Monday, May 10, 2010

In which I decide I've been a hypocrital ass

I work in health policy. My paid hours are spent thinking about how to improve Oregon's and the U.S. health care system. How to improve quality, expand coverage and yes, lower costs. From that perspective, I have always thought that it made good public policy that insurance does not cover invitro fertilization. It is expensive and for many people with infertility, a last ditch effort for which cheaper and less invasive treatments can be substituted. Adding it as a covered benefit in health insurance, even if it was only used by a few members, would increase premiums for all members. I have held this view even as I went through a round of IVF in 2004 and four rounds in 2007-08. I knew that Chris and I were lucky to have family support (both financial and emotional) as we went through this process, but I did not think much about what this process is like for people who can only afford one $20,000 attempt, or who can not afford it at all.

And then I watched this, by Hannah Wept, Sarah Laughed:

What IF? A Portrait of Infertility from Keiko Zoll on Vimeo.

And I cried. I cried not just because I could relate to the "What IFs" raised in this moving piece, but also because unlike many women in my situation, I never had to worry about whether we could afford to try, or when one round failed, to try again. My family is wonderful and supportive. They are also financially able to help us pay for the multiple rounds of IVF we needed to build our family. I know that not everyone is that lucky, but it wasn't until I watched this video that I really felt the fear that many women go through when facing the knowledge that they have only one very expensive but iffy shot at getting pregnant.

I am sure my mom is reading this and feeling disappointed in me (hi Mom!), but this video changed my mind about insurance funding for IVF. In many European countries, insurance coverage for IVF is paired with limits on the number of embryos that can be transferred. Our last IVF involved the transfer of three embryos and I know that a one-embryo rule could have meant that I didn't get pregnant at all. But from where I sit now, with a complete family that is more than I could have asked for, I think it would be a fair trade to have financial assistance paired with embryo-transfer limits. I got the help I needed. It pains me that money can be the difference between building a family through IVF and not being able to do that.

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