Obamacare as a Tax

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The Supreme Court says that Obamacare is a new tax on Americans. 

President Obama agrees. 

That is the basis for the Court’s decision to allow the mandates forcing the American people to buy insurance stand. They are not, in the Court’s view, a mandate to purchase a product. They are, rather, a tax on the American people. 

Ok then, let’s look at Obamacare as a tax. 

Based entirely on what I saw when I went to the website yesterday, this new tax is a hefty one.

Let’s look at the lower end of the income spectrum first. Based on what I saw when I visited the healthcare.gov website, if you have a family of four with two children under the age of 18, and your family income totals less than $35,000 per year, your premium for Obamacare will be somewhere around $1200/year. That comes to a hike in your monthly taxes of about $100/month. 

I am using Oklahoma figures for this estimate, and Oklahoma did not set up a health care exchange. It may be better for those in other states. I hope so. 

My husband and I had a monthly income even lower than this when our kids were little. We qualified for free and reduced lunches at school. A car with 100,000 miles on it was new to us. My husband did all our auto repairs himself, in the driveway in front of our house. I carefully balanced meals to keep us well fed and the grocery bills do-able. Both my husband and I went without clothes, new glasses (even when we were having trouble seeing) and dental work so the kids could have those things.

I can tell you that an extra $100/month tax hike would have been a big bite for us back then. It would have had to come out of necessity money. 

Now, let’s go to the other end. Consider those “wealthy” families of four with two kids under 18 who have a combined family income of $90,000 per year. Housing/automobiles/education/clothing/food/gasoline/etc are all massively more expensive now than they were even a few years ago. If the house hunter shows I watch on HGTV are accurate, home ownership (at least on the coasts) is totally out of sight for the family that makes $35,000/year and barely in sight for the $90,000 earners. 

If a simple three bedroom one bath house costs between $200,000 – $300,00 and even a modest new car costs over $20,000 and a community college with the kid living at home costs $4,000-$5,000/year and gasoline hovers around $4/gallon, as does a gallon of milk, then $90,000 only seems rich to those who are barely scraping by. 

Add another $6,000 or $7,000 in annual taxes for healthcare that was previously paid for by your employer (this is a bit of conjecture that employers are going to be less inclined to provide health insurance after Obamacare sinks in) and things start looking almost as dicey for these $90,000 earners as it did for my husband and me back in the day. 

The point here, at least for me, is that the primary winners in the Obamacare sweepstakes are the insurance companies and a few favored recipients such as Planned Parenthood. In exchange for guaranteed minimum coverage and paying for abortions they get government enforced enrollment in their wares and their premiums become a tax. 

I’m not talking here about the serious considerations of cost to the tax payer in terms of government expenditures to underwrite this plan. That is going to come around and bite us in a more indirect, but perhaps more damaging way as time goes by. 

I personally think that there were any number of better ways to provide health care for those who didn’t have it. I also do not believe that Obamacare is going to “contain” rising health care costs. I think that, by underwriting them, it will probably turn health care costs into something akin to the defense budget and largesse to corporations — an ever-enlarging pork barrel that devours the treasure of this nation. 

Will Obamacare “work?”

Probably. At least somewhat. 

I think that it will provide health care insurance for most Americans. 

But it is also going to eat into their personal finances. What our elected officials don’t seem to get is that the American people are stretched financially like a piano wire already. They’re having to work more than one job each, just to make ends meet. Every passing year, inflation (which government formulas no longer accurately represent) eats deeper into their already stretched budgets, and every passing year, their incomes stagnate or fall. 

Good jobs keep going away. For decades now, the news has been about this or that American corporation leaving this country to go use cheap labor elsewhere to manufacture its wares, which it then sells to the American people. 

We are being robbed. 

Will Obamacare fix this?

Does it even address it?

No and no. 

What it does do is underwrite a medical care system that is deeply flawed and overpriced. It puts insurance companies on the government dole and uses a new direct tax on the American people to pay for that. 

I have always believed that this country had to address the need for affordable health care. I am not a neocon. Far from it. I personally know people who forego necessary medical care because of costs. In fact, I have been one of them. 

However, this plan is more an accommodation to special interests than a solution for those problems. There is a limit on what the budget of the ordinary American can absorb. I think this plans pushes a lot people painfully close to that limit. 

The question, of course, is what Obamacare will look like in years going forward. The tinkering with this plan has not even begun. There is also the question of whether or not it will be repealed by future Congresses. 

Personally, I doubt it. Once the plan locks in and the special interests start getting their take, the political will to either repeal or reform Obamacare will vanish like smoke in your morning coffee. 

 See also: Obamacare Threatens to Hit Many Pocketbooks; Health Care Law Fails to Lower Prices in Rural Areas

I Didn’t Sign Up. But the Obamacare Website Seemed to Work for Me

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I didn’t sign up because I already have health care coverage.

However, I did go to the Obamacare website at healthcare.gov and put myself through the steps. I got to the point where I select a plan and click “buy.”

It worked ok for me.

I dunno. Maybe I didn’t go far enough with it.

Or maybe I have a magic touch.

What I did learn is that the premiums for health care are no bargain. If health insurance wasn’t affordable before Obamacare, it will become a major burden, at least for the middle class, after Obamacare. The premiums I was offered were actually higher than what my employer pays for my insurance.

I played with the numbers a bit, and if I had an income under $35,000 and a family of four with two children under 20, the premiums would become affordable. This is because the government pays a tax credit directly to the insurance company, which subsidizes the health insurance costs of the family. That’s part of where the huge increases in government spending come in.

