A New Way of Declaring War on Women

So, the FDA is considering allowing oral contraceptives (hereafter referred to as BCPs, or birth control pills) to be made available over the counter (OTC) and without a prescription (RX).

At first I thought this was a joke, but the joke is on me. It’s a real consideration… not something anyone thinks will happen in the next 5 minutes, but it’s a real thing. A real STUPID thing.

First, let’s consider the pro’s:

1.      Even today, approximately 50% of pregnancies are unplanned and/or unwanted.  Easier access to BCPs could impact this statistic and decrease the # of unwanted pregnancies.

2.      Many women have difficulty affording the doctor visit to get the RX, or getting the appointment in a timely manner when their pills are running low, which in turn leads to skipped pills and decreased efficiency. If available OTC, they can go get more pills the same day that they take the last one.

3.      The main “serious” side effect of BCPs is developing blood clots, and even then, it happens infrequently and the clots are quite small; plus such clots are even more dangerous during a pregnancy or right after giving birth.

IMO, all 3 pro’s are nonsense.

Ok, so the stat for unplanned/unwanted pregnancies remains at about 50%, unchanged over the past 20 years. This, despite the onset of HIV and AIDS, increased transmission of Hepatitis, etc. What does one have to do with the other? CONDOMS            are available OTC for purchase by anyone, anytime. There are also advocacy groups all over who provide baskets or fishbowls filled with condoms (at bars, bookstores, lots of places) FOR FREE. Women are more than welcome to purchase condoms or grab a few at their leisure. The up side? Not only will they help prevent an unplanned/unwanted pregnancy, but they will protect themselves from giving or receiving a sexually transmitted disease. The fact that these unplanned/unwanted pregnancies continue to occur at such a high rate is proof positive that those folks who are having unprotected sex are doing so by choice. Making BCPs available OTC will not change that.

Next: women can’t afford the doctor’s appointment or the BCPs. This is bullshit (pardon my French) for reasons both pre- and post-Obamacare.

Pre-Obamacare: I have 2 words for you: Planned Parenthood. This is a federally funded program that provides wellness care for women on a sliding scale, based on your income. If you have insurance, great. Provide that info and they will either bill insurance for you OR provide you with the info you will need to file the claim on your own behalf. No insurance? No problem. That’s where the sliding scale comes in. Women who have little or no income pay little or nothing for the care received.  I remember when I was much younger, taking BCPs, I was in college and worked a part time job, about 10-15 hrs/week. I had no money really. I paid $10 for my doctor visit and my pills were free. So, no… the affordability is not a valid issue. Go to Planned Parenthood.

Post-Obamacare: I have 2 new words for you: Mandated Coverage. Under Obamacare, insurance plans are required to provide coverage for well-woman visits with no cost-sharing to the member (so there’s no out-of-pocket expense to the member). Insurance is also required to provide coverage for BCPs.

If you make BCPs available OTC, women are even worse off financially. Insurance does not provide a benefit for OTC medications, such as Tylenol, Benadryl, cold medicines, etc. The cost of the pills will fall back to the woman, 100%. In addition, because the BCPs are no longer an RX item, Planned Parenthood’s ability to provide the pills to its patients at low- or no-cost may also be impacted. But… even if they are still able to provide the pills, we are back to a pre-Obamacare state where the pills can be obtained at low- or no-cost from Planned Parenthood OR women can pay the cost out of pocket at the pharmacy. (And… might I add… they will still have to stand in line to get them from behind the pharmacy counter due to the age limit that will be on them. End result: no gain.)

This so-called difficulty getting appointments with doctors in time so that you don’t miss pills is just an attempt to cover up individuals’ sheer, unadulterated LAZINESS.  Personal responsibility and accountability, my friends.

Last, let’s talk about the side effects. It’s been reported that the main “serious” side effect is developing blood clots, which isn’t that serious after all (see http://www.foxnews.com/health/2012/11/21/obgyns-back-over-counter-birth-control-pills/).

I beg to differ.

The possible side effects of BCPs include not only developing blood clots, but also increased blood pressure (worse for smokers and/or women over the age of 30), acne, breast tenderness, breakthrough bleeding/spotting between periods, nausea and vomiting, changes in vision, headaches, dizziness, and decreased libido. The thing is, these symptoms could also be indicative of more serious medical problems. Without medical management, a woman may just think that it’s because of the pills and not pursue any additional medical attention.

That notwithstanding, if a blood clot moves to the lung or brain, you die. Simply put, you die. I find it appalling that the clots are considered not all that serious.

