moral argument that you folks are making, (many of my conservative friends make this argument) but I would respond with a practical cost/benefit analysis argument:

The folks who are least likely to be able to afford the $50 per month for birth control, are precisely those folks (young, uneducated, unmarried, underemployed women) who will be least likely able to properly care for a child financially or in any other way...(instilling the value of education, keeping them away from criminal elements, etc.)

Therefore, the question isn't should we be paying for these folks to "bang way" but how we as a society are going to bear those costs...

Are we going to bear them in terms of a host of subsidies we provide for the child (or children) that the person cannot afford to raise on their own? Are we going to bear them in terms of the additional costs to our society and legal system that children born into situations like this disproportionately represent when they get older? Are we going to bear them in terms of the whole cycle repeating itself with the children then born to these children, raised and living in the same circumstances?

Or are we going to provide $50 a month (less from a government cost standpoint) to prevent that from happening? (And then perhaps the women involved will choose to have children at a time in their life when they are more mature and better prepared, and those children will represent less of a burden to society and have a better chance in life.)

When you crunch the numbers there's no comparison...

"We" are going to "pay" either way...that's simply a fact...

Providing birth control costs a hell of a lot less...

[Big RR]

[Econoline]

The folks who are least likely to be able to afford the $50 per month for birth control, are precisely those folks (young, uneducated, unmarried, underemployed women) who will be least likely able to properly care for a child financially or in any other way...(instilling the value of education, keeping them away from criminal elements, etc.)

Therefore, the question isn't should we be paying for these folks to "bang way" but how we as a society are going to bear those costs.

[BoSoxGal]

Bravo LJ!

If Republicans were really Republicans anymore, they'd subscribe to your rational, fiscally conservative position.

But the Tea Party rules with its religious zealotry, so instead we must punish the women for saying yes to sex - never mind considering that all this procreative sex is only happening because men are asking for it - no moral judgments there!

[Crackpot]

There is also the medical applicatio of contraceptives that are largely ignored. I suspect not so much on purpose but as a seemingly instinctive reaction by men to tune out any "bad news" about our favorite hiding place. The only reason I know they exist is a girlfriend of mine had those issues and all I can remember about the conversation is "painful" and "birth control helps" and that was almost too much to take about our personal happy place. Unfortunately us guys just want to enjoy the place and not know about the cost of upkeep.

[MajGenl.Meade]

we must punish the women for saying yes to sex

Goodness me - is that what "we" are doing? This is not, on the level I am suggesting, a 'moral' issue at all (LJ) but entirely one of respecting a person's free choice to do what they want.

Some of you seem to have a view of women as powerless idiots who need a nanny to stop them from "falling" pregnant. They don't fall - they leap. You have sex = you get kids (or not as fortune has it). That is the natural way of the world.

Women control their own bodies, don't they?

Mind you, where a company does have a moral position (whether I agree or not), is it not possible for them to provide some kind of medical savings plan which the good ladies can use to purchase aspirin or support hose or contraceptives according to their own desires and sense of self-responsibility?

True, this is rather like the USA providing money to Israel for "non-military" projects, knowing all the time that it frees the Israeli budget to buy weapons instead of park benches. It's a bit 'turning a blind eye'. (But it would my solution if I were an employer - hypocrisy anyone?)

I am willing to bet that the numbers of women accidentally becoming pregnant (who on earth would guess that might happen?) because they chose to say "yes" without protection will not alter one bit. Because women, being about as human as men, choose just as often to do the stupid thing rather than take advantage of what is available by their own choice.

What we need is some data on how many women who do have health insurance with contraceptive benefits "accidentally" become pregnant and how many women who can afford contraception actually don't . . . and get pregnant. Is there such information? Unless there is, to strenuously claim that the inclusion of contraception in HC will reduce those numbers is to whistle in the wind. In the dark.

[Long Run]

It would be interesting to see a study on whether having access to free/low-cost contraception reduces unwanted pregnancies. I would assume that it does, and for that reason, I would go with the practical approach of making contraceptives a required part of a health plan (there are many required provisions in health plans that are not nearly so cost-effective and do not help eliminate such a significant societal problem). The above cited arguments against requiring providing contraceptives all are reasonable, but they are trumped by the practicality of following reasonable policies to reduce unwanted pregnancies.