Obamacare appears to be set up a lot like Medicare, except that Medicare actually is a big cost reducer for the citizen taxpayer. The best plan that I was offered also included the messiness of paying at least 10% of my health care costs out of pocket. Ten percent of the cost of treatment for cancer or something equally serious puts most people into bankruptcy territory.

Beginning in 2015, employers who offer health insurance are going to have to meet the coverage requirements of Obamacare. I imagine that will lead to considerable sticker shock for these employers and that many of them will stop offering health care to their employees.

That will push people who had previously had their health care subsidized by their employer into paying for their own costs through Obamacare. Many of these people will earn enough money that they don’t qualify for the tax credit. They will face a sudden increase in expenditure for health care, and, based on what I saw on the web site, it won’t be a small one.

I am not talking about wealthy people. I mean households with a combined income of say, 90,000 dollars or more. These are people who have to make car and mortgage payments, deal with ever increasing costs in everything from gasoline to tuition, and who fall through all the cracks when it comes to getting help. Obamacare is going to squeeze them.

To summarize: I think Obamacare will be an expensive problem for both the middle class and the government. The people it will help the most are lower-income working couples with young children who make too much money to get other forms of aid and don’t get employer-sponsored health insurance.

I need to add a serious disclaimer to these conclusions in that this is a cursory take on a complicated program. Also, I went through the web site as an Oklahoman and Oklahoma has not set up health care exchanges. Maybe I got higher premiums because of that.

But my takeaway from visiting the web site is that, yes, I at least can use the web site, and, yes, I think Obamacare itself has serious flaws regarding costs to the taxpayer, both in terms of coverage and the costs to our government.

This Way of Life Fulfills Me. I am Very Happy.

Only God would use lung cancer as a opportunity to offer a vocation.

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Culture of Death News

Buckle your seat belts.

The list below contains a few headlines from the culture of death. Look at them and remember why we fight this fight.

 

Wendy Davis, winner of the Texas pro choice filibuster, runs for Governor

UK Takes Step Toward Three-Parent Babies

Belgian Transsexual Dies of Euthanasia After Botched Sex Change Surgery

Number of Dutch Deaths by Euthanasia Rises by 13% 

 

Abortion  Contracts and $45,000 for abortions

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Planned Parenthood: No Matter What

This enlightening video is from Students for Life.

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Endangering Women’s Lives in the Name of Women’s Health

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I published this post about 10 months ago. I’m re-running it today because of the combox discussions on birth control.

I am, as I’ve said many times on this blog, a feminist. I’m also no spring chicken. I remember back when feminists actually agitated for safer forms of contraception for women and criticized the marketing of dangerous chemical birth control to women without regard for their health and safety.

No more.

The “feminism” of today equates any form of chemical contraceptive — no matter the health dangers to women — as not only ok, but an absolutely imperative and vital part of “women’s health.” They have turned the phrase “women’s health” into a synonym for abortion and the massive application of a chemical band-aid to the sexual exploitation of women and sexualizing of young girls.

They are, in short, exactly who they used to oppose.

Remember Yaz?

I’ve lost count of the Yaz commercials I saw. Here are a couple of examples. Notice the lack of warning about side effects and the age of the girls this pill is marketed to in the first one.

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And another ad pushing Yaz, but this time with warnings:

 

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And the FDA finally takes note of the young women who are dying because of this totally unnecessary medication:

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The important thing to remember is that none of this is necessary. Yaz is not being used to treat cancer or any other illness. It is marketed for mild teen-age acne, pre-menstrual emotional upset and to prevent pregnancy. It is an entirely elective medication with fatal side effects, being marketed directly to young women and girls.

After Yaz had been on the market a number of years, and probably damaged the health of many young women, ABC News finally wrote a story about it.

The 2011 ABC News article reads in part:

The blockbuster birth control pill with benefits, Yaz was pitched as the choice for women desperate for relief from severe PMS and acne. But now, new independent studies have found that Yaz carries higher blood clotting risks than other leading birth control pills.

ABC News investigated whether tens of millions of women switched to a more potentially risky pill that, as it turns out, was never proven to treat common PMS.

In 2007, Carissa Ubersox, 24, was fresh out of college and starting her dream job as a pediatric nurse in Madison, Wis. On Christmas day, while working the holiday shift, her boyfriend surprised her at the hospital with a marriage proposal.

Wanting to look and feel her best for her wedding day, Carissa said she switched to Yaz after watching one of its commercials that suggested this pill could help with bloating and acne.

“Yaz is the only birth control proven to treat the physical and emotional premenstrual symptoms that are severe enough to impact your life,” claimed the ad.

It “sounds like a miracle drug,” Carissa said she remembers thinking.

But just three months later, in February 2008, Carissa’s legs started to ache. She didn’t pay much attention to it, assuming, she said, that it was just soreness from being on her feet for a 12-hour shift.

Birth Control Medication Under
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By the next evening, she was gasping for air. Blood clots in her legs had traveled through her veins to her lungs, causing a massive double pulmonary embolism.

Her fiance called 911, but on the way to the hospital Carissa’s heart stopped. Doctors revived her, but she slipped into a coma for almost two weeks.

Carissa’s only memory of that time is something she refers to as an extraordinary dreamlike experience. She said she remembers a big ornate gate and seeing a recently deceased cousin.

That cousin, Carissa said, told her, “You can stay here with me or you can go back.”

But, she recounted, he told her if she goes back she’ll end up blind.

“I just remember waking up in the hospital and I was like, ‘Oh, I guess I chose to stay,’” Carissa told ABC News.

Like her cousin in her dreamlike experience foretold, she actually did wake up blind, and remains blind to this day.