I can also attest from personal experience that BCPs can have effects on a person’s blood pressure. I was on BCPs for about 3 years in my late teens/early 20s. Initially, I had no side effects at all.  Each year, when I would have my exam (at Planned Parenthood, by the way), they noted that my blood pressure was slowly increasing.  Did I “feel” anything on a day-to-day basis? No. But it was at my yearly exam, to renew my RX, that it was noted.  After discussing options, I decided to stop using BCPs and switch to Depo Provera injection.  This is a little more inconvenient, since I had to go into the office every 3 months for the injection. But, it was the best alternative overall for me. So, when I returned 3 months later for my second injection, the clinician took my blood pressure, and it was back down to where it normally was.

If I didn’t need to see the doctor every year to renew my RX, I never would have known that the BCPs were affecting my blood pressure. I would have continued to use the pills, increasing my risk for heart disease and adverse effects on other vital organs. There’s a reason for medical management by a licensed medical provider.

Lastly… let’s talk about one oral contraceptive option that’s currently available by prescription only: Yaz.  There are currently over 10,000 lawsuits filed in this country against Bayer Pharmaceuticals, the manufacturer of Yaz, due to strokes, blood clots, and other dangerous side effects suffered by women who took Yaz (http://www.drugwatch.com/yaz/lawsuit.php).  One of the claims of the lawsuits is that the side effects of the drug were considerably down played. Can you think of any more considerable down play of effects as removing the requirement of a prescription for the drug? Really?

Now let’s see what might really be behind this…

People all over the place are pissed off about Obamacare.  This appears to me to be a way to sidestep one of the provisions of Obamacare.  By making BCPs available OTC and without a prescription, insurance companies will not have to provide coverage. People (and let’s be honest, WOMEN) will be back on the hook for procuring and funding their contraceptive rights.

We are talking about our health and wellness. The inclusion of a licensed healthcare professional should not be taken out of the mix.

Take this drug and get some money!!

Although my family was a single-mother family, in many ways, I had 3 parents. My maternal grandparents were a presence in my life I think from the day I was born, but certainly as far back as my memory goes. We lived with them from the time I was maybe 5 or 6, I think, because my mom worked 3rd shift as a nurse and needed to have proper care for me, my brother and my sister. So, not to belittle the efforts of my mom (which were considerable!), I feel like a lot of my rearing and upbringing belongs to my Grandma. And my Grandma always said that anything worth having was worth working for.

My Grandma, of course, came up during the Depression and was no stranger to hard work... her entire life. In fact, she had to work entirely too hard her whole life. But I don't remember her ever complaining about it, or wishing for the lottery or some other windfall that would allow her (or my mom, my Grandpa or any of us kids, for that matter) the opportunity to not work. Work was expected.

These days, though, I don't know what happened to that mindset. Everyone seems to want everything, for nothing. Of course, people play the lottery and dream... but that's not what I'm even referring to.

There seems to be at least one commercial during every TV show that starts, "Did you or someone you love take the prescription drug...", followed by "YOU MAY BE ENTITLED TO A CASH SETTLEMENT!"

What the...?????

Now, these aren't settlements regarding unregulated "medicines", tonics, herbs, vitamins, supplements, etc. These are prescription drugs that went through FDA clinical trials, etc. Each of these drugs are prescribed for a medical condition, and have warnings regarding side effects, etc. It is at the discretion of not only the prescribing physician but the patient him or herself whether or not the risk of side effects outweighs the benefits of taking the drug.

Maybe 12-15 years ago, as I recall, people who struggled with their weight saw the FDA approval of Phen-Fen, a combination of 2 drugs that showed remarkable success in losing weight. People were lined up to go on the drugs. They didn't have to necessarily "diet" or exercise, but would still lose weight. NOW, common sense says that eating what you want and sitting around on your butt but still losing weight just doesn't add up. There were, of course, risks and side effects. People, though, always think that they won't be the ones to suffer the side effects.

Well, lo and behold, many people did develop side effects of the drugs, including damage to their heart. They all got together to form a class and brought class action suit against the drug companies. And they got paid! Not just the health care services needed to treat the cardiac complications, but for damages too. Pain and suffering.

What the...?????

So basically, people who took a short cut and avoided the actual work needed to drop weight were rewarded for their laziness? Ridiculous!

