Affording IVF

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Healthcare Bluebook Gives You Fair Prices for Medical Treatment

healthcare bluebook
Find out how Healthcare Bluebook can save you money. Image from Google Play

One of the problems with healthcare is that costs are typically not very transparent. This makes it very difficult for consumers to shop around for the “cheapest” provider in town. If you are able to obtain prices for the services you need, how are you going to be able to know if they are fair or overpriced? This is a big problem for the millions of people with no health insurance. If you do have insurance, it can be helpful to know if the “non-covered” services are priced fairly or not.

Most providers bill out one amount to insurance companies, while being willing to accept a lower (sometimes much lower) amount upfront from cash pay patients. As a default, all patients are charged this standard billing rate, but providers are often very willing to accept a lower price for their services. The problem has always been, what is a good price? Healthcare Bluebook website is just the place to go for an answer.

Healthcare Bluebook aims to help fix all the confusion by publishing fair prices for a large variety of medical and dental procedures. The prices are different depending on your area and are pulled from industry data from healthcare providers and employers all over the country. According to the site these prices are what you should expect to pay a quality provider for the particular service. These prices are best used as a basis for bargaining your bill down before they are actually carried out. They offer a printable pricing agreement for each service that can aid your efforts to lock in that lower price. It is still possible to bargain after a service is carried out, just more difficult.

The site offers tips on how to use their fair pricing data and instructions on how to bargain down your costs. I found the information very helpful, and have already recommended it to a cousin of mine that is in need for a teeth cleaning, but doesn’t currently have insurance and had no idea where to start looking.

While the site is more useful for those of us without health insurance, it can also be valuable for those of us with insurance. Either way it pays to be an informed consumer, and Healthcare Bluebook certainly helps in that regard. So check out the site if you don’t have insurance and need some medical care, it could save you a bundle on your medical or dental work.

Cheers!

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But the _____ study says so…

IVF studies
Just because a study says something doesn’t make it true
I have a gripe to share. It seems like I see studies coming out almost every single day that claim to have the latest science about IVF. The problem is, every study proclaims something different. One day I will see a study saying IVF causes birth defects, and the next day I will see another study that says the opposite. Talk about confusing! What is a person to believe?

This train of thought was brought on today when I was surfing the web and came across this piece about stress during pregnancy. The piece talks about a few conflicting studies about whether or not stress is actually harmful or not during pregnancy.

The first study they mention concludes:

The weight of evidence suggests that moderate levels of stress and anxiety do none of the things we fear. They seem not to affect whether women are able to conceive, whether they carry the fetus to term, or whether their kids reach normal developmental milestones. (If anything, some maternal stress during pregnancy seems to make kids mature a little faster.)

While the second study they cite has the opposite to say:

“After controlling for other conditions that could cause stillbirths, we found that experience of a stressful event in all four factors increased the risk of stillbirths by about two fold,” explains Hogue.

Also, there was an increased risk of stillbirths associated with an increasing number of events, suggesting a ‘dose-response’ effect of stress on stillbirth risk.”

What are we supposed to believe?

Now it turns out this type of thing is very common in science. Just think about anything you ever heard about diet. A few examples: ‘Saturated fat is going to kill us all,’ to the ‘turns out saturated fat is not that bad‘. Or the classic, “Eggs are as bad as smoking‘ vs ‘Eggs are Actually good for us‘. If you are interested you could Google ‘the cholesterol myth’ to sort through tons of this stuff.

You can find this sort of conflicting studies all over the place for just about any subject. To make matters worse, the more controversial the study’s conclusions, the more journalists will tend to sensationalize it (Gasp!). This is often done without any regard to the structure or validity of the study. To a lay person, a story about a study proving cholesterol is bad for us sounds pretty convincing.

The sad truth is that somebody could run a study that proves just about anything. Remember all those studies funded by the tobacco companies that never seemed to be able to prove that tobacco was harmful? *cough, cough.. lies*

So what can we do about it?

The best thing to do is actually read the study and see if it has any merit. Now this does requires some knowledge of statistics, and the scientific method, not to mention, the time to actually read all the studies… Which, lets be honest, most of us don’t have.

This is a skill and the more you do it the better you will be at calling “BullSh$t.” One of the most common errors that is made with many studies is that they do not actually prove causality, only show a correlation between one or more variables. Basically, just becuase it one variable appears to affect the variable being studied, does not actually mean that it is. It could just be a coincidence (one form of correlation), and have no direct effect (causation). This is a vital concept to internalize when it comes to trying to figure out if a study actually holds any water or not, and my explanation is a bit lacking. Here is a good Wikipedia article on the topic for a better explanation

The easier path is to find a few authority figures, or thought leaders, in the topic at hand and let them do the hard work for you. You want to pick good ones though. The old saying, “who is the more foolish? The fool, or the person who follows him?,” comes to mind here :)

Most of all, you should really take everything you hear about a study proving this or that with a grain of salt. It may be great research, with a valid conclusion. If it is, it is very likely you will hear more about it. Science is great, and it has provided us with an enormous understanding of the world we live in. However, it was often very wrong along the way.

What do you thing about the all the headlining studies? Do you believe them?

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Infertility News April 2nd Edition

Hello all, once again life has reared its head and I didn’t get the time to post last week. Hopefully, I will be able to fix that this week. Here are the new stories of the last week. Enjoy!

First off I found this article on Techcrunch about a new device that promises to be able to help increase couples chances to conceive. I am not sure exactly how the device works, but it certainly piqued my interest. It sounds like the device monitors basal temperature levels, and a few other data points to identify peak fertility points (ovulation) each month. I hope they are successful.

DuoFertility Is A Fertility Monitoring Sensor-Plus-Service That Helps Childless Couples Get Pregnant

Techcrunch April 1, 2013

UK startup DuoFertility is tackling a really tough problem: infertility. The company has built a sensor-plus-service business to predict the most fertile days of women who are having difficulty conceiving to improve the chances of conception — hence its tagline: “assisted natural conception”. There is no invasive technology involved, just a lot of number crunching.

The startup’s approach sits somewhere in the middle of the competition in this space. It argues its technology is more sophisticated than more basic over-the-counter physical products such as home urine tests or body-basal-thermometers (which are also cheaper than DuoFertility’s offering), as the data captured by its wearable sensor is more accurate. Data is also sent back to DuoFertility staff for monitoring and reviewing – so it’s being looked at by specialist staff using bespoke algorithms rather than generalised models…

ART (assisted reproductive technology) is also widely used for selective breeding in the animal kingdom, or, in this case, breeding period.

Trying again for a baby panda

Washington March 30, 2013

So much for Date Night.

After determining “no competent breeding” had occurred between Giant Pandas Mei Xiang and Tian Tian on Friday , despite the two having been left alone together for a couple hours, scientists and veterinarians at the Smithsonian National Zoo moved quickly Saturday morning to artificially inseminate the female, Mei Xiang.

Pandas are able to breed once a year for a few days. And Mei Xiang and Tian Tian have never been successful breeding naturally, said Zoo spokesman Pamela Baker-Masson. Their only living offspring, Tai Shan, who was born in 2005 and nicknamed Butterstick, was the product of human intervention, and since then scientists and veterinarians have inseminated Mei Xiang five times without success.

This next article is about gay marriage and how it can be viewed as a form of infertility. Specifically in context with that would mean with regards to the contentious Prop 8.

Why the infertility issue will finally end the divide over same-sex marriage (Commentary)

March 31, 2013

WASHINGTON — Will the gay marriage debate ever end? I’m not just talking about the political or legal fight. I’m talking about the culture war. Supporters of same-sex marriage liken it to interracial marriage, an idea that once seemed bizarre to most Americans but is now almost universally accepted. Opponents of gay marriage liken it to abortion, which continues to divide and inflame the country. Which way will this battle go?

Until now, I thought it would rage on. Same-sex marriage is far more radical than interracial marriage. It challenges our basic understanding of the institution. You can’t expect people to accept such a change overnight.

But now I see a way out. Tuesday’s Supreme Court hearing on Proposition 8, which banned same-sex marriage in California, has exposed the exit route…

Want to learn how to inseminate cattle? Well, probably not, but now there is a school for just that. Don’t forget to register soon, as this is a one time opportunity :)

Beef cattle artificial insemination school coming April 30-May 2

thecattlenetwork.com March 26, 2013

Beef cattle producers who want boost their profit potential by increasing success with artificial insemination can attend a school on the subject April 30 through May 2, taught by Ohio State University Extension and Ohio Agricultural Research and Development Center experts.

The three-day program covers a broad range of artificial insemination topics, including factors that influence reproduction efficiencies, heat synchronization, semen handling and thawing.

An interesting story about an IVF nurse that gets some disturbing genetic test results and her fertility journey.

An IVF Nurse Becomes an IVF Patient

The Official Counsyl blog March 30, 2013

An IVF nurse that needs IVF, how ironic? That is the thought that kept running through my head as I stared at our Counsyl results. Smith-Lemli-Opitz? What was this? I had never heard of it and certainly did not expect to be a carrier of this. Smith-Lemli-Optiz? How could these 3 words be changing all of our plans? I read the report over and over. How could this be happening?

It all started when a doctor I work with came back from a conference and informed us of this new test called Counsyl. She described this test, how it tests for multiple recessive diseases, like cystic fibrosis and spinal muscular atrophy, and how its costs were less than just getting screened for cystic fibrosis. I knew this test sounded like something I wanted to do, along with my husband. I wanted to “make sure” we did not carry anything on the test. I assumed we did not but felt it would be the responsible thing to do. I worked with Counsyl to set up our clinic to offer the test to our patients.

Last story of the day is about a recent study that claims that IVF related birth defects are not actually caused by the treatment, but by the parents.

Study Says Fertility Treatments Not to Blame for Baby’s Developmental Delays — So, What Is?

The Babybump blog March 27, 2013

New research sheds light on why babies born from in vitro fertilization (IVF) treatments have shown a higher risk for developmental delays. In the past, low birth weight, issues with brain development and premature birth have all been correlated with fertility treatments. Researchers are now noticing that while it’s possible the treatments themselves are contributing to the alterations in development, it’s also time to factor in infertility as one of the precursors to these developmental issues.

That’s it for today folks, enjoy your Tuesday!

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Infertility News

Well folks, its Wednesday again. March is more than half over, and Spring is starting to rear its head up here. The weather up here (Seattle), has been more than a little crazy today. It has been sunny, rainy, sunny, windy, really rainy, and sunny again… Nature just cant make up her mind. I apologize that I haven’t had the time to write up any proper posts for the site recently, but I assure you that I have a few brewing in the back of my mind and I hope to start cranking them out over the next couple days so I should have a least one or two out in the next week. In the mean time, I thought I would go over some infertility news instead :)

This first story has been getting a fair amount of attention lately and has to do with surrogacy law down in AU.

Facing financial oblivion: the crippling cost of IVF surrogacy

http://www.mamamia.com.au 3/16/13
If an Australian woman is using IVF in order to get pregnant, she can access financial assistance from Medicare.

But if she is undertaking IVF as part of a legal surrogacy arrangement, she is not entitled to a medical rebate for her cycles – even if she is medically incapable of carrying a child herself.

Once her child is born through IVF surrogacy, she is eligible for paid parental leave and the baby bonus because the Government recognizes her as that child’s mother. But she gets no help with the financially crippling costs of undertaking IVF in the first place…

This next article is about the Personhood Bill. (FYI I am against it, as it treads on people’s right to choose, and could interfere with availability of reproductive technology such as IVF)

Personhood cannot permit IVF exceptions

www.parentsagainstpersonhood.com
It’s universally agreed by personhood supporters and opponents alike that one of the main concerns people have about personhood is its effect on infertility treatment. The argument many pro-life people make is a sincere one: they only want to ban elective abortion, not infertility treatment or contraception or treatment for life-threatening complications. Therefore, they will just amend the personhood statutes to make exceptions for these situations, and pass personhood to ban elective abortion.

However, this represents a fundamental misunderstanding of the concept of personhood…

The next article expands on the idea that expanding Medicare could help us control our health care costs.

How Medicare Could Fix U.S. Healthcare

www.dailyyonder.com
Expanding the number of people who are eligible to participate in Medicare could help contain health-care costs and provide benefits for individuals, employers, private insurers and rural hospitals. That proposal, unfortunately, doesn’t have enough political support to fly. But if we phase in a gradual expansion of Medicare over a good many years, we might negotiate a way for the federal insurance program to solve some of its own problems and help fix what ails the American health-care system…

The last article today is about a few things you should look for when selecting an IVF clinic.

What to Look for In an IVF Clinic

anationofmoms.com
You and your spouse have decided to start a family! It’s a wonderful time in a couple’s lives. The excitement and anticipation of bringing a new life into the world is a personal and emotional journey. After trying to conceive for an extended period of time, you are still not pregnant. You wonder what is going on. After seeing a fertility expert, you discover that you have fertility issues and becoming pregnant could be difficult. What do you do? What are your options?…

That’s it for today. Cheers!

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Infertility Also Costs the Dairy Industry

infertile dairy cows
Yes, infertility affects cows too.

Okay, so you might be asking why do I have a picture of a cow at the top of this post. Let me explain. Today I was catching up on my Reader backlog and I came across an article that I caught my eye. The article is about how rising infertility rates in our dairy cows is one of the biggest costs the industry faces.

According to the article published at Westernfarmpress.com the conception rate of an average herd in the 1980’s was 50%. That rate has fallen to about 30% in recent surveys. A 20% drop in conception rates in the last 30 years seems fairly dramatic to me and would certainly get me worrying, if I was a dairy farmer. The two main costs in raising dairy cows for milk production have historically been the labor and the feed (thanks Wikipedia!). Now it looks like they might have to add infertility costs to that list.

My first thoughts upon reading this article were what are the farmers doing to their herds that is resulting in this kind of wide reaching infertility? 30 years is a decent amount of time when measured in the lifespans of a dairy cow. If I had more time, and interest, I would certainly want to take a look at what kind of practices the industry has adopted in that time frame to see if some probably causes to this infertility problem could be sorted out.

I have a more holistic view on health and my first thought is that the dairy industry has inadvertently done something to its own herds that are reducing their fertility, or that the quoted 1980 rates were inflated in some manner. I would be very interested to see if they figure out the problem, and if was caused by their own methods to get the cows to produce more milk. The article mentions that the farmers(corporations) want to solve the issue through selective breeding, although I would bet that is just one option they will be pursuing.

As I finished the article, I was curious about human infertility rates have done in that same time frame. To that end I found a good analysis of just that question here. The study looked at the global trends in infertility prevalence since 1990 through the analysis of 277 separate health surveys. They found that infertility rates have remained relatively stable during the last 20 years for both primary infertility (failure to bear your first child) and secondary infertility (inability to have a second child). So even though infertility has become more talked about, and less of a taboo subject (its about time!), there is little evidence that the overall rates are increasing or decreasing. Whew!

I got a little off topic today, but I thought it was an interesting share. Hope you enjoyed it!

Cheers!