Conference turris::womannotes-v3

    
    
    see also:
    
    womannotes-V2
    735 - two-legged incubators
    
    -Jody
    

    Being an independent cuss, I hate anything "mandatory".
    
    Why can't the company just make the care available, and take steps
    to _encourage_ their employees to avail themselves? 

    well I agree w/.2, but from the company's point of view it's
    self-protection.  They almost went under as a result of (possibly)
    preventable health conditions.  It _is_ true that women who don't
    bother with docs while pregnant suffer more complications of pregnancy
    and childbirth than women who do the reg-sched-doc-visits.  (Though
    heaven knows my own experience shows that this is not any kind of
    guarantee!)
    
    Other factors to consider, on various sides of the question:
    Does the company mandate a smoke-free environment?  Charge higher
      premiums for smokers than non-smokers?
    Does the company have an AIDS-education program?  (jeepers, if they
      think preemie-care is expensive, wait'll they see their first AIDS
      case!)
    How much of a budget does the company have/can the company afford for
      education on these and other health issues?
    How much if any employee participatin was there, is there, should there
      be, in this kind of policy making by the company?
    How do the employees in general, and the pregnant women in particular,
      feel about this policy?
    
    And lastly, remember that all the world loves a pregnant woman -- else
    why would people I didn't know -- heck, people I didn't *like*, who
    knew that! -- walk up and pat the belly without so much as a how-de-do!
    It is offensive, but well-meant.  It is hard to be unalterably opposed
    to something that benefits the health of women and their children.
    
    Sara
    

	Who pays the fiddler calls the tune.

	If you shirk responsibility for something, does it not follow
	that you also lose control over it?

			Tom_K

    I wish the world would stay the hell out of my womb.
    
    Nancy

    Me too, but they're not likely to, Nancy.  Who controls women's fertility,
    controls women.  The womb is the major "theatre of operations" in the
    battle for control of women.  And I fear the grip will even tighten. 
    We've gotten "way out of line" in the past 30 years or so.  After all
    the "woman's liberation" talk and stuff, it's all finally come down to 
    the bottom line - women's fertility - as being not only just the
    traditional way but really the ultimate way to control women.  There's
    much more at stake than even insurance companies and lawsuits.  As
    someone already mentioned, wait until they get their first AIDS case. 
    It's likely they already have!  They've probably got some emphysema
    cases and lung cancer cases, too as well as some alcoholics and some work
    injuries due to alcoholism, etc.  But those cases don't elicit the 
    same absurd response and that's because traditionally those cases
    involve mostly men and so they're pretty much just accepted as part of 
    life.  The underlying battle for control of women is what makes caring 
    for these babies seem "unnecessarily expensive" and worthy of invading 
    women's privacy and limiting their freedom.  It's an irresistable 
    platform for furthering the hidden agenda of a desire for control of
    women.  Not that they *wouldn't* save money and not that it *wouldn't*
    result in healthier babies, but because they are not choosing to save
    money and create healthier people by invading men's privacy and
    limiting their freedoms makes this particular choice suspect.  If they
    did it all, I'd say ok.  But selecting out only this one single area 
    and then *requiring* participation rather than simply making this
    alleged "help" available, betrays the real motive. 
            
    Sandy
                              

I don't know about this particular compnay but many companies *are* starting to
act on the smokers, the overweight, the geneticaly predisposed to disease. It's
not *just* pregnant women. We are in a health care crisis and lines are going
to be drawn. And some individuals are going to be virtually unemployable becasue
of it. 

I also think the pregnant women is special case. It is different. The child who
results is usually better off for having had pre-natal care. I just read in the
paper where some state is thinking of requring Norplant use by women who have
already had one drug baby and who still use drugs. (meaning they've been busted)

Interestingly enough, the forced use of contraception(and possibly abortion) was
the reasons Justise O'Connor gave for disenting on one of the anti-abortion
cases. She said if the state could prevent abortion, they could also mandate it.
liesl

    It was pointed out in the EXPATRIATE notes conference recently that 
    the American system of EMPLOYERS providing the means for insuring people's
    health is  unusual in a world sense. While a person's employment may
    have *some*  impact on hir health, most people will get sick, have
    accidents, have  babies, etc. regardless of whether they are employed
    or not, let alone  by whom. Most countries in Europe have a system of
    National health  coverage, regardless of a person's employer/employment
    status. 