(Read more here.)

What Does the ‘Infant Born Alive Act’ Really Mean?

There seems to be a dedicated group of abortion advocates who don’t care about human life, except, perhaps, their own.

I am not saying that everyone who thinks abortion should be legal falls into this category. But I have no other way to characterize people who would oppose the requirement that babies who survive an abortion be given medical care.

What am I supposed to say about these people?

One of Public Catholic’s readers went all apoplectic over Obama’s Lowest Moment in the 2008 Campaign. He denounced Infant Born Alive Acts as “garbage” and “thinly-veiled” attempts “to encroach on Roe v Wade.” Then, I guess to add what he thought was the cherry on top this little statement, sputtered at me to get out of the Democratic Party.

Not only is he confused about the Democratic Party — (It’s not an invitation-only private club run just for him.) — but his grip on what the Infant Born Alive Acts are about is tenuous, as well.

The video below is a sweet reminder of what Infant Born Alive Acts are addressing: The human lives of real human beings.

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Ding! Ding! Ding! And We Have a Winner!

 

The Christian Bashers Defense team has pretty much taken over the comboxes on my recent post Constitutional Rights for Me, But Not for Thee. 

They are as predictable as mosquitoes. Just say something really true about their behavior, and they show up, armed to buzz bomb you until you go inside and close the door.

In this instance, I asked the simple question: Do Constitutional rights apply to Christians the same as everybody else?

The answer should seem obvious. But of course it’s not. The reason it’s not is the bullies who want to limit other people’s rights always get mad and deny what they are doing when someone calls them on it. They do it every single time.

We’re all supposed to join them in their pretense that there’s nothing discriminatory or offensive in their attempts to drive Christians from the public square. No one is supposed to challenge their idiotic pretense that using government controls to limit the free exercise of religion in this country is actually a push for freedom, instead of the tyranny that it is. 

If we can’t be agree with them, they want us to sit down and be quiet and stop contradicting them. If we don’t, well then, they’ll scream and shout until everybody gives up and lets them have the day.

It has always been thus. People who do things like this always deny it, and they always get mean when someone calls them on their facile denials.

That’s why this particular post ended up being dive-bombed by a whole troupe of angry combox mosquitoes. Even though the readership of this blog is heavily — and I mean heavily – Christian, the Christian defenders were outnumbered. In fact, only three stalwart souls tried to stand up for Christ in these arguments. In the end, it got down mostly to one stubborn Christian, who is hanging in there to this very moment.

For all that, this lone fellow managed to push the whole mosquito assault into a slow unwinding of their lies until, one of them just came out with it.

And I quote:

No one is forcing anyone to do anything. And no one is driving anyone out. But if it does not believe it can conscientiously comply with the law, the Catholic Church can sell its hospitals, schools, universities and charity organizations. And the church and its members have the right to protest and encourage that the law be changed.

Of course, that would dramatically change the face of the church in the United States.

And then the commenter goes on, blah, blah, blahing with a lot of stats (which may or may not be accurate. I haven’t checked.) about the Church’s holdings.

How about that? Not, mind you, that forcing the largest denomination in the country to “sell its hospitals, school, universities and charity organizations” if it won’t violate its 2,000 year-old religious teachings due to government demands that it do so might be …  ummm …. a slight violation of the principles of that fictional “wall of separation between church and state” of which militant atheist are so proud. Also, not that it might be an outright dismissal and abrogation of religious freedom as defined in the Bill of Rights. Nor that it might be just a wee bit of outright tyranny.

Nope.

It’s just deserts for those who have the temerity to think that their individual rights as free Americans amount to a hill of beans to the post Christian, militant secularist demands for moral conformity (with moral being defined by them and them alone) that must govern us all.

I want to remind you that this is about birth control and abortifacients. Nowhere that I know of is there a Constitutional right to free birth control and free abortifacients. Also, nowhere that I know of is there a Constitutional right to force other people to pay for your birth control and abortifacients, even, or in this case, especially if it violates their religious beliefs to do so.

There is, however, a pretty strong Constitutional right to the free exercise of religion. Not even President Obama is debating that. What he’s trying to do is re-define this Constitutional Right to the free exercise of religion along the lines of how it is defined in Communist dictatorships. He wants to say that freedom of religion is actually just freedom of worship and that only in governmentally prescribed “houses of worship.” And, oh yes, behind the closed doors of your own house.

FireSale

It takes a combox firebrand to just come out and say what all this truly means and where it leads. It is leading to stripping the Church of all its “hospitals, schools, universities, and charity organizations” in what would certainly amount to a fire sale. It means driving the Church out of public life, totally and absolutely.

There’s nothing dishonest about what this person said. In fact what’s powerful about it is that it is the truth of where we are heading. It is exactly where we are going if this tyrannical abuse of the freedoms of Christians as citizens of the United States is allowed to continue.

If the Obama administration succeeds in redefining religious freedom in these terms, it will  have destroyed the First Freedom of the American people.

And all this so that it could bend this country over and bow it down to the little g gods of abortion and death.

I want to thank the strong-hearted Christians who have hung in there during this debate. I encourage some of the rest of you to get in the game along with them. Standing up for Jesus is not a spectator sport. We all need to do it.

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Texas and Abortion: This is How Pro Choice Created Gosnell

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I’ve written before that Dr Gosnell is the monster that pro choice built.

Dr Gosnell is the recently convicted serial killer/abortionist who operated what some people have described as a “chamber of horrors” in Pennsylvania.

I knew I would catch some flak for saying that, and I did. But I had said it advisedly, based on my experience on both sides of the abortion wars. I knew what I was talking about.

We are seeing the dynamic I referred to acted out once again in Texas; pro choice people are going over the top to fight the regulation of abortion clinics in the name of “women’s health.”

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About a week ago, Senator Wendy Davis of the Texas State Senate engaged in a 13-hour filibuster that resulted in a legislative train wreck for a good piece of pro life legislation. Her actions, along with some filibustering from the Senate gallery, effectively killed a bill that would have required that:

1. Abortion clinics provide the same kind of patient safety as any other ambulatory outpatient surgical center,

2. Doctors who perform abortions in clinics must have hospital privileges at a hospital that is within 30 miles of the clinic,

3. Abortion clinics provide their patients with a phone number which would be answered 24 hours so that they can call for medical follow-up to their abortions,

4. Abortion clinics give women the name and phone number of the emergency facility nearest to her home where she can go for medical care in the case of an emergency after her abortion,

5. Doctors, and not staff, prescribe drugs for a chemical abortion according to FDA guidelines, and that the drugs for chemical abortions may not be dispensed until after the prescribing physician has examined the patient and determined that she is not carrying an ectopic pregnancy.

6. Doctors who perform abortions who prescribe drugs for a chemical abortion also provide follow-up care, including a follow-up examination by the physician to determine that the abortion is complete and a 24 hour phone number in case the woman needs questions answered.

7. Doctors who perform abortions must report adverse affects caused by drugs used in chemical abortions to the FDA according to FDA guidelines.

These are the “outrageous” regulations that pro choice people are demonstrating to stop. In my humble opinion, there is not one thing on this list of requirements that even the most pro choice person would not want for their daughter if she was undergoing an abortion.

Doctors who do abortions — which are a surgery — should have hospital privileges?

Duh.

Abortion clinics — which are outpatient surgical clinics — should comply with the same health and safety regulations that every other outpatient surgical clinic does?

Abortion docs should examine their patients before surgery and follow up with them afterwards? They should report side effects of the drugs they prescribe to the FDA? They should make sure that women they give abortion-causing drugs aren’t carrying an ectopic pregnancy, when giving those drugs to a woman who is carrying an ectopic pregnancy can cause her to bleed to death?

Er

These regulations are exactly what anyone who is interested in “safe, legal” abortions should want. Frankly, I think the pro choice people should thank the pro life legislators who are pushing this bill for cleaning up their dirty little industry.

However, the pro abortionists have pulled out all the stops to kill this bill, including misrepresenting it to their own followers. I doubt very much that the many “pro choice” people in this country who are buying the stuff the abortion industry is putting out about this legislation actually know what the bill contains.

If they did, most of them would favor the legislation. Frankly, anyone who favors “women’s health” should favor this legislation. But they’ve been conditioned for many decades by the constant drum beat of pro abortion extremists to believe any stupid thing those extremists say. There is little actual thinking that goes into the positions they take on abortion.

I would imagine that even most of the legislators who oppose this bill think they are doing it because if they don’t women will be “sent to the back alleys.”

The Texas legislature can not overturn the United States Supreme Court. Roe is not in danger. What is in danger is the lives of the young women who go to clinics that are protected from providing good medical care by abortion zealots who are so caught up in their cause that they don’t have a genuine thought in their heads.

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I read this morning that there are plans for celebrities to come to Texas and speak against the bill. The whole thing has turned into a cause celeb, both literally and figuratively. After all, it turns out that many of the clinics in Texas will have to close because they can’t comply with operating like regular outpatient surgical clinics do.

They want, they demand, that they be exempted from providing good medical care to women because if they do have to provide the same level of care that other outpatient surgical clinics provide, it will endanger women’s health.

Does anyone know who’s on first?

Lessee …

What are we making sure of?

That women’s doctors are free to not follow up with them, don’t have to provide the same health and safety for them that they would for any other surgery, don’t need to examine them before doing surgery on them or administering dangerous drugs to them, and … get ready for this now … don’t even have to have hospital privileges at a nearby hospital.

That’s “women’s health,” abortion style.

Remember Dr Gosnell and his chamber of horrors? This kind of folderol is exactly how pro choice built that monster.

They fight against any and all pro life legislation on the grounds that even safety standards “narrow” Roe. They tell poor deluded women that if laws like this one pass, they will be “forced into the back alleys” again.

So what happens to the women?

A lot of them end up suffering harm that would have been prevented by better medical care. I’m not even talking about what happens to the baby here. I am talking solely about women’s health.

I had to have a couple of surgeries last year. I came home the same day after both of them. Neither of them was as risky as poking around in a pregnant uterus.

I can tell you that I wanted a doctor with hospital privileges holding the knife when he went to work on me. I wanted him to examine me beforehand and make sure that he knew what he was doing and that I was a good candidate for the surgery. I wanted health and safety standards dutifully enforced in the place where he did this surgery. I would have been outraged if I had learned that I was on my own after the surgery with no support or follow up if something went wrong.

Nobody anywhere was out demonstrating for the doctor who cut into my foot to be free to practice dirty medicine, not have hospital privileges and dump me after the surgery. Not one person thought it was outrageous or a violation of my rights that my doctor was required to practice competent medicine on me.

But if I had been a woman who was seeking an abortion, they would have been jumping up and down, demonstrating, filibustering, importing celebrities to defend my “right” to incompetent medical practices.

That’s how pro choice built Dr Gosnell and his chamber of horrors. It’s how they endanger women’s lives all over this country.

Look at this carefully and tell me: What’s wrong with this picture?

If It’s Not Prostitution, Take the Money out of It

MH900448636 I knew when I posted The New Prostitution: Surrogate Pregnancy that I would get a flurry of indignant responses and lies from people who buy and sell women’s bodies in this new, medical form of prostitution.

