Health Care and Contraception: Did the Supreme Court Get It Right?

[Brian]

Should religious family-owned companies be required to cover contraceptives under their insurance plans? The high court says no.

I'm curious how you nurses feel about this? Please take a second to vote in our quick poll.

This is a highly political topic, I'd rather not turn this into a hot argumentative subject, so please keep your comments civil :) But please feel free to comment. Thanks

Here is an article on the topic:

Hobby Lobby Ruling Cuts Into Contraceptive Mandate

In a 5-4 decision Monday, the Supreme Court allowed a key exemption to the health law's contraception coverage requirements when it ruled that closely held for-profit businesses could assert a religious objection to the Obama administration's regulations. What does it mean? Here are some questions and answers about the case.What did the court's ruling do?

The court's majority said that the for-profit companies that filed suit-Hobby Lobby Stores, a nationwide chain of 500 arts and crafts stores, and Conestoga Wood Specialties, a maker of custom cabinets-didn't have to offer female employeesall Food and Drug Administration-approved contraceptivesas part of a package of preventive services that must be covered without copays or deductibles under the law. The companies had argued that several types of contraceptivesviolate their owners' religious beliefs. The ruling also covers a Hobby Lobby subsidiary, the Mardel Christian bookstores.

[Othernothing]

Estrogen-progestogen combinations act primarily through the mechanism of gonadotropin suppression due to the estrogenic and progestational activity of their components. Although the primary mechanism of action is inhibition of ovulation, alterations in the cervical mucus and the endometrium may also contribute to effectiveness.

http://www.pfizer.ca/en/our_products/products/monograph/305

This means the theoretical suppression of ovulation through altering the HPG axic is the goal. Failing that, hampering nidation is a back up.

You can think whatever you want to about the morality of doing this, but how can you deny it? Pfizer doesn't.

[klone, MSN, RN]

Also worth mentioning is that Plan B and Ella are simply high doses of estrogen. Not dissimilar to regular combination oral contraceptives. All oral contraceptives have the ability to prevent implantation of a fertilized egg (and before the advent of Plan B and Ella, providers would simply give a woman several regular COCs to take all at once which did the same thing).

The primary mechanism of Mirena (one of the two IUDs on the market) is by making the environment inhospitable to sperm, and affecting sperm motility. Implantation prevention is sort of a fall-back mechanism of action (Plan B, if you will).

Mirena is also extremely valuable in helping abnormal uterine bleeding and menorrhagia. It's a great, inexpensive alternative to hysterectomy.

This is more than just prevention of access to certain BCMs. This is a women's health issue.

As they say, "If you're not outraged, you're not paying attention."

[Othernothing]

Whats more its horrifying that nurses posting here have the wrong idea about how contraceptives work.

.

Look, I am really sorry that it may seem like some kind of personal attack and I don't mean it to be at all, but I take issue with "horrifying" being used to describe what you evidently view as ignorance. Those who are ignorant about something deserve our assistance, not our scorn. Even if we feel they should know better.

I posted from Pfizer a bit of a monograph for COC's. There is a reason people think differently than you do. Their opinion is based on drug monographs and industry information as well as studies. Please don't believe you (in the general sense-not you personally) are more in the know that others whose views differ. You may be in need of some education too. I know I am, which is why I read drug monographs.

[MunoRN, RN]

Ok . . . we need to really and truly stop making blanket statement that are not completely true.

This case is not about taking away ALL contraceptives. It is about the ones that are deemed abortifacients. There were four. Not ALL.

I'm truly frustrated by the hyperbole and outright misinformation regarding this case.

We can discuss whether a fertilized egg is the point of conception or not but this case is not about every single birth control pill offered.

People are so misinformed about this issue; it hurts.

While the examples the court heard only blocked coverage of specific contraceptives, the decision applies to ALL contraceptives. Based on the decision, a company now can deny coverage of ALL types of contraceptives.

WASHINGTON (AP) — The Supreme Court on Tuesday confirmed that its decision a day earlier extending religious rights to closely held corporations applies broadly to the contraceptive coverage requirement in the new health care law, not just the handful of methods the justices considered in their ruling.

Justices act in other health law mandate cases

[ppfd, BSN, EMT-P]

I didn't see an option for I really don't care either way.

People have accepted employment with these religious biased companies. I guess they can resign just as easy if they don't like the way things are done?

Kind of like me coming into one of your homes and demanding beer when you don't drink alcohol.

Personally I think this whole social medicine is going to be a disaster and pills are the least of the problem.

[lrobinson5]

Please, please be honest in your arguments and defense of your positions.

Yes let's be honest. Can we acknowledge that NO ONE at Hobby Lobby is getting FREE birth control because it is health insurance that they pay for? Also, saying that this is not an access issue is not being honest. These women could probably afford oral contraceptives on their own, but that isn't necessarily the case for IUD's. Also, SCOTUS wants the federal government to just pay for the birth control, but the federal government is barred from using money to fund abortions. What happened Scalia, I thought these options are abortifacients?

[klone, MSN, RN]

Also, SCOTUS wants the federal government to just pay for the birth control, but the federal government is barred from using money to fund abortions. What happened Scalia, I thought these options are abortifacients?

Ha. Maybe Title X clinics will be able to start offering TABs now, after this ruling. :)

[pmabraham, BSN, RN]

Good day:

This was and has never been an access issue. It is an issue of one group saying stay out of my private business while allowing one to steal from your pocket so the one can pay for their private business. Plain and simple.

Thank you.

[klone, MSN, RN]

Good day:

This was and has never been an access issue. It is an issue of one group saying stay out of my private business while allowing one to steal from your pocket so the one can pay for their private business. Plain and simple.

Thank you.

It most certainly is an access issue. Thank you.

[pmabraham, BSN, RN]

Good day, klone:

Absolutely no one is forcing HobbyLobby, Conestoga Wood, etc. employees to work there. Those employees who want to use one of the FOUR contraceptives not paid for by the company can be personally responsible (gee, a novel concept) to pay for it themselves. Absolutely no one is stopping their access.

Thank you.

[klone, MSN, RN]

It's not always as simple as "find a different job." That very unhelpful suggestion comes from a position of privilege. And what happens if an IUD is the only method of BC that a woman can tolerate? What if she has risk factors that preclude her using other BCMs? What if a woman has horrible menorrhagia, but still wants to protect her ability to have children at some point in the future? Why should she be denied the ability to get an FDA-approved BCM that every single other insurance policy covers, simply because of the religious beliefs of her employer.

It's misogynistic, paternalistic CRAP.

[waterbabies]

Raviepoo,

"The scientific consensus is that IUDs and the morning after pill do not cause abortion. The SUpreme Court chose to ignore that."

IUD prevents implantation of an embryo, morning after pill does the same unless it is taken within a narrow window.