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#IVFContests #IVFAwareness #BuildJewish Families

Another group held a video conference for a free IVF. This was a new twist however, because the host of the contest was a radio station in Utah. The ends of the contest – the chance for someone without the financial means to be able to receive treatment that may lead to having a baby – is a wonderful goal. An important question is if those ends justify the means.

Unlike most coverage of these contests, a recent article reporting about this contest shared both sides of this story. The pro’s include building awareness about infertility, the emotional and financial costs that it takes, and providing someone with treatment. It may also help people speak out and get support they may not have otherwise received.

The con’s are another story.  “Asking couples to create a video for a radio station about raw, difficult experiences can feel like making entertainment out of someone’s misery” said one contributor to the story. Another shared that the contest is, “ a very offhand or casual way to deal with something that we generally view as being a more serious issue.” Indeed.

The public votes on the videos submitted by the finalist for the radio station contest. Imagine you are applying for this and were told you were a finalist. Do you make your story the saddest? Do you show yourself as the most hopeful? The most desperate? Do you need good production values? Do you have others speak for you? Should you be funny? How do you get people to vote for your video? Whatever the criteria for earning IVF treatment, it seems as much a reflection of how to use publicity to show yourself as deserving treatment.  And that is a problem. Someone deserves treatment more than others? Someone’s story is more compelling? Or is it a popularity contest with extremely high stakes? None of the answers are good.

Another con is that these contests overshadow an underlying issue of why the treatment is not funded in the first place. The insurance industry is not taking on this issue and the idea that it is expensive is not a legitimate answer. Cancer treatment is not cheap. Neither is a mastectomy, cataract surgery, diabetes treatment or treatments for accidents and traumas. We ought to be asking more challenging questions about why treatment for infertility like IVF is not available and affordable.

For Hasidah, these issues are not taken lightly. The medical appropriateness, financial need, and personal information are taken seriously to ensure the best possibility of building a Jewish family. Hasidah grant applicants take a significant amount of time and effort to apply which often is not rewarded with funding. We try to honor that with continual efforts to build awareness, to treat our clients with the utmost respect and not make a spectacle of their experiences.

If there was a contest to be held, perhaps it ought to be finding the most effective strategy for making IVF affordable and making insurance coverage for it part of standard health insurance. That would be the mother of all contests.

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It’s a great day to introduce new political platforms.  One area particularly open to change is support for building families. Today one candidate said that tax credits for adoption and insurance coverage for fertilty treatment like IVF would be instituted in her first 100 days. According to Politico, no Democratic candidate is currently opposing any of these suggestions which also includes pre-K childcare.

Not opposing is not the same as endorsing. It is a beautiful and silent way of squashing legislation – just don’t endorse it. Since the primary races are starting early, this means we can start speaking up early and often to make this a platform for all candidates. And regardless of what side of the isle you are sitting on, this opens up the conversation about reproductive healthcare in a new way. Reproductive care is healthcare. Reproductive justice includes support for having a child. The biggest barriers to parenthood are financial and they include a lack of financial support for family building and the expenses of childcare for working families.

We can make this happen. The first step is to get the issue on the table. So keep talking!

 

 

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Take the one with the best benefits. My dad gave me that advice when I was faced with the enviable position of choosing which job to accept after college. The advice struck me because it was not on my radar at all. It didn’t influence me much at the time, but it did in the long run. Benefits like health insurance, savings plans, and retirement plans become more important every year of our lives. Lately baby benefits are making news. They come with good intentions to be sure, but they are a privilege nonetheless.

Baby benefits are a growing trend in large corporations and provide various financial incentives, insurance, and other accommodations for family building. Young women are already  looking at jobs considering when they plan to have children. More often it is with the idea that they will postpone having a family until they feel they are established. So why not take the job that helps ensure you can have a baby whenever you want?

That sounds wonderful. What an amazing corporate citizen to help women in the work place, to support family building for men and women,  and to be family focused as an organization. However, what message is this sending to people who don’t have those jobs and benefits?  That’s most of us.

At a recent conference, one of the brainstorming topics was the growth of entrepreneurial endeavors that help companies provide fertility benefits to their employees. Hurray. It is about time that someone realized the connection between women, families, the workplace, and the need for full reproductive and family care. However, woe is us that we keep weaving family building into the fabric of business and not part of our culture. These endeavors are replacing the insurance industry – just as fertility clinics operate outside of most hospitals – because our culture has not made reproduction a part of any social policy. To be clear, outside of birth control, family building it is not part of insurance legislation, employment legislation, or conversations about inclusion and equity. The baby benefit is a business response to a social issue that isn’t being addressed otherwise.

Thank you to these innovative leaders who are responding to a need. Thank you also to the companies who see that supporting families benefits the bottom line and their employees.  That is perhaps a move towards social responsibility.  A healthy doubt about the insurance industry’s ability to navigate fertility or our government’s ability to legislate family friendly policies is warranted. But can we also ensure this does not create a have vs have not culture for baby benefits? Can we make sure this approach doesn’t effectively privatize fertility insurance? Can we consider the effects on small business and just about everyone else? What about the attempts to change the system and make healthcare include proper reproductive care? We cannot ignore the larger need for family planning and support.

Perhaps the introduction of business backed #BabyBenefits can be the beginning of a change in our social policy. People certainly will want to work at companies that offer good benefits. But the real success comes with #BabyBenefitsForAll.

 

 

 

 

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Like other types of insurance coverage, many people are unaware if they have insurance  for infertility treatment until they find themselves in need of using it. Some may have coverage but are unaware of the limitations or restrictions. The reality is that insurance coverage varies greatly depending on the state, the medical situation, the treatment, and the individual. And the exceptions can make holes big enough to drive trucks through.

According to American Society for Reproductive Medicine, there are 15 states that have some form of insurance coverage requirements for treatment. Most of them cover treatments (Arkansas, Connecticut, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, and West Virginia) while others “offer coverage” (Texas and California).  The coverage mandate in some states includes in vitro fertilization (IVF), in other states it excludes IVF, and in others it includes only IVF. Moreover being in a state with a mandate that includes IVF (or anything else) does not mean that your employer will provide coverage. Many employers are exempt from the law for a variety of reasons.

In addition to exemptions that can entirely eliminate any infertility coverage, insurance may not cover certain treatments or fertility drugs in all cases. The coverage may have specific medical requirements, limitations on methods, age requirements, caps on number of cycles or lifetime spending limits.

IVF procedures are usually performed after prepayment which means a large out-of-pocket expense since the average cost is $12,400.  In a state without a mandate or if the employer doesn’t provide the coverage for whatever reason, that is a potentially roadblocking cash payment standing in the way of a possible solution to infertility. Someone with insurance coverage of 50% for infertility treatment still has to pay $6,200 cash or equivalent for treatment. That is not small change.

Insurance coverage can be helpful and some coverage is better than no coverage. However there are many exclusions, exceptions, hurdles and holes which often make it less effective. The result is that for many people experiencing infertility, insurance is no solution to the expense of infertility.

[For the chart of insurance coverage by state, see American Society for Reproductive Medicine Insurance: http://www.asrm.org/detail.aspx?id=2850]

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