The Cost of Contraception

pwurple · 03-11-2014 08:15AM

Snoopy1 wrote: »

If your[sic] moaning that much about having kids, don't have them

Where was I moaning about having kids? I was pointing out that your impressions of the financial benefits are incorrect.

skallywag · 03-11-2014 10:05AM

Snoopy1 wrote: »

I'd love to be sterilised to end all this buying contraception every month

So why not do so then? Is it offered in Ireland? (I know it's on the NHS).

Penny Tration · 03-11-2014 10:20AM

skallywag wrote: »

So why not do so then? Is it offered in Ireland? (I know it's on the NHS).

If you're female, under the age of thirty, and don't have kids or medical conditions making it dangerous for you to conceive, it's damn near impossible to get a sterilisation unless you pay privately.

My boyfriend is in his 30s and can't even get the snip!

skallywag · 03-11-2014 10:59AM

Jingle_Balls wrote: »

If you're female, under the age of thirty, and don't have kids or medical conditions making it dangerous for you to conceive, it's damn near impossible to get a sterilisation unless you pay privately

I can see how sterilising a healthy woman who is under 30 could be a heavy ethical issue for the medical profession.

Morag · 03-11-2014 11:02AM

skallywag wrote: »

I can see how sterilising a healthy woman who is under 30 could be a heavy ethical issue for the medical profession.

Bullcrap it's not in many other EU countries.

skallywag · 03-11-2014 11:09AM

Morag wrote: »

Bullcrap it's not in many other EU countries.

I fail to see how your comment is relative at all to a doctor having ethical reservations in performing such a procedure on a healthy woman?

Regardless of whether the procedure is offered in a country or not, the moral dilemma will still hold.

Dial Hard · 03-11-2014 11:38AM

skallywag wrote: »

I fail to see how your comment is relative at all to a doctor having ethical reservations in performing such a procedure on a healthy woman?

Regardless of whether the procedure is offered in a country or not, the moral dilemma will still hold.

How is there a moral dilemma involved if it's the woman in question's informed choice?

Morag · 03-11-2014 11:51AM

skallywag wrote: »

I fail to see how your comment is relative at all to a doctor having ethical reservations in performing such a procedure on a healthy woman?

Regardless of whether the procedure is offered in a country or not, the moral dilemma will still hold.

This is not a individual drs dilemma this is the entire HSE having a blanket policy of not allowing women to make their own choice about controlling their fertility.

skallywag · 03-11-2014 11:57AM

Morag wrote: »

This is not a individual drs dilemma this is the entire HSE having a blanket policy of not allowing women to make their own choice about controlling their fertility.

The HSE website states the following:

Surgeons are more willing to perform sterilisation when women are over 30 years old and have had children.

This would imply to me that there is no blanket policy per se, but rather that it comes down the ethical decision taken by the individual surgeon?

pwurple · 03-11-2014 12:31PM

How much does sterilisation cost privately?

I don't really see why it should be funded publically either. I'd put it up there with a boob-job in terms of public health priority. If someone needed it for health reasons, certainly, but not for lifestyle reasons.

skallywag · 03-11-2014 01:07PM

Dial Hard wrote: »

How is there a moral dilemma involved if it's the woman in question's informed choice?

Regardless of whether it is an informed choice or not, I would still see a very clear ethical decision to be taken here by the health professional who conducts such an operation on a healthy woman.

If I am interpreting the quote which I provided above from the HSE website correctly, then this is indeed the case, with the majority of surgeons not feeling comfortable in performing this operation on a healthy woman under the age of 30; i.e. it seems to me that their decision is a matter of personal conscience rather than a blanket ban or general rule at the HSE.

ash23 · 03-11-2014 01:29PM

I don't mind paying for contraception.
But I was really annoyed recently when my health insurance refused to cover my coil insertion.

I thought it would be covered under the day to day doctors visits as my plan covers 50% of the cost for GP visits. But because it was 2 visits for Mirena insertion, they wouldn't pay up.

It really bugged me because had I just sent in a blank receipt for it, I'd have been paid. But because my GP had the procedure on it, it was denied.

I must mention it to the GP when I'm back in. Not for myself but for other women getting it done, so that they know they can't claim it back from their health insurance.

pwurple · 03-11-2014 02:21PM

ash23 wrote: »

I don't mind paying for contraception.
But I was really annoyed recently when my health insurance refused to cover my coil insertion.

I thought it would be covered under the day to day doctors visits as my plan covers 50% of the cost for GP visits. But because it was 2 visits for Mirena insertion, they wouldn't pay up.

It really bugged me because had I just sent in a blank receipt for it, I'd have been paid. But because my GP had the procedure on it, it was denied.

I must mention it to the GP when I'm back in. Not for myself but for other women getting it done, so that they know they can't claim it back from their health insurance.

I got the same out of them. Coil only paid for if you go to a consultant rather than a GP... and only if you go to a consultant on their list. But they couldn't give me anyone's name on the list. The GP has to refer you, and then you phone again and they tell you if that consultant is on the list or not. If not, back to the GP again for another referral, until you get one on the list.

I ate the ear off the person on the phone. That's jumping through hoops for the laugh. What are we, performing monkeys?

ash23 · 03-11-2014 02:27PM

pwurple wrote: »

I got the same out of them. Coil only paid for if you go to a consultant rather than a GP... and only if you go to a consultant on their list. But they couldn't give me anyone's name on the list. The GP has to refer you, and then you phone again and they tell you if that consultant is on the list or not. If not, back to the GP again for another referral, until you get one on the list.

I ate the ear off the person on the phone. That's jumping through hoops for the laugh. What are we, performing monkeys?

I pointed out to them that if I'd been every three months for a pill renewal or the injection over 3 years (which my coil lasts for) it'd cost them an awful lot more. No joy though. It's absurd.

meeeeh · 03-11-2014 02:33PM

pwurple wrote: »

I got the same out of them. Coil only paid for if you go to a consultant rather than a GP... and only if you go to a consultant on their list. But they couldn't give me anyone's name on the list. The GP has to refer you, and then you phone again and they tell you if that consultant is on the list or not. If not, back to the GP again for another referral, until you get one on the list.

I ate the ear off the person on the phone. That's jumping through hoops for the laugh. What are we, performing monkeys?

It's getting ridicolous. My partner had to have some check ups and CT scan was among them. The insurance fully covered the ct scan if it was preformed on the same day as other procedures and it wouldn't be covered at all if done separately. The other procedures were completely unrelated to ct scan.

Neyite · 03-11-2014 02:37PM

Jingle_Balls wrote: »

If you're female, under the age of thirty, and don't have kids or medical conditions making it dangerous for you to conceive, it's damn near impossible to get a sterilisation unless you pay privately.

My boyfriend is in his 30s and can't even get the snip!

So pay privately then.

pwurple wrote: »

How much does sterilisation cost privately?

I don't really see why it should be funded publically either. I'd put it up there with a boob-job in terms of public health priority. If someone needed it for health reasons, certainly, but not for lifestyle reasons.

I agree - health reasons only. I dont see why contraceptives or contraceptive procedures should be free when the flip side of the coin - assisted conception is fully private and not even medical insurance will cover it.

And I say that as someone who never had a medical card, I always paid for my contraception and GP visits, I will likely be moving from the gynae public system to private fertility treatment for the second time very soon, that I can barely afford.

For me, this choice is a lifestyle choice, just as getting sterilised is a valid lifestyle choice for other families. There are far more critical areas in the health care system that I'd prefer free medications and services to go to - mental health services and medications for instance, or special needs therapy and support staff, or cut waiting lists in outpatients clinics, or provide more A&E nursing staff.

Neyite · 03-11-2014 02:40PM

ash23 wrote: »

I don't mind paying for contraception.
But I was really annoyed recently when my health insurance refused to cover my coil insertion.

I thought it would be covered under the day to day doctors visits as my plan covers 50% of the cost for GP visits. But because it was 2 visits for Mirena insertion, they wouldn't pay up.

It really bugged me because had I just sent in a blank receipt for it, I'd have been paid. But because my GP had the procedure on it, it was denied.

I must mention it to the GP when I'm back in. Not for myself but for other women getting it done, so that they know they can't claim it back from their health insurance.

Anything related to fertility is not covered. If you can argue that it was for medical reasons say, gynae, so for example, if you got the mirena to control heavy periods etc then its a gynae procedure and therefore could theoretically be covered, and the contraceptive element was a bonus on the side.

I had to have a HSG xray, and insurance paid for it because it was ordered as a gynae investigation rather than a fertility one.

meeeeh · 03-11-2014 02:41PM

I agree up to a point about sterilization being a lifestyle choice. But there are vulnerable people (addicts and similar) for whom sterilization would be an optimal form of contraception. I am absolutely against forced sterilization but in some cases voluntary sterilization is by far the best option.

Scarinae · 03-11-2014 02:53PM

Neyite wrote: »

Anything related to fertility is not covered. If you can argue that it was for medical reasons say, gynae, so for example, if you got the mirena to control heavy periods etc then its a gynae procedure and therefore could theoretically be covered, and the contraceptive element was a bonus on the side.

I had to have a HSG xray, and insurance paid for it because it was ordered as a gynae investigation rather than a fertility one.

This is quite interesting because it seems to be the other way around in the UK (for the pill anyway, not sure about other contraception). The pill that I'm on is also used for acne treatment - apparently if you're using it for contraception it is free, but if you're using it for your skin then you have to pay for it. It's only about £8 for the entire prescription though so it's not expensive.

IVF is also available free under some circumstances, although the waiting lists are huge. I know someone over here who had IVF but ended up paying for it privately because they were waiting for so long for the NHS. It's just a different system I suppose.

rainbow kirby · 03-11-2014 03:00PM

Scarinae wrote: »

IVF is also available free under some circumstances, although the waiting lists are huge. I know someone over here who had IVF but ended up paying for it privately because they were waiting for so long for the NHS. It's just a different system I suppose.

There's a bit of a postcode lottery too - one shot if you are in various central London boroughs, up to three elsewhere.

Neyite · 03-11-2014 03:12PM

Scarinae wrote: »

This is quite interesting because it seems to be the other way around in the UK (for the pill anyway, not sure about other contraception). The pill that I'm on is also used for acne treatment - apparently if you're using it for contraception it is free, but if you're using it for your skin then you have to pay for it. It's only about £8 for the entire prescription though so it's not expensive.

IVF is also available free under some circumstances, although the waiting lists are huge. I know someone over here who had IVF but ended up paying for it privately because they were waiting for so long for the NHS. It's just a different system I suppose.

That is interesting. Just classified differently I suppose.

You can get some fertility treatment on the HSE public system, but the waiting lists for very few who go through rigerous screening is years and years long - since most couples only realise their issues in mid thirties, often time isn't on their side to wait. Pomegranate is a charity which fund fertility treatment. But then you get into the whole argument of 'well, why are you having kids if you cant afford IVF then' usually from some 22 year old who thinks that by the grand old age of 37 people should have their mortgage paid off and 30k in the bank. That argument also applies when the cost of childcare is brought up.

Morag · 03-11-2014 04:38PM

The HSE own and run the majority of operating rooms in the country, Surgeons have to be consultants with privileges in a hospital to use them for private patients, there are a few private clinics but currently non which will do tubal ligations.

In order to use the HSE facilities surgeons have to work with in thier rules and guidelines and so can not operate on a private patient to preform a tubal ligation which does not fall under the HSE policy.

Surgeons are more willing to perform sterilisation when women are over 30 years old and have had children.

That is the policy if you are not over 30 and if you do not have children, you can not get sterilised there even if you are willing to go private and pay for it.
There are some extreme exceptions but the procedure happens not for the good of the woman but as it's deemed better for society, as in the policy to preform it on young women who have down syndrome.

I was 25 with two kids, and didn't want any more and was told I could not possible know my own mind well enough.
I know other parents who have kids with special needs, who also do not want any more children and were refused.

If you want a tubal ligation then you have to go via Maire Stopes clinics and be referred to one of their surgical clinics in the UK.
Last I heard the clinic fees were about 10 grand never mind the cost of travelling and staying somewhere until you are well enough to travel home.

I have heard it's possible to get a referral to the Black Rock Clinic to have it done there but it is more expensive then travelling to the UK.

pwurple · 03-11-2014 05:04PM

Morag wrote: »

I was 25 with two kids, and didn't want any more and was told I could not possible know my own mind well enough.

Was vasectomy not an option?

Morag · 03-11-2014 05:10PM

pwurple wrote: »

Was vasectomy not an option?

What had that got to do with it?

Tubal ligation is about controlling my fertility for my health reasons, my choice for my body.

skallywag · 03-11-2014 05:17PM

Morag wrote: »

Tubal ligation is about controlling my fertility for my health reasons, my choice for my body.

My understanding is that the HSE will indeed offer the procedure if there are genuine health concerns?

Morag · 03-11-2014 05:21PM

skallywag wrote: »

My understanding is that the HSE will indeed offer the procedure if there are genuine health concerns?

And what does the HSE consider 'genuine health concerns' and what is your understanding based on?

skallywag · 03-11-2014 05:26PM

Morag wrote: »

And what does the HSE consider 'genuine health concerns' and what is your understanding based on?

It's based on reading the material on the HSE web page.

Are you of the opinion that the HSE are not taking certain potential health concerns seriously enough, or even not classifying them as valid health concerns in the first instance?

Morag · 03-11-2014 05:27PM

skallywag wrote: »

Are you of the opinion that the HSE are not taking certain potential health concerns seriously enough, or even not classifying them as valid health concerns in the first instance?

Yes, based on trying to get a tubal ligation for 10 years for myself and trying to assist others through the maze of consultations.

pwurple · 03-11-2014 05:28PM

Morag wrote: »

What had that got to do with it?

Tubal ligation is about controlling my fertility for my health reasons, my choice for my body.

Takes two to produce children. I'm all for having men step up to contraceptive choices, instead of taking all the responsibility on ourselves and letting them off the hook. Vacestomy is considered a far less invasive option than female sterilisation.

Apologies if that was prying.

Morag · 03-11-2014 05:39PM

pwurple wrote: »

Takes two to produce children. I'm all for having men step up to contraceptive choices, instead of taking all the responsibility on ourselves and letting them off the hook. Vacestomy is considered a far less invasive option than female sterilisation.

Apologies if that was prying.

If a couple is in a stable long term relationship and that is an option for them then yes it is less costly, invasive and takes a lot less time to recover from.

But I don't think that the answer to the lack of provision for women who want a tubal ligation (no matter if they have kids or not) is to say get your man to have a vasectomy.

The Cost of Contraception

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