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Would You Do It: An ART Boycott

As I was reading the comments on this last post about trusting those bringing help to the infertility community, the same thought kept popping up: we pay what we pay in America because we are willing to accept those price tags.  People pointed out the difference in cost between those insured and those uninsured who are using ART.  People pointed out the difference in cost between those doing IVF in another country and those doing IVF in America (same technology, same drugs, very different price tags).  People pointed out the difference in price tags on an IVF cycle out of a university hospital vs. a private clinic.  Though we focused on ART, I’m fairly certain that we could ask the same questions about adoption agencies, surrogacy agencies, and donor gamete agencies.  Our price tags are where they are because the general population is willing to pay it.

Wait, willing is the wrong term.  We blog about how we make gut-wrenching decisions based on the financial side of infertility.  There are those who are not cycling or pursing other paths to parenthood due to the cost.  There are those who are using up the time that is on their side because they need to save in order to cycle, wasting the years when they perhaps would be more successful.

But here’s the question — if the only way things would change would be for everyone to stay home from the clinics, would you?

If you could know without a doubt that everyone would stay home from the clinics and refuse to treat their infertility; that the waiting rooms of clinics would become barren wastelands with tumbleweed gauze blowing under the chairs; that the doctors would all be standing daily at the front desk, drumming their fingers, waiting for anyone to step through the doors: would you do it?

What if the boycott would need to be going on for a year or more in order to effectively lower the price so it is accessible to all Americans?  Would you forgo utilizing ART (or replace that with whatever area of family building assistance you’re utilizing) for a year?  Put off family building for an entire year?  Could you wait out a year if you knew without a doubt that family building assistance would be affordable to many more people if everyone participated?

Time means something with infertility — both in the physical sense of success rates and the emotional sense of peace of heart.  What is worth more — being mindful of time but spending more than you can afford, or sacrificing some time in order to make fertility treatments affordable?  And would you be willing to sacrifice your own time in order to ensure that someone else has access to ART?

I don’t have an answer.  I’d like to believe that we’d all collectively work together towards a common goal, but I also know the emotional side of infertility and how long a year is in infertility years.  Can we really ask that of one another?  My hert tells me that we’d be asking too much.  And at the same time, can we really passionately argue that we want a change if we’re not willing to make sacrifices in order to achieve it?  Boycotts are never easy.  Evoking change is never easy.  It is scary to take a leap of faith that your efforts will be rewarded.

The whole thing is just for shit.

Knowing from historical evidence that boycotts are often an effective tool to evoke change, would you participate in an ART boycott — why or why not?

36 comments

1 Christa L Singleton { 08.15.11 at 1:20 pm }

I would, but part of me thinks that because infertility treatments are becoming the norm, that drives more clinics to open up. And the more clinics that are open, the more choices in doctors we have, which theoretically should cause competition amongst clinics. That competition should keep prices in check, because if America gets too expensive, at least we have the option of going overseas, or trying some other means to build our family such as foster care or adoption.

Now that my husband and I are moving from fertility treatments to adoption, I’ve wondered how the expiration of the adoption tax credit in 2012 will affect adoption rates, and the rate of fertility treatments as well. Was the increase in the adoption tax credit the cause for the increase the price of adoption? And when people go back to getting only $5k in adoption credits instead of the $13K they get this year, will IVF become the more affordable option? Or will neither be an option anymore?

2 April { 08.15.11 at 1:36 pm }

Since it’s been a year since I’ve been able to actively pursue treatments because of the need for surgery at some point in time, I think I could go another year of waiting, but at the same time I keep watching the months tick by for me and wonder if all the waiting will destroy my chances and if by waiting longer I’ll be giving up my own dream of motherhood.

3 Cathy { 08.15.11 at 1:55 pm }

I would not participate in such a boycott, no. For me, dealing with my infertility is part of dealing with my larger long-term health issues. (Stage IV endo, “aggressive and severe” – i.e. it likes to eat through organ walls.) I don’t have a year to dick around with it, even if it would help other couples. I already came to a now-or-never point twice, and it’s a scary place to be.

Moreover? I don’t think it would work. I think the costs are in line with the cost of other medical care. And while I think the costs are insane across the board, unless we’re going to boycott all healthcare, it’s not going to have the desired effect. If your clinic is not making money, your RE can just as easily go be an OB or gyn surgeon. They’re not going to sit there for a year making no income out of the goodness of their hearts, and lower costs to be compassionate. Some might, but what I think we’d see is less availability which would lead to higher costs – not lower – because of supply and demand.

Minus the drugs (which the REs aren’t making money off of), each of my IVF cycles cost $6-8K for the monitoring, bloodwork, retrieval, and transfer. FETs were less. Compared to other medical procedures? Quite reasonable! For a 10 minute procedure in IR for my son, our insurance was shelling out $15K, minimally 4 times a year. Then there were the 4 times a year specialist visits ($600 ish for 15 minutes), the consults to other specialists, the other tests and procedures. (Very thankful for good insurance!) Healthcare ITSELF is expensive, it’s not unique to ART. I think the perception of it being so outrageous is because it’s one of the few branches of healthcare in this country that is largely self-pay.

So no, I don’t really think the costs are out of line with the rest of the medical costs in this country – and I think instead of driving prices down, we’d see clinics shut down as the REs went to more lucrative fields that they already have the training to do anyways.

4 Mo { 08.15.11 at 1:55 pm }

I think a boycott is not really a healthy option for exactly the reasons you stated. Our biological clock is ticking. Time matters in IF. In Israel, IVF is completely covered by universal health care. This is, I think partially because of the whole “be fruitful and multiply” commandment, and a strong belief in socialized medicine. I think that if anything, a movement toward a socialized medical system which assists in covering ART is a far more practical option. There are a lot of reasons for Americans to protest these days, this one seems like just as strong a point. I’m sure the IF community is a strong enough “voter base” to make a difference. Just my two cents.

5 Sarah { 08.15.11 at 2:08 pm }

I would like to say I would wait, but it would have been so difficult when we were in the throws of infertility. Now it seems doable, but then… I would have been hard. I remember when there was the question of getting short term disibility at my work, but to get maternity leave there was a waiting period. We were going to have to take like 2-3 months off of trying. And we waited, but it was SO PAINFUL. It felt like time lost, adn with endometriosis, time really is important.

But at the same time, the money is the sole reason we are no longer pursuing baby #2. It hurts, knowing someone out there set this price point and at this point we have been priced out. It is all so unfair.

6 It Is What It Is { 08.15.11 at 2:29 pm }

To the commenter who said the costs are for IVF are in line with other medical care she is sadly mistaken. “Other” medical care, especially that required covered by insurance is nowhere near the average cost of ART. So, it might be in line with say other elective, out of pocket treatment like cosmetic surgery, but I can get my breasts augmented at 1/2 the price of the average IVF. Furthermore, advent of IVF-cations to foreign countries magnifies just how out of whack the prices in this country (for ART and many medical procedures (chemotherapy, heart surgery, donor organ transplants, etc) are.

So, while I am not actively pursuing treatment in longer and am not sure that a boycott would work, I would for sure spend my time in protest that infertility is not a widely accepted medical malady requiring insurance coverage. With 1:8 American couples suffering from some form of infertility, it is shameful that we do not see infertility for what it is, a medical condition, and require insurance companies to provide real coverage.

I am ready to march, picket, or protest.

7 Meredith { 08.15.11 at 2:41 pm }

I love this thought-provoking post. I like the idea of strength in numbers, e.g. the group boycott. On a different note, I wonder if a group could also possibly go abroad during that period of time for treatments and rent a house or big block of rooms together. I can’t imagine going at it alone.

8 Kami { 08.15.11 at 2:51 pm }

I don’t know that I would have. Although if I really saw a concerted effort of all those involved – making it much more likely to succeed I have no doubt I would have joined in. (I use the past tense because I have the family I was hoping to have). The problem is that it would be difficult if not impossible to get that critical mass.

When I read the article about that lawyer, my first thought was “This isn’t that much different to what is going on now.” Yes, what she was doing was illegal. Yes, it was not all above board.

BUT

We are selling children and gametes now – as long as someone makes a profit by ‘donating’ their gametes or arranging adoptions or practicing ART. The problem is that there is a desperation to become parents making the profits sufficiently acceptable to pay those amounts.

Further, I don’t know what the solution is. If calling it egg ‘donation’ when thousands of dollars for a couple of weeks inconvenience is involved, allows me to become a mom in the next best way, then I am all for it.

9 Alexis { 08.15.11 at 3:09 pm }

I also don’t think it would be effective. IVF is cheaper in other countries for two reasons: one, meds are cheaper (and this is true across the board, not just for IVF; the US market is pure profit and R&D cost recuperation), and two, their staff make less money. Of course, their MDs don’t have $200K in loans to repay plus accumulated interest from deferring those loans through residency and fellowship. If reproductive endocrinology became less profitable, fewer people would enter the field and costs would not drop. It would find its own best level.

I’m not sure overseas IVF is really the answer. When you add in travel costs, not to mention time and lost income, the gap starts narrowing. I know someone who went and did it in Israel; she said it only worked financially because she had relatives to stay with. Health tourism introduces its own set of problems that I’m not entirely comfortable with, and while it may benefit my pocket in the short term, it does nothing to affect the factors underlying high costs in the US. Our system has high fixed costs that drive up prices, and trying to drive those prices down has had negative consequences as well as positive: a shortage of primary care physicians, a flight to lucrative specialties that don’t rely on insurance payments, and increasing numbers of doctors that don’t take insurance.

Also, insurers negotiate a better price for all procedures rthan we do on our own; ART is no different. My RE billed BCBS $400 per pelvic u/s. BCBS paid $130. I don’t know what price they would have come to if I had been fully self pay. (My insurance does not cover ART procedures, but pays for diagnosis, monitoring, and meds.)

I had my first in the UK, and while I didn’t need to go to ART for that one, private prices seemed close to the US. NHS funded IVF is very hard to access.

I think we’d have a better shot of controlling out of pocket costs by pushing for more insurance coverage. Even if we pay a cost share, we’re paying a percentage of their negotiated rate, not the sticker price.

10 Cathy { 08.15.11 at 3:39 pm }

It is what it is –

Oh I think it’s something that should be covered by insurance, surely, on that we can agree. Mine actually is, because live in a mandated state (though I still had to fight my ass off for them to recognize it).

But that means I see the prices of ART compared to the prices of all kinds of other medical procedures. They’re not differentiated in my mind or on our statements. And sheer prices are just not out of line with other medical care. Does it cost more out of pocket because it’s not covered by insurance? Yes. But that does not mean it costs more than other medical procedures.

I could do 2 IVF cycles for the cost it takes to replace one gj feeding tube (which needs to be done every 3 months).

The cost of feeding tube supplies (my son is tube fed) is as much per month as my under-responsive ovaries require in meds for an IVF cycle.

Office visits – the pediatrician is almost as much is the RE who is only 2/3 as much as a pediatric GI, who is 3/4 as much as neurosurgery.

The cost of ultrasound at the RE is not more than the cost of a similar ultrasound at gyn. Same with bloodwork all around.

Etc, etc, etc. (This is at least true in the doctors we see, the hospitals we go to.)

So while it may cost more without insurance – it’s not costing more than OTHER procedures would without insurance. You can’t compare it to the costs in other countries and say it’s out of line with “what it costs” . It’s in line with a lot of other healthcare costs within THIS country, within THIS medical system. The jacked costs are not peculiar to ART.

We can either treat it as a medical issue, fight for insurance coverage for it, and accept that the prices are in line with other medical procedures in the US (and then worry about lowering healthcare costs across the board) OR treat it as a lifestyle choice and let supply and demand dictate the cost (along the lines of elective cosmetic surgery). It can’t go both ways.

11 JessPond { 08.15.11 at 3:56 pm }

I agree with Cathy….my husband had gallbladder surgery at the start of the year…around 10k. Ended up needing a hosp stay and a scope, which was around 15k for a couple days and the scope. I had a baby, and the hospital bill was around 9k (vaginal delivery, no epi, no complications). Our daughter’s (very short and uncomplicated) NICU stay back in 07? Around 40k.

Of course these things were covered by insurance. However, negotiated insurance price was actually quite in line with an IVF cycle being around 8-10k, imo. There’s a lot of monitoring, a minor surgery including anesthesiologist, and a lot of blood tests involved in an IVF cycle, kwim? Medical care is EXPENSIVE.

I also agree that a boycott wouldn’t work because RE’s would just go be ob/gyn’s. There’s always going to be a baby to deliver, after all.

12 magpie { 08.15.11 at 4:00 pm }

i also don’t think a boycott would work, because the people that would be hurt financially by it – the doctors and clinics – would just go do other things.

13 Jamie { 08.15.11 at 5:19 pm }

No, I would not. Unless you go to certain practices (CCRM), you can have a top-notch IVF experience for $10K. That was the price I paid last year for all monitoring, ICSI, transfer, etc. I now have a beautiful daughter and two frozen blasts out of the experience, at age 39 no less! $10K does not sound out of line to me; my husband recently had some of his soft palate and tonsils removed (an easy outpatient procedure) and that cost almost $9K (we have high-deductible insurance, and that was WITH insurance discounts). The competition among the clinics actually keeps costs fairly low, and there are places that charge even less than what I paid, such as Cooper in New Jersey.

14 Sushigirl { 08.15.11 at 5:42 pm }

I’m not sure if it would work for lots of reasons. I’m not sure how elastic IVF pricing is – I imagine a lot of the drugs, research and so on will have a price that isn’t much affected by demand. But I don’t know for sure.

Anyway, rather than a boycott, wouldn’t it be better to go and do your treatment in another country? That gets round the emotional and time cost but would have the same effect on targeting suppliers in the US. And it might be cheaper too.

15 Sushigirl { 08.15.11 at 5:44 pm }

Or maybe we need to organise IVF on Groupon? Clinics could throw in a free bottle of wine and a fish pedicure. 😉

16 Marissa { 08.15.11 at 6:03 pm }

Absolutely not. Time is of the essence, for both biological reasons (and I say this as someone who began IVF at 30) and for emotional reasons. I’m sorry, but IVF/ICSI is our only path to biological children, and there’s no way in hell I’d give that up for a whole year in hopes that it would be cheaper.

Family building is not imported Thai goods, it’s not the choice to shop at Walmart or somewhere else. I’m not going to boycott my only option. Especially when, for many of us, it’s not a in-and-out thing. I began doing IVF in September of last year. I dealt with cysts, cancelled cycles, bad reactions to Lupron, miscarriage, etc. I mean, from the time I laid down my $8,000 to the time of my first egg retrieval was 5 months. And now, almost a year later, I am still in my first trimester, unsure if I’ll be getting children out of this, to be honest, or not.

It’s a nice idea, but I don’t think supply-and-demand should have a role in healthcare, and I’m sure not going to propagate that notion by acting like IVF is something I want, but at a lower price, and if I can’t get it that way, I’ll just go without. As opposed to the way i feel, which is that I need children, IVF is the best way for me to get them, and I will take on every loan, climb every mountain, do everything possible, to get it.

17 StacieT { 08.15.11 at 6:48 pm }

The short answer is that I would NOT agree to a boycott, mainly because I think a boycott would have the undesired effect of driving out talented and respected REs to other specialties. For the most part, I believe the fact that so many of us ARE paying out of pocket is making the REs become more competitive for our dollars. We research. We expect service. We expect (and hope for with all we’ve got) success. A clinic that charges too much (which is relative, I know), or fails to provide adequate services or results will simply not get as much business.

I paid out of pocket for all 5 of my IVF’s/meds and 2.5 FETs. Did I pay more than I wanted to? Hell yes. Frankly, I can’t even tell you how much we paid in total because I think the number would make me sick. Do I believe with all my heart that IF treatments should be covered by insurance? Hell yes.

That said, did I think that the services I received were overpriced? No.

I agree that the price of IVF is comparable to other medical procedures…less than, in our case, other many procedures we’ve had.

How can I say I overpaid for my infertility when my RE worked harder for me as his patient than nearly any other doctor I’ve had? He wasn’t doing it just for the money. If he was, he’d certainly be in a specialty that allowed him to work less/more predictable hours.

18 Chickenpig { 08.15.11 at 7:02 pm }

There is no reason why it should cost this much. The retrieval of eggs and the transfer of embryos can be, and is, done by vet techs. It is easier than pulling wisdom teeth, for crying out loud. In many countries these procedures are already done by nurses. As more and more of these procedures are done, the actual cost of doing them goes down rapidly, but that savings isn’t passed on to the consumer here in the US.

I would do a boycott, sure, for one year. I had to take a year off for surgery. If I could wait a year for that I could wait to make the prices fair.

19 T_Lee { 08.15.11 at 7:10 pm }

Right now, at this moment in time, yes, I would definitely boycott for a year if need be. But, I could completely understand why many would not. I’m 27… I (sort of) do have the ‘time to wait.’ If you were to ask me again in 10 years, then my reaction would probably be much more visceral and emotional…

20 BigP's Heather { 08.15.11 at 7:17 pm }

If I KNEW it would bring change – absolutely. I sat out almost this entire year. I know how bad it sucks to want to be cycling and not be able to.

But, if I am being completely honest, it would be hard – REAL HARD – for me to sit out ANOTHER year. When this year is up and BigP is done with his training program at work and we can cycle, to sit out another year would be excruciatingly hard. I could only do it if I absolutely knew it would bring change. We have sat out too many cycles due to cost in the past.

21 Geochick { 08.15.11 at 7:45 pm }

Interesting thoughts. By the time we were doing treatments and deciding on alternatives, it felt too late to me. As much as I agree with the outrageous fees for things like IVF, fertility drugs and IUI’s (hello, the doctor doesn’t even see you, the visit is less than one hour, a centrifuge takes care of the sperm yet it costs around $1,000 a pop?) I don’t think we could have put anything off another year. The reality is, the fertility industry has you by the short and curlies and they know it. (Adoption industry as well. Adoptions should not cost $40,000+ yet I’ve heard of many that do)

22 a { 08.15.11 at 8:06 pm }

A boycott in this area would not work because, as Cathy said, there are some people who can’t wait and the doctors’ training is easily assimilated into other specialties. I looked at my costs, and some of my expenses were due to places refusing to take my insurance (resulting in going outside my preferred practitioners, and therefore activating my deductible rather than a copay), drugs that were not on my formulary list, and unusual blood tests. Everything else had a code and a negotiated price. A complete overhaul of the medical/pharmalogical system might help, but otherwise, I think the market is the market. It’s unfortunate that infertile people must pay for something that others can do for free. It’s unfortunate that prices around the world do not compare (I guess that’s the price we pay for our relatively cheap gas?).

I don’t think we’re really accepting of the price tag. I think that we’ve gotten used to being in a society where the price is not negotiable for the average joe. When someone quotes us a price, we tend to just pay it. Maybe people should start negotiating for lower prices – I’d be interested to see what would happen. I believe that some of these doctors are in it for the win rather than for the profit margin, and they might be willing to work on a sliding scale.

23 Natalie { 08.15.11 at 8:21 pm }

In an ideal world, waiting seems like a good option. But the cynic in me says, if I wait and loose that year, will other people really wait too? There are plenty of people out there that have more money at their disposal than I do. Unless you are going to convince them to wait too, I would just be throwing a year away for nothing. And with my clock ticking and not knowing how many treatments it might take, asking people to wait would be asking too much. Also, as another poster already mentioned, the costs my insurance gets billed for my other medical needs (outside of IF) is pretty comparable to the costs I pay for my treatments. It is jut the no insurance thing that makes the price seem so high. I would rather spend my time lobbying for socialized health care with ART coverage than try and force doctors to lower their individual prices.

24 Angela { 08.15.11 at 8:52 pm }

Where I live, there is funding for two free IVF cycles for people who qualify. Insurance in our country almost never covers infertility – so unless you get the state-funded rounds, you’re paying all the way.

The thing with the state-funded option, though, is that the waiting lists are quite long. We’re currently about 6 months into what will be over a year long wait. And yes, I can say that a year DOES feel hard: at 35, I’m definitely feeling clock ticking, and I do have days where I wonder if we’re doing the right thing. That said, some enforced time out from the testing/treatment treadmill has probably been good for me in some ways.

We didn’t take the decision to wait a year lightly. Time is obviously of the essence, but the $8k we’ll hopefully save (if it works!) is a big consideration too. While the system here is a little different to in the US, the feeling of being at the mercy of the medical machine is pretty much the same.

25 mash { 08.16.11 at 5:55 am }

I realised yesterday that I exaggerated somewhat, but the point is still valid. At today’s exchange rates a full IVF usually costs between $4600 and $5500 in South Africa. A cancelled cycle at some clinics is cheaper, then you would pay around $2000. A government hospital here will offer a full IVF at $1700 (subsidised obviously) and that’s in a third world country. So not quite TEN times higher than in the States, but substantially higher (my understanding is that you guys pay around $15,000 for a cycle).

In economics, one of the most interesting things I learned was about the elasticity of demand curves, meaning the sale of some products depends more heavily on pricing than others (like narcotics, cigarrettes and alcohol which you could charge just about anything for and you would still have buyers).

Unfortunately I think that ART would fall in the “inelastic” category, something that people are prepared to pay for no matter what the charge. Generally, inelastic demand curves tend to get targetted by government for price fixing or really high taxes, because of the potential for exploitation.

And that would really be the only solution I think. Government intervention… and everyone loves THAT!

26 mash { 08.16.11 at 5:58 am }

And PS – yes, medical tourism in this country is common, people come here for plastic surgery, IVF, etc.

27 loribeth { 08.16.11 at 9:47 am }

Coincidentally, the Toronto Star published an opinion piece by one of its columnists yesterday, advocating government funding of IVF in Ontario. Predictably, the comments have been less than kind. :p

http://www.thestar.com/opinion/editorialopinion/article/1039328–a-healthy-choice-funding-in-vitro-fertilization#article

I’m not sure a boycott would work, even if you could get everyone to agree to it (which I highly doubt — waiting a year would be just too long for too many people). I’ve read about shortages of ob-gyns & midwifes to deliver babies, and many REs or fertility specialists (who are already ob-gyns) could simply go back to doing that.

We are a culture of instant gratification. We’ve all become very used to getting what we want, when we want it — which is one of the hardest things for us to learn to accept in this whole process — that sometimes, that’s just not possible (and sometimes, even when you wait, you don’t get your wish).

28 Sharon { 08.16.11 at 11:51 am }

Having married and started TTC at age 37, time was of the essence for us from the beginning. I chafed at every delay. Maybe it’s selfish, but I would not have agreed to boycott ART. First, I don’t think it would make a difference, and second, I didn’t want to wait longer than I already had to become a parent.

29 katedaphne { 08.16.11 at 11:52 am }

No, I wouldn’t participate or condone such a boycott. After years of treatments and almost $90,000 in debt before finally having my girls — I am bitter about the money. But I am REALLY BITTER and also just plain sad about the years of our lives that were lost. I love having my girls; I just wish I had them five years ago. Money isn’t meaningless, and the financial consequences of ART will negatively affect my husband and me for the rest of our lives. But time is more important. You can never get lost time back again.

There has to be another way.

30 Deborah { 08.16.11 at 11:54 am }

Fertility clinics, adoption agencies and the like do not operate on medical need, but emotional need. I happen to believe that many clincs overcharge, because they can. The demand is there and when it comes to price, many, if able to do so, will get a second mortgage, borrow from relatives or give up the newer house or car if it means bringing home a baby. Fertility clinics are a business and a very profitable one at that. My company provided materials for the construction of a new fertility clinic and I ran the credit info for this clinic, umm…it’s a very profitable business. Now for the side where I tick people off., which I tend to do. The underlying causes of infertility in my opinion are medically based and should be covered under insurance and from what I know usually are, in my case, they were. However, there is no medical need to get pregnant and I don’t feel that it should be covered under medical insurance and quite frankly have no problem with fertility clinics operating to make money. I wanted to be a mother and as expensive as it was, I could have lived without being one, if I couldn’t afford it. Is it fair, no, it’s not fair that some can become mothers quickly and practically for nothing, but I and many others know, life is not fair.

31 Cate { 08.16.11 at 12:29 pm }

I want to say yes, but the answer probably would have been no. (It’s no longer relevant since we decided to adopt, but our last cycle was in June so I think I can still chime in here!). But the truth is that it’s the WAITING that kills/killed me about the whole process. The waiting and that darn ticking biological clock! You want to say that a year won’t make a difference in your eggs, but I ‘m not brave enough to take that chance.
On the other hand, the costs of ART are ridiculous. Even in NJ, so many companies are able to get out of the insurance mandate, and I am convinced that if costs were lower, more insurance carriers would be willing to chip in.

32 Alexicographer { 08.16.11 at 5:28 pm }

I’m past those days, but I don’t think I would have participated, no. And certainly not if the outcome (of the boycott, not of waiting on my infertility) was not a “slam dunk.” I so, so, so, so, so wanted to have a baby.

33 Sara { 08.16.11 at 9:53 pm }

I’m already participating in an USA ART boycott, but not by choice. Every one of my cycles has been overseas, and the next one will be also. I was living in Korea for my first 3 cycles, so it wasn’t really an IVF vacation, although I admit that the pricing of IVF in Korea was one of the reasons that I moved there in the first place. I did travel there for one cycle last year, and the total cost including travel was about $5000. We stayed with friends, so if you didn’t know anyone, you’d have to add about $1400 for hotels. It’s an expensive PITA to have to travel and spend my vacation time cycling, rather than visiting a clinic in my home state, but they’ve priced me out. I don’t think I’d join a boycott if I was planning to pursue treatment in the US, though. First, because of the ticking clock problem, and second, because if I could afford ART in the US in the first place, then I probably wouldn’t perceive the cost of ART to be a crisis in the way that I do being unable to afford it.

I don’t really think that this is the right question, though, Mel. People don’t sit out cancer treatment to get lower prices and nobody would ask them to. Consumer protection agencies, governments, and insurance companies step in when pricing gets out of hand for treating diseases that are perceived as diseases, not lifestyle choices. The problem is that IF treatment is perceived as a luxury, not by the consumers (who KNOW that it’s a necessity for some of us) but by everyone else.

Regarding the comparability of pricing of IVF and other treatments, it is true that health care costs in the US are absurd in general, but insurance companies have managed to negotiate much more reasonable prices for treatments that they pay for (thus demonstrating that doctors don’t just quit if you pay them less), but since IVF is sold to one patient at a time, there is little incentive to lower the price. I do kind of wonder what would happen if a group of us self-pay patients tried to negotiate for a lower group rate at the RE. It’s possible that they are more flexible than they seem, but few of us dare to ask.

I’m kind of amazed at some of the prices that people are quoting for their cycles. Every clinic within a several-hour drive of either of the places n the US that I’ve lived in while struggling with IF has had MUCH higher prices.

34 Sara { 08.16.11 at 10:17 pm }

Just looking at my previous post, and realizing that despite being very long, parts were unclear. What I meant by “if I could afford ART in the US in the first place, then I probably wouldn’t perceive the cost of ART to be a crisis in the way that I do being unable to afford it” was that there is a difference between being in a situation where you are upset that you have to choose to defer buying a new car in order to do IVF and being in a situation where you cannot realistically save enough money to use ART at US prices before your eggs expire. The people who are in a position to choose to boycott ART are those for whom the financial cost may be painful, but is bearable. So, a boycott would be asking for people to make a HUGE personal sacrifice to help people who are not in their same situation, and I just meant that it’s all very well and good to say that if I was on the other side, I’d want to stick up for people who can’t afford treatment, but realistically, I don’t think that’s human nature, and I just don’t see how many people throwing away precious time and opportunities could possibly be a good thing.

35 Trinity { 08.18.11 at 1:42 am }

I want to say that I would participate in a year long boycott. I want to want to believe that it would make some kind of difference. But the cynic in me is a loudmouth, man. I was fortunate to conceive with my first IVF cycle. Maybe I would participate in such a boycott now, but, if I’m being honest, I don’t know that I would want to (nor would I expect anyone else to) who was trying to conceive their first child. I totally get that the personal is political, and the political is personal, but this is someone’s life. Their family. You just can’t dick around with that kind of dream. There’s no easy answer.

I much prefer Meredith’s idea of getting a bunch of IFers together and making a giant trip for ART elsewhere. Boycotting the high US costs here, taking our limited funds elsewhere, and making a statement that way. It could be the best of both worlds–a boycott while pursuing your family building goals.

36 Battynurse { 09.01.11 at 4:18 am }

I have to say for myself, that yes I would. Mostly because as it sits right now the only way I will ever cycle again is if I marry someone wealthy enough to afford it (yeah right) or go somewhere out of the US.

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