[Lord Jim]

Well, here's a study that shows that the availability of free contraception not only dramatically reduces the pregnancy rate among teens, but slashes the abortion rate as well:

The researchers enrolled 9,256 women from the St. Louis region into the Contraceptive Choice Project between August 2007 and September 2011. The women were aged 14 to 45, with an average age of 25, and many were poor and uninsured with low education. Nearly two-thirds had had an unintended pregnancy previously. Participants were either not using a reversible contraception method or willing to switch to a new one.

Researchers provided free, FDA-approved birth control to the women for three years. The women were given their choice of contraception, including oral birth control pills and long-acting reversible contraceptive (LARC) methods like implants and IUDs. The researchers specially briefed the participants on the “superior effectiveness” of LARC methods — the T-shaped IUD, or intrauterine device, has close to 100% effectiveness and can last five to 10 years, for instance — and 75% of women chose those devices over the pill, patch or ring.

Over the course of the study, which lasted from 2008 to 2010, women experienced far fewer unintended pregnancies than expected: there were 4.4 to 7.5 abortions per 1,000 women in the study, after adjusting for age and race — much fewer than the national rate of 19.6 abortions per 1,000 women and lower also than the rate in the St. Louis area of 13.4 to 17 abortions per 1,000 women.

The effect of free contraception on the teen birth rate was remarkable: there were 6.3 births per 1,000 girls aged 15 to 19 in the study, compared with the national rate of 34.3 births per 1,000 teen girls.

http://healthland.time.com/2012/10/05/s ... ion-rates/

[Guinevere]

Yo, LJ and Long Run, rubato posted that data a page before . . . .

IUDs and norplant are the two most effect and long-term cost effective forms of birth control. High initial costs prevent a lot of women from getting them; an ideal candidate for an insured benefit or one at public cost.


One of the best ways of avoiding poverty for children as well.

http://www.usatoday.com/story/news/nati ... n/1613691/

Free birth control project cuts teen births, abortions
Kim Painter, Special for USA TODAY 12:34 a.m. EDT October 5, 2012
hormonal implant


An experimental project that gave free birth control to more than 9,000 teen girls and women in one metropolitan area resulted in a dramatic decrease in abortions and teen pregnancies, a new study shows.

It wasn't just the "free" part that led to rates far below national averages, researchers say. They also credit the long-acting highly effective methods of contraception chosen by 75% of the participants – namely intrauterine devices (IUDs) and hormonal implants.The findings come as cost-free birth control is becoming available to more women under a much-debated provision of the federal health care law. The provision was supported by many women's health advocates but
strongly opposed by the Catholic Church and many social conservatives. Dozens of lawsuits have been filed around the country. The study also comes weeks after the American College of Obstetricians and Gynecologists declared IUDs and implants front-line contraceptive choices for sexually active teen girls.

The study, published online in Obstetrics & Gynecology, was carried out in the St. Louis area from 2007 to 2011 and included participants ages 14 to 45 who said they wanted to avoid pregnancy for at least a year.

All were told about various methods of birth control and allowed to choose among them – but they did get counseling that stressed that IUDs and implants are much more effective than birth control pills and other methods, says lead researcher Jeffrey Peipert, professor of obstetrics and gynecology at Washington University School of Medicine.

Data suggest IUDs and implants fail up to 20 times less often than pills, which failed at a rate of about 4.5% in this study. Yet just 8.5% of U.S. women used IUDs and implants in 2009, says Megan Kavanaugh, senior research associate at the Guttmacher Institute in New York.

So the St. Louis researchers were stunned when 58% of the participants chose IUDs and 17% chose implants, Peipert says: "We found that when cost is not an issue, what is really important to women is that a method work really well."

Among the results:

-- A teen birth rate of 6.3 per 1,000 in the study, compared with 34.3 per 1,000 nationwide.