    With health insurance being related to employment, maintaining ones 
    position at a certain company may actually become an issue of life or 
    death! If a person has a 'pre-existing condition' type of 
    illness/disability and gets laid off/fired from a company within 
    whose system s/he was insured and is no longer insurable for that 
    condition, their life may actually become at risk. 

    This strikes me as fundamentally flawed.

    Having an employer-based insurance system can yield the type of issue
    in the base note. It also can (will) be addressed in different ways by
    different employers' insurance schemes.

Cheers,
George

Wasn't there a similar case in Massachusetts that affected mostly
men?  Something about firefighters, a law declaring that any heart
or lung disease they developed was automatically considered work
related (with subsequent disability payments, etc), and a resulting
ban on smoking for them?

re .-1, with employer based medical insurance, the insurance company
and employer tell you what you can and can't do in order to maintain
coverage.  With a government based medical insurance, it is the government
that tells you.

Dan

    I wonder how many employees had heart attacks during that time?  
    
    I wonder whether, if a significant number (say five) of 
    male employees suffered from some expensive condition, they would be
    ORDERED to have checkups and attend health classes on site?  I have a
    hard time imagining that would happen.
    
    -Tracy
                                 
     

    Tracy,
    
    Here's something even more interesting to wonder about:
    
    If five of the one hundred men with a given medical condition had
    it turn expensive on them, would all one hundred then be "ORDERED to
    have checkups and attend health classes on site?"
    
    						Ann B.

    I saw the broadcast discussed in .0.
    
    I think this company did the right thing, given their set of
    circumstances.  
    
    First, I must say I agree with every person that put a note in here 
    stating something to the effect that no one has the right to tell
    any other person what to do (or not to do) with their body.  
    
    But while I was watching this story about a factory in a small town, it
    occurred to me that the management of this company was really helping
    out by providing the training and making the women attend it.  The
    reason I feel this way is many of the women they interviewed hadn't
    gone to the doctor (and didn't believe it was necessary to) until, say,
    the seventh+ month of a pregnancy.  They simply saw no need or benefit
    from doing so. 
    
    Just because the company made training available didn't mean the women
    working for this factory would attend it.  By making the training
    mandatory the women now realize how important prenatal care is during
    the entire pregnancy.  (It so happens this factory produces irons as a
    product, and the workforce there is comprised of mostly women of
    child-bearing age.)
    
    The way I see it is the company is not only protecting those unborn
    babies from potentially avoidable birth defects, it is protecting the
    futures of those unborn babies.  It was implied (if not stated) that
    this factory was one of the only places a woman could work in this
    small town.  If the factory couldn't afford to stay open due to costly
    hospital bills, hence closing the doors to the factory, the local
    economy would be destroyed.  Food for those babies could then very well
    be a concern.
    
    >sigh<  Whatda world.
    
    -jc
    

	Gee, whiz ! All this talk about control of the womb and
	stuff !  This ain't Red China !

	It's more likely that the paternal "Now go see the 
	nurse, honey" stuff is pure self defense on the part
	of the company.

	Ever wonder why everything you buy has warning placards
	all over it ?  As:

	"Caution:  This basketball may cause severe injury if
	 thrown from a speeding car into a baby carriage."

	"This GE oven uses electricity, and there is a danger of
	 fatal shock if you pour salt water into the control panel
	 while standing in a puddle."

	.... and so forth.

	These days, juries award MILLIONS of dollars for "injuries"
	that may or may not be attributable to a defendant.  It's
	gotten so bad that I know of companies that have renamed
	themselves:  "The Uninsured XYZ Company".  They hope to
	deflect "deep pockets" lawsuits.

	These days, with unproven accusations flying about 
	video display radiation, electromagnetic fields, and
	the dangerous effects of exposure to pink Post-It Notes,
	I can understand a company's impulse to go overboard on
	this stuff.

	Steve H

    
    I can understand their impulse to go overboard
    but I don't have to condone it
    nor should I be forced to comply with it.
    
