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A True Miracle

Baby Amillia Sonja Taylor is a double miracle. Conceived via in vitro fertilization, she was born on Oct. 24, less than 22 weeks into her mother's pregnancy, weighing less than 10 ounces and measuring 9½ inches long. "We weren't too optimistic," Dr. William Smalling told the Associated Press. "But she proved us all wrong."

And how could they have been optimistic: Only a few babies have survived with less than 22 weeks gestation. Doctors at Baptist Children's Hospital in Miami expected to send Amillia home yesterday, then changed their minds, deciding to keep her for a few extra days. Still, she's made it this far and now weighs 4 1/2 pounds.

Baby Amillia's story puts a face on a growing trend. The number of high-risk pregnancies in the U.S. has been rising, according to the Associated Press. Some reasons for the increasing numbers of these pregnancies are that chronic health problems are occurring in more women, which makes their pregnancies more difficult to manage; moms are giving birth at older ages; and infertility treatments are leading to more multiple births. The latest Centers for Disease Control statistics show egg donations to infertile women are up more than 60 percent from 1996 to 2004.

I'm a big supporter of these miracles of science regardless of whether they are egg donor children, IVF babies or doctors performing major miracles on too tiny infants. What do you think of these trends?

Today's Other Talkers: With One Word, Children's Book Sets Off Uproar ... Her Autistic Brothers ... Black Parents Work Hard to Raise Their Sons' Ambitions ... Organic Baby Food Recalled

By Stacey Garfinkle |  February 21, 2007; 7:00 AM ET  | Category:  Babies
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Comments


If someone wants to be a parent and is having a difficult time, there is a perfectly beuatiful and valid way to it without the pain, the cost and the difficulties that come with having a child born with serious disabilities-- adoption. I am speaking as someone with a disability. If you can avoid inflicting that burden on a child, you should do it. Adopt instead. these high-risk pregnancies shouldn't just be about making the parents happy-- it should also consider the future of the child and the resources of the community needed to care for the child-- especially where the parents are older and who will care for the child when the parents have passed away.

Posted by: 505 | February 21, 2007 7:47 AM | Report abuse

Stories like this and sextuplets through fetility drugs put me firmly in the camp of those who say science should not try to usurp mother nature. The money that the parents spend on fetility treatments seems better spent on some counsling work through the implied need the parent(s) have to have a biological child, and then consider adoption.

And I'm speaking as a PhD scientist and as an adoptee. And frankly, a pretty bitter adoptee at that. But still, I see the place for it.

Posted by: Ruby | February 21, 2007 7:58 AM | Report abuse

Sometimes my personal experience in this camp, clouds my judgment. I do believe in the US, parenting is a natural right. Unless you prove you are unfit, abusive, or in some way a danger to children, you do legally have a right to form your family by your choosing (minus child brides, polygamy etc...). But I am an adoptee myself and a perspective adoptive parent. I do have one biological daughter but we hope to expand our family through adoption. I do want to say adoption of a healthy child is NOT an easy task but well worth the time and expense. I just think these high risk pregnancies are dangerous to the mother and child. It puts a medical burden on society for the rest of these kids lives. Everyone wants to see families like the Dilly sextuplets. An awesome loving family of 8. But what are the odds? For every Dilly family there are probably three families dealing with serious handicaps. I know from friends and family, that infertility is heart breaking. Almost unbearable. I just don't "get" the desire to replicates one's own genes worth the risk and expense. Trust me, we have a biological daughter and she is the absolute love of our lives. Not because she shares our DNA but because we are committed to be her parents for the rest of her life. And she adores us to no end. It is about the loving relationship and not the shared DNA. I would encourage all families to look at all their options in creating a family. And of course it is always your right to choose. This is America.

Posted by: foamgnome | February 21, 2007 8:12 AM | Report abuse

Now that we've heard from one side, allow me to speak from the other.

My wife and I are actively trying to start a family, after many years of marriage without children. She is in the age category that will put her in the "high risk" classification should she become pregnant, although her doctor has assured her the odds are great she will have no problems, and the baby would be perfectly normal. However, if for some reason we cannot conceive naturally, I like to know that there are other options instead of just giving up.

My wife was an adopted child, BTW, but she would like to exhaust the reasonable options for becoming pregnant before considering adoption for ourselves.

Posted by: John | February 21, 2007 8:14 AM | Report abuse

John, we all wish you and your wife the best at forming your family. I hope you find what you are looking for. I think the key is you said exhaust reasonable options. For some people reasonable is IUI, for others it is 3 rounds of invitro, and for others it is powerful hyper stimulating ovulation drugs. Again, I wish you the best. A family is a beautiful thing.

Posted by: foamgnome | February 21, 2007 8:23 AM | Report abuse

I have to say that stories like these are one reason that we don't have affordable health insurance in this country. This baby has been in the NICU for 4 or 5 months-- her care probably cost in the millions. The more babies we have like this, the more unaffordable health insurance will be.

In Massachusetts right now, they are trying to get everyone covered with health insurance. One of their problems is that they can't get a minimum health insurance package that includes all of their mandates. One of the statewide insurance mandates is basically unlimited right to infertility treatments.

I see the tradeoffs very clearly-- the cost of these "miracles" to society, and to affordable health insurance for the rest of us.

It's a touchy issue, but I don't think health insurance and infertility insurance should be grouped together.

Posted by: Got affordable health insurance? | February 21, 2007 8:33 AM | Report abuse

My wife and I reluctantly turned to IVF/ICSI after 8 years of infertility. We now have a beautiful 6 y.o. daughter, and also a 4 y.o. daughter (beautiful, too, and no technological assistance was required for her!).

Doing IVF was an incredibly difficult decision, but in hindsight I'm glad we went that route.

Posted by: ViennaDad | February 21, 2007 8:42 AM | Report abuse

Vienna Dad: What is ICSI? Do you believe if you never did IVF, you would have still conceived your second DD naturally or that fertility treatments have affected her later fertility? I have read that it has no effect on future fertility. But you constantly hear of I did FT for first one and second child was conceived naturally. My only qualm here are people not patient enough? Would they have conceived naturally if they gave it more time? Just a question medically. Certainly not a judgement on your choices.

Posted by: foamgnome | February 21, 2007 8:46 AM | Report abuse

My husband and I have been trying to start our family for about a year and a half now. Recently, we sought the helpf of a fertility specialist and and have been trying the first line fertility drugs for several months without success. Though we have not struggled as much as some, I can say from firsthand experience that infertility is heartbreaking. I am in my late twenties and am healthy...certainly not the time in my life when I would have expected fertility trouble. I can absolutely understand why people go to great lengths to have their own children. The grief that goes with the inability to conceive your own child has been unexpectedly difficult.

Even treatement with relatively inexpensive fertility drugs (clomid, etc) carries risks of multiple (i.e. high risk) pregnancies. Unfortunately, adoption is incredibly expensive and waiting periods can be very long. So, it makes financial sense for people to try things like ovulation-stimulating drugs (which can lead to high-risk pregnancies) before choosing to adopt. If we as a society really want infertile couples to seriously consider adoption as a first option for building their families, we ought to be looking for ways to reduce the financial burden of adoption. (There is a $10,000 tax credit for adoption, but it has income restrictions and often does not cover the cost of adoption.)

Posted by: EE | February 21, 2007 8:56 AM | Report abuse

I agree with EE. i really shouldn't be criticizing people for doing these high-risk pregnancies unless I am working on making adoption an easier process. It is crazy that with health care coverage it would cost a family less more out of pocket to do fertiliti=y treatments than it costs for adoption.

