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Bitch of the Day

Jill

My school insurance didn’t cover Gardasil, the HPV vaccine. So I waited until I got a job, found a new doctor and started on private insurance. The new doc is great, and she gave me a Gardasil prescription on my first visit, saying that I have to get it filled at the pharmacy but that insurance should cover it. I’m supposed to go back today and get the first round.

I went to get it filled yesterday. Turns out my insurance doesn’t cover “injectables.” I don’t really have an extra $600 to spend on a vaccine right now (it’s $200 per shot, and it’s a three-round vaccine), but I think I’m going to have to just suck it up and do it anyway. What’s another $600 when I already have $200,000 in student loan debt, right?

The U.S. health care system sucks.

81 thoughts on Bitch of the Day

  1. Why should anyone but the person engaging in risky behavior pay for the costs of that behavior?

    I could understand if it were, say, the flu, and could be transmitted inadvertently and constitutes a true public problem.

    But it seems like people who willingly engage in activities should alone bear the costs for them.

  2. Because that’s how our health care system is supposed to work.

    Do you think insurance shouldn’t cover birth control? Viagra? STD treatment? HIV meds? Vasectomies? Painkillers if you caused the injury yourself through “risky behavior” (like driving a car)? Treatment for diabetes or high blood pressure if your doctor concludes that poor diet was a primary cause?

    A whole lot of our health care costs center around reactions to “risky behavior,” whether it’s emergency care for accidents or treatment for conditions exacerbated by poor diet and exercise (often caused by lack of access to healthy foods and leisure time). Preventative care is key, but we don’t seem too interested in providing that for patients.

    Funny how this argument only gets trotted out when it comes to medications related to sex. And only when those medications are being given to women.

  3. Well, let’s start with because she pays for insurance and it wouldn’t kill them to actually cover something she needs and second of all because gardasil has fuck all to do with risky behavior. I’ve been married to the same person for 7 years and I got the gardasil vaccine last year because you never know what can happen and all women should be protected against cervical cancer as much as possible. Oh and my insurance covered all but a co-pay for all three visits (mine ended up being 75.00 overall for the shots) so clearly this isn’t an across the board policy, meaning she is at the mercy of her personal insurance plan of which she probably didn’t have much choice in selecting thus indicating a much larger problem with health care in general. What is it with the recent flux of asshole comments lately?

  4. What Julie said.

    I mean, for fuck’s sake. I don’t know what’s going on here lately, but I’m getting really fucking tired of people showing up in the first comment to whatever post I write with something obnoxious and negative to say — whether it’s calling me a bad feminist for liking Gossip Girl, or subtly slut-shaming me for wishing my insurance (which I pay for) would cover a vaccine that could prevent me from getting cancer.

    Where are you people coming from? And if you’re going to be complete dickbags, could you please consider leaving?

  5. Hmmm sez: “Why should anyone but the person engaging in risky behavior pay for the costs of that behavior?”

    Then why should insurance pay for Viagra and other ED meds? Since they only enable men to engage in risky behavior.

    Free love should be as low a risk activity as anything else. When I went looking for a name for my blog I chose “womanrebel” because that was the name of Margaret Sanger’s paper. Now along with being an advocate for birth control Margaret Sanger was a free thinker and a feminist.

    Some of us think sexual freedom is a part of feminism and that the right to say “yes” and mean it is as important as the right to say “no” and mean it.

    That is control over our own bodi8es and we don’t feel a need to be dictated to by some misogynistic creepy Christofascist agents of the patriarchy.

  6. Well, maybe because “health insurance” is supposed to cover things like this? Because they’re related to, um, health? And because just having sex doesn’t automatically qualify as risky behavior, and because preventative medicine is in general a positive step? My insurance included no co-pay at the dentist’s office for check-ups and cleanings because they realized that proper care ahead of time meant it would be less likely they’d have to pay for an expensive procedure later. I don’t see how this is much different. …Oh and I hope next time you, for example, cut yourself on a kitchen knife while slicing onions, the hospital tells you you have to pay full cost for your stitches, because you engaged in “risky behavior”. Hey you alone made the choice to slice the onion, why should anyone else have to pay for your stupidity?

  7. Clearly Hmmm is great opposed to car insurance. And home owner’s insurance. I mean, if people want to take the risk of driving a car and owning a home, it’s sure as hell not the insurance company’s job to pay for any negative results that may come of that, even if that’s exactly what you’re paying the insurance company for!

  9. Sorry, I thought she said her insurance did cover it and she was complaining that she had to get it through insurance or something. I misread the post sorry!

  10. Why do you feel entitled to have other people pay for something you want? Exactly who’s responsibility is it to pay for this if not your own?

    And I’m not sure why this means that health care “sucks.” The vaccine you desire is readily available. You just don’t particularly want to pay for it.

  11. Well, CTD, because it’s a pretty important preventative health care tool, AND BECAUSE I FUCKING PAY FOR INSURANCE FOR THIS EXACT REASON.