    U.S. out of my Uterus.
    
    -Jody

    I'm not trying to step on anyone's toes here, but I don't agree that
    this is a bad thing.
    
    
    In fact, it reminds me of the seatbelt law... which Massachussetts
    people got appealed, but most of the rest of the nation puts up with.
    Maybe the fact that lots of Womannoters are in Mass. explains some of
    the "its my body I can die if I want to" attitudes. 
    
    Its obvious that many state governments have decided to legislate
    safety. Its not a new thing. And by the fact that most states haven't
    repealed the laws, I tend to assume that lots of people think its okay.
    So, when a company mandates medical care, especially FREE PREVENTATIVE
    care, I ain't gonna complain. The fact is, if people were doing the
    right thing, they wouldn't notice the mandate! 
    
    I think anyone in the situation of wanting to have the choice of
    whether to obtain proper pre-natal care, or whether to wear a seat-belt
    or whatever, should sign a waiver, witnessed by at least one relative
    and two other sane individuals, including the insuring party, waiving a
    right to sue, seek redress, or obtain reimbursement for sustained trauma.
    
    
    Last time this came up was when we went down the enforced Norplant
    rathole. This strikes a similar chord. Its all well and good to wish
    that companies would try positive incentive programs instead of mandatory
    programs. But the motives are different. The latter is designed to
    reduce risk and save money, the former is a nicety. I think its highly
    understandable for a body which bears financial responsibility for
    others to impose mandates which reduce financial risk. 
                                           
    If you don't want someone else telling you what to do, its time to
    become SELF-EMPLOYED and SELF-INSURED!!!!!!!!

    
    its an extension of the politikal korrektness syndrome that sez
    the liberal we-know-whats-best-fer-you cognoscenti have every right 
    to ride herd on what we say, who we hire, what we buy, how fast can
    you drive.  
    
    you can't expect to enjoy pc-ness in some things and have freedom in
    other things...

    HOLTski, of COURSE you can!!!  all depends on who's defining pc, and
    who's defining freedom.
    
    a little grok that applies here:
    
    	Freedom means you're free to do
    	Just whatever pleases you
    	If of course that is to say
    	What you please is what you may
    				(Piet Hein)
    
    remember, the conservative viewpoint also has its view of what's
    'korrekt', and the question of which viewpoint wins (and in what areas)
    is far from settled.

      Not an attempt to bring ab8r&io- in to the discussion please. But, 
      Surely it is all a matter of timing, When does child abuse begin?
      Whether the abuser is ignorant, sick or malicious, I believe that the
      child should be protected.
      Is there really a difference between the mother who exposes the unborn
      to *unnecessary* injury and the father who lets his 3 year old play
      beside the main road.
      Rgds,

    A lot of you are talking in generalities.  And from that angle, those
    who support this "forced compliance" are right.  The problem I see is
    that they're only choosing *one particular area* in which to force this
    compliance!  I have no argument with a company who moves to reduce its
    liability.  We've got a ton of lawyers and they like to keep busy and
    well fed.  But when only one area becomes the target, I can't help but
    suspect that more is at work than just "covering their behinds". 
    Why have they not considered forcing all cigarette smokers into yearly 
    lung X-rays?  Why haven't they considered forcing all drinkers into
    liver function studies?  Are they monitoring the local drinking water
    closely?  Are they checking the tires on their employees' cars?  How
    about making sure their employees have smoke alarms in their homes -
    are they doing that?  Are they as interested in children as they are
    fetuses?  Are they supporting, (or even mandating which they are for
    women carrying fetuses), visits to the well-baby clinics and immunizations?
    
    There is much that can be done.  My beef is that they've chosen only to
    focus on women of child-bearing age when that's merely one area.  And
    not even the biggest.  So I wonder how much of it is really interest in
    saving money or interest in employee well-being and how much of it is a
    desire to view women of child-bearing age as a "special" group in need
    of "special" treatment, (like being kept away from the jobs that pay
    the most, for instance).
    
    Sandy

    One real solution would be preventive care for *everyone*, wouldn't it?
    So, uh, why don't they just do that?  Too much like a national health
    policy?  We all know the AMA is huge, powerful and extremely profit
    motivated.  It depends on sickness and disease to survive.  And there's
    no glory in immunizing babies but there certainly is in transplanting
    the lungs of a smoker!  The AMA is mainly interested in heroic medicine 
    and has little patience for standard patient care.  To ascribe such
    altruistic motivations to the company policy we're talking about here
    is to know nothing about the AMA or the insurance companies.  They
    don't want to get into the business of preventive medicine, it's boring
    and inflating a pressure cuff 85 times a day just doesn't bring the
    same personal rewards to doctors, (and I've already talked about the
    medical school selection process which selects for highly competetive
    and profit motivated candidates), that transplanting a heart or saving
    a preemie does.  Your "well-being" is of far less interest to them than
    a body ravaged by disease whose life they might be able to prolong by
    some heroic measure.
    
    Sandy  

re .9 Dan, 

While I agree that *any* policy of health insurance will have 'rules',
there is a large difference to me between having one governmental
policy and thousands and thousands of employers/insurers establishing
a wide variety of policies. 

In the latter instance, some companies will, as in the base note, have 
mandatory pre-natal care, some will offer optional pre-natal care of a 
wide variety of usefulness and others will offer no pre-natal care at
all. Also, the types of inconsistencies Sandy pointed out have a 
higher likelihood of occurring in many more instances.

The wide variation of health care made available and especially its
linkage with employment is what seems strange to me. If someone works
for Company XYZ s/he is covered for <condition A> but if s/he works
for Company ABC s/he's not. If s/he loses hir job, s/he may lose hir
coverage. 

If there were a national policy, individual companies such as Sunbeam
would not have to set its own health policy based in part upon fiscal
reasons. To adjust health offerings based in part upon the
profitability of each of many thousands of businesses seems extreme. 

There would, of course, be issues of what the correct national health 
policy should be. But the issue is addressed once, and not many
thousands of times with a wide variation of answers. It also becomes
separated from employment or individual company profitability issues,
and can be addressed on health grounds. 

Cheers,
George

    I too saw a bit of this program. I was bothered by the mandatory
    business and surprised at how one-sided the reporting was. They did not
    interview any woman complaining about this program and I'm sure there
    must be a few who resent it. 
    
    On the whole though, I'm with 'ren. The company providing the insurance
    has a right to say what it'll insure and not. A lot of companies have
    different rates for smokers and obese people. I see this in the same
    light. Basically cutting down medical costs. They started this program
    after they went almost bankrupt over five premature babies. They did
    have some numbers about how the cost per birth has gone down.
    
    manisha

re .9

	I'd rather have the multitude of private plans. What is best for
	one is not always what is best for all. Also, having a multitude
	of plans makes it easier to experiment with different approaches
	to health care issues than a single government plan. Lastly,
	government has an abysmal record in the majority of its endeavors...

						Tom_K

    
    I disagree with something 'ren (I think) said a few back - that
    mandatory programs are to manage risk and voluntary programs are just
    niceties.  I think both are different approaches to managing risk (or
    increasing productivity) -- I don't think any program exists in a
    corporate setting that is JUST a nicety.
    
    For example, Employee Assistance Programs are mostly (if not entirely)
    voluntary, but they were created to help deal with the problem of
    alcoholism in the workforce (I believe that is what the first EAPs were
    designed for, though now EAPs provide a wide range of counselling and
    referral services).  Anyway, an EAP is a nice thing to have from an
    employee perspective, but it saves a corporate money to keep employees
    functioning at their best.
    
    I think if a company sees that it's losing a lot of money (worker
    productivity) because of pregnancy-related illnesses, work-site
    prenatal care is an excellent idea.  I see no reason to make it
    mandatory.  
    
    Justine

    1) Sounds like the insurance plan maybe needs better management or the 
    whole system needs revamping.  Suppose the near-bankrupcy was due to
    five people requiring full life support for the next 39 years.  And
    suppose one of those persons fell off a ten story building.  Would you
    expect the insurers to set a requirement of insurance on not going on
    any roof higher than two stories?  Maybe you could live with never
    going to the top of the World Trade Center.  I couldn't.
    
    2) Ok, suppose it's ethically sound for my insurer to require some
    particular behavior like not going to the top of the World Trade
    Center.  Why not let me sign a waiver stating my responsibility if I do
    decide to go up that high.
       I rented a car in Edinburgh once.  I wasn't told I *couldn't* go into
    Northern Ireland, I was only told that if I did I would be entirely
    responsible for any damages to the car.  Sounded fair to me.
    
    
    I would be deeply touched if my insurer cared so much about *me* that I
    was *offered* coverage on any procedure to protect my health.  But only
    *I* decide when my child's life begins.  I cannot list a child as a
    dependent on my policy until *it is born*, so why act like it is being
    insured ahead of time?!  Then again, I could afford to pay for my own 
    prenatal care and delivery if I had to.  There is no freedom without 
    economic freedom.
    
    I don't believe this type of policy would be so easily mandated for any
    male-oriented condition.
    
    Nancy

    
    Okay, here's another example, real close to home.
    
    A man died in the Hudson, MA Digital facility because of an accident in
    which a breathing apparatus had been disconnected, but not labeled. The
    man was alone at the time, his "buddy" had left the room to grab
    something, and by the time the buddy returned, the man had suffocated.
    
    As a result of this one incident, the Hudson facility has a MANDATORY
    buddy policy in the lab areas. 
    
    Because a voluntary policy won't keep DEC from getting sued if someone
    else dies.
    
    So, while Digital has not removed the safety hazards that exist, it has
    MANDATED that people take precautions. And you can get fired for not
    doing so.
    
    The policy is NOT well liked. It requires that a buddy be present, when
    at many times and in many cases, it forces one person to stand idly by
    just so that an accident won't become a disaster.
    
    But there's no question about the reason. This isn't a "nicety". Its
    Digital's way of saving itself from lawsuits by saving its employees
    from injury and death. There is no doubt in my mind what the bottom
    line is.
    
    Digital does have its share of niceties. Volunteer stuff. But when you
    see something MANDATORY, its because someone has determined that the
    risk is not worth the gain, or the expense is worth avoiding the losses
    of a suit.
    
    I'm running, so this isn't coherent. But I don't think this is about
    being warm and fuzzy and protecting women. I think its about protecting
    a company's profits. Those are terms I can respect. Because they keep
    ME employed, too. 

    	Maybe the problem is that the company is for whatever reason acting
    as a parent not an employer.  Laws mandating that employers provide
    health insurance result in employers attempting to control the
    employees lives in ways that have nothing to do with an
    employer/employee relationship.  Maybe we should let employers return
    to the practice of compensating employees for services rendered, and
    let individuals take care of their own health as they feel best.  
    	I am not advocating abolishing health insurance, only having the
    premium payer and the beneficiary be the same person.  This of course
    would be very unpopular with the powers because individuals would make
    cost/benefit decisions about care, instead of taking/spending as much
    as possible in each case.  If this were done, our health care crisis
    might come to a sudden end.  We might even get better care because good
    doctors would get paid more and bad ones would go broke.  The present
    system tends to equalize the reward to all doctors regardless of
    competence, and in the case of HMOs not even give the patient a choice
    of which incompetent will treat them.
    						John
    

    I differentiate between my work life and my private life.  If the
    company in the basenote is requiring prenatal care because of a
    potential workplace hazard to the pregnant woman or fetus, I read the
    situation a little differently but still do not condone mandatory
    behavior of this type.  Here in Hudson I am allowed to *not* work in
    the wafer fab while I am pregnant (and lactating?) because of the known
    hazards.  
    
    Remember the story of mandatory sterilization for the women in a
    (battery?) factory?  Wasn't there some discussion here--Jody--can you
    help, please?
    
    Love ya, 'ren, cuz we can do this and still go for walks during lunch!
    
    Nancy  

	Hi folks,

	These companies' behaviour is really NOT about keepin'
	'em barefoot and pregnant.

	It's not about some power move to "reach into the womb"
	or any of that.  Looking at this policy through political
	lenses distorts the problem.

	The problem is the tort system today.  Any woman who gives
	birth to a child with birth defects can sue anyone or
	any entity she had contact with during the gestation period.

	Since we don't know what causes birth defects, lawyers 
	can take cases like these and use a non-objective, possibly
	uneducated jury to extract huge judgements against a
	defendant.

	So, employers who may have been the targets of suits in the
	past adopt defensive measures:  barring women from some types
	of work; insisting on company-monitored prenatal care, and
	so forth.

	My sympathy goes out to mothers of handicapped babies, but
	we reap in these defensive policies what we sow in non-objective
	law....

	Regards,

	Steve H

    
    Every human female should have a blood test at birth.  If she is found
    to be suitable for breeding, she should be kept in a pen where her
    environment and behavior can be efficiently monitored.  This would only
    be for her childbearing years, after which time she could be released
    to help care for the babies and the younger women still in the pen.
    
    The future of the species cannot be entrusted to irresponsible women.
    
    Ofnoman

    
    I've put in all the pointers I could find, folks.
    what you want is in there somewhere!
    
    -Jody
    

    
    'ren, your analogy doesn't hold up because in the Hudson
    plant's case, the requirement is part of the *job*.  I do
    believe it's an employer's right to require a job being
    done in a certain way.  I might not like it, but I wouldn't
    feel like it was *wrong* for Digital to insist on it.
    This doesn't extend as well to a woman's personal life and
    that of her baby.  I *would* be upset if I had to take
    mandatory prenatal classes.  And that's just the way I feel.
    

    re .30, funny. :-)
    
    Lorna
    

    
    Ellen, I am comfortable with my analogy because I'm not very defensive
    about my "private time". If you don't like that example, consider the
    seat belt laws which exist in nearly every state. Its the same issue.
    
    There was an amusing Robin Cook novel about something similar recently.
    Spoilers follow...

    
    
    In the novel, the hospital was trying to cut its losses, and had found
    that high-profile VP's with a history of smoking and eating red meat
    etc. were prone to cost the hospital more money from high-cost surgery,
    heart attacks, etc. So the hospital undertook to kill them off...
    
    I can only re-iterate, with privilege comes responsibility. And vice
    versa. When you give the responsibility for your well-being to someone
    else, they should have some privileges in your life. And if you don't
    welcome such an invasion of privacy, then you shouldn't hold them
    responsible for your care.
    
    When we ask a corporation to underwrite our health costs, and they turn
    around and ask us to act in a healthy, responsible manner, it seems
    quite fair to me. On the job or off the job.
    
    What is most amusing to me is that I would predict that many insurance
    companies and actuarians will keep an eye on this company. And if the
    cost-benefit ratio is good enough, this isolated incident may spread
    easily.
    
    I'm rambling... and the more I think about it, the more I realize that
    my opinion is going to be a minority one here. So, I will try to bow
    out gracefully...
    

    There are  a  few  seperable  arguments  here.  Perhaps  the  most
    pervasive  is  "Does  society have a right to limit the risks that
    individuals can take?". Closely related is the question of whether
    an  individual  can  accept  the  responsibility for taking a risk
    which  society  feels is inappropriate. Many people argue for this
    ability  to  accept  responsibility,  but  nobody  actually  fully
    accepts those risks because we are unwilling to watch someone die,
    even if he is dieing of a risk which he voluntarily assumed.

    We are  even  less  willing to allow children to suffer when their
    parents take a risk. (I'm talking here about visible children with
    serious,  catastrophic  problems.  Allowing  people  to  starve is
    apparently  quite different.) Given this societal behaviour, it is
    meaningless  for  someone  to  say "I'll do this even if I lose my
    health  insurance.",  because  if someone says that, and gets hurt
    we  will insist that a hospital treat that person. For proof, look
    at  the  tremendous bad press insurers get when they try to refuse
    treatment, even when that refusal is within their contract.

    The next  issue  is  whether  we accept requirments for our health
    care,  and  we  clearly  do.  Most  insurers won't pay for any but
    emergency  surgery unless the patient submits to an examination by
    another  doctor  (second  opinion). What is different here is that
    the requirement be enforced by an employer.

    Sandy's questions  about  discrimination  are interesting, but the
    problem  is  that pre-natal care is one of the most cost-effective
    kinds  of preventive medicine. Underweight babies are tremendously
    expensive  to  care  for. Routine examinations of men are not very
    useful,  as  there  are very few diseases which they are likely to
    catch.  Routine  exams  for women make sense for breast cancer and
    cervical  cancer.  (This despite the claims that far more money is
    spent  on men's diseases than women's. It is the case that most of
    the  diseases  which  can  be caught by periodic exams are women's
    diseases.)

    Her point makes sense in a more global view, if one can claim that
    while each instance of different rules for women is defensible (as
    I  believe  this rule is), the fact that whenever the rules differ
    they are more demanding of women points to discrimination. This is
    the argument for statistical evidence.

--David

    Sorry, Jody--should have read bach thru first.
    
    re: .35 >>Underweight babies are tremendously expensive to care for.<<
        It deeply saddens me that underweight babies are considered a
    commodity on which we have to affix a cost.  (Nothing personal,
    David 8-) )   More of our objectification of women and children....  
    Guess I'd feel a whole lot better about all this if I thought the 
    company was trying to ensure the health of mothers and babies on a
    caring basis first rather than a financial one. 
    
    There seems to be a myth that we don't pay for our (company- 
    provided) insurance.  Sure it's a cost to the employer, but I'd 
    take a rebate over mandatory prenatal care any day.
    
    Education would be the best preventive medicine.  Maybe we need to
    benchmark against countries which have better infant mortality rates. 
    (Ours is not as low as one would expect, compared to other
    industrialized nations.)  Anyone know how we compare on birth weights? 
    
    Seems to me I got thru public school without any mandatory anatomy and 
    physiology or reproductive biology.  There was the term paper I did in 
    10th grade bio on various forms of birth control, my way of educating 
    myself, but I was too embarassed to leave it on my desk with the title 
    page up.  That sort of thing wasn't discussed openly in the 'burbs in 
    the early 70's.  I remember seeing a public service announcenent on 
    television or a bus stop or something in the last year urging women to 
    get prenatal care.  It was phrased in real-life language--very effective. 
    
    Nancy
    reactionary_at_large

    re.36 I don't think the implication was that 'babies are a
    commodity'. It's a simple observation of the fact that resources 
    are finite.
    

RE: .36

    I was  talking  about  costs for two reasons. First, the company's
    (public)  rationale  for the rule was costs, and second, the US is
    currently  wrestling  with limiting the total cost of health care.
    Health care was around 11% of the Gross National Product last time
    I looked, and still climbing. One way or another, that growth will
    have  to  stop.  There are a lot of efforts to control health care
    costs, some well thought out, others less so. This note started as
    a discussion of one attempt to control those costs.

    In answer  to  your  question,  the  US  has more low birth weight
    babies  than  most (any?) other industrialized nation. Considering
    the  number of underweight babies, our post-natal care is actually
    quite  good.  The US also has a remarkably high number of teen-age
    preganancies, which tend to be more difficult (for both mother and
    baby)  than  pregnancies  in  the  woman's mid- 20's. I personally
    believe that if we made contraception more available the number of
    teen-age  pregnancies  would  go  down,  and  that would be a good
    thing, but our politicians disagree.

    As for  health  coverage, the US is the only industrialized nation
    which  does  not  have  some  form of universal health care (often
    referred  to  as  Socialized Medicine, but the German system isn't
    all   that   socialized.)  I  would  argue  that  this  is  mainly
    responsible  for our very expensive health care which leaves large
    numbers of people without health care.

    I don't  know  of any countries in which individuals are primarily
    responsible  for  their  health  care  costs  (with  or without an
    insurance  system) which have respectable health care (measured by
    infant mortality, life expectancy, or something similar.)

--David

    I think that the company's main problem is that it decided to become
    self-insured instead of using an insurance company.  That made the
    size of the group over which to spread the risk very small.  The
    company should change to using an insurance company so that the
    risk spread is much larger and therefore would not cost as much
    
    I used to work for an insurance company. 
    
    I'm very much in favor of national health.  Insurance companies have
    taken on too much power.  They should not be able to tell a doctor
    or a hospital what is required for patient care.  If a doctor decides
    a patient needs to stay in the hospital for 5 days instead of 3, then
    the insurance company should not say it won't pay!!  
    
    Linda
    

	Well, this may be closer to all of you than you may think.

	I was watching a documentary, and it was regarding a State in the US,
	I think it was Carolina.


	If you go to the state run ante-natal clinic, you are tested for
	alchohol/drug abuse.

	If any traces are found, you are asked questions of how you obtained
	the substance, and if you sold your body to obtain the substances.

	You are put on a programme to help you quit.

	If you fail to turn up at the second testing, or are found positive
	on the second testing, you are gaoled until after the birth.
	You may, or may not, get your child back, it could be taken into care.

	This is only the procedure for the state ante-natal clinics, not the
	private clinics.

	Most of the women interviewed who were detained in gaol were black, and
	I quote "from the wrong side of the tracks".

	I was absolutely dumb-struck (very unusual for me)

	If one state already does this lawfully, which ones will be next?

	Heather

    Whats "gaol"?
    
    D!

    "Jail," in English. 
    
    ;-)
    
    -b

    
    Nah - "gaol" in English, "jail" in British, and "prison" in most
    other languages...
    
    ;-)
    gaol...oops....'gail

    How is that pronounced?
    
    D!

    "gaol" is pronounced in exactly the same way as "jail" and both are
    correct in Britain. "Jail" seems to be used more often, though.
    
    Alice T.

    RATGAOL

	When you say Gaol or Jail, they sound the same (give or take an
	accent or two).

	Gaol is the correct spelling according the the Oxford English 
	dictionary, it has (jail - in US) printed after it.


	But back to the point, this isn't just a company reducing or refusing
	money for medical aid, it is people being deprived of their liberty for
	not being PC.

	How long before anyone who drings or smokes gets locked up????

	Heather

    Heather, not long.  Here in the good old land of the free, you can get
    your property seized for just looking like you might have been going to
    make a drug buy with all that cash.  Or for 'fitting a profile'.  Less
    savory motivations left to the imagination of the reader.  And so far
    the courts have upheld the practice, as it is a civil procedure, not a
    criminal one, and thus not subject to the protections enumerated by but
    not limited to the Bill of Rights.
    
    (this is about an application of the federal RICO laws.  Bad laws, they
    are too widely applied, with few-to-no safeguards or oversight.  They
    were/are bad when applied to pro-lifers too.  SOAPBOX has a fair bit on
    this topic.  Don't have the note # just now.)
    
    You don't say whether or not the pregnant women who test positive for
    drugs are offered counseling or treatment for addiction.  If not, the
    whole thing is just another net in the WoD, and on the rights of the
    individual.  If yes, then ditto since I still have much discomfort
    about the govt intervening in such a way.  These my feelings on this
    are all *before* we get to worrying about racism/sexism, though it
    seems to have those kinds of effects, even if we assume good
    intentions.  Which I'm not sure I can.
    
    Sara

    
>    You don't say whether or not the pregnant women who test positive for
>    drugs are offered counseling or treatment for addiction.  

	Opps, I thought I did, yes they were offered councelling, but it wasn't
	just drugs, it was also alcohol.

>   If not, the
>    whole thing is just another net in the WoD, and on the rights of the
>    individual.  If yes, then ditto since I still have much discomfort
>    about the govt intervening in such a way.  These my feelings on this
>    are all *before* we get to worrying about racism/sexism, though it
>    seems to have those kinds of effects, even if we assume good
>    intentions.  Which I'm not sure I can.
 
	My real shock was twofold,

	Firstly that these people were locked up for the remainder
	of the pregnancy for being tested +ve the second time, for traces of
	drugs OR alchohol - they were NOT taken to court and charged 
	with drug abuse or alcohol abuse - they had no defense opportunity. 
	NOONE tried to find their dealer - they weren't asked about who their 
	dealer was, just how they got the money to pay for it (ie prostitution).

	Secondly, that this was only for people who had to rely on the state for
	care, anyone with enough money to pay for their own care didn't get 
	tested.

	It gave me the creeps

	Heather