I’ve been to this particular rodeo before. What I encountered then and now is what people who stand up for the human rights of women always encounter: Lying attacks from their exploiters, self-destructive defenses of their own dehumanization by self-hating women, and stories of the “benefits” of the prostitution from their purchasers.

Just for the record, I don’t put pimps’ testimony on this blog. That includes pimp husbands who take money from their wives selling their bodies to medical science and doctors who buy and sell women’s bodies. I also don’t put johns’ excuses for their behavior on this blog. You’re wasting your time, trying to comment here.

My experience with this began when I went through infertility treatment to have my first child. I know a lot of about these drugs they give people. I know about their side effects and how they make you feel. I do not have first-hand knowledge of the irresponsible medical practice of egg harvesting.

My doctor was treating me for a diagnosed medical condition. The dangers and miseries I endured were part of a legitimate treatment for a bodily disfunction. She never over-stimulated my ovaries to try to make as many eggs as she could. She also never lied to me about the risks. She told me everything before we ever started, including the fact that the treatment could kill me.

The doctors who perform egg harvesting in Oklahoma lie about the risks. I know they lie because when I introduced a bill to stop them from paying women to undergo egg harvesting, they lied to other legislators and to the press. One of them said that egg harvesting was no more dangerous than riding in a car, among other flat-out lies.

They also claimed that they had not ever had a single complication. Another lie. One of these docs was part of the infertility clinic I went to. He wasn’t my doctor, but I knew him. While I was undergoing treatment, one of his patients lost an ovary. Call me crazy, but I think that qualifies as a complication.

These doctors are misrepresenting the risks and exploiting young women, endangering their lives, future health and fertility. They are reducing women and children to things to be bought and sold on the marketplace. They are also turning medical practice into an exploitative and dangerous profession that people cannot trust. 

If doctors can subject people to dangerous treatments that the patients have no medical need of in order to make money, if they can lie about the risks and use their professional associations’ political clout to create an environment that allows them to do this with impunity, then how can anyone ever trust their doctor?

We rely on these medical people to tell us the truth. We rely on them to give us treatments that we need because we are sick and need those treatments to get well. We rely on them not to inflict unnecessary medical treatments on us to make money.

These doctors are preying on women. They are buying and selling babies. All the lies in the world won’t change that.

There is one simple solution. Take the money out of the equation. If a woman wants to undergo a surrogate pregnancy for someone out of the goodness of her heart and she knows the risks and freely undertakes them, ok. But do not allow anyone to pay her to do this.  The same should go for egg harvesting. 

There is a reason we have laws that do not allow people to sell their bodily organs. The same laws should to apply to egg donation and surrogate pregnancies.

What I want to do is,

TAKE THIS:

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AND THIS

  • First-time surrogates receive a base payment of $23,000, paid in installments throughout the pregnancy.
  • Additional payments total $4,000 or more, which increases the total compensation to $27,000. These payments include money for maternity clothes, payment for completing the embryo transfer, and a monthly expense allowance beginning when the surrogate signs the contract with the intended parents.
  • Surrogates who carry twins receive an additional $5,000, raising their total to at least $32,000.
  • Women who become surrogates a second time have their base payment increase to $28,000. This means they receive at least $32,000 total, or $37,000 if they carry twins. (see here.)

AND THIS

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OUT OF THE EQUATION. 

Give women and children their human dignity under the law. 

Otherwise, stop lying and call it what it is: The new prostitution.

The story below comes from a young doctor. She gave me permission to use her testimony when I was working to pass a bill to make it illegal to pay for egg harvesting in Oklahoma. I never used it, even though she gave me permission. She was still a student and afraid of what public use might do to her medical career. I didn’t think she understood how vicious and slandering these people really are, and I did not want to harm her in any way. I left her out of that fight.

However, she is in a different place in her career now.  She has offered her story as testimony to the Kansas State Senate and it is published at the Eggsploitation web site.

I reprint it here with permission. From Eggsploitation:

 

Sindy’s Testimony

Testimony by Sindy, M.D., Ph.D. to Kansas State Senate on Senate Bill 509, “Women’s Health and Embryo Monitoring Program Act,” March 2010

My name is Sindy. I have an M.D. and a Ph.D. in Biology with specialization in the field of real-time live imaging of the early immune response. With my strong background in basic science research and publications in top scientific journals such as Nature and Science, I have always been an avid supporter of biological research using live subjects and donated tissue, both animal and human. However, my experiences have taught me that at times, even a scrupulous medical scientist may be tempted to make erroneous assumptions, cut corners, or risk safety in order to save time or achieve success. In my medical and research training I have learned the importance of certain principles whenever attempting a procedure or study. These include: 1) ethics, 2) subject safety, 3) informed consent, and 4) patient autonomy. I am testifying today as a former egg donor on the dangers posed to women by the egg harvesting industry. I believe that all four of the above key principles had been violated in my case. Even though I suffered immediate life-threatening complications from the process, it wasn’t until many more years of medical training that I was able to understand the full scope of how I had been taken advantage of, mislead, and abandoned by the egg harvesting industry. As a medical professional it is still difficult to accept that such abuses are allowed to exist in my profession. Meanwhile, players “behind the scenes” such as the egg donation agency and the egg brokers have left the issues of ethics, health, and safety to the doctors, so that they can concentrate on profit. It is my assessment that the egg donation industry cannot be allowed to continue without regulations aimed at preventing unethical recruitment, substandard practices, and inadequate monitoring of women for the purpose of egg harvesting.

The goal of my testimony is to illuminate the importance of placing regulations on the way that the egg harvesting industry is run — from ethical, legal, and medical standpoints. 1) The health and safety of women must be protected first and foremost in any procedure related to ovum production, and should never be superseded by concerns of profit, costs of screening and monitoring the subject, quantity of eggs produced, quantity of eggs retrieved, or completion of the cycle. 2) Furthermore, like any other industry, the egg harvesting industry must be held accountable for reporting adverse effects and for tracking the long-term health of donors. 3) Ethically, informed consent must be properly obtained, with an admission that more research is needed to illuminate the long-term risks to donors. It is also an ethical responsibility for those who profit from egg harvesting to track the health of donors, including conducting large scale research in order to study risks.

I will now relate my experience. In 2001, while still in the combined MD/PhD program, I signed up for egg donation after seeing a university newspaper advertisement for egg donors. The monetary compensation of $6,500 seemed like a lot to me at the time, as I made barely enough to live on. Though I had a desire to help an infertile couple, money was definitely a major driving factor in my decision. Before I started, I searched the medical literature with a fine-tooth comb to verify that this procedure was indeed as harmless as advertised by the egg donation agency. I did not find any hard evidence in the literature of future infertility and cancers, and it seemed that the risks of other complications were extremely low. However, I was not told that the egg donors were rarely followed after the donation, and that doctors were under no obligation to report adverse events.1 Like many other women egg donors, I was bound by legal contracts to remain anonymous and therefore even if late complications occurred, they would be difficult to report.

At this point I had a normal gynecologic history, including normal age at first menses, regular menstrual cycles, and nothing significant on pelvic ultrasounds. It was assumed that I was healthy enough to undergo the egg harvesting protocol. Then I submitted my photographs, passed my genetic screening as a “quality assurance” for the tissue purchaser, and submitted myself to a psychological screen and IQ test administered by a psychiatrist. Based on these results I was chosen as the egg donor, from whom a “designer offspring” would be created.

The legal contract stated that the creation of these eggs were for the purpose of in vitro fertilization. The recipients of my eggs would retain all rights to my eggs and any subsequent embryos created from my eggs, “including but not limited to the ability to make all decisions regarding disposition of embryos.” The literature given by the egg donation agency outlined the possible risks of ovarian hyperstimulation syndrome (OHSS), as well as some other theoretical risks that they assured me were rare. What I did not realize at this time was that there were other hidden players in the egg industry who could potentially make money off my eggs, and that there were no laws in place to discourage hyperstimulation of many more eggs than reasonably needed for the goal of helping the infertile couple. My contract did not guarantee that third parties would not be involved in the trading or selling of these eggs, though it specifically forbade donations to other infertile couples without the donor’s consent. My eggs could have been a high-value commodity for profiteers who had nothing to do with the infertile couple, and I was not made aware of this possibility in a forthcoming and direct manner.

The below was part of the information provided to the public by the egg donation agency:

Q: How many eggs are removed during the retrieval? A: The average is 10-15 eggs aspirated per cycle, but donors can produce 16 or more eggs.

Q: Can a donor not produce enough eggs in a stimulated cycle? A: Yes, if the doctor cancels the cycle for poor response the donor will be compensated between $650.00 — $750.00.

According to my agency, failure to produce more than 4 eggs qualifies as “not enough eggs”. Four is typically higher than the target for women who are receiving fertility treatment using oral medications. However, note that there is no upper limit for the number of eggs a donor may safely “produce”, indicating that safety of ovum overproduction is being ignored. This illustrates that the drive to produce a higher number of eggs is extremely high, and failure to produce “adequate” eggs is linked with reduced financial compensation for the donor. Needless to say, this concept of “more is better” brings up ethical questions concerning the use of financial compensation for the recruitment of egg donors. This is especially alarming when no standards are in place to prevent an agency from overproducing eggs. The agency also told me that if I had a successful donation and become a proven donor, I may receive more compensation for future cycles, upwards of $8,000 (on paper) to $20,000 (verbally) – more than I would make in a year of intensive lab work. When “successful” production cycles are linked to increased financial compensation and “failures” are linked to a decrease in financial compensation, women will become more likely to tolerate untoward side effects, including those of OHSS, for fear of losing this compensation. This payment structure poses an obvious ethical conflict.

After signing my legal contract I began to administer all the medications as directed by the egg donation agency. These medications arrived by mail. I already knew how to mix and administer the medications but I don’t recall being instructed by medical personnel. At no point did they adjust my dosage. I remember receiving follow-up early on with a local doctor, and more exams after I travelled by plane to Northern California for the harvesting. Imagine my surprise when they told me that I was producing approximately 60 egg follicles! A mature follicle measures ~2 cm in diameter. The normal ovary measures approximately 4 x 2.5 x 1 cm, and is analogous to the testes. Therefore, you can imagine how 30 mature follicles of 2 cm diameter clustered within each gonad must look like and feel. I was concerned, but the doctors and nurses assured me that this was within the reasonable range for a fertile young woman.

A couple of days before the retrieval the nurse emailed me that my blood estrogen (estradiol) levels came back much higher than they had anticipated (~10,000 pg/ml). A woman in her 20s has an average estrogen level of ~150 pg/ml, with a peak of ~400 pg/ml prior to ovulation. In late pregnancy, the levels may rise 100-fold, but this rise normally occurs over a 6 month period. I asked the fertility specialist to consider altering the timing and course of this process. I was concerned because the drugs I received were probably tested on Caucasian women of average weight. I am a thin non-Caucasian woman. Studies have shown genetic differences in liver drug metabolism for ethnic populations; the examples are too many to reference and are beyond the scope of this topic. Despite my concerns, the doctor told me that even though my hormone levels were extremely high, they would not make any adjustments to the protocol because they did not want to risk failure. I continued to follow all their directions, as it stipulated in my legal contract that I “[understood] it [was] imperative” that I “not deviate from [the protocol] unless instructed to do so by the IVF physician.” Therefore, I proceeded to finish my ovarian stimulation, finishing off with a shot of human chorionic gonadotropin (HCG) to help release the eggs for the harvesting. The next morning, I underwent transvaginal needle retrieval of the eggs.