I was under the impression adoption was relatively inexpensive. I had a friend adopt through
Maryland a healthy infant 9 months after the home study was completed and it didn't cost him anything more than the home study fees, I think-- it was through MD's public agency. Maybe he was an anomoly? I don't see why adoption should be expensive.

Posted by: 505 | February 21, 2007 9:10 AM | Report abuse

Here in NC adoption is an expensive, lengthy and nervewracking process. The adoption agents scrutinize your entire life, it takes at least two years, and rejection can come at any time for a variety of reasons. The adoption agencies also will tell you that being infertile puts you ahead of the couples still able to conceive naturally.

Posted by: John | February 21, 2007 9:23 AM | Report abuse

The cost of 5 months in intensive care is only the beginning: Most likely, this "miracle" will have severe mental and developmental problems for the rest of her life, and will need special teaching, training and facilities. This will sound harsh--but there is a reason that children this age don't survive without massive intervention.

Posted by: DC | February 21, 2007 9:26 AM | Report abuse

I'll never understand the extremes people will go to just to have a baby of their own. The high-risk pregnancies are too much: too much for the health-care system, too much when it risks the health of the mother, too much when it risks the lifetime health of the baby. It's hardly considered a 'miracle' if the baby needs 24/7 health care for the rest of it's life. Adopt. Volunteer as a Big Brother/Big Sister/Mentor. There's so many ways to help neglected healthy children that would love for someone to enter their lives.

Posted by: Anonymous | February 21, 2007 9:33 AM | Report abuse

I think adoption is a wonderful thing, but let's not be so quick to dismiss the strong pull of having a biological child that shares your DNA. That after all is why the human race never went extinct: all animal species are hard-wired to want to procreate their own young, it's just biology.

The twist on this story that I personally find the most interesting is how the ever-increasing odds of micropreemie survival might impact the abortion debate. Back in the 70s, a baby born at THIRTY weeks gestation was considered endangered: now most people would barely bat an eye at that, and the survival rate for those babies is well over 75%.

Regarding the cost of care, true it is extremely expensive ... which is why I personally hate the idea of a national healthcare system. The UK - which has such a system - recently was advised by a parliamentary medical committee to let preemies born before 25 weeks gestation die. That's right, with NO ATTEMPT to even save them. You have to read between the lines in the oh-so-PC articles on this, but one is left with the distinct impression that the government simply didn't want to have to pay for long-term care for those kids.

Posted by: StudentMom | February 21, 2007 9:39 AM | Report abuse

I am amazed by the people who pass judgment on those families who choose to undertake fertility treatments. Sure it increases the risk of having a premature baby, but there are LOTS of women who carry to full term babies after undergoing fertility treatments. And obesity also increases the risk of a premature baby (as do multiple other factors). Are you going to tell overweight people to not have biological children and adopt as well??

Why criticize a couple's choice to undergo fertility treatments instead of adoption? Unless you have been in their shoes, you don't know how you would feel/act.

We can promote adoption without slamming other people's choices.

Posted by: londonmom | February 21, 2007 9:44 AM | Report abuse

But why should the government have to go to such extraordinary lengths and expense to pay the care for babies born so premature they otherwise stand no chance at survival? That doesn't sound like an expense that we as a society should embrace, particularly given the overwhelming odds that those babies are going to need care 24/7 for the rest of their lives. If the family can afford it on their own, they're welcome to do so, but otherwise it seems like it's more humane and better for society in the long run not to take extraordinary action in some situations.

On a separate note, my husband and I want to have kids, but our health insurance doesn't cover any kind of fertility treatments at all. If we can't conceive naturally, we either have to adopt or we have to pay for IVF ourselves. That makes sense to me - the expense is so great, and why should other people insured by my carrier have to subsidize the cost of our desire to procreate?

Posted by: Kate | February 21, 2007 9:52 AM | Report abuse

A lot of this boils down to where we should draw the line. And I don't think anyone has a good answer for this. Sometimes high risk pregnancies just happen. Otherwise healthy women with healthy pregnancies go into labor early and have premies. Women, who look at first assessment like they're going to have problem pregnancies, do just fine. It's not just infertile couples who seek fertility treatment who have dangerous pregnancies and unhealthy infants. Medical technology now enables doctors to save a lot of babies that would not have survived decades ago, but it comes with a big price tag.

Could any of us, if faced with having a sick, premature baby, accept a doctor telling us that he or she won't do everything in his or her power to save our child because it's not cost effective?

Posted by: EE | February 21, 2007 10:07 AM | Report abuse

It actually increases the risk A LOT for premature babies. The rate is staggering for a developed nation- and precisely because of old moms undergoing fertility treatments.
The sharp increase in the past 10 years is even after factoring in lack of access to healthcare that everyone likes to blame for premature babies. In fact, the opposite is true- it's those who go to drs to get these interventions.

I'm surprised the medical community can keep endorsing these practices with the risks of prematurity and following that, the medical and develepmental issues that will be LIFELONG for many of these kids.

It's selfish to only consider wanting a biological child. I would rather pay 50,000 bucks on adoption than becoming a walking medical experiment.

Posted by: Anonymous | February 21, 2007 10:14 AM | Report abuse

Many years ago, one of my coworkers told us when she was pregnant, the doctors told her she was in the "high risk" group. She successfully carried the baby to term though, but during delivery there were sudden complications. The doctor actually came to her husband and said "which one do you want me to save, your wife or the baby?".

Imagine that situation.

Needless to say, the husband demanded the doctor do his utmost to save both, and the child and mom got through the emergency without any further problems. That doctor's question wasn't based on cost, but on his own ability, but still, how could a couple make that kind of decision if the doctor told them "sorry, I can save your baby only if you can afford the procedure".

Posted by: John | February 21, 2007 10:16 AM | Report abuse

There are difficult questions here:

Who deserves access to prenatal and neonatal specialty care?

Who pays for this care?

How can this care be assured and equitably distributed?

Are some babies too sick or too premature for newborn intensive care?

Who decides whether an infant receives care?

How are these decisions made?

Kate -

You said your insurance wouldn't pay for IVF. Would it limit NICU coverage if your infant required it?

Posted by: datadiva | February 21, 2007 10:19 AM | Report abuse

While I applaud attempts to extend the ability of human medicine to save human lives, I am concerned about the consequences of having medical technology enough to extend quantity of life without necessarily improving quality of life. This concern applies to the beginning and the end of human life.

At the end of human life, we have the capacity to keep the human body alive long after it would once have died through surgical and other short-term interventions like short-term life support, and through treatment of chronic conditions and long-term mechanical life-support. But is any life a life worth living? I don't know the answer to this, but it's a question that we need to ask. Not everything that can be done should be done.

At the beginning of life, we are pushing the gestational mark of "viability" (ability of the fetus to survive outside the womb) ever earlier. Our ability to help a developing human life continue to live outside the womb has tended to far outstrip our ability to ensure that this life will develop normally. Severely premature babies do have dramatically higher instances of developmental and other abnormalities. Again, we ought to be asking ourselves, is any quality of life a life worth living? I still don't know the answer, but it's important to consider the ramifications of this question.

Suppose our answer is "no, there are some cases where life is intractably painful or without reward for the living being." How bad does it have to get before this is the case? At least two responses may arise from a realization (assuming we come to such a realization) that there may be such a state as "a life not worth living."
(1) we should not use life-extending technologies in such cases
AND/OR
(2) we should focus research on developing science and technology that will allow us to grant severely premature babies and life-extended adults quality of life

Certainly, it would seem to be folly (assuming we believe there is such a thing as a "life not worth living") to focus our collective efforts on extending life before we also make an effort to improve the quality of extended lives.

