Roundup: Want to Anger a LOT of Women? Propose Eliminating Epidurals to "Save Money"

by Robin Marty, RH Reality Check

August 23, 2010 - 8:58am (Print)

We all know that states are dealing with huge budget deficits, and that medical costs are skyrocketing. Well, one Utah legislator believes he has come up with a partial solution to the problem: deny epidurals for any pregnant woman on Medicaid.

From the Daily Herald:

Under the theory that perhaps thousands of Utah college students are having babies paid for by Medicaid that they could pay for themselves, one lawmaker has a plan: cut all elective epidurals and elective C-sections.

Sen. Dan Liljenquist, R-Bountiful, has vowed massive Medicaid reform in next year's legislative session, and first on the list is people who may be freeloading. Medicaid pays for 15,000 births a year in Utah, a third of the total, Liljenquist says.

"Do we save some kid or make birth easier?" he said, noting that the waiting list for Medicaid in Utah just for the disabled has reached 4,400 people.

Liljenquist says the state could save millions. Epidurals, a shot given in the spine, are a common method of relieving pain during labor. At Utah Valley Regional Medical Center in Provo, 86 to 87 percent of women who deliver babies at the hospital get an epidural; studies show about 65 percent of births nationwide happen with an epidural.

And it's not just one lawmaker. From the same article:

"These are 90 percent out-of-state students having babies on our dime," Sen. Howard Stephenson, R-Draper, told Liljenquist, referring to BYU students. Conservative lawmakers have been upset about anecdotal evidence of students with a Lexus and trust fund having a baby under Medicaid. They qualify because there may technically be no income.

During the legislative session earlier this year, Rep. John Dougall, R-Highland, caused a stir for saying the same thing.

So, first you eliminate abortion options so women are forced to give birth should they have a birth control failure, then you tell them it needs to be as painful as possible as well? It's not surprising that the reaction has been somewhat...passionate.

From Opposing Views:

Denying patients epidural anesthesia is a great way to put misogynistic, classist douchebaggery into action. Rich women will be able to afford paying for pain relief and poor and middle class women will not have access to it. It’s about as thoughtful a move as trying to force more women to breastfeed by making formula available by prescription only.

Sen. Liljenquist claims people are misunderstanding him, according to the Daily Herald in a follow-up. He's just saying that things that are elective should be treated as such, and not covered. But why doesn't he just propose eliminating all anesthesia, then, since none of it is "necessary?"

Other legislators and health care policy-makers are quick to point out that Liljenquist is way out of line with his proposal:

Liljenquist has already been the target of radio talk shows and a fellow Republican senator who isn't impressed with his ideas.

"All I can say is thank God for anesthesia," said Sen. Peter Knudson, assistant majority whip, who said on KSL Radio that Liljenquist's pitch is "absolutely not" a good one.

"There are people who have pain thresholds who can tolerate a lot of discomfort, but not everyone," he said. "I'm all for saving money ... but this is not where we should begin."

Knudson isn't the only one who isn't on board with Liljenquist. Lincoln Nehring at the Utah Health Policy Project said the Bountiful Republican is mistaken to think Medicaid is some sort of luxury program.

"Sen. Liljenquist has this belief that it would be better if Medicaid provided subpar care to encourage people to move into the private market," said Nehring, the project's Medicaid policy director.

"As a rule, Medicaid doesn't provide access to optional services," he said. "Nobody's getting plastic surgery on the taxpayers' dime unless it's really necessary."

Mini Roundup: Rethinking your contraception options? Looks like you can either choose by cost, or by environmental factors. But whichever you choose, don't look to get it in this corner of New York.

Aug 23

Aug 22

Aug 21

Aug 20

. . . . . . . . . .

16 comments

Comments are rated by readers on a scale from 1 to 5. Comments with a rating of 2 or less are hidden. Click on hidden comments to view them.