  12. Why do you feel entitled to have other people pay for something you want? Exactly who’s responsibility is it to pay for this if not your own?

    And I’m not sure why this means that health care “sucks.” The vaccine you desire is readily available. You just don’t particularly want to pay for it.

    I don’t think she’s saying that, she’s just complaining that insurance doesn’t cover it (which is weird). She’s not saying taxpayers should subsidize it.

  14. It’s interesting that your doc had you get Gardasil from a pharmacy. Why wouldn’t your doc give it to you in the office like any other vaccination? Would there be a difference in insurance coverage, then?

  16. Is your doctor on your side?

    Could you tell your doctor about a fictitious boyfriend “who has just been diagnosed with PPV” and somehow convert this from ‘optional vaccine’ into ‘treatment,’ thus bringing it within coverage? Obviously this requires a bit of suspension of disbelief on the part of your doctor, but…

  18. “Oh look, Hmmm apologized, and CTD picked up the asshole torch within a single minute! Nice work!”

    I wasn’t trying to be a dick I just misread! It’s hard to comment on here and take Administrative Law notes at same time.

  19. Oh dear. This is why I love Canada’s social health care system. We don’t have this insane idea that people are responsible for their own diseases and therefore should ‘pay’ for them themselves. Because we believe in taking care of people, no matter what their socio-economic status is. THAT makes me damn proud to be Canadian.

    Given that, I don’t think Gardisil is covered in every province or to everyone. I know that a lot of provinces give it free to young girls.

  21. Yeah, I wonder what diabetics do.

    But then, I suppose they shouldn’t feel entitled to have someone else pay for something they want. Selfish bastards.

  22. What Cara (and others) said. “Risky behavior?” Sheesh. I suppose, “Hmmmm”, that you’ll be the first to insist that anyone with a broken bone from BMX racing, or a pulled muscle from working out, ought to be denied health insurance benefits since they knew the “risk” beforehand. Or, hey, a guy who had his nose broken because he inadvertantly got punched by some drunken asshole at a bar, since he should have known that occasionally, drunken assholes start swinging without provocation, and the only non-risky thing is to avoid bars to begin with?

    What am I missing here? Isn’t it the point of “insurance” to, hmmm, wha’wuzz ‘at? protect against risk?

    But with that said….Jill, does Gardasil give much benefit to women who have been sexually active for awhile? It seems like a big expense ($600 is about two house payments for me) for something that (I’m assuming in my case, since I’m 41) that provides less protection than condoms. But I definitely hear you on the insurance—I’m waiting for my insurance to cover it so my daughter can get it.

  23. Actually, it’s possible to get HPV from just sleeping with one person, so ‘risky’ behavior doesn’t even come into the equation. Not that it should be a factor in getting affordable access to health care anyhow, as many other people here have already highlighted – everyday life is always risky to some degree.

    Moralizing shouldn’t even come into this. It’s a chance to save lives, & that’s great. Wish it was cheaply available for all.

  24. Yeah, I wonder what diabetics do.

    You know, I hadn’t even thought about that, and my brother has Type 1 diabetes. I know that it costs my parents a small fortune already, and their insurance does cover part of it.

  25. Hmmm, thank you for apologizing, but your comment about “risky behavior” is still a little off. What OF people who get HIV? What if they don’t have insurance? Should they just be allowed to die? And besides, even if you are as careful as you can be, that carefulness does not mean you are 100% not going to get something. Condoms aren’t perfect. Just like you can get pregnant while on the pill or using a condom, you can get an STD even if you try to be as careful as possible.

    What if, for instance, you are in a monogamous relationship, and so you don’t use condoms, but one partner strays and suddenly you have an STD? Is that “risky” behavior?

    I really, really dislike when people say things like “well, they put themselves at risk!” or “They should be RESPONSIBLE!” or “They should take responsibility for their actions!” or “If you have sex, you best be prepared for the option to get pregnant, so I don’t want to hear this “accident” stuff because it’s always possible!” (You know, the typical responsibility-anti-abortion rhetoric).

    Shit happens, even if people are as careful and responsible as they can be. Or perhaps someone just makes a bad choice or decision (humans are only, well, human after all, and humans make mistakes), or maybe someone isn’t educated enough to know the options out there to BE safe.

    Honestly I think vaccinations should always be at least partially covered, insurance or no insurance, not just for the person getting the vaccine, but because vaccines can help humanity as a whole.

  26. If you want or expect your insurance to cover every possible eventuality or cost that comes up, or service you desire, then what you’re talking about isn’t insurance. It’s a health care subsidy. Insurance should be for the unexpected costs that you cannot predict. I have home insurance and auto insurance, even though I don’t expect to get t-boned in an intersection or have my house burn down.

    Your auto insurance doesn’t pay for new tires or a new oil filter, no matter how badly you might need them. That’s because they are expected, routine costs that you know will come up regularly. “Insuring” for those things isn’t insurance at all. What you, and many other people mean when they talk of insurance is a subsidy.

