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MidLife GridLife - Trends With Benefits

by Elaine Johnson, published on October 21, 2011 at 9:25 AM

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Sign on the reception desk in my Mercy Ob-Gyn office: “Medical does not cover annual exams or birth control. Birth control pills are available for $9.00 at…”

My first thought:

Seriously?

My second thought:

Seriously??

Followed closely by thoughts that are mostly made up of pointless obscenities unnecessary to print.

Of all the things that ought to be covered by Medi-cal, this would be top of my list.

I am not a political person, meaning, I don’t follow politics closely enough to have an intelligent discussion about who is doing what at any given time. If I’m not informed, I don’t feel I have a right to weigh in—from that perspective. But I work with people on Medi-cal every day, and from that position, I definitely have an opinion.

As is so often the case, there seems to be a lack of Big Picture awareness. No one appears to be doing the math, which is probably the most ironic statement ever, coming from yours truly, but even someone who failed Autoshop Math (yes, really) can see the sense in short term spending for long term savings here.

First, it was ridiculous when the government abolished dental benefits for adults.

What is the biggest drug problem in Northern California?

Meth.

Have you ever seen a meth addict’s teeth?

Perhaps not, because often they don’t have many left!

Many of the people taking advantage—and by that I don’t mean exploiting—of Medi-cal benefits to get their lives and their families back on track and in the black are recovering addicts.

Not having dental benefits is counterproductive for them and taxpayers for two reasons right up front: First, their mouths become infected and require prescribed medication constantly, in the form of antibiotics or pain medication, if they’re willing to take it (which, let’s be honest, isn’t a good idea); second, if you owned a business or were hiring for a business, would you seriously consider an applicant with only half their teeth?
Probably not.

Medi-cal will pay to pull those teeth—all of them, if necessary—but not for dentures to replace them.

Killing dental benefits, not really in line with “hand up” as opposed to “hand out” philosophy everyone is so hot to promote.

You can teach a man to fish, but you can also get him some teeth so the guy who owns the fishing fleet will hire him and give him medical and dental and paid vacation after 90 days, or eventually he’s going to get frustrated and tired of eating fish and start selling it illegally off the back of a truck to make some cash!

Birth control is also a Big Picture issue.

Since the recent cuts, there are families currently living on $300 a month from Calworks (plus food stamps). Families with three children. Single mothers who are already overwhelmed, and have no desire to bring another child into their family.

But it could happen.

Yet the government has somehow decided that $9 a month is less feasible than the 18 years that would begin with diapers and end with…well, potentially more diapers!

Seriously?

Seriously.

 

 

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October 21, 2011 | 10:31 AM
There's a much simpler answer for birth control that doesn't cost anything.
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October 24, 2011 | 8:50 AM
Let's see, condoms cost money so you must be suggesting abstinence? Good luck with that.
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edited on  October 24, 2011 | 3:11 PM
Let's see, are you suggesting that CONDOMS can't be paid out of pocket either and must be covered by insurance? What's next? Toothbrushes and toothpaste, since dental coverage is also mentioned?

And you wonder why insurance costs are so astronomical?
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October 25, 2011 | 9:13 AM
Uh, no, I'm suggesting that condoms cost money & therefore aren't the "much simpler form of birth control that doesn't cost anything" mentioned above. Not sure how you got that I think condoms should be paid for with insurance. I didn't say anything of the sort. But hey, some people just see what they want to see.
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October 25, 2011 | 9:43 AM
Apologies to mtsacramento. It seems like everyone else on the conversation thread thinks insurance should cover everything, when it economically can't.
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October 21, 2011 | 11:33 AM
Not covering annual exams?

I'm not sure how much an annual exam would cost out of pocket but when it comes down to "Should I spend a couple of hundred dollars on my annual exam or purchase groceries to feed my children and pay my utilities?" I'm willing to bet most will push off that appointment a couple of months...then a couple more months, and before you know it they have missed their annual exam.

God forbid a woman has a serious but silent health condition, such as the early stages of cervical cancer, a year is a long time for it to develop. The same for other diseases. Like you said, treatment costs much more than preventative care.

It's mind-boggling. Thanks for the great read, as always!
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edited on  October 21, 2011 | 5:21 PM
Sorry, but NO! WRONG! Routine and minor medical expenses *should not* be covered by Medi-Cal, or private insurance for that matter.

And please don't give me this nonsense about the out-of-pocket costs for birth control being too much. Young women spend far more each month on their cell phone bills.

Mentalities like this are precisely why medical insurance and medical costs skyrocket.

Q: What do we insure to protect against?
A: Major financial catastrophe.

NOT out of pocket routine costs.

Imagine what your car insurance would cost if routine oil changes were paid by insurers, rather than out of pocket. There would be $200 oil changes rather than $40 ones, too. That is what happens when 3rd parties and other indirect agents pay for something. All cost containment goes out the window.
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October 21, 2011 | 12:59 PM
The car insurance analogy is bad as car insurance doesn't cover the outcome of not having your oil changed, whereas medical insurance does cover the outcomes of problems not discovered during routine checkups. But the fact that we still get our oil changed on a regular basis demonstrates that we understand the concept of preventative care - most of us actually take better care of our cars than we do our bodies in that regard. We don't wait for our engines to seize up, but we do wait for our hearts and joints to seize up.

Preventative care makes sense and is cheaper in the long run, or else we wouldn't have oil change businesses in existence - it simply seems to get ignored by the US medical establishment. And so we have emergency rooms engaging in profound interventions costing tens of thousands of dollars because we don't make it easy to access a brief consultation and five dollars worth of generic anti-biotics.
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edited on  October 21, 2011 | 5:34 PM
Speak for yourself--some of us DO our own regular preventative care. And we don't expect 3rd party insurers to pay for it either. And no, we aren't made of money, but we budget for the necessary routine appointments just as we budget for necessary personal care items, food, clothing, and shelter.

If you demand insurers cover more and more, even down to the NINE dollars of birth control pills, why are you surprised that insurance premiums go up and up? And if you think getting the government to pay for it all changes these underlying facts, you are dreaming.

Frankly, someone who can't pony up $9.00 co-pay for birth control (and *that* is a figure already subsidized by the insurer, and I will wager anything that even the full out of pocket amount would be a fraction of this woman's cell phone bills) probably wouldn't do it if it was utterly free--just going to the clinic alone will take over $9 in fuel and time off work!

As for dental care, how about *not* doing meth? How are subsidized cleaning appointments (normally $100 or so out of pocket, typically less with co-pays, which are like deductibles for auto insurance) going to stop the underlying calcium robbery of meth? They aren't.
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October 21, 2011 | 4:13 PM
"Single mothers who are already overwhelmed, and have no desire to bring another child into their family.

But it could happen."

How could it happen? If these women truly "have no desire to bring another child into their family" then if it does happen, it would not be an accident, it would be a choice.

I'm pretty sure that after three kids, most women have a pretty good idea of what causes pregnancy. Birth control is completely unnecessary in this situation and if its necessary, maybe the father's could take some responsibility both during the act and after a child, if there is one, is born.
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October 21, 2011 | 7:59 PM
It's so gratifying when all the ranting isn't mine! It makes me feel so...read!

I agree completely about fathers taking responsibility. But, for the record, I feel the same way about abstinence among single mothers as I do about abstinence among teenagers: I support it and recommend it, but I don't necessarily think it's realistic to universally expect it, particularly among consenting adults. Condoms fail, and, unfortunately, in my experience, sometimes so do sperm donors.
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October 21, 2011 | 11:52 PM
I just go to Planned Parenthood. You'd be surprised at how much is covered there. Not just ob-gyn stuff. I got a cholesterol test, anti biotics for infections, physicals, along with the yearly exam and birth control. They ask for a donation, you're not pressured to give if you can't afford it. It is a WONDERFUL organization and without it I would have NO form of health coverage what so ever.
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October 28, 2011 | 10:50 PM
I had great health insurance for years as a sheet metal worker. It covered many things but a tetnus shot wasn't one of them. Go figure. Personaly as a tax payer I'd rather see my dollars going to birth control if it meant fewer unwanted births. I've never had children accidental or ortherwise but I know doctors, nurses and my ex, a pharmacist, who had accidental pregnancies from one night stands. In their cases they could afford the result but it shows that abstinence isn't likely to happen even in well to do educated indiviguals. Human nature is what it is.
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