GrayDuck Could someone please explain August 23, 2010 - 7:27pm

Could someone please explain to me why the taxpayer should pay for births rather than the father of the child? The father of the child is getting the benefit of having a child and has the power to prevent the child's conception, so he would seem to be the appropriate person to bankroll the birth.

squirrely girl Good point! August 23, 2010 - 10:59pm

Please feel free to spearhead that movement - there are plenty of women and government agencies that would appreciate the help. Until then, somebody has to pay for it :/

GrayDuck "Until then, somebody has to August 24, 2010 - 5:28pm

"Until then, somebody has to pay for it"

Why do you say that? The procedure is elective, so it need not be done. Allowing women to suffer pain while giving birth would be a good way of encouraging them to restrict their sexual partners to men who are responsible.

beenthere72 Did you seriously just say August 24, 2010 - 5:45pm

Did you seriously just say that? Make women suffer - even MORE - than they already do during child birth? Seriously? GTFO.

GrayDuck Did you seriously just say August 24, 2010 - 9:09pm

Did you seriously just say that? Make women suffer - even MORE - than they already do during child birth? Seriously?

I used the word "allow," not the word "make."

squirrely girl What's good for the goose... August 24, 2010 - 9:26pm

Why not just allow men to suffer through the pains of kidney stones then? Hell, by doing that you'll probably stem a few prescription painkiller addictions that cost states millions! Win Win!

squirrely girl Elective procedures August 24, 2010 - 9:25pm

Maybe before spouting off about medical terms you should look up a few basic terms and definitions. Elective does NOT mean "optional" or "not necessary." It means planned.

An elective surgery is a planned, non-emergency surgical procedure. It may be either medically required (e.g., cataract surgery), or optional (e.g., breast augmentation or implant) surgery.

Some elective procedures are necessary to prolong life, such as an angioplasty . However, unlike emergency surgery (e.g., appendectomy ), which must be performed immediately, a required elective procedure can be scheduled at the patient's and surgeon's convenience.

Several major categories of common elective procedures include:

Plastic surgery. Cosmetic or reconstructive surgery that improves appearance and in some cases, physical function.

Refractive surgery. Laser surgery for vision correction.

Gynecological surgery. Either medically necessary or optional surgery (e.g., hysterectomy , tubal ligation ).

Exploratory or diagnostic surgery. Surgery to determine the origin and extent of a medical problem, or to biopsy tissue samples.

Cardiovascular surgery. Non-emergency procedures to improve blood flow or heart function, such as angioplasty or the implantation of a pacemaker.

Musculoskeletal system surgery. Orthopedic surgical procedures, such as hip replacement and ACL reconstruction.

Read more: http://www.surgeryencyclopedia.com/Ce-Fi/Elective-Surgery.html#ixzz0xa4JlmDC

Seraph Since we're talking about Medicaid... August 23, 2010 - 11:31pm

I would assume that the father of the child is either unavailable for some reason (dead, in prison, a rapist, skipped town, an abuser that the woman fled and wishes no contact with, refusing to acknowledge he even slept with the woman without 3 DNA tests and a court order...), or too poor to be of any help.

GrayDuck "I would assume that the August 24, 2010 - 7:23pm

"I would assume that the father of the child is either unavailable for some reason (dead, in prison, a rapist, skipped town, an abuser that the woman fled and wishes no contact with, refusing to acknowledge he even slept with the woman without 3 DNA tests and a court order...), or too poor to be of any help."

Why would you make such an assumption?

Even in those cases where the assumption is accurate, how do you know that the women could not have found more responsible sexual partners by more carefully vetting them? If you look at dating sites like Match.com, women say that they are looking for men who are tall, funny, and romantic, not men who are honest, dependable, and law-abiding. Women do not seem to prefer men who have the latter qualities.

carolyninthecity GrayDuck, you're a mystery. August 25, 2010 - 1:11pm

Do you mean why don't they impose mandetory payment from the father of the child as a way to hold him accountable and responsible for the choice to have sex and get a woman pregnant? hmmm. You might actually be onto something...