Now, I am not saying that the drug companies, or even the FDA for that matter, are "innocent". The truth of the matter is that as a society, we want quick and easy solutions to everything. There's GOT to be a pill (or two or twelve) to cure whatever ails you. If there's not, then we have to find one. Perhaps these drugs are being rushed through clinical trials for FDA approval so that they can be marketed. In that case, the FDA needs to review and amend their requirements for approval. But let's be honest. We as consumers are clamoring for these drugs to be approved for use as quickly as possible. How many times do we hear a story about someone suffering from an ailment. There's drug X that's in clinical studies and the preliminary results are so promising! Yet the big bad insurance company won't pay for the drug! How terrible! Yet it seems that those preliminary results (and we all know what the word preliminary means, right?) are just that. If we can allow the clinical researchers to complete their trials, maybe we find out that the drug isn't as wonderful as it was first thought.

Lately, I've heard commercials for not only some chemo drugs that were used in off-label treatment protocols, but also drugs for treatment of conditions such as arthritis pain, high blood pressure, diabetes, and birth control. The one for birth control is actually what prompted my thoughts on this topic, which in turn led to this rant.

Those of us who have taken advantage of the various methods of birth control that are available have all been advised of the risks of the birth control, including developing blood clots, increased risk of stroke, etc. The commercial I saw was urging women who were using Yaz and developed blood clots or suffered a stroke to call a specified law firm, as they may be eligible for monetary compensation.

WHAT THE...??????

So, they were told of the risks/side effects, chose to use that method of birth control, experienced the side effects and now they get paid? You can't be serious!

If there is clear evidence that a drug company lied to or misled the FDA in order to gain approval, that's one thing. That, to me, falls under malpractice. In the absence of that, though, it's just part of life. A sucky part, perhaps, but still just life.

What happened to accepting responsibility for the repercussions of one's actions?

The FDA needs to review and amend their approval protocol for drugs, and require ongoing study of approved drugs for up to 10-15 years or longer. We know that as a society, we are getting sicker younger because of a failure to take care of our health. Whereas diabetes and high blood pressure were typically found in aging adults, it's not uncommon for people in their 20s and 30s to have these diseases. Since these diseases are primarily managed using medication, we need to know what these drugs will do to our body when used for 10, 15, 20 or more years. If we were 60 years old at the time of diagnosis, chances are we wouldn't be on the drug for 20 or more years. If we're diagnosed in our 20s and 30s... chances are, we will be! What kind of toll are these drugs going to take on us? We need to know.

The second part of the solution here is to strictly limit the type of litigation that can be brought.  If a medication is used for an OFF LABEL condition, then the only claims that should be able to be filed are for actual damages, i.e., the cost of the medical care needed to treat whatever the side effect is. Not a single cent more.

If the drug was prescribed for the approved condition, then no claims at all can be filed if side effects are developed. It was a risk that the patient was made aware of and accepted. Therefore, accept responsibility for your decision. Period.

If I wanted a kid, I would have had one of my own....

So, I haven't been a regular blogger... but to be honest, I'm lazy so I need to get worked up enough to want to write. I got worked up over the whole Big Soda Ban thing in NYC, and this actually is a wee bit related.

In the 6/21/12 edition of the New York Daily News, there was an article about how a children's advocacy group (A Campaign for Children) dismissed Mayor Bloomberg's claim that the ban would help reduce the obesity rate in the city's children. The group states that the ban will not reduce childhood obesity, but that proposed budget cuts to children's after-school programs would lead to higher rates of obesity. The mindset is that without after-school programs, kids will go home, sit around being lazy and get fat. Therefore, the City needs to provide the same, and even more funding, to these programs.

QUESTION: Where does the City get the $$ for these programs? From taxpayers! The money doesn't just magically appear. Mind you, the proposal is to reduce the City's funding from +$91 million to +$73 million annually.

The children advocacy groups across the board, and each individual project, cries that the City needs to provide these programs, in many cases, at no cost to the families because the families are already struggling to make ends meet. They can't afford to pay for their kids to have whatever it is the program is providing to their children.

Now, I am not, in any way, suggesting that children should be left to fend for themselves. However, if I wanted to take on the financial responsibility of a child, I would have given birth to a child. I am tired, so very tired, of the city, state and federal government usurping a ridiculous percentage of my income as taxes, when I get nothing in return.

As a single person with no dependents, I have less chance of getting any kind of financial assistance as a snowball's chance in hell. I have to pay full rent, all by myself. My rent, by the way, will be going up yet again when my lease is up. I have to pay for my Metrocard, all by myself. I have to pay Con Ed, all by myself. (Sidebar: no one has been able to explain to me why the charges for the delivery of my electricity are HIGHER than the charges for the actual electricity I use. I live in a studio apartment, most of my time at home is actually spent sleeping, yet my electric bill is still $60-$70 per month in the winter, and can get as high as $250 a month in the summer when my A/C is on!) I pay for all of my own groceries. I can't qualify for any kind of assistance, whether it be food stamps or EBT, or even some sort of subsidy to buy local fruits/veggies. I get NO RELIEF, NO ASSISTANCE whatsoever to help me stretch my dollars.