What was unknown after the surgery was that the doctor had punctured an artery during the harvesting. When I woke from the anesthesia I became weak, nauseous, and dizzy. I was scheduled to catch a plane that afternoon, to return home. They told me that I looked good and was ready to go home, even though I had problems maintaining my blood pressure. At this point I refused to leave, because I could not stand without getting dizzy – orthostatic hypotension after an invasive procedure typically raises the suspicion of blood loss. A few hours later they started giving me intravenous fluids because they thought that the anesthesia was causing my low blood pressure. Then I developed pain and difficulty breathing. An ultrasound showed that everything was fine except for fluid in my pelvis, which they said was normal (later, this was documented as “fluid pocket near the right kidney”. During this entire time the doctor and nurse persisted in trying to get me to leave, which would mean hours of traveling by car and plane. The pain in my belly became unbearable and I became convinced that I was bleeding internally; something was irritating and pushing on my diaphragm. When I asked if I could be bleeding internally, they told me that it was unlikely. My blood pressure was even lower at this time, so they gave me medication to raise it. Unfortunately giving pressors in a bleeding patient increases the bleeding rate. At 6pm, after 8 hours of slowly and painfully bleeding out, they FINALLY admitted me to the hospital. To me it seemed like they had done just about everything to get rid of me up until that point. The fertility doctor ordered me to eat something. As soon as I sat up in bed to eat, I developed sudden distress and difficulty breathing. They took my blood pressure and called out “40/20″. At that moment I feared that I was going to die. In my medical records the blood pressure reported was 61/29. At this point they finally began to realize that something was terribly wrong, that I was going into shock from blood loss, so I was taken into the operating room for an emergency exploratory laparotomy to find the source of bleeding. The surgeons flipped through my bowels three times to ensure that no other organs were punctured.

During the harvesting of ~60 eggs, which I assume required 60 passes of the needle through my ovaries, the fertility doctor had punctured a high pressure artery in my right ovary. This tiny bleeder was easily fixed with a touch of electrocautery. I had an emergency blood transfusion to replace the 1.5 liters of blood lost. There is absolutely no reason why they should have waited so long to properly diagnose me, thus turning this into an emergency surgical situation when they could have done a small laparoscopic procedure to diagnose and fix a small bleeding artery. Had I followed their directions and gone home, I would have died. Unfortunately their disregard of the signs of OHSS, low index of clinical suspicion for post surgical complications, and their extremely slow response resulted in a horrific clinical outcome.

After the surgery, I had to be kept on a breathing machine in the intensive care unit (ICU) and treated for acidosis throughout the next day. After I was stabilized enough to move to the regular medical wards, the fertility doctor came to see me. She told me that the bleeding was probably due to a genetic bleeding disorder (i.e. my own fault) and that this has never happened before. Then she proceeded to check me for rare genetic bleeding disorders – nothing. I found the doctor’s reluctance to accept that a simple, clear-cut complication had occurred to be highly disturbing. A few days after I was admitted, the 9/11 attack occurred and all planes were grounded for a week. Despite not being able to walk or tolerate a 10 hour car ride home, the doctor told me I needed to free up medical resources and go home now. She tried to get me to leave by stating that when she had her C-section it only took her 3 days to start walking again. However, she neglected the fact that I had gone into prolonged shock caused by her own negligence, spent time in the ICU, underwent a massive surgical procedure, and had emergency blood transfusions. There were no apologies from beginning to end. I was shocked by this dismissive attitude from a top doctor of a top fertility treatment center, a medical expert who has published many articles on safety evaluation and recommendations for egg harvesting. At the same time, I was afraid to launch any complaints because I was a student in the same hospital system with plans to pursue the same field – Ob/Gyn; years later I decided on another medical specialty for unrelated reasons.

I am thankful to be alive, but I know that it was not because the doctor caught the post surgical complication. It was because I finally took a stand, and refused to go home when I knew that something was wrong. If I had died I would not be here to tell my story. I fear that cases like mine are buried deep by the fertility centers who do not want to lower their reputation. While I was in the hospital the fertility doctor told me that she would write a case report on the complication I had. When I searched the medical literature for all of her publications some years later, I wasn’t surprised to find that there was no such report. I have no way of knowing if this incident even made it into a statistical analysis somewhere in the medical literature. It makes sense that an industry thriving on profits and reputation has little incentive to report adverse events, for fear of driving away potential IVF clients and egg donors.

The $6,500 I was given has long since evaporated into medical treatments for multiple late complications caused by this incident. I developed an infection inside my incision site and required multiple steroid injections into the scar to stop it from growing out of control. I suffered from post traumatic stress for months because of my near-death incident, and was unable to work for two months due to both physical and mental deterioration. When I came off birth control a few years later I discovered that my previously normal menstrual cycles and hormone levels had become irregular. My previously normal ovaries took on a polycystic appearance, with more than 25 small follicles in each ovary. I developed occasional incontinence and pelvic pain likely as a consequence of the emergency surgery causing adhesions (fibrotic bands, analogous to scarring) around my organs.