But in all seriousness, that doesn't really make sense. Why does the father not pay out of pocket? Well, why does the mother not pay? Because it's expensive, and not everyone has thousands of dollars of "incase of unplanned parenthood" money saved up. I know from reading your other comments on other posts that you're anti-abortion, and yet you also seem to think women (and the men involved) should be punished for giving birth as well. interesting.

ALSO, your implyed suggestion that only straight couples who have money should be allowed to have children in hospitals is problematic. (I know you're going to say that you never said that, but you definitely did).

colleen If you look at dating sites August 24, 2010 - 7:55pm

If you look at dating sites like Match.com, women say that they are looking for men who are tall, funny, and romantic, not men who are honest, dependable, and law-abiding.

Perhaps because if one lowers expectations to men who are simply honest, dependable and law abiding and with enough money to pay for an epitural one could still end up dating a guy who believes things like:

Allowing women to suffer pain while giving birth would be a good way of encouraging them to restrict their sexual partners to men who are responsible.

That said, we're talking about Utah, a state so poorly governed that polygamous communities and entire towns are an increasing problem and where the women on medicaid are the 4th or 5th or 6th 'wife' of a fundamentalist Mormon patriarch and who had no say at all about their sexual partners. Poor Utah, so far from God, so close to Saudi Arabia.

GrayDuck "Perhaps because if one August 24, 2010 - 9:26pm

"Perhaps because if one lowers expectations to men who are simply honest, dependable and law abiding and with enough money to pay for an epitural..."

I am not suggesting that women disregard other characteristics in potential mates. I am simply suggesting that they can sometimes secure the money needed for epidurals without taxpayer assistance by trying to avoid men who are "...unavailable for some reason (dead, in prison, a rapist, skipped town, an abuser that the woman fled and wishes no contact with, refusing to acknowledge he even slept with the woman without 3 DNA tests and a court order...), or too poor to be of any help."

Seraph And sometimes they cannot. August 24, 2010 - 10:23pm

Which is what Medicaid is for.

BTW, what makes you think that the women in question didn't try to avoid abusers or deadbeats? It's not like men advertise those qualities on their Match.com profiles. Nor do most have the ability to say "are you sure this is a good time to try for a child, honey? I'm going to die in a car accident/get laid off sometime around the third month."

Jodi Jacobson Seriously..... August 24, 2010 - 10:46pm

What planet do you live on? Because it appears to be a planet so far distant from reality, I think you could be of help to the space program.

carolyninthecity This is part of a much bigger August 25, 2010 - 12:53pm

This is part of a much bigger issue. If the state is spending so much money on maternity care, maybe they should start supporting midwives and free-standing birth centres. That would absolutely bring costs down. Banning epidurals out-right is just ridiculous and not the solution. It might look logical on paper, but you can't tell a woman who's been on a pitocin drip for 5 hours that she CAN'T have an epidural unless she pays for it. That's straight up inhumane (imho).

Liljenquist seems to have this additude that somehow it's women's fault that medicaid spends so much on them.

GrayDuck carolyninthecity on August August 28, 2010 - 6:43pm

carolyninthecity on August 25, 2010 - 2:11pm: "Why does the father not pay out of pocket? Well, why does the mother not pay? Because it's expensive, and not everyone has thousands of dollars of "incase of unplanned parenthood" money saved up."

So you think that the taxpayer does have that money saved up?

"I know from reading your other comments on other posts that you're anti-abortion, and yet you also seem to think women (and the men involved) should be punished for giving birth as well."

I said nothing about punishing anyone for giving birth. I asked why the taxpayer should bear the burden of paying for a procedure rather than the man who caused the need for the procedure.

Roundup: Want to Anger a LOT of Women? Propose Eliminating Epidurals to "Save Money"

Aug 23

Aug 22

Aug 21

Aug 20

Maryland Law Expanding Medicaid Access to Women's Health Services Takes Effect

Kansas in 2012? A Prediction of More Legal Battles, Higher Tax Bills, and Declining Access to Services