Last night, there was a vote regarding whether or not there could be increases to rent stabilized units. Advocates for renters wanted a rent freeze, citing the continued economic woes and steady past increases in rents. Landlords wanted upwards of 5-9% to help offset costs for repairs and maintenance, and increased heating costs. They met in the middle, approving a 2% increase on 1 year leases and 4% on 2 year leases.

You know what would have been nice? A rent freeze for tenants, with the City offering to provide subsidies to the landlords to help with the costs of the repairs and heating costs. That way, those of us already struggling to make our rent won't be further burdened, but landlords would also have some relief from having to cover the higher costs.

I would have taken money FROM the after school programs. Why, you ask? Well, let me tell you why. First of all, e-v-e-r-y-o-n-e gets a benefit, not just people with kids. Trust me when I tell you as a single person, my money spends as quickly as a person who has kids. Now, I am not leaving all the little kiddies hanging out to dry. So many non-profits pay some pretty significant salaries to Fundraisers. Let them start earning that salary. There is a TON of money in NYC... most of it being held by that elusive 1%. Plus, there are major corporations. Whether private citizens or corporations, they have to give money away in order to reduce the taxes they pay (a whole other issue.... but I digress....) The funds that are reallocated to my little rent resolution can be replaced by private donations. And let's be honest... of all the various charitable organizations out there, CHILDREN'S charities get the most money and support.

What isn't replaced by private donations can, AND SHOULD, be replaced by the parents of the children utilizing the after school programs. Yes, I said that the parents of the children who use the programs should pony up some money for said programs. I don't care if it's $5, and if it is a hardship. Pay to play. Period.

The number of single parent households has exploded. I am so disgusted at the general opinion of so many women that they "don't need no man" to take care of their children. (Coincidentally, the next thing they spew out of their mouths is usually that the dead beat loser man doesn't take care of his child... but again, I digress.) Please. The next one I hear brag about how they're raising that child all on her own, I am going to correct her to explain that although Daddy may or may not be providing for that child, I and every single taxpayer are paying her child support. That "free" Metrocard each child gets? That's not free! My tax dollars are paying for that. That free lunch your kid qualifies for? That's not free! My tax dollars are paying for that lunch. The after school programs that you are demanding for free? Those aren't free! My tax dollars are paying for them. So that YOU don't have to arrange for a baby sitter for YOUR child/children.

Now, I know it sounds like I hate kids, but I don't. I am not saying that there should be no public funding for these things. These kids, regardless of their economic, social, and/or familial circumstances, did not ask to be born. And I do believe that as a community, we ALL have a stake in a child's upbringing.

But I also know first hand that hard decisions have to be made when we're talking about money. Spent money is gone. Hence the word, "budget". We are all struggling out here.

Everyone has a right to become a parent, if they so choose. But with rights come responsibilities. I understand everyone has a back story. But keeping it real and being honest, I have a real hard time feeling bad for a woman with 5 kids, by 3, 4 or 5 different men, crying how she need help to feed her babies. She should have taken her ability to provide for those children into account before she laid down with those men and let them cum inside her. Period. And while I do not feel those children should have to "pay the price" for her irresponsibility, I shouldn't have to pay the price either.

So what's my point? While I support some public funding for after school programs that are so desperately needed by so many children, there's just not enough money to assume most or all of the financial burden for the programs.  My point is, to the various advocacy groups (not just children's advocacy groups), YES, the work that the groups provide is important and worthy of support. But there's only so many dollars that are available. Everyone can't have everything and all for free. It's just not realistic.

Bloomy's War Against Soda

So, Mayor Bloomberg has declared a war against sugary drinks, mostly soda. His goal is to ban such beverages that come in sizes of more than 16 oz.

I understand the rationale behind the move... I really do. The obesity rate in this country is skyrocketing. Kids (as well as adults) are getting fatter and fatter, and lazier and lazier. Whereas visits to McDonald's were a periodic treat when I was a kid, they are daily (sometimes multiple times per day) occurrences in most families. Even Happy Meals have changed. When I was a child, a Happy Meal consisted of a hamburger (or cheeseburger), a small fries, cookies and a small soda. Now, there's not only a Happy Meal but a Big Kid's Meal, which has a DOUBLE cheeseburger, more fries, a bigger soda. Probably cookies or a sundae too. The thing is... children that are 4, 5 and 6 years old are eating Big Kid's Meals.