The worst part of this is my current struggle with infertility, requiring continued exposure to the very same types of fertility drugs that I had already been overexposed to in the past – exposure whose link to cancer has not been adequately studied and may take decades to emerge.1 I may need more surgeries in the future to determine if the emergency surgery that was done had damaged my reproductive organs. I fear that the procedure may have harmed the quality of my eggs, even if the fertility experts are certain (at least theoretically) that quantity of eggs remains unaffected. Because of the high hormonal exposure during my egg donation cycle and multiple anecdotes from other egg donors, the development of early cancer is always in the back of my mind. Though a large study has found no evidence linking IVF to ovarian cancer, there is a generalized, undeniable causal relationship between transient exposure to female hormones and transient risk of rapid-growth gynecologic cancer.2 I believe that is absolutely necessary for egg donors to be followed and studied, especially if they had experienced hyperstimulation during the process. No follow up has ever been offered to me. Nobody from the egg donation agency, fertility clinics, or hospital has contacted me since, except to obtain my insurance information so that they could pass my hospital bill to my own health insurance company.

Summary and Conclusion:

1) Ethical considerations:

Financial compensation for eggs disproportionately targets college women with financial hardships. These women usually have long academic careers ahead of them and have not considered childbearing yet, so any infertility caused by the procedure would cause more psychological and physical damage to these women. Docked pay for failure to produce a target number of eggs and escalating pay scales for subsequent cycles are factors that may encourage underreporting of adverse side effects by the egg donor.

2) Subject safety:

Subject safety is variable, being highly dependent on the individual clinician’s practice. This is why there needs to be standardized safety practices and mandatory reporting of complications. In the article “Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report (2007)”, one fertility expert advocated the following:3

By working from such information as a patient’s age, weight, and follicle count… a doctor can begin with an FSH dose based on those factors and then modify it as necessary. We monitor during the course of the stimulation to further decrease the dose if too many follicles are developing or the estradiol levels are too high.

To reduce risk of hyperstimulation, these actions were also recommended:

  • •Modify stimulation protocol
    • ◦Decrease gonadotropin dosage
    • ◦OCP/Lupron/Low dose gonadotropins
  • •Reduce the ovulatory dose of hCG
  • •Delay administration of hCG: “Coast”
  • •Cancellation of cycle eliminates the risk of OHSS
  • •Withhold hCG administration

Basically the safety recommendations for egg donors include determining the initial dosing of these powerful drugs on the weight and age of the patient. If there is any evidence of producing more eggs or hormones than expected during routine monitoring, then the drug dosage should be reduced, the administration of stimulating medications delayed, or the cycle cancelled. None of these recommendations were followed in my case. In fact, it was one of my own egg donation doctors who was consulted and quoted in the above article.

Regarding the risk during surgical retrieval of the eggs, the perceived negligible risk of complications is likely due to incomplete data:2

It is difficult to know, however, exactly how often such complications occur . . . Although excellent statistics are kept on such things as how many viable eggs each procedure produces, the statistics are not so complete on the complications that ensue during and after.

As my case illustrates, this perceived near-zero risk is inherently dangerous because it will not raise red flags when complications do occur, resulting in delayed intervention and a poorer-than-expected outcome. When a complication does occur, the denial of medical responsibility based on statistical rarity is a faulty and circular argument. This denial of responsibility would also prevent egg donors from obtaining monetary compensation for treatment of complications and appropriate follow-up. As my case illustrates, poor management of retrieval complications can be a problem even in the hands of the most experienced clinician.

Lastly, I received no follow up after my procedure. It is the ethical duty of the fertility industry to conduct timely follow-up and research studies in order to promote safety. This is true of any other industry especially pharmaceutical – so why make fertility an exception?

3) Informed consent:

Many are improperly informed about the risks of the egg harvesting process. Verbally I was told that risk was virtually non-existent and that studies have not linked the procedure to cancer and infertility. I should have been told that there were not enough studies or long-term follow up to determine risk.

It should be made abundantly clear if embryos or stem cells may potentially be secondarily sold, traded, or gifted. The amount of profit potentially generated from each transaction and the purpose of each transaction should be transparent to everyone involved, especially the donor. Without this information, the egg donor cannot possibly make an informed decision.

4) Patient autonomy:

I was hyperstimulated with approximately 60 eggs retrieved. During the procedure I expressed concerns about not using weight-based dosing of fertility medication, the excessive number of follicles produced, and skyrocketing estradiol levels. Nothing was done to personalize my procedure based on clinical findings, which is clearly incongruent with the standard of care. After the procedure my concerns about internal bleeding were not adequately acknowledged until I went into shock and had to undergo an emergency laparotomy. In my experience, the pressure to complete a successful cycle became stronger as I became more invested in the process, and thus I progressively lost my right to make decisions regarding my own body.

Final thoughts:

Even the tiniest risk of complication needs to be taken seriously especially when dealing with perfectly healthy young women, who have no need to undergo a potentially life-threatening procedure. Procedures with risk are performed on sick patients with the understanding is that the benefits of the procedure outweigh the risks or the consequences of doing nothing. In egg donation there is no medical benefit, only risk. It represents a conflict of interest when the physician does not perceive the egg donor as a patient for whom they have the responsibility to minimize risk. This aspect must be considered when treating healthy young women with everything to lose.

References:

1. Nature. 2006 Sep 7;443(7107):26. Health effects of egg donation may take decades to emerge.

2. American Journal of Epidemiology Vol. 153, No. 11 : 1079-1084.

3. Assessing the Medical Risks of Human Oocyte Donation for Stem Cell Research: Workshop Report (2007).


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