-- Annual abortion rates ranging from 4.4 to 7.5 per 1,000 women in the study vs. 13.4 to 17 per 1,000 in the region and to 19.6 per 1,000 nationwide in 2008, the most recent national data available.-- Falling rates of repeat abortions in the entire St. Louis region but not nearby Kansas City. The researchers say this is linked to their study, which recruited some women from abortion clinics.

"These findings really show promise for what could happen on a national level," with a combination of free birth control and promotion of the most effective methods, Kavanaugh says.

Jeanne Monahan of the conservative Family Research Council suggested contraceptive use can encourage riskier sexual behavior. "One might conclude that the Obama administration's contraception mandate may ultimately cause more unplanned pregnancies since it mandates that all health plans cover contraceptives, including those that the study's authors claim are less effective," Monahan said.

The devices and insertion can cost several hundred dollars. An IUD, which contains copper or a progestin hormone, is inserted in the uterus and lasts five to 10 years. Hormone implants, the size of a matchstick, are placed in the arm and last three years.

Cost is not the only barrier to more widespread use, says Tina Raine-Bennett, research director at the Women's Health Research Institute at Kaiser Permanente Northern California. Many doctors don't suggest the long-acting methods, she says, because they are not trained to insert them or remember outdated information about a faulty IUD discontinued decades ago.

Raine-Bennett led the committee of obstetricians and gynecologists that recently recommended IUDs and implants for teens. "They are as effective as sterilization, but they are reversible," she says.

Under provisions of the Affordable Care Act that went into effect in August, insurers must cover birth control as well as many other preventive health services for women. Colleges, non-profits and other employers affiliated with religious organizations that object to the rule have been given an extra year to comply. A number of legal challenges by states and employers are underway; one was dismissed this week.

yrs,
rubato

[MajGenl.Meade]

No LJ (and Guin) it does not show anything about the "availability" of free contraception.

These studies show what happens when women are "given" free contraception and sign up for a monitoring programme which pressures/reminds/requires them to keep choosing to use it - or in the case of IUD/implant their 'choice' is required only once. Even the pill/condom group tend to (oddly enough) keep using it. All it proves is that contraception reduces unwanted pregnancy and abortion - has that ever been in dispute in this century?

We need a study that demonstrates women availing themselves not of something handed to them but of something they have to go get. How many go get it? How many don't and become pregnant? Does the sheer fact of availability make the difference and if so, by how much? Is there a case then for compulsory use of IUD/implant type devices so that women of all classes, incomes and HC coverage can enjoy saying "yes" without a worry or care?

None of this is to indicate that I'm particularly opposed to the notion of contraceptives on HC plans. Practically, the ones who use it will avoid pregnancy, abortion and STDs to a major degree which is a good thing. The ones who don't, won't... and will continue to be a burden on society.

I don't have a dog in this fight other than to take a dim view of government "compulsion" which, I'm sure, would be frowned upon if it forced women to use birth control but is perfectly OK in forcing the owner of a company to provide access to birth control for all.

[Lord Jim]

Yo, LJ and Long Run, rubato posted that data a page before . . . .

Gee, must have scrolled past it...

[Joe Guy]

I agree with Meade. The key factor is that the study "included participants ages 14 to 45 who said they wanted to avoid pregnancy for at least a year".

That's quite a lot different than making free birth control available to everyone. Having birth control available for free is not the same as giving it to people who want to use it and counseling them on the best methods.

[Gob]

Abortions carried out on women living in England and Wales fell 2.5% to 185,122 last year, Department of Health figures show.

For women aged 15-44, the abortion rate was down 5.4% to 16.5 per 1,000 women - the lowest since 1997.

From information included in abortion forms in 2012, almost half were medically-induced using drugs as opposed to surgery - similar to 2011.

Among under-18s, the abortion rate continued to fall last year.

The number of teenagers having abortions has been on a downward trend for the past five years. Between 2011 and 2012, the under-18 abortion rate fell again from 15 to 12.8 per 1,000.

The Department of Health report on the 2012 statistics said that 91% of abortions were carried out before the 13th week of pregnancy.

It also noted that fewer abortions were carried out on women from other countries, such as Ireland, than in any year since 1969.

Last year, non-residents accounted for 5,850 abortions.