Posted by: Philos | February 21, 2007 10:27 AM | Report abuse

I had a high risk pregnancy and I was a healthy 29 year old woman with no family history of pre-term labor. I went into labor at 7 1/2 months, but it was stopped with terbutaline and bed rest. My daughter was born three weeks early, but healthy. I am trying to get pregnant again and the doctor said I will be high risk from the start, but he can't determine whether I will have the same problems.

Sometimes you just don't know you will have issues until you are pregnant.

Posted by: scarry | February 21, 2007 10:33 AM | Report abuse

"One of the statewide insurance mandates is basically unlimited right to infertility treatments...I see the tradeoffs very clearly-- the cost of these "miracles" to society, and to affordable health insurance for the rest of us...It's a touchy issue, but I don't think health insurance and infertility insurance should be grouped together."

I agree completely.

These "little miracles" cost all of us a lot of money, and they put affordable health insurance out of reach of those who need it most.

Infertility treatments should be categorized for insurance purposes with elective cosmetic surgery. Then, perhaps, fewer people would get them, and we wouldn't be paying for months of intensive care for these infants.

Posted by: Anonymous | February 21, 2007 10:38 AM | Report abuse

I have a pretty severe case of PCOS, and knew at quite a young age that natural conception would be impossible. When my husband and I were ready to have a child, we thought long and hard about which route to go. Neither of us felt we had enough experience with children to take on a disabled, or even an older adopted child, and adopting a healthy baby is so expensive and takes a long time. So we pursued fertility treatment until we reached the limits of our health care coverage, which was one attempt at IUI. Luckily, we succeeded, with a completely uncomplicated pregnancy and a healthy single child.

Now we're discussing how to add to the family. We'll probably go a little further than last time with fertility treatment if needed, but my doctors are very conservative and consciously adjust treatment to reduce the chance of multiples. I'm not sure how I would deal with the guilt of deciding to undergo a treatment that results in one (or several) disabled children. Not because nature made them that way, but because we manipulated them that way. I would love them just the same, but it would be hard for me to believe that when they struggle, it's not my fault.

We struggle a lot with this issue. It's difficult to feel right about any of these choices.

Posted by: P's Mom | February 21, 2007 10:42 AM | Report abuse

I agree completely with anon. 10:38. Why should the rest of us pay for the indulgences of a few? If people want to undergo infertility treatments and produce high risk babies, let them pay for them themselves.

Posted by: Anonymous | February 21, 2007 10:44 AM | Report abuse

Four years ago, I ended up in the hosipital on bedrest at 25 weeks due to complications with my pregnancy. It turned out that I had a blood clotting disorder that was retricting blood flow to the placenta; therefore my baby wasn't growing as she should have been. We were trying to get to at least 28 weeks where the neonatologists felt she had a better chance in the NICU. I almost made it- 27.4 weeks. I knew she would be small but my daughter was born weighing 15.7 oz. Due to steriod shots for lung development, she was breathing on her own for 4 hours before going on a ventalator. No one knew what the future would hold for her... we took it day by day, ounce by ounce. The NICU doctors and nurses at Holy Cross were amazing. Samantha came home after 3 months. Was there a point were we would have said enough was enough? I don't know. She never had the major complications that happen. She was alive and we wanted to give her every chance to be someone.

Today she is 4 years old, small for her age w/ some fine/gross motor skills delays. She worked with MC Infant & Toddlers program for 3 years and gets OT/PT in the MK school system.

I know not all micro preemies grow up with few complications but that's the thing, no one knows. I guesss every baby deserves the chance to grow.

Posted by: klb | February 21, 2007 10:45 AM | Report abuse

"Why criticize a couple's choice to undergo fertility treatments "

Engineering an embrio inside of a science lab shows grave disrespect for human life. If the embrio is unwanted for any reason, it will be discarded. I think it is a real and legitimate fear that willfully terminating unwanted human life is a very dangerous concept to embrace.

Posted by: Fear | February 21, 2007 10:55 AM | Report abuse

"I guesss every baby deserves the chance to grow."

Is there a limit? If there was a way we could save a 10-week-old fetus (I'm not sure it's technically even a fetus), but it would cost $1 billion, should we do it?

One of the reasons health insurance is so high is because we aren't asking tough questions like this. So there are lots of school-age kids who aren't getting their checkups, treatment for asthma, etcetera, because of high insurance, which is caused in part by these high-risk, high-expense births. There are very real costs to our save-at-whatever-cost attitude-- and it's not necessarily the parents or even the insurers who are paying that cost.

Posted by: Got affordable health insurance? | February 21, 2007 10:57 AM | Report abuse

"Is there a limit? If there was a way we could save a 10-week-old fetus (I'm not sure it's technically even a fetus), but it would cost $1 billion, should we do it?...One of the reasons health insurance is so high is because we aren't asking tough questions like this."

The ethical problem here isn't whether we withhold treatment from micro-preemies.

The problem is that infertility treatments are so rampant nowadays that these cases have become commonplace -- and an extraordinary drain on the public health dollar.

If fewer parents were having infertility treatments, there would be fewer micro-preemies born and fewer multiple births.

Posted by: Anonymous | February 21, 2007 11:04 AM | Report abuse

To foamgnome:

ICSI is an acronym for a procedure called Intracytoplasmic Sperm Injection in which individual sperm are injected into each egg.

Posted by: Stacey Garfinkle | February 21, 2007 11:06 AM | Report abuse

You know there are a lot of illegal people in this country who also receive health benefits who shouldn't. They are also driving up the costs of health care. At least the parents pay their premiums.

Posted by: what is your point | February 21, 2007 11:07 AM | Report abuse

Philos, thank you for your excellent thoughts. This has been very much on my mind recently as I saw two elderly relatives die in the past few months.

Both had terminal illnesses (congestive heart failure for one, end-stage stomach cancer for the other). There was absolutely no hope of survival for either one.

One chose hospice and died in her home, peacefully and with loving care from relatives, with her pain carefully managed. I was there till the last moment, and it was a beautiful death (as deaths go, of course).

The other chose hospital care and was poked and prodded and attached to machines, and was completely miserable and *still* in pain. The cost to Medicare was enormous, and the cost to him and his family was huge, too. In the last 12 hours he chose to switch to hospice care, though still in the hospital. Only then did his care become more pleasant.

I'm sure if he had thought about it and really known what it would have been like, he would have chosen hospice care for the last throes of his illness. But we don't talk about death enough as a society, and folks don't necessarily know how awful a protracted hospital death can be.

Posted by: Neighbor | February 21, 2007 11:08 AM | Report abuse

Another question to consider is one of scarce resources in the NICU. If there are a limited number of ventilators or nurses or incubators or other specialized equipment, how are these being allocated? Not every area has multiple hospitals able to care for extremely low birthweight babies.

Posted by: datadiva | February 21, 2007 11:09 AM | Report abuse

A couple of misconceptions:

First, I don't know of one state the requires unrestricted access to infertility treatments. Most states that do require coverage have limits to the coverage. I.e. they will only cover a certain number of IVFs or IUIs. And most of the time, even if you do have coverage, you are paying a lot of money out of pocket. So the idea that infertile women are running around rampant having many procedures is ludicrious.