What does this have to do with sugary drinks? It's all part of the same problem. We can supersize everything. Instead of a 12 or 16 oz soda, we can get a 32 oz soda. Used to be that we could stop at the gas station or convenience store for a 12 oz can of Coke or Pepsi. That morphed into a 20 oz bottle... which morphed into a liter bottle (you know, for a family). Now we can get 1.5 liter bottles for ourselves (because the 1 liter bottle is too small) or a 3 liter bottle.

Every week, at least once a week, there's an article in the newspaper or on TV news about weight and health issues. There's how many "reality" TV shows now about weight loss? The Biggest Loser is (to the best of my knowledge) the grandfather of them all. The thing is, these shows expose many of the ways that society contributes to this plague on humanity. We see how many calories are in the beverages we choose, whether it's sugar-filled Kool Aid, soda, beer, wine, alcohol, fruit juices... whatever. The number of calories we DRINK, on top of the calories we eat??? Shocking to say the least.

To that end... here in NYC, if you go to chain restarants, calorie counts are, by law, printed on the menus. And trust me when I tell you it was quite the rude awakening... at least to me, and just about everyone I've talked to about this. Call it wishful thinking, but I terribly underestimated the number of calories in... well... everything. Everyone thinks salads, for example, are healthy... yet many of the salads that are offered up as a healthy alternative have more calories than some burgers, chicken and/or fish dishes. But i digress....

So, we have calories printed on the menu. And yes, to some degree, that has resulted in behavior changes. Maybe people choose to get a small or medium fries instead of a large fries. Maybe they leave the cheese off their sandwich. Some still order that double quarter pounder with cheese value meal, super size, with a Diet Coke. Each person who places their food order, whether at a fast food joint or a sit down restaurant, makes their own personal choices. Personal choices.

Which brings me to another point... Diet Coke. Diet Pepsi. Sugar free Kool Aid. Crystal Light. Diet Snapple. All of these have something in common... NO sugar. So these beverage options will be exempt from Bloomy's wrath. Right?

EXCEPT that dieticians, doctors, health enthusiasts alike all condemn these diet/sugar free drinks. ALL of them. They are no healthier, and in many ways worse choices, than their sugary counterparts. So why not ban these as well?

In fact, most doctors and health professionals agree that unprocessed foods and drinks are the only GOOD choices for people to make. Eat fresh fruits and vegetables instead of canned or frozen. Lean cuts of meat (IF you feel the need to eat meat at all). Drink lots and lots of water. Maybe some milk if you must (and did you realize MILK has sugar in it??), but almond or coconut milk, or soy milk, would be better. Even though those are, I think, processed alternatives... and the more processed something is the worse it is for us health-wise....

Geez, I have really talked myself into a circle here, haven't I? But isn't that the point? Everything that's good for us, if you look long and hard enough, isn't always going to be good for us. But that mean that stuff that's bad for us really is bad? Maybe. Kind of.

Sugar, I believe, is bad for us. It really is. But what's the difference between the sugar that's found in Coke or Pepsi or Sprite or Dr. Pepper or Gatorade or Red Bull or Kool Aid or some of those "energy" drinks, and the sugar that's found in alcohol? or candy? or hot chocolate? or cookies? or cake? or cupcakes? or brownies? or ice cream? or frozen yogurt?

Super sizing at McDonald's is bad. It IS bad! And does anyone really need a liter, or 2, or 3, of Coke? Probably not. But do we need the King Size Hershey's? Pints, quarts, half gallons or gallons of ice cream? Look at the size of cupcakes from Crumb! Are we still going to have the freedom to buy a bottle of booze or wine? They are, after all, more than 16 oz, and FULL of sugar!

Although it may appear that I've kind of digressed a bunch and talked in circles, at the end of the day, I have to concur that I understand that obesity is killing us. How can I not concur when I have struggled with my weight my e n t i r e life? But I don't know that this ban on soda or sugary beverages is or can be effective. For the sake of arguments, let's say that ALL non-plain-water beverages are banned and no one ever drinks a drop of them again. We still get to buy burgers and pizza and fries and cake and cookies and ice cream and a whole host of other sugary, evil, fattening, fried foods. We are still a lazy lot of people, overall. We still spend the majority of our time on our butts at work, sitting in a car or on a train or on a bus,  at the movies, sleeping, etc. We are under-active overall. So, how is banning the purchase of a 20 oz bottle of Coke going to solve the problem of obesity? It simply will not.