[Lord Jim]

We need a study that demonstrates women availing themselves not of something handed to them but of something they have to go get. How many go get it? How many don't and become pregnant? Does the sheer fact of availability make the difference and if so, by how much?

So what you would like is a study done of women who have free birth control available to them but aren't told that it's available, or where or how to get it?

Well gee whiz, I have to admit you have a point there...

If they were passing out free beer and lobsters a few blocks from here, but I didn't know that this was available, I almost certainly wouldn't take advantage of it...

I suspect that the percentage of folks who will avail themselves of anything that they don't know is available will be pretty close to zero...

[Lord Jim]

Look, I'll concede that particular study has some imperfections in it (the one that jumps out at me as I look at it is "Nearly two-thirds had had an unintended pregnancy previously"; that might have been a learning experience that skews the average...)

But there are other studies out there that back up the contention that making contraception available for free (particularly to young, low income women) reduces both abortion rates and the instance of teen pregnancy...(I've seen them; when I have a little more time I'll hunt them up)

But I will concede there probably isn't a single study that shows that the availability of free contraception has an impact if you don't tell people it's available...

[MajGenl.Meade]

[quote="Lord Jim]So what you would like is a study done of women who have free birth control available to them but aren't told that it's available, or where or how to get it?[/quote]

And where, sweetness, do you find any intimation from me that women should not be "told that it's available or where or how to get it"?

Do not insurance plans that include contraception list that as a benefit? Evidently I have a higher opinion of women's ability to read, understand and implement a health care plan than do some

Clearly, the study I would be interested in would be of those women who have it available (as an insurance plan benefit, not as a free gift as part of a study), know they have it available and choose not to use it vs. those who DO use it.

I would have thought that the meaning of "availability" was quite clear but you are surely confusing "availability" with "acted upon".

Back to basics, lobster boy

[Lord Jim]

And where, sweetness, do you find any intimation from me that women should not be "told that it's available or where or how to get it"?

Well, from this Old Darling:

Does the sheer fact of availability make the difference and if so, by how much?

From that I drew the conclusion that you wanted a study that isolated "the sheer fact of availability" as the variable...

Silly me...

[Joe Guy]

The referenced study shows that if people who want to practice birth control are given free birth control methods and counseling to help them choose what is best for them, they will do more to prevent unwanted births than people who don't use birth control.

The pro-choice people that reviewed the study used that information and implied a very different and successful result. They interpreted that free contraceptive are the answer to unwanted births in order to promote their idea that a free birth control insurance policy should be mandatory for employers.

[MajGenl.Meade]

Er yes.... that is so, sugarlump.

Does the fact that contraception is available in a health care plan mean that the plan participants take advantage of it? (One assumes that they know what their plan includes - such as coverage for broken legs, IUDs, smallpox, herpes, flatulence and so on).

You claim that people who were told they were taking part in a test, volunteered to do so to avoid pregnancy for at least a year and physically handed the products (or had it installed) before they could run away yielded data about availability in Health Care plans. It didn't and it doesn't. It gives data on how effective contraceptives are in reducing unwanted pregnancy and abortion.

It says nothing about health care plans that offer contraception and how women in those plans choose to use that coverage. Does the availability of the coverage produce the same results as having the product presented on a plate (so to speak)?

[Lord Jim]

The referenced study shows that if people who want to practice birth control are given free birth control methods and counseling to help them choose what is best for them, they will do more to prevent unwanted births than people who don't use birth control.

The pro-choice people that reviewed the study used that information and implied a very different and successful result.

Aw gee, I'm going to have to concede that point as well...

I should have known as soon as it was pointed out to me that I was using a study that rubato had referenced that there would be these kinds data-conclusion disconnect problems...there always are...

The objections being raised to this study are legitimate; I didn't read it closely enough, that's my bad...

But I still stand by the argument I made in my initial post on this. It's pretty much inconceivable from a common sense standpoint to think that making contraception available for free, (especially to young, unmarried, uneducated, under-employed women...and educating them about it's availability) wouldn't make a significant difference and be a lot cheaper from a societal and government expense standpoint then not doing so...

But I'm compelled to agree that we're going to have to disregard this particular study as evidence to prove that point...