Second, responsible and reputable infertility specialist have a goal of ONE healthy child per pregnancy. Those women who have had multiples in the last few years are usually ones who have been prescribed clomid by the their OB-GYN without any testing as to what their actual problem is. If you're having problems conceiving - go to a specialist.

Third, where do you people live that you have all of your treatments covered for you and your families by insurance companies and government? I'd love to move there because where I live there are limits to what gets covered and families have to pay for the services they receive.

Finally, adoption, though lovely, isn't all its cracked up to be -- especially in the US. On the whole, states and agencies favor the rights of the biological parents throughout the process and in some cases, treat adoptive parents as glorified nannies. If it has worked out for you -- great -- congrats. But just because you chose to build your family that -- doesn't mean its right for everyone else.

Posted by: Danielle | February 21, 2007 11:10 AM | Report abuse

Datadiva, I'd have to go back and look at the fine print (we're not planning to start trying for kids for another several years), but I believe that once I get pregnant, the insurance kicks in for me and the baby regardless of how I got pregnant. The lack of coverage for IVF is not a cost-based objection, but rather a moral one. We aren't Catholic, but my husband's employer is, so doctrinal issues affect what the insurance covers. The insurance doesn't cover birth control either.

In terms of paying for the costs of keeping extreme preemies alive, it's certainly heartbreaking to imagine being in a position where a doctor isn't willing to spend millions to keep your baby alive because you can't pay for it. But don't we, at some point, need to accept responsibility for ourselves and our families? Why should we spare the family in that situation the heartache while not sparing the family who has no health insurance and is unable to pay for a heart transplant for their child? (Just to pick a random example.) The fact is that we *do not* do everything we can to save everyone's life. We don't for people who are poor-but-not-poor-enough-for-Medicaid; we don't for people who work but don't have health insurance. It's not unreasonable to ask why we should here, if for no other reason than because we need to have a justification for this sort of decision-making.

Posted by: Kate | February 21, 2007 11:11 AM | Report abuse

I guess what people are confusing is knowingly taking risks and unknown complications. Sure lots of women have complications during pregnancy. And preemies can occur with out fertility treatments. But knowingly undertaking a high risk procedure is different. If you knowingly choose this option, should you be financially, morally, physically, and emotionally responsible? I am not sure. Regrads to adoption. Yes, international adoption runs from about 25K-50K depending on country of origin. Domestic adoption is very inexpensive. The availability of healthy infants, Cacuasian in particular, is always a hard thing to get a hold on. Because states are NOT required to reveal or document the number of children adopted outside of foster care, it is really not known how many healthy infants are adopted each year domestically. We do know the number of single mothers giving birth has gone down. This is due to increased contraception/awareness, abortion, economics. The number of healthy infants release to foster care has also gone down. This is attributed to the acceptance of single parenting in our society. Adoption costs $$. But I would argue so does fertility treatment. If insurance stopped paying for even the simplest of procedures, chlomid, would more people adopt? Possibly. But I doubt it is just a financial matter. We have all read the cases were people have spent far more then the cost of an international adoption trying to get pregnant. I have BIL who is a mortgage broker and he did a loan for a couple who took out a second mortage to pay for fertility treatments. They borrowed 100K. Good golly, you could adopt two children for that price. So don't tell me that everyone who does fertility treatments is doing it to save money. It really comes down to do you believe parenting is more about replicating DNA or nurturing a child. This is America, and you are more then welcome to make your choice. But it is not really about how complex adoption is or how expensive. Getting pregnant using fertility treatments is just as much a gamble. You could have all the procedures in the world but they can not guarantee you a healthy child. It is financial risk and health risk. A risk you are free to make. But even if you are forced to pay for your own fertility treatments, if you give birth to a severely handicapped child, your family becomes a burden on the health care system for everyone. Should we still take care of that child? Of course, it is insane and inhuman to think otherwise. But it is on your head and heart that you knowingly went into the situation. That is very different than something by chance giving birth to a handicapped child. I wish we could wipe away the pain of infertility for all people. It is a mind numbing pain. At least that is what I have heard from friends and family members that have gone through it. But my question to all of them is, do you want to parent or do you want to replicate your own DNA?

Posted by: foamgnome | February 21, 2007 11:12 AM | Report abuse

"At least the parents pay their premiums."

The premiums they pay aren't even a discernible fraction of the cost of treatments and subsequent intensive care for the infants.

And the costs for a few thousand immigrants passing ilegally through our health system also don't begin to compare with the huge costs incurred in caring for preemies for months at a time in NICUs.

This argument has no merit.

Posted by: Anonymous | February 21, 2007 11:13 AM | Report abuse

"At least the parents pay their premiums."

The premiums they pay aren't even a discernible fraction of the cost of treatments and subsequent intensive care for the infants.

And the costs for a few thousand immigrants passing ilegally through our health system also don't begin to compare with the huge costs incurred in caring for preemies for months at a time in NICUs.

This argument has no merit.

Posted by: Anonymous | February 21, 2007 11:16 AM | Report abuse

"This argument has no merit."

Why not? None of them have pregnancy issues? Have pre-term babies, etc. Do they pay anything when they have a baby? No, so that is a huge bill for the hospital right there and a huge bill for the state while the kid is growing up.


What about fat people, people who smoke, people who don't exercise?

Posted by: Anonymous | February 21, 2007 11:20 AM | Report abuse

Finally, adoption, though lovely, isn't all its cracked up to be -- especially in the US. On the whole, states and agencies favor the rights of the biological parents throughout the process and in some cases, treat adoptive parents as glorified nannies. If it has worked out for you -- great -- congrats. But just because you chose to build your family that -- doesn't mean its right for everyone else.


I don't think anyone is saying you shouldn't be allowed to have fertility treatments. People are arguing if you knowingly undertake a risky procedure, the family should be responsible for all health care regarding that situation. Everything from the conception to the follow up care of a handicapped child. Similar to a preexisting condition that bars you of health coverage. I, for one, do not agree that it should bar you from post birth issues. But that is my opinion. It is also a misconception that there is a large number of domestic adoptions that are over turned to the biological parent. A few high profile cases, gives life to this false information. But I understand a risk is a risk and I totally understand why people would rather adopt internationally.

Posted by: foamgnome | February 21, 2007 11:21 AM | Report abuse

The premiums they pay aren't even a discernible fraction of the cost of treatments and subsequent intensive care for the infants.

I am pretty sure that no one pays enough premiums to cover a severe illness. My uncle has parkinsons and he is always in and out of the hospital, going to the doctor, on all kinds of meds and sometimes needs a nurse.

Posted by: scarry | February 21, 2007 11:28 AM | Report abuse

But why should the government have to go to such extraordinary lengths and expense to pay the care for babies born so premature they otherwise stand no chance at survival? That doesn't sound like an expense that we as a society should embrace, particularly given the overwhelming odds that those babies are going to need care 24/7 for the rest of their lives. If the family can afford it on their own, they're welcome to do so, but otherwise it seems like it's more humane and better for society in the long run not to take extraordinary action in some situations.

____________
But society pays huge amounts to pay for extension-of-life care for older adults, even though such care will still ultimately result in their death. For example, a friend of mine told of a case where a man had a liver transplant because he was an alcoholic, then drank that one to destruction, had a second liver transplant, and drank that one to destruction. At that point, he was so sick he died. These two procedures, no doubt, cost millions of dollars, as well as maybe depriving someone more responsible, of both livers. Not to mention all the heart bypass surgeries, desperate last-ditch cancer treatments, etc. We spend all this money on people who have had many years of good living, and there are more of them around than of micropreemies. Why are we willing to spend millions to extend the lives of a 70 or 80 year old for a year or two, but not willigg to spend it so a preemie can even have a chance to get started.