  27. Doesn’t cover injectables?

    How arbitrary.

    Not arbitrary at all. If the policy is not to cover “injectables”, then the insurance company is off the hook for common expenses of diabetes and children’s vaccinations, and also off the hook for more expensive “injectables” like treatment for hepatitis C, vaccinations against RSV, and Gardasil. And since most people don’t need an injection to get through the day, they probably won’t discover they are underinsured until something of this nature comes up.

    And yes, that means the U.S. healthcare system sucks!

  28. “If you have sex, you best be prepared for the option to get pregnant”

    LOL, option? Well, it is indeed an option, but I should have said “risk” instead. *finds coffee*

  29. every possible eventuality

    And therein CTD reveals hir problem—CTD isn’t haveing any sex, hus thinks that sexual activity is an outlying phenomenon, thus thinks insurance shouldnt cover anything related to this abnormal, once-in-a-lifetime, Lotto-winning experience.

  30. CTD, do you understand how health insurance works? You can purchase health insurance that only covers emergencies and things you can’t predict, but you can also get insurance that is supposed to cover regular visits and treatments. I pay for a more comprehensive insurance plan with prescription drug benefits specifically because I need my prescriptions covered. If I was only paying for emergency-care insurance, I wouldn’t be complaning.

    Is your argument now that all health insurance should only cover ER visits? Should my insurance not cover regular doctors appointments or diagnostic tests?

    Just out of curiosity, are you over the age of 18? Have you ever had a job or had private insurance coverage? Because you seem seriously ignorant as to how this all operates in real life.

  31. CTD … do you think a vaccination against HPV is just … a routine cost? It sounds like a preventative need to me. Which is what vaccines are — they help prevent you from getting “sick” later.

    Which would ultimately make medical costs cheaper — since getting sick is ultimately more expensive than not getting sick.

    Getting cancer is expensive, horrible, and a lot of the time deadly. Why would you have a problem with insurance covering a vaccine that helps prevent cancer?

    Especially considering how very EASY it is to get HPV — it’s not like you have to try to get it. It is one of the easiest “STDs” in the entire world to get, and even those who only have ONE partner get it.

  32. I have home insurance and auto insurance, even though I don’t expect to get t-boned in an intersection or have my house burn down.

    Well clearly you know it’s a risk, or you wouldn’t have it (or would be whining about being required to have it). You act as though women are in fact expecting to get cancer. No, they know it’s a possibility. Just like you know it’s a possibility that your house might burn down. Because shit happens, no matter how careful you are.

    But in any case you’re being a major pest, so as far as I’m concerned you can fuck off.

  33. But with that said….Jill, does Gardasil give much benefit to women who have been sexually active for awhile? It seems like a big expense ($600 is about two house payments for me) for something that (I’m assuming in my case, since I’m 41) that provides less protection than condoms. But I definitely hear you on the insurance—I’m waiting for my insurance to cover it so my daughter can get it.

    Yeah, Lubu, it does. It prevents (I think) 6 major strains of HPV, which make up the majority of HPVs that lead to cancer. So if you’ve been sexually active for a while, there’s a chance you have one strain, but it’s unlikely you have all 6. Gardasil can significantly decrease your risk of cancer by preventing all of them, or at least the ones you don’t have.

  34. “Insurance should be for the unexpected costs that you cannot predict. ”

    And, really, CTD? Then why does my (thankfully pretty awesome) insurance cover my regular doctor visits? My yearly visits to the gyno, for instance, only cost me $15 for the co-pay. What about my birth control pills? What about my sister’s psoriasis medication, which her insurance covers? She knows she has to take it regularly, therefore it’s not unexpected … and yet *gasp* her health insurance covers it!

    I think you don’t quite understand how insurance works.

  35. Luckily, my insurance views Guardasil as “prevention” so it’s fully covered… however, my co-pay for prescriptions went up, and the amount that Regence will pay for my birth control ($245 Seasonale — used to be $270) went down, so I had to pay $130 last week to get my birth control. Thank god for credit cards. Before the prescription co-pay went up I only had to pay $90. Then, I guess the price of Seasonale went down… I mean, even if I still had to pay $90, Regence would still be paying less. I’m really pissed about it, but I’m lucky that I could scrape it together (and if I couldn’t, my boyfriend would).

  36. I got the vaccine at the beginning of the year, even though I’m married and don’t imagine that either my husband or I are going to engage in any “risky behavior.” I’m not sure I would have shelled out the money, but my insurance covered it. Or so I thought… apparently there is a maximum they will spend on “preventative care,” so I had to pay for half of my pap smear. I pay for health insurance, I even choose one of the more expensive plans, so I get pretty pissed off when I have to pay out of pocket for something that, in the long run, saves them money.

    I find the comments that imply you’re looking for a subsidy amusing, who do they think is paying the subsidy? As far as I can tell, we’re the ones subsidizing the insurance companies.

  37. In the process of constructing an insult instead of an argument, La Lubu has inadvertently proven my point, while at the same time getting everything precisely backwards.

    Sexual activity is, for most of us anyway, something that is routine and expected. Ergo it’s silly to expect a true insurance policy (under the commonly heald understanding of the term) to cover planned costs associated with it. Getting some tail on the weekend isn’t like getting blindsided by a drunken 17-year-old in a busted Trans-Am.

    If I really believed sexual activity was an “abnormal, once-in-a-lifetime, Lotto-winning experience” then wouldn’t it be precisely the type of thing that I’ve been saying that insurance should cover?

  39. Again, CTD, you seem not to understand that health insurance doesn’t work the same way as auto insurance. You may wish that it did, but it doesn’t. Which is why it’s not totally out of line to complain when it doesn’t cover routine preventative care.

  40. Sexual activity is, for most of us anyway, something that is routine and expected. Ergo it’s silly to expect a true insurance policy (under the commonly heald understanding of the term) to cover planned costs associated with it.

    Normal insurance doesn’t cost the same amount that health care insurance costs. So don’t try to compare those two things.

  41. What concerns me about Gardasil is the lack of long-term studies of side effects, potential resulting conditions, and the effectiveness of long-term prevention. Time Magazine’s latest issue has an A-Z of the year in health in America, with a brief blurb on Gardasil – 27 girls receiving the vaccine have died, and others report seizures as a side effect. Is it the worst of the side effects? No, but with Merck’s history with Vioxx, I get a little nervous.

  42. I think I’m being misunderstood here.

    Yes, Jill, I have insurance. Yes, I know how it works. And yes, I am fortunately closer to 40 than I am to 18.

    My point I’ve been getting at is that one of the reasons the health insurance system we have is so dysfunctional, and why so many people like Jill are disappointed in it, is that what they think that they’re getting when they buy “insurance” really isn’t. There is a disconnect between what we think we’re getting and what insurance really is.

    What most people want is subsidized health care, not insurance. For example, most women who go on birth control do so for a long time. Years, if not decades. Other than a health “insurance” plan, what kind of insurance policy pays out for the same thing, over and over again, for years? For something it knows is going to happen month after month after month?

    One of the reasons that health insurance has gotten so expensive is our collective expectation that it not only cover unexpected costs, but that it cover virtually everything under the sun, no matter how routine. Insurance companies have largely obliged. (Good god, mine even covers quack practices like acupuncture and chiropractic.) The result is what’s really subsidized health care, rather than a true insurance policy. Catastrophic policies are rarely offered by group plans because so few people want them, even when gold-plated insurance packages (and their premiums) are often a bad deal for young, healthy people.

    People have to understand that insurance != subsidized health care if they want to get to a system that doesn’t bankrupt themselves or the public.

  43. “Getting some tail”? Well, I guess this means CTD fucks animals or else regards his/her/whatever sexual partners as mere body parts.

  44. So, CTD, is your point that insurance shouldn’t pay for routine care, like annual doctor visits, and should only cover catastrophic injuries and emergencies? Because if that’s your ideal, then fine — I still disagree with you, but I get it. Except I’m not talking about your ideal. I’m talking about the system we live in, where we pay into insurance plans with the understanding that health insurance does operate to subsidize routine care, as well as emergency care. You may think it’s a bad system, but that’s the reality. Which doesn’t make it unreasonable for me to wish that my insurance covered a vaccine that prevents cancer, when such a vaccine is now considered a routine part of women’s health care.

  45. “Sexual activity is, for most of us anyway, something that is routine and expected.”

    That’s irrelevant. The fact that sex was or is expected does not dictate whether one contracts HPV, or any STD for that matter. One’s risk to getting infected does not end because one knew that he/she was going to get laid, and it does not increase simply because it was unplanned. This has to with PREVENTION and practicing not just personal, but good public health. So I don’t understand personal issues with subsidizing measures like Gardasil, or any other prevention methods, when these things are created to decrease the overall risk to the PUBLIC!

  46. So, i didn’t read the thread, but wanted to point out that if you’re already sexually active, you’ve probably already been exposed to the HPV virus and the vaccine is pointless. this is why they are targeting very young girls in Canada for the vaccine – i.e. 12-13 year olds. don’t waste your money.

  47. So, i didn’t read the thread, but wanted to point out that if you’re already sexually active, you’ve probably already been exposed to the HPV virus and the vaccine is pointless. this is why they are targeting very young girls in Canada for the vaccine – i.e. 12-13 year olds. don’t waste your money.

    That isn’t true. The vaccine is most effective before you’ve ever been sexually active, but that doesn’t make it pointless for older girls/women. And as Jill said, there are many strains of HPV. Further, most HPV goes away on its own without treatment. Most women will be exposed to HPV multiple times throughout their lives, most thankfully do not result in cancer in the end, and when cervical cancer occurs it’s generally not because of the first exposure when you were 16 or whatever (though of course it can happen).

  49. Ergo it’s silly to expect a true insurance policy (under the commonly heald understanding of the term) to cover planned costs associated with it.

    Which is exactly why you advocate for the planned expenses of routine vaccinations and medications to manage chronic conditions such as diabetes, heart disease, hypo- or hyperthyroid, Addison’s disease, etc. to be eliminated from insurance coverage, right?

    Look, the correct comparison between how health insurance covers a human being and how auto insurance covers a car isn’t “but you pay for routine auto care such as oil changes out of your own pocket!” No. Oil changes on a car are roughly the equivalent of bathing and brushing one’s teeth as a human being. The human body is considerably more complex than a car, with fewer obvious signals that something is in the process of going wrong. Why? Because unlike a car, a human body attempts to repair itself. Accurate diagnosis of many common, yet serious health problems requires more intervention that what one’s car undergoes in the garage. Additionally, folks who work on cars tend to not carry the same baggage, stereotypes, or emotional assumptions about vehicles that doctors and other healthcare providers have towards humans. Granted, a mechanic might pay attention to the common maladies and timetables for developing them when it comes to certain makes and models, but on nowhere near the scale as healthcare providers do towards humans. Further, humans are often in the position of having to beg their providers for a thorough examination (yes, even when they are fully covered by insurance)—that never happens at the garage.

    I’m assuming that CTD isn’t very familiar with how health insurance operates or is obtained in the United States. Ze seems to be under the impression that health insurance is obtained the same way that auto or homeowners insurance is—that one researches various policies by various providers, then picks one based on its cost effectiveness to necessary coverage. That is most certainly NOT how health insurance functions.

    In the United States, health insurance is obtained through work. There is either a limited option of HMOs/PPOs, or no option as to coverage—one size fits all. Privately obtained health insurance is out of the financial reach of all but a tiny portion of U.S. residents. Private insurance is completely out of reach for anyone who has a chronic condition, or a previous serious condition (try finding insurance as a cancer survivor).

    Now, while someone like CTD might say, “fine then, buck the system and don’t use health insurance—take your healthcare expenses into your own hands and pay out-of-pocket, perhaps through a healthcare savings account”—that illuminates another part of the catch 22. Insurance providers negotiate lower costs for their customers in exchange for designating “preferred providers”. Preferred providers then drop the cost on their bills off the top because you (the policy holder) obtained your services from them.

    Meaning, if you have no insurance, you will be charged anywhere from two to four times the amount that someone with insurance is charged.

    Now, if CTD is arguing in favor of a nationalized healthcare system, cutting the insurance companies completely out of the picture, then I’d say we’re on to something. Jill (and the rest of us) would get Gardasil as a matter of public health policy, and it wouldn’t cost $200 a shot, either.

  50. It’s interesting that your doc had you get Gardasil from a pharmacy. Why wouldn’t your doc give it to you in the office like any other vaccination?

    I got my Hepatitis B vaccine from a pharmacy. My doctor wrote me a prescription, I went to the pharmacy next door and grabbed it, I came back and gave it to her, and she injected me with it. So I don’t think that’s uncommon.

    (I’m assuming in my case, since I’m 41)

    I’m pretty sure Gardasil is currently only approved for women from 9-26, so it’s probably not an option for you at this time anyway.

  51. CTD says:
    November 24th, 2008 at 12:14 pm – Edit

    If you want or expect your insurance to cover every possible eventuality or cost that comes up, or service you desire, then what you’re talking about isn’t insurance. It’s a health care subsidy. ”

    Hey just call me a Socialist but paying for some bazzionaire’s private jets and 2000 dollar a night suites so that private health insurance can rip me off and deny covering anything sucks big time.

    I want my National Health Insurance with no freaking profit CEOs getting a cut. Like they have in Europe and Canada.

  52. Actually, the vaccines cover only 2 strains of cancer-causing strains. There are quite a few more but they are very rare in comparison. Gardasil also covers two strains preventing genital warts. But nobody knows how long the protection will hold up and whether there are any long-term side effects. Since there are no reliable tests to determine if one is already infected, taking the vaccine as a sexually active woman is weighing the risk of cancer against the risk of *we don’t know yet* and already having the responsible strains.

    Aside from the pharma companies doing a hell of a job there promoting their vaccines, it’s pretty fucked up that insurance companies try to avoid doing what they’re supposed to do and this “I don’t want to have to pay for your mistakes belief is spreading. Even though getting vaccinated prevents way more expensive procedures later.

  53. It’s also worth noting that insurance, as our newest dweller-under-bridges has decided it must be, would be an incredibly inefficient system both in terms of dollars and human health and lives. By refusing to cover routine or preventative care, such a system would make it more likely that catastrophic (and very, very expensive) care will be needed. It will also result in poorer health for the insured (also driving up long-term costs). Your insurance won’t cover your $30 flu shot, but will cover your $35,000 in-patient stay after you come down with the flu and nearly die? How is that better for either the insurance company, or for you?

  54. To: Hmmm

    Please click here

    The Feministe cannot control her partner’s behavior. That is why gardisil should be covered. Suppose the Feministe, in a remarkably unFeminist decision, did not have sex or until marriage, trusting in some nebulous concept of god and her family to choose her perfect mate. She remains absolutely faithful to him. Perfect mate on teh other hand, through no fault of Feministe, likese to f**k hookers. Now, Feministe can develop cancer through no fault of her own.

    This is where your ridiculous argument falls apart. It’s also how my cousin got AIDS. Turns out her perfect, Christian husband was gay. Instead of just admitting his orientation and buying a few condoms, he had unprotected sex with hookers, and then came home to have unfulfilling sex with his wife.

    Epic fail, my dear.

  55. As someone who just got the first shot a week and a half ago and has spent some time looking at all this and talking to a number of different people in the medical world:

    First of all, not all doctors stock the vaccine, and sometimes they run out even if they do stock it, so it is perfectly normal for the doc to ask you to pick it up at the pharmacy. This is actually one of the FAQs on the Gardasil website. They really don’t have the most user-friendly website on the face of the planet, but go ahead and poke around: http://www.gardasil.com.

    The vaccine covers 4 types of HPV: 6, 11, 16, 18. They’re the top cancer-and wart-causing strains. So, you can still get other strains, you can still get cancer and you can still get warts. It doesn’t protect you against any strains you have already encountered. BUT, even if you have 6 and 11, getting the vaccine will protect you from 16 and 18, should you ever come into contact with them. Also, the personelle at my Gyno’s office said that they’re finding that it *may* cover other strains, but it’s not proven yet.

    If your insurance company does cover it, they may only cover it for the approved age group. So older/younger people may be able to talk their doctors into prescribing it, but it may or may not be covered, because that is considered off-label use.

    If your insurance does decide to cover it, ask your doctor’s office if they’re going to charge you for office visits every time. My insurance covers the shot, and a nurse gives it to me, so I’m not paying the copays for office visits like I would if I was coming in to see the doctor. I had my initial consultation and information session when I went for my annual appointment. For as shitty as my health insurance is on everything else, I’m not actually paying anything for this vaccine. Also, my insurance policy allows for my Gyno to prescribe it, even though she is not my PCP, but you might want to ask about that as well.

    This is a required vaccine for all women looking to become U.S. citizens. They’re also testing it on men. I suspect it will not be seen as a “public health benefit” until teh menfolks are approved/required to take it. It’s a preventative measure, it’s a public health concern, and being as it’s all falling on teh wimminz to take care of the entire population’s health in this situation, the least the health insurance companies can do is pick up the tab.

  56. Hey Jill, I don’t know if you may have already gotten this information from your doctor, but I used to work for an insurance company, and I can tell you generally vaccines are only covered if the doctor provides it for you in the office, also, most vaccines the doctors can call 1 800 vaccine and get it sent to them for free. I hope this may be helpful?

  57. Let me know if you are still interested, I can probably get it to you for free at our clinic. Katherine Kramer, MD

  58. Regardless of whether you can get your insurance to cover the expense (and it TOTALLY SHOULD!) if you can manage it/can stomach the extra debt (and trust me I know what that is like), I would totally get it. If it provides even partial protection against having a lifetime of irregular paps, colposcopies, and painful biopsies (ya know, cutting chunks of flesh out of your cervix) DO IT!

    The funny thing is for me, while I’ve had to go through this process several times, I have had 2 tests for almost 20 strains of the HPV virus come up negative. The biopsies always come back negative. I guess I should be glad each time I don’t have cervical cancer, and I am, but I’m getting really sick of the process. And, it makes me realize how actually having the cancer and undergoing treatment (as in having even more of your cervix cut off or a hysterectomy) is so fucking awful. It makes me livid that anybody would argue against getting this vaccine.

  60. I ran into a similar problem with the Gardasil vaccine. My doctor recommended I get it, we talked, I researched and then agreed. He called my insurance company for me, they sent me a letter: “Gardasil is covered, and all we require is that you pay $200 for each of the three vaccines, in addition to the usual copay.”

    Um. So how is this covered???

    We’re switching insurance companies next year, so if I’m lucky my next company will be a wee bit better…

  61. If it makes you feel better at all… I’m in Canada and will have to wait till I get a job with health benefits before I can get the Gardasil shot. Between repaying student loans and meeting living expenses, this recent English Lit grad does not have the $600 to drop on the thing, on top of the $60 per perscription I already pay for The Pill.

    Damn the financial burden of my uncontrollable cunt and its risky behavior!! At least the taxpayer will foot the bill for all those abortions I’m bound to undergo as a direct result of my wanton promiscuity. /irritated sarcasm

    Sigh, the world.

  62. I know you may have already tried this or someone has already suggested it but just in case…

    My insurance covers gardasil but only if it is in stock at the doctors office. So when a co-worker of mine went to get it they made her pick up a prescription and then do the injection so she had to pay. But I went to a clinic that stocked it so I had it covered. The point is, sometimes there are ways to get it paid for with different codes etc.

    Health insurance does suck though. I have a 69 dollar bill for a pap smear that I didn’t get. My health insurance only covers one a year and they have a claim for two! I’m pretty sure I remember how many times it’s happened.

    I wish you the best in getting the shot and covering the cost.

  63. To add to La Lubu’s comment, health insurance is completely different from auto or home insurance in another way:

    Prevention. Regular oil changes cannot prevent a pileup; regular pap smears can detect cancerous cells. Prenatal care, perinatal and infant care, birth contol and safer-sex information, physical therapy and rehabilitation, vaccinations, screenings and checkups, HIV tests: these things prevent horrible illnesses from taking hold. It’s why some of the better HMOs and all non-profit systems are all over them. Comprehensive care isn’t catastrophic coverage plus a roster of frills for hypochondriac whiners. It’s healthcare inclusive of the instances where it’s most necessary to longevity and quality of life. And if our insurance companies didn’t have so much power to abrogate their catastrophic liability–“lifetime limits,” “pre-existing conditions”–it would be in their best financial interests as well.

    And, of course, what everyone else said about the purpose of insurance: you pay premiums to take care of costs that are otherwise unmanageable. In this system, that bar is set at a single urgent-care appointment to figure out if you have strep throat.

  64. I honestly can’t understand what’s going on in these comments, but then again I have no experience of how the health system works in the US. Of course health insurance should cover Gardasil. It’s a vaccine that could potentially eliminate a devastating, deadly disease. It’s one of the biggest anti-cancer breakthroughs in years, every woman should have access to it.

    In Australia the vaccine was free for all women within a certain age group (I can’t remember specifically, but it was something like 16-26). All students over the age of 16 who wanted it were given their shots at school. I can’t believe America wouldn’t have a similar system in place, at best it seems reckless and at worst it looks like your government just doesn’t care very much about women’s lives.

  65. *I* can’t get it. no one will give me a Rx even for me to pay OUT OF POCKET (which i totally would…) because i am 31.

    fuckers. i don’t have HPV now, i want to make sure i never will, but i can’t get the vaccine because i am too old. because women over the age of 27 don’t have sex? because it might be less effective? because in theory i already have been exposed (but i come up negative on every test so i OBVIOUSLY don’t have it). this is stupidstupidstupidstupidstupid.

  66. I’m not really that worried about side-effects, personally, at least not more so than with any other vaccine. Vaccines are basically your only hope for dealing with viruses at this point (unless you want to live in a bucket of bleach and filter all your air… :p) so I think there’s not much of an alternative. Everyone should be thrilled to get such an “easy” fix to this kind of cancer, ’cause it’s not terribly common for cancers to be caused by viruses, which means this kind of cancer-fightin’ viral vaccine has only a limited application.

    I know everyone’s said this already, but if it’s not a huge financial burden I would totally recommend getting this unless you know for a fact that you have *all* the strains of the virus it covers. It’s just a probability thing: each copy of the virus is one more tiny chance to get cervical cancer, and the chances add up with each strain of the virus/reinfection. (Disclaimer: I’m a biology student, not a doctor! My medical advice is worth what you’re paying for it!)

    I lucked out, and got Gardasil while still covered by my parents’ insurance (which knocked the price down to the still-pretty-fricking-high copay). I have no desire to shell out half a grand for 3 shots that take about a total of 2 minutes to give me, if given the option…

  67. Since there are no reliable tests to determine if one is already infected, taking the vaccine as a sexually active woman is weighing the risk of cancer against the risk of *we don’t know yet* and already having the responsible strains.

    There is a reliable test, actually. This is why they do pap smears. These days, labs do genetic testing on samples with abnormal paps — so you get the strain of HPV causing the problem.

    Still no test for men, though. Which is why after responsible me and my committed, monogamous boyfriend paid out of pocket for a wide swath of STD testing, not covered by insurance because we were both symptomless, I still caught an STD (presumedly from him).

    Part of the treatment once you’ve been diagnosed with atypical cells caused by one of the strains of HPV gardasil protects against is to get the immunization — but my doctor wouldn’t prescribe the vaccine for me, at 28, since the FDA had not approved it for women over 26.

    And two years later, with multiple coloscopies and biopsies, and a LEEP conization under my belt, I encourage all the young women I know to get the vaccine and increase their chances of avoiding crap like I’ve gone through.

  69. From what I understand (and I could be wrong) HMO’s aren’t really health insurance as much as a bunch of people buying a block of services as cheap as possible versus insuring against loss. By buying in bulk the costs are cheaper and thus more affordable. To keep the costs down the HMO restricts what services are covered. There are HMO’s that are non profit and thus your money buys more services. Think a membership to Costco versus flood insurance.

  70. Why should anyone but the person engaging in risky behavior pay for the costs of that behavior?

    I could understand if it were, say, the flu, and could be transmitted inadvertently and constitutes a true public problem.

    But it seems like people who willingly engage in activities should alone bear the costs for them.

    I agree. Anyone who gets injured in a car crash because they were driving to fast, should have to eat the medical expenses.

    Anyone who willingly chooses to live in a city with bad air pollution, should have to pay for their own asthma treatments.

    (Rolls eyes).

  71. There is a reliable test, actually. This is why they do pap smears. These days, labs do genetic testing on samples with abnormal paps — so you get the strain of HPV causing the problem.

    That’s only working if you have an abnormal pap smear. If the virus titer is low or the virus is inactive the screenings aren’t done routinely and, if done, may produce many false negative results.

  72. Does anyone know what provinces it is covered in Canada? Not that I plan on moving around just to get the Gardasil vaccination I am just curious because it is not covered in Ontario nor is it covered by my health insurance via my University…which gives me 5 years to find a job that has health insurance which will cover it!…or marry my electrician boyfriend because his union offered package is pretty sweet! lol jk

  73. Part of the treatment once you’ve been diagnosed with atypical cells caused by one of the strains of HPV gardasil protects against is to get the immunization

    Do you happen to know how this is supposed to work? ‘Cause that doesn’t jive with my understanding of “immunization”… (If you don’t know off the top of your head, I’ll go ahead and not be lazy and look it up myself!)

  75. Jill, I have almost the exact same issue. Grad school insurance didn’t cover it. (How on earth can a grad student fork out that much? The insurance policies are creepily and distinctly anti-woman here.) And now that I finished and purchased my own health insurance, guess what isn’t covered again… What. The. Hell. And.. AND! I understand there is an age limit of something like 28 or 29 to getting the shot.. so by the time I make a non-struggling to survive wage, I won’t be able to get it anymore! So only the very wealthy and young can possibly get this?! Thanks a lot healthcare for giving a shit about cancer in women..

  76. Ugh. I hate dealing with health insurance. I’m currently dealing with the prospect of wisdom teeth removal which costs a butt-load (at least, to a college student with pretty much no money).

    I went to the emergency room last year because I was having severe lower back pain, which I had never experienced before. Despite my answering the question of “ARE YOU PREGNANT?” and “COULD YOU BE PREGNANT?” and “HAVE YOU EVER BEEN PREGNANT?” with “I’M A SUPER VIRGIN. MY FEAR OF THE ONE-EYED TROUSER SNAKE WOULD RENDER YOU SPEECHLESS. SO NO. DUH.” they decided to secretly do a pregnancy test without telling me. I mean, they collected my pee, but they said it was to test for a UTI . So they did the very scientific thing of “sticking a stick in a cup of pee” and charged me $200 for it, along with a different stick to test for a UTI. And I didn’t even know they had done it until I got a bill from the insurance company stating they don’t cover pregnancy tests. (Apparently.) Despite telling the hospital that I did not request this service and I was never informed that this service was going to be performed and I did not benefit in any way from this service, I still had to pay it. Wah-wah-wah, I know.

    And I’m never going to have a kid. Holy heck, the price tags on those suckers, who can afford it? The birth alone!

  77. Do you happen to know how this is supposed to work? ‘Cause that doesn’t jive with my understanding of “immunization”… (If you don’t know off the top of your head, I’ll go ahead and not be lazy and look it up myself!)

    It doesn’t quite jive with my understanding, either. But this is what my ob/gyn (who I’ve been very happy with) originally told me. I know that part of the goal of a LEEP conization is to provoke a localized immune response…

  78. Personal Failure,

    Perfect mate on teh other hand, through no fault of Feministe, likese to f**k hookers. Now, Feministe can develop cancer through no fault of her own.

    This comment makes me uneasy. I know people who have a lot more sex than some sex workers. Really, it doesn’t matter who the partner had sex with. What matters is the dishonesty, at least in my book. It could have been another “good Christian woman” and I think she’d have just as much to be worried and upset about. Contracting a sexually transmittable disease isn’t really dependent on how much sex you’ve had before or what someone’s profession is. You can only protect yourself against STDs by dealing with the disease state of the person you are having sex with.

    I’m not trying to be a jerk here. I just don’t think this subject should get mixed up with any unfair blaming of sex workers.

  79. Do you happen to know how this is supposed to work? ‘Cause that doesn’t jive with my understanding of “immunization”… (If you don’t know off the top of your head, I’ll go ahead and not be lazy and look it up myself!)

    It doesn’t quite jive with my understanding, either. But this is what my ob/gyn (who I’ve been very happy with) originally told me. I know that part of the goal of a LEEP conization is to provoke a localized immune response…

    Some times if you catch a virus and you find out soon enough, the virus hasn’t yet “settled” in, the vaccine will wipe it out. This is what happens when you are exposed to rabies. Even if you have the vaccine ