Slog Comments
Pediatricians Org: Prescribe Plan B to Teens Before They Need It
1
The problem with making it OTC is the same with making the pill OTC: harder to get insurance to cover it.
4
@3: Only if you are seventeen or older, unfortunately. Used to be a lot worse though, it used to depend where you lived.
So basically, we think you are too young and immature to handle the morning after pill, but we are glad to assume you are old enough and mature enough to raise a child.
Daffy.
So basically, we think you are too young and immature to handle the morning after pill, but we are glad to assume you are old enough and mature enough to raise a child.
Daffy.
5
Yes, make it OTC and costs should come down. No need for insurance as it should fall under the category of 'personal responsibly' anyway.
6
@3 - apparently not. But it should be. This is the absolute best thing, in my opinion. Terminating a recently fertilized egg is a COMPLETELY different proposition from terminating an advanced fetus. Time is of the essence. Thisshould be embraced by anyone with an ounce of humanity and sense. But the f*%&ing Christianists have neither.
9
I agree that all BC should be provided for free, anytime, anywhere. Including the nurses office at high school and JR high. Getting insurance to cover it isn't an always the answer. Market forces will take care of the price when birth control becomes OTC. Insurance companies sometimes demand only certain pills, manufacturer, time frame for pick up, for the prescriptions. Even though my BC pills were "covered", they cost $35 and I could only buy a pack a month. My solution was to make a boarder crossing to Mexico yearly. Cost? $9 for 3 months worth and of the pills I wanted to take. Most of the current cost of BC pills is insurance driven.
11
@5: Absolutely not. If he's not a cad, he'll rush out and buy it.
But if the woman was raped... I must admit I haven't thought that angle through -- though crisis centers should have it in stock.
But if the woman was raped... I must admit I haven't thought that angle through -- though crisis centers should have it in stock.
13
@4 is correct. Teen preganancy rate in US still 2-10 times higher than in other developed countries. This would be a win for common sense if the right wing doesn't manage to derail it with the myth that telling teens encourages sexual behavior.
14
I think it should be over the counter, I don't think suggesting that there is a "pill" to cure every ill is good, NOT that this is the case. But ya know like #2 said, why can't we teach REAL sex education to these youth instead of having goofy religious idiots tell schools what to teach. Taking a pill should be the LAST step after all else has failed. (Except of course in a rape I get that).
15
Canadian lawyer here, who published a paper in law school about the interaction between regulation of Plan B and human rights law. In Canada, Plan B is a grey area known as "behind the counter", meaning a doctor's prescription is not required, but it is not displayed on shelves and must be requested from the pharmacist.
On making the request, the patient will be subjected to questioning by the pharmacist, ostensibly to determine if the use of Plan B is appropriate (still within the window if it is effective). In reality, this can become far more intrusive/embarrassing than it needs to be, and can be a tool for pharmacists to deny the drug if they don't approve of the reasons for wanting it. Further still, some pharmacists simply refuse to stock it all, citing ethical or religious objections.
I argued in my paper that anything other than full OTC status for Plan B is an unreasonable barrier to women accessing this drug. (relevant, there are no adverse health consequences to taking Plan B even when it is not effective, ie, too late - so even if someone takes it who technically shouldn't, no harm). I do not believe pharmacists are legally entitled to refuse to dispense a drug unless there is another option for the patient such as another pharmacy (open and reasonably nearby) that will dispense it, however this still happens and is a huge problem in small towns where there isn't another pharmacy.
Given that we still have these issues even in relatively liberal Canada, advance prescription writing by sympathetic docs is one of the better stop-gap measures. Teens would be smart to not only get a prescription, but get it filled (to avoid finding out too late that the local pharmacist refuses to stock) and keep that pill handy just in case.
On making the request, the patient will be subjected to questioning by the pharmacist, ostensibly to determine if the use of Plan B is appropriate (still within the window if it is effective). In reality, this can become far more intrusive/embarrassing than it needs to be, and can be a tool for pharmacists to deny the drug if they don't approve of the reasons for wanting it. Further still, some pharmacists simply refuse to stock it all, citing ethical or religious objections.
I argued in my paper that anything other than full OTC status for Plan B is an unreasonable barrier to women accessing this drug. (relevant, there are no adverse health consequences to taking Plan B even when it is not effective, ie, too late - so even if someone takes it who technically shouldn't, no harm). I do not believe pharmacists are legally entitled to refuse to dispense a drug unless there is another option for the patient such as another pharmacy (open and reasonably nearby) that will dispense it, however this still happens and is a huge problem in small towns where there isn't another pharmacy.
Given that we still have these issues even in relatively liberal Canada, advance prescription writing by sympathetic docs is one of the better stop-gap measures. Teens would be smart to not only get a prescription, but get it filled (to avoid finding out too late that the local pharmacist refuses to stock) and keep that pill handy just in case.
16
@5: I guess if a smoker gets lung cancer, that should not be covered either? Personal responsibility, right?
Hey, no coverage for childbirth either...take some responsibility, and pay for it yourself if you choose to get pregnant.
Also, get in a car accident that is your fault? Sorry, pay for your own ER visit, you chose to drive that car, not the insurance company you pay premiums to!
Football player breaks his spine, insurance shouldn't pay for the rehab and surgery right? He chose to play football!
Hey, no coverage for childbirth either...take some responsibility, and pay for it yourself if you choose to get pregnant.
Also, get in a car accident that is your fault? Sorry, pay for your own ER visit, you chose to drive that car, not the insurance company you pay premiums to!
Football player breaks his spine, insurance shouldn't pay for the rehab and surgery right? He chose to play football!
17
@5: Insurance coverage has nothing to do with whether or not someone deems something to be a "personal responsibility." Routine physical exams are a personal responsibility ...
The reason insurance should cover it is because by decreasing the cost, the usage rate goes up, driving down the incidence of unwanted pregnancies, which are much more expensive to cover.
There is also a social benefit to having planned families, making birth control a great candidate for subsidy.
The reason insurance should cover it is because by decreasing the cost, the usage rate goes up, driving down the incidence of unwanted pregnancies, which are much more expensive to cover.
There is also a social benefit to having planned families, making birth control a great candidate for subsidy.
18
It sounds like a good idea on paper, but gynecologists are complaining. They say that pediatricians aren't prepared to deal with the side effects like bleeding and nausea (Since when can't kid doctors deal with puke? But I get it about the bleeding.) and that they won't have to deal with any pregnancies that result from misuse. They say that instead of pediatricians prescribing Plan B, those teenagers should be sent to gynecologists instead.
One the one hand, telling parents to take their kid to yet another doc appointment is a big behavioral barrier. On the other hand, it's possible that the gynecologists have a point about who is more likely to be able to weigh risk and reward about birth control.
On yet another hand, studies don't exactly show that increased availability of Plan B lowers the pregnancy rate or abortion rate. We might be arguing about nothing.
One the one hand, telling parents to take their kid to yet another doc appointment is a big behavioral barrier. On the other hand, it's possible that the gynecologists have a point about who is more likely to be able to weigh risk and reward about birth control.
On yet another hand, studies don't exactly show that increased availability of Plan B lowers the pregnancy rate or abortion rate. We might be arguing about nothing.
19
@16, 17: Let's follow through with this contorted logic exercise. Insurance should cover all our food costs right? Otherwise, we'd get sick and all die.
Insurance is for accidents, illness, and horrible things that afflict humankind.
Also, no drug should be a default crutch for controlling procreation when safer chemical-free means and forethought should be the higher standard. That's a far heather disposition for a society regardless of any drug's social ramifications.
Insurance is for accidents, illness, and horrible things that afflict humankind.
Also, no drug should be a default crutch for controlling procreation when safer chemical-free means and forethought should be the higher standard. That's a far heather disposition for a society regardless of any drug's social ramifications.
21
@19: "Insurance is for accidents, illness, and horrible things that afflict humankind."
Hm. Well, an accidental pregnancy can be a horrible thing to an unprepared teenager. (Or adult, for that matter.)
"Safer chemical-free means and forethought should be the higher standard."
Yes, "forethought", one of the great strengths of the average teenager.
Hm. Well, an accidental pregnancy can be a horrible thing to an unprepared teenager. (Or adult, for that matter.)
"Safer chemical-free means and forethought should be the higher standard."
Yes, "forethought", one of the great strengths of the average teenager.
22
@19 If by "safer, chemical-free means" you mean condoms, then yes they're safe--and can prevent the spread of disease--but they can break, especially if used incorrectly. The best thing to do is to use a condom and a hormonal method.
If instead you mean the sympto-thermal method, which does have a very high success rate when used perfectly by women whose cycles are like clockwork, it is simply not practical for most people for many reasons. Teenaged girls usually have more unpredictable cycles than adult women, so I'd be surprised if any doctor recommended STM as a method of birth control for teenagers.
Follow-up to my previous comment, the studies also show that increased availability of Plan B doesn't increase sexual activity among teenagers, so the social conservatives might be arguing about nothing too.
If instead you mean the sympto-thermal method, which does have a very high success rate when used perfectly by women whose cycles are like clockwork, it is simply not practical for most people for many reasons. Teenaged girls usually have more unpredictable cycles than adult women, so I'd be surprised if any doctor recommended STM as a method of birth control for teenagers.
Follow-up to my previous comment, the studies also show that increased availability of Plan B doesn't increase sexual activity among teenagers, so the social conservatives might be arguing about nothing too.
23
Oh jeezus, Phoebe. Unclench your prissy republican ass. Read what 'backyard bombardier' posted. An unintended teenage pregnancy is a pretty life-wrecking event and it behooves us to reduce or eliminate them.
Or do you think the number of teenage dropout single mothers is satisfactorily high enough at the moment?
Or do you think the number of teenage dropout single mothers is satisfactorily high enough at the moment?
24
@21: I wrote 'default' didn't I? Yes, forethought. A great attribute to teach your children, as well as a continuing lesson for adults. And, believe it or not, we can do it - unless you perceive society as just a bunch of horny bunnies.
26
@19: Your analogy fails horribly, just like everything here I see you post.
Food is not medication, food is not healthcare.
Pharmaceuticals are.
The morning after pill is a pharmaceutical.
Health care covers medical needs, regardless of responsibility. Which is why you have no response to the examples I gave.
Are you able to follow that? Try to read it really slowly. Please do try to keep up with the conversation.
Food is not medication, food is not healthcare.
Pharmaceuticals are.
The morning after pill is a pharmaceutical.
Health care covers medical needs, regardless of responsibility. Which is why you have no response to the examples I gave.
Are you able to follow that? Try to read it really slowly. Please do try to keep up with the conversation.
27
Dan,
Just a little reality check for you:
Plan B is available OTC in Ontario, Canada. But what this means is that a box sits on the shelf in the drug store with a label saying, "See the pharmacist" because, as a $40 item, it's kept behind the counter to prevent theft.
And because it's OTC, it's not covered by any insurance plan. It's too bloody expensive, and it's almost always going to have to be the woman taking it who ends up covering the cost of this sex-related expense.
Just a little reality check for you:
Plan B is available OTC in Ontario, Canada. But what this means is that a box sits on the shelf in the drug store with a label saying, "See the pharmacist" because, as a $40 item, it's kept behind the counter to prevent theft.
And because it's OTC, it's not covered by any insurance plan. It's too bloody expensive, and it's almost always going to have to be the woman taking it who ends up covering the cost of this sex-related expense.
28
@24: I don't believe that society is a "bunch of horny bunnies", but I do believe that many teenagers are physiologically incapable of adult levels of risk assessment, weighing consequences, impulse control, etc. For example, see http://www.hhs.gov/opa/familylife/tech_a….
These things can be taught - but if all we provide is lectures, stern looks, and boxes of condoms, there are going to continue to be unacceptable levels of teen pregnancy.
These things can be taught - but if all we provide is lectures, stern looks, and boxes of condoms, there are going to continue to be unacceptable levels of teen pregnancy.
29
@28: Yes, you are right. And that goes for adults as well. That's why I agree plan B should be available without a Rx. We're only quibbling about insurance.
30
@18,
Or maybe they just want more customers.
The morning after pill, and actually the birth control pill in general, is available without a prescription in many parts of the world with no significant negative repercussions, and making them readily available has been proven to decrease unintended pregnancies.
Or did you think that your doctor puts your welfare ahead of his or her paycheck?
Or maybe they just want more customers.
The morning after pill, and actually the birth control pill in general, is available without a prescription in many parts of the world with no significant negative repercussions, and making them readily available has been proven to decrease unintended pregnancies.
Or did you think that your doctor puts your welfare ahead of his or her paycheck?
31
@27 Wow, $40 ! In France it costs about $15. You get it at the pharmacist, no questions asked. I think the minors can get it for free on Family Planning.
32
@26: We should differentiate:
Private insurance - You should get what you pay for.
Public insurance - You should get what our taxes pay for but be respectful of the public trust.
Private insurance - You should get what you pay for.
Public insurance - You should get what our taxes pay for but be respectful of the public trust.
33
@32: Indeed, let's respect the public trust. Don't want to waste $40 just to prevent an unwanted pregnancy, after all.
Or, do we? "Taxpayers spend about $12 billion annually on publicly financed medical care for women who experience unintended pregnancies and on infants who were conceived unintentionally... we also estimate that taxpayers would save about half of this amount if all unintended pregnancies could be prevented."
$6 billion would buy one hell of a lot of Plan B.
http://www.brookings.edu/research/papers…
Or, do we? "Taxpayers spend about $12 billion annually on publicly financed medical care for women who experience unintended pregnancies and on infants who were conceived unintentionally... we also estimate that taxpayers would save about half of this amount if all unintended pregnancies could be prevented."
$6 billion would buy one hell of a lot of Plan B.
http://www.brookings.edu/research/papers…
34
Better to teach kids how to use standard birth control properly well in advance of when we think they will need it. Unless it's changed a lot in the last 20 years, the morning-after pill should only be taken perhaps 3 times in a woman's lifetime, because it contains such massive doses of hormones. Plus, it makes you feel desperately nauseas.
IMO, sexually active teens should have free access to standard birth control and certainly to condoms. If they don't want a baby, they should definitely not be having one. As far as possible, they should also not have to take the morning-after pill, because of its side effects. Although, of the two options, an unwanted baby is (again, IMO) the worse outcome.
IMO, sexually active teens should have free access to standard birth control and certainly to condoms. If they don't want a baby, they should definitely not be having one. As far as possible, they should also not have to take the morning-after pill, because of its side effects. Although, of the two options, an unwanted baby is (again, IMO) the worse outcome.
35
Plan B is available OTC here in NY. It's in Rite Aid & all the other pharmacies. There is an age limit & it is expensive (probably over $50). It's like liquor, if a kid really needs (wants) it, they can (will) ask an adult to get it for them. Happened to me.
36
Yes, $40 is too expensive to make sure you don't get pregnant. Obviously, the cost of raising a child is much cheaper.
37
I don't get the whole "free access to condoms" things. Condoms aren't that expensive to begin with, and you only have to be what, fourteen to buy them? Besides, a good girlfriend would be willing to go in for half the cost, just as a good boyfriend should fork over 20 bucks for half of a morning after pill. I don't see why teenagers would get to pork on my dime when I have to buy my own damn condoms.
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