I think the bottom line of this issue is that society should expect adults to be able to face the possibilities of their own deaths. I don't think we should expect this of babies and children. It is inhumane and selfish.

Posted by: m | February 21, 2007 11:29 AM | Report abuse

It is inhumane and selfish

good point

Posted by: Anonymous | February 21, 2007 11:32 AM | Report abuse

"And the costs for a few thousand immigrants passing ilegally through our health system also don't begin to compare with the huge costs incurred in caring for preemies for months at a time in NICUs."

Are you kidding? Have you never been to the emergency room in a public hospital? If there are 20 million illegals in the country -- there are way more than a 'few thousand' using health services without insurance.

Posted by: Danielle | February 21, 2007 11:41 AM | Report abuse

"People are arguing if you knowingly undertake a risky procedure, the family should be responsible for all health care regarding that situation. Everything from the conception to the follow up care of a handicapped child."

Actually, this is not at all what I'm arguing.

It's naive to expect that any family will have the resources to be able to pay the multi-million-dollar costs of months of NICU care. Once the child is born, insurance must kick in or insurers will be accused of negligent homicide.

My point is that making fertility treatments ineligible for insurance coverage will cut down substantially on the number of couples getting them. Consequently, there will be fewer "little miracles" for the taxpayers to support.

Posted by: Anonymous | February 21, 2007 11:43 AM | Report abuse

"People are arguing if you knowingly undertake a risky procedure, the family should be responsible for all health care regarding that situation. Everything from the conception to the follow up care of a handicapped child."

Actually, this is not at all what I'm arguing.

It's naive to expect that any family will have the resources to be able to pay the multi-million-dollar costs of months of NICU care. Once the child is born, insurance must kick in or insurers will be accused of negligent homicide.

My point is that making fertility treatments ineligible for insurance coverage will cut down substantially on the number of couples getting them. Consequently, there will be fewer "little miracles" for the taxpayers to support.

Posted by: Anonymous | February 21, 2007 11:45 AM | Report abuse

"First, I don't know of one state the requires unrestricted access to infertility treatments...So the idea that infertile women are running around rampant having many procedures is ludicrious."

Danielle, your ignorance is not convincing evidence. Check out 211 CMR 37.05 of Massachusetts law/regs. You may want to move there.

Posted by: Got affordable health insurance? | February 21, 2007 11:46 AM | Report abuse

My point is that making fertility treatments ineligible for insurance coverage will cut down substantially on the number of couples getting them. Consequently, there will be fewer "little miracles" for the taxpayers to support.

He is just anti-child. He says nothing of the other questions posed: illegal immigrants, obese people, drinker/smokers, etc.

We all pay taxes buddy and I don't like where some of mine go either, but that is the way the system is set up.

Posted by: Anonymous | February 21, 2007 11:47 AM | Report abuse

Washington Post reporters, could you look into the longterm health risks to the mother of these hormone-based fertility treatments? I have read about a few cases of ovarian and endometrial cancer as early as seven years later. In other words, they not only lost half their life span, they didn't even get to raise the child. How common is this?

Also, readers, what do you call the baby born here to an illegal immigrant? That's right, a U.S. citizen.

Posted by: Margaret | February 21, 2007 11:47 AM | Report abuse

Also, readers, what do you call the baby born here to an illegal immigrant? That's right, a U.S. citizen.

Yes, but that law should be changed. I guess that is okay though to come here have an anchor baby and then milk the system, but someone who works, was born here is not allowed to try for a child of their own.

Posted by: Anonymous | February 21, 2007 11:52 AM | Report abuse

Danielle -

Perhaps some of those hordes of individuals you see in public emergency rooms are US citizens who, for whatever reason, don't have health insurance. Lack of afforable health care in the US is a problem that affects many.

Posted by: datadiva | February 21, 2007 11:56 AM | Report abuse

"Not to mention all the heart bypass surgeries, desperate last-ditch cancer treatments, etc."

Couple of points.

First, heart bypass surgery is a fairly standard treatment nowadays, usually giving patients at least 10 years of life if they watch diet and exercise. It's rarely done on desperately sick or otherwise terminal patients, and endoscopic techniques have made some heart bypass surgery much less invasive (with shorter recovery periods).

So, bypass surgery really can't be equated with last-ditch cancer treatments.

About these, I'm in complete agreement with you. The culprit, though, is the oncology specialists whose toolbox of lifesaving treatments has made them highly resistant to "giving up" and letting patients die in peace.

I have seen oncological surgeons pressure patients to go through tortuous surgeries and hideous follow-up therapy because there's a 5% chance that they might get another 18 months of life.

When this doesn't happen, the oncologists wander away, leaving the patient in the care of ICUs while homing in on another hapless victim.

This emphasis on fighting cancer at any cost has truly created a ghoulish growth industry. Physicians keep working their "miracles" on patients who die anyway and could have had a much more pain-free and peaceful death if allowed to expire naturally in hospice care (which is far less costly than the "treatments").

As for people who get new organs and ruin them (e.g., livers), yes, they drive up medical insurance costs, too. People should be permitted only one liver transplant in their lifetime. You get a second chance, but, if you blow it, that's it.

Posted by: Anonymous | February 21, 2007 12:02 PM | Report abuse

To foamgnome,
Someone else answered about your ICSI question.

I do believe that my DW's first pregnancy (via IVF) triggered some change. Our cause for infertility was never determined. We did IVF after trying on our own for 8 years. Then DW became preg. with daughter no. 2 only 2 months after going off b. control. But obviously, we have no way of proving a causal effect.

Posted by: ViennaDad | February 21, 2007 12:05 PM | Report abuse

11:46 -- That law allows for eligibility requirements and treatment standards based on a the insured's medical history, contractacting standards and allows them to set coverage standards according to ASRM's and other medical associations' standards. It's very liberal but not a free pass.

Also - only 15 states have enacted laws re: infertility coverage - either mandating that insurers' offer coverage if requested or mandating coverage.

Posted by: Danielle | February 21, 2007 12:06 PM | Report abuse

We may have fewer miracle babies if insurance stopped paying for fertility treatments. But they will still be around. Why? Because a good number of people care more about their own DNA then worry about their financial health.

Posted by: foamgnome | February 21, 2007 12:06 PM | Report abuse

I am against people going to extreme lengths to have a child, but I think it should still be an option. What is needed is education and frank talk about costs to parents and society.

It's kind of like the U.S. versus China debate. China, acting in an authoritarian manner, limits children to 1 per couple. However, the U.S. has no limits, and people are starting to self-limit (for many people, three children are rare these days). The U.S. raised the economic, educational status of its women and they USE BIRTH CONTROL and also DECIDE on their own to have less children than previous generations (that's an estimate on my part). Meanwhile, China's population is about 1 billion!

DH's sister is currently undergoing round after round of IVF, probably bankrupting her and her husband, for a miniscule chance to concieve and much heartbreak on her part. If, from the beginning, she had come to terms with her unlikely ability to get pregnant, she could be enjoying an adopted child probably right now, instead of being in constant pain from fertility treatments and depressed.

Posted by: R | February 21, 2007 12:12 PM | Report abuse

"He is just anti-child. He says nothing of the other questions posed: illegal immigrants, obese people, drinker/smokers, etc."

"He" is a she. She is not "anti-child." And she believes that, once a person is born and exists here, that person must be cared for by society. Therefore, not encouraging the conception and birth of high-risk infants -- by denying insurance coverage for fertility treatments -- is a reasonable, ethical, and humane way to approach this problem. Don't pay for it to happen in the first place.

As to the drinkers/smokers, obese people, and immigrants, I would add: motorcyclists who ride without helmets, drunk drivers, drivers with road rage, drivers who don't wear seatbelts, and abusers of prescription drugs. These are all types that cost taxpayers enormous health insurance $$ due to their willfully self-destructive behavior. And I'd bet that you're guilty of at least one or two of them!


Posted by: Anonymous | February 21, 2007 12:15 PM | Report abuse

I'm not sure what the "it costs too much in insurance to save the life of such a micro-preemie" people expect should have been done. Turn to the parents and say, "I'm sorry...we're going to put your live-born daughter aside to die, since it will cost too much to try to save her. She's over there on the file cabinet...you have a few moments to say good-bye." Preemies are born unexpectedly, in most cases, there's little to be done to prevent it. Should we revisit the Viking or Spartan eras, when less than perfectly healthy children were left to the elements to die? I'm not trying to be sarcastic, I really want to know what these people think the alternative is.

Posted by: T. Roth | February 21, 2007 12:18 PM | Report abuse

T. Roth --

Exactly my point!

You can't refuse treatment once the child is here. So you need to approach the problem by not funding fertility treatments in the first place!

Posted by: Anonymous | February 21, 2007 12:24 PM | Report abuse

T.Roth: A friend of the family gave birth to a preemie with multiple heart and lung problems. They told her that she would need like 8 surgeries before the age of 3 and will have multiple handicaps. BTW, this was not a child conceived by fertility treatments. The doctors laid out the pros and cons of proceeding with care. The family choose to let their child die in peace. As far as she was told, the baby was not in pain. She was given pain medication but the family refused surgery. It is very much like hospice care. They do not simply leave the child on the file cabinet to die. I am sure it was the hardest decision they will ever have to make. But decisions like that are made every day in this country.

Posted by: foamgnome | February 21, 2007 12:24 PM | Report abuse

T. Roth --

Exactly my point!

You can't refuse treatment once the child is here. So you need to approach the problem by not funding fertility treatments in the first place!

Posted by: Anonymous | February 21, 2007 12:26 PM | Report abuse

T.Roth: A friend of the family gave birth to a preemie with multiple heart and lung problems. They told her that she would need like 8 surgeries before the age of 3 and will have multiple handicaps. BTW, this was not a child conceived by fertility treatments. The doctors laid out the pros and cons of proceeding with care. The family choose to let their child die in peace. As far as she was told, the baby was not in pain. She was given pain medication but the family refused surgery. It is very much like hospice care. They do not simply leave the child on the file cabinet to die. I am sure it was the hardest decision they will ever have to make. But decisions like that are made every day in this country.

Posted by: foamgnome | February 21, 2007 12:26 PM | Report abuse

Actually, actuarially, it's the motorcyclists who ride *with* helmets that are the risk. Those that ride without helmets usually don't live to cost society any money. But I get your point. ;)

Posted by: Anonymous | February 21, 2007 12:27 PM | Report abuse

And I'd bet that you're guilty of at least one or two of them!

Even worse that you are a SHE.

Posted by: Anonymous | February 21, 2007 12:28 PM | Report abuse

"Even worse that you are a SHE."

WHY?

Posted by: Anonymous | February 21, 2007 12:31 PM | Report abuse

T. Roth --

Exactly my point!

You can't refuse treatment once the child is here. So you need to approach the problem by not funding fertility treatments in the first place!

Every child who comes from fertility treatments isn't a preemie or doesn't have problems. Do you think women who go into pre-term labor who conceived naturally should be refused treatment? I really think you are a bitter woman. What's the matter can't you have kids? Why so much anger directed at people who want children.

Posted by: Anonymous | February 21, 2007 12:35 PM | Report abuse

Anyone have any information on the percentage of severely premature babies born as a result of fertility treatments vs. babies conceived naturally? Anyone want to differentiate between types of fertility treatments? The levels of intervention vary widely. There is also a diabetes epidemic in this country, which causes significant pregnancy risks, perhaps we should make mandatory birth control a requriement for treatment.

As a commenter noted, the reports of extreme multiple births are most likely the result of Clomid prescribed by OB/GYNs, not fertility specialists who monitor ovulation with the use of fertility drugs and limit the number of fertilized eggs implanted with IVF (and its varients).

I find the attack on fertility treatements as the cause of out of control healthcare costs without any factual basis ridiculous.

Posted by: Jane | February 21, 2007 12:40 PM | Report abuse

Anyone care to answer my question?

Is there a limit? If there was a way we could save a 10-week-old fetus (I'm not sure it's technically even a fetus), but it would cost $1 billion, should we do it?

Posted by: Anonymous | February 21, 2007 12:41 PM | Report abuse

"Do you think women who go into pre-term labor who conceived naturally should be refused treatment?"

If you actually READ the line you quoted, you'd see that I said you CAN'T refuse treatment once the child -- ANY CHILD -- is here.

As for the rest of your illiterate rant, go irritate someone else, 'cause you won't get any satisfaction from me.

Posted by: Anonymous | February 21, 2007 12:42 PM | Report abuse

"Anyone care to answer my question? Is there a limit? If there was a way we could save a 10-week-old fetus (I'm not sure it's technically even a fetus), but it would cost $1 billion, should we do it?"

At 10 weeks, it's only an embryo. Might as well be in a test tube for all the success you'd have at "saving" it.

This is a really stupid question.

Posted by: Anonymous | February 21, 2007 12:45 PM | Report abuse

"If you actually READ the line you quoted, you'd see that I said you CAN'T refuse treatment once the child -- ANY CHILD -- is here."

I wasn't talking about when they are born. I was talking about treatments to keep them from being born. You know that cost money too.

"As for the rest of your illiterate rant, go irritate someone else, 'cause you won't get any satisfaction from me."

Wow, now I see why you are so angry. Sorry to upset you.

Posted by: Anonymous | February 21, 2007 12:46 PM | Report abuse

http://abcnews.go.com/Health/story?id=2185683&page=1

This article states about 10% of preemie cases are due to infertility treatments. At a cost of 26billion dollars in just 2005, we would have saved 2.6billion in one year alone if we didn't have the fertility treatment preemie babies. The major risk is multiple births. It is a short article. So I doubt if simple IVF or IUI or ICSI is the cause. The article seems to say it is multiple births caused either from drugs like chlomid or implanting more then one embryo. The problem is not with the guidelines but with parents willing to only implant one embryo at a time.

Posted by: foamgnome | February 21, 2007 12:50 PM | Report abuse

No, it's not a stupid question. The point is, is any life worth $1 billion? Do we have to save everyone, regardless of stage of development, regardless of cost, regardless of quality of life?

Posted by: Anonymous | February 21, 2007 12:50 PM | Report abuse

"I wasn't talking about when they are born. I was talking about treatments to keep them from being born. You know that cost money too."

Huh?

This is all a little too "Twilight Zone" for me.

What kind of "treatments" "keep them from being born"?

What are you talking about???

Posted by: Anonymous | February 21, 2007 12:50 PM | Report abuse

"What kind of "treatments" "keep them from being born"?"

I think there are different treatments to try and stop labor.

Posted by: scarry | February 21, 2007 1:02 PM | Report abuse

"What kind of "treatments" "keep them from being born"?"

I think there are different treatments to try and stop labor.
No, I think she was talking about fertility treatments. It would stop them from being born because they would never been conceived. At least that is how I understood the passage.

Posted by: foamgnome | February 21, 2007 1:06 PM | Report abuse

I believe the multiple implantation strategy used in IVF is due to the low chance that any one embryo will actually "take". If just one embryo is implanted, chances are the procedure will have to be done again, costing everyone even more money than if multiple embryos are implanted at once.

Of course, when that is done, statistically there is a chance that more than one will survive to full term, but the majority of IVF attempts result in only one live birth.

Posted by: John | February 21, 2007 1:10 PM | Report abuse

Foamgnome,

But, if by restricting fertility treatments to only those who can afford to pay out of pocket instead of health insurance coverage, how many normal, healthy children to couples unable to conceive normally are you stopping as well?

Posted by: John | February 21, 2007 1:14 PM | Report abuse

A very low birthweight baby born in a hospital without a level 3 NICU, or with one that has less than 20 beds is less likely to survive. So while treatment may be offered to every child, the quality of that treatment, and the ultimate outcome could be very different.

Posted by: datadiva | February 21, 2007 1:18 PM | Report abuse

John, I read in article once that the ultimate goal is to perfect IVF to the point where they can implant a single embryo with a large chance of success. If IVF was not covered by insurance, multiple rounds would be at the cost of the parents. My friends did IVF funded from their own pockets. I think Drs are getting better. 8 years ago, another friend implanted 4 embryos at one time. Now Drs. tend to limit to 3 embryos.

Posted by: foamgnome | February 21, 2007 1:19 PM | Report abuse

John,I am not trying to stop fertility treatments. I was just trying to explain the argument that the anonymous poster was making. My guess if you stop funding fertility treatment, many healthy children would cease being born. But some healthy and unhealthy children would still be born because parents would still choose to pay for fertility treatments out of their own pocket. Please do not confuse me with anonymous poster. I am not for or against insurance paying for any of these treatments.

Posted by: foamgnome | February 21, 2007 1:26 PM | Report abuse

Humans are born every day into a world where they are not wanted and they wait sometimes forever to be adopted. Our tax dollars take care of these children and our "medical" dollars take care of all sorts of "experiments" to have the perfect biological child. Give me a break; give my tax dollars a break; and please give our medical dollars a break. The truth is, that if someone wants to really be a parent, then it matters not whether it's their own biological child. What if this woman had to pay out of pocket the hundreds of thousands of dollars to take care of this child??? What if health care plans refused to pay for these procedures? After all, they are not medically necessary. These women will not die if they don't "give birth". Health care should be for preventative care and then for Medically necessary care. How many people have to choose between the medicines that will save their lives and the food and shelter that is necessary to sustain them?

Posted by: Debbie | February 21, 2007 1:35 PM | Report abuse

Thank you, Debbie.

You are the voice of sanity.

Posted by: Anonymous | February 21, 2007 1:46 PM | Report abuse

Taxes go towards all kinds of things. I think people who are so against this have issues.

Posted by: Anonymous | February 21, 2007 2:00 PM | Report abuse

"I have seen oncological surgeons pressure patients to go through tortuous surgeries and hideous follow-up therapy because there's a 5% chance that they might get another 18 months of life.

When this doesn't happen, the oncologists wander away, leaving the patient in the care of ICUs while homing in on another hapless victim."

Certain people who are very suspicious of the medical field (and especially the world-renowned medical facilities) would call this "experimenting on people." So they are hesitant to seek medical care. They are very much resistant to taking certain prescription medicines regularly or consenting to certain surgeries. Call it paranoia, but their beliefs may have some basis in fact. Such paranoia creates another health problem -- people who don't seek preventive or early medical care, and as a result go to the doctor later in the game, when it will cost more for them and others.

The more you try to limit who should get what medical procedure, the more you run the risk of discriminating against more people. Who should get what is a very tough decision.

But with regard to the drunk, how did he get one liver to pickle, let alone two? I thought full health assessments were done for transplant candidates, and if they weren't a good candidate healthwise, they couldn't get a transplant? Or at least they got bumped down on the list.

I don't believe in shafting the miracle preemies or the old people; all human life is valuable.

Posted by: theoriginalmomof2 | February 21, 2007 2:17 PM | Report abuse

"But even if you are forced to pay for your own fertility treatments, if you give birth to a severely handicapped child, your family becomes a burden on the health care system for everyone. Should we still take care of that child? Of course, it is insane and inhuman to think otherwise. But it is on your head and heart that you knowingly went into the situation. That is very different than something by chance giving birth to a handicapped child."


This comment is very very close to the issue of prenatal testing and preimplantation genetic diagnosis. If diagnostic testing revealed that the unborn child had a disability should the child be automatically aborted because we KNEW about it ahead of time and we need to save the tax payer dollars? Only the children born to those without such foreknowledge should be allowed to receive care and assistance?

Posted by: hatsat | February 21, 2007 2:21 PM | Report abuse

"But even if you are forced to pay for your own fertility treatments, if you give birth to a severely handicapped child, your family becomes a burden on the health care system for everyone. Should we still take care of that child? Of course, it is insane and inhuman to think otherwise. But it is on your head and heart that you knowingly went into the situation. That is very different than something by chance giving birth to a handicapped child."


This comment is very very close to the issue of prenatal testing and preimplantation genetic diagnosis. If diagnostic testing revealed that the unborn child had a disability should the child be automatically aborted because we KNEW about it ahead of time and we need to save the tax payer dollars? Only the children born to those without such foreknowledge should be allowed to receive care and assistance?

Posted by: hatsat | February 21, 2007 2:24 PM | Report abuse

If diagnostic testing revealed that the unborn child had a disability should the child be automatically aborted because we KNEW about it ahead of time and we need to save the tax payer dollars?

No, because the testing could be wrong. I've read about such things happening. Also because people have some basic rights. And, is there any definitive proof that health insurance companies pay out more than they earn on premiums and co-pays? I find that hard to believe, since many people may use their health insurance sparingly and may be very healthy. I just don't buy that insurance companies are losing money.

Posted by: theoriginalmomof2 | February 21, 2007 2:31 PM | Report abuse

"Yes, but that law should be changed. I guess that is okay though to come here have an anchor baby and then milk the system, but someone who works, was born here is not allowed to try for a child of their own."

I see a perception out there that the vast majority of illegal immigrants are milking the system, and I just don't see any foundation for this kind of thinking. These people are here to work, and they do that. They work as day laborers, nannies, handymen, gardeners, maids, dishwashers, and all sorts of other jobs that american citizens consider to be beneath them. They also contribute to our economy by consuming products. They are here because the market gives them a niche in which to work, and they often work two or three jobs to get by. And they do get by, and eventually prosper, raising children who are American citizens and who become self-sufficient, responsible and tax-paying. These people are no different from the Eastern Europeans, Irish, Italian, and other immigrants who came to this country in the past.

It has been my experience that those who are receiving welfare and milking the system are mostly Americans, who are eligible for these entitlements and are either too lazy to work, or think that they are above mopping floors or putting up drywall.

Posted by: Anonymous | February 21, 2007 2:32 PM | Report abuse

Health care should be for preventative care and then for Medically necessary care.

So if someone is unable to get pregnant, care to remedy that is necessary or unecessary? Should health care pay for birth control which in most cases only serves to inhibit a natural function but is not medically necessary? Should health insurance pay so that I can have sex and not have it result in a baby? I would argue that fertility treatments correct something that is not working properly and it makes more sense to cover that than contraceptives.

Posted by: moxiemom | February 21, 2007 3:50 PM | Report abuse

Two thoughts come to mind on this topic: 1) re: prenatal diagnostic testing - I was pregnant at 35/36 with child #2 and my ob/gyn suggested amnio. When I asked him how couples decide whether or not to have this test, he put it very simply: "what would you do if there were a problem? would you terminate the pregnancy, or let it go to term, knowing you would be raising a disabled child?" My husband and I are not saints - we knew we could not deal with a severely handicapped baby, so we went and had the test. No problems showed up (altho it turns out our son has a minor orthopedic disability, which we have dealt with).

Second item: "Those that ride without helmets usually don't live to cost society any money." NOT TRUE. A 20-year-old son of my boss was in a motorcycle wreck without a helmet. He survived, but was so severely brain-injured he had to be institutionalized for the rest of his life. No cost to society, my eye.

Posted by: Loren | February 21, 2007 3:53 PM | Report abuse

"I would argue that fertility treatments correct something that is not working properly and it makes more sense to cover that than contraceptives."

Maybe.

But fertility treatments cost tens of thousands of dollars; oral contraceptives, merely pennies a month.

Medical insurance will always cover inexpensive meds that many people want. It would be fiscally ridiculous not to.

Posted by: Anonymous | February 21, 2007 3:55 PM | Report abuse

But fertility treatments cost tens of thousands of dollars; oral contraceptives, merely pennies a month.

Agreed on the pennies a month although its more like $10 a month. Where do you draw the line between covering things people want but aren't necessary but cheap and things that are necessary but expensive. Clearly I'd be more in favor of covering bone marrow transplants than contraceptives. I'd also argue that the high cost of health insurance is not caused by fertility treatments or premature babies but the chronic conditions that plague the inactive, obese and smokers. Argue against coverage for IVF if you will, but to argue that it will help fix healthcare is simply not true. That said, I have two children conceived naturally, trouble free pregnanies that resulted in both children being born 5 wks early for no known clinical reason.

Posted by: moxiemom | February 21, 2007 4:01 PM | Report abuse

Moxiemom: The difference is that BC saves the insurance company and society $$. It is simple dollars and cents. By avoiding unwanted pregnancies from occuring, we are avoiding future payments in social and medical services. By paying for fertility treatments, we increase our costs. One for thing, we get more people to take care. And the second is because if there is an increased risk of severe medical problems, then we save tons by not insuring FTs. Again, I am not personally advocating not insuring FTs. I really think that it is up to individual plan members and insurers. But it is just a reality that we spent an extra 2.6 billion dollars in 2005 to cover preemies born as a result of FTs.

Posted by: foamgnome | February 21, 2007 4:06 PM | Report abuse

"the chronic conditions that plague the inactive, obese and smokers"

Oh, for god's sake, stop lumping obese people in with smokers and alcoholics!

It's an ignorant attitude, as everyone does things that put them and others at risk for costly medical problems.

Sports enthusiasts are always straining, spraining, and breaking things; patching them up costs money, and insurance covers it.

People who drive unsafely or drunk cause accidents and injuries that push up the premiums on everyone's medical AND auto insurance.

People who insist on doing their own home repairs have accidents that cause serious injury; again, insurance covers it.

Blaming one sector of the population because they're easy targets is just plain mean-spirited, and it's not based on anything beyond personal prejudices.

Find another horse to beat.

Posted by: Anonymous | February 21, 2007 4:13 PM | Report abuse

moxiemom:I don't think anyone arguing that the current crisis in health care is due to preemies born from FTs. And frankly a lot of us would like to do something about obese people and smokers. But it is harder to regulate exercise or put further bans on smoking. I also think with obesity, we tend to back off because some small part of us realizes we are one twinkie away from being on that side of the camp.

Posted by: foamgnome | February 21, 2007 4:14 PM | Report abuse

foamgnome - I guess we may have a fundamental disagreement on what the purpose of health insurance is. I think it should provide proven preventive care and for some portion of care to "fix" things. Aetna doesn't cove contraceptives because it saves money, they do it because it is politically correct and something asked for by employers. You assume that if contraceptives weren't covered then people wouldn't pay for them on their own and just have tons of babies which I don't think is the case. I think most people with health insurance would pay out of pocket.

"But it is just a reality that we spent an extra 2.6 billion dollars in 2005 to cover preemies born as a result of FTs."

I think its dangerous to single out groups like that. How much did we spend to cover smokers and all their related ills? Should we not provide care for the obese? They have chosen their situation the same way that someone undergoing FT with a preemie has.

Fun discussion - gotta go.

Posted by: moxiemom | February 21, 2007 4:15 PM | Report abuse

According to the linked article, the 2.6 million dollars is not the cost of NICU care for premature babies born of fertility treatments. It includes estimated costs of things like occupational therapy and parents lost productivity. I think it is a very squishy number.

Posted by: Jane | February 21, 2007 5:22 PM | Report abuse

oops, I meant billion, not million.

Posted by: Jane | February 21, 2007 5:27 PM | Report abuse

We're still a culture that promotes biological children as part of the "American Dream." Far too many people are having children because they want to fit an ideal, not because they could be considered very fit parents.
Not having children and adoption needs to be promoted as completely wonderful options for adults to have in life, with just as much fulfillment as reproducing and raising children. I don't see this happening any time soon unfortunately.
While there are some downsides to medical treatments for fertilization, I do think it is a viable option and shouldn't be denied to someone just because they can't do it the old fashioned way.

Posted by: Liz D | February 21, 2007 5:28 PM | Report abuse

It has been my experience that those who are receiving welfare and milking the system are mostly Americans, who are eligible for these entitlements and are either too lazy to work, or think that they are above mopping floors or putting up drywall.

Nice to know that there are still people like you out there who live in the big city bubble.

Many people in the Midwest, West, and South would kill for jobs that include hanging dry wall or moping floors. These people are called "blue collar."

Posted by: Anonymous | February 22, 2007 1:26 PM | Report abuse

If you have not personally experienced infertility, you should keep your mouth shut because you have NO IDEA what you are talking about.

I tried for a child from my late 20s until two years ago, when I finally was able to have my beautiful (and very healthy) twins, at the age of 43. We (willingly) paid out of pocket for our fertility treatment.

Our precious children haven't cost any of you people a single dime, so clam up.

Oh and, by the way, we were not eligible to adopt because we are too old.

Posted by: Finally Mom | February 23, 2007 2:16 PM | Report abuse

Adopt. I just don't get these women who pine and whine for naturally born children. Never have. I hope to have at least one of my own - we'll start trying in 2008 - but regardless of the outcome, we're going to consider adoption as well. Probably fostering, too... You can get the same nurturing and parenting experience with a child that is not carrying your own DNA. (And they don't have to be fresh-from-the-womb infants either.)

I've got that clock going like any other mid-30s woman, and I want kids as much as the next person...but I know that there are so many wonderful children out there who could make our house a home - and I don't have to spend gobs of money, derail our lives, risk low-birth-weight babies with high potential for neurological disorders, end up with crazy numbers of lab-produced multiples, etc to be fulfilled. Being a mother is far more than genetics.

On healthcare/insurance paying for fertility treatments, I would go half way. It's one thing to say that one is getting some shots or testing to deal with fertility issues and it's wholly another to talk about IVF and other more dramatic procedures. I don't know what the current line in the sand is, but I'd support something that does delineate b/w what is medically necessary and what is purely optional.

Posted by: hurricanewarningdc | March 2, 2007 10:13 AM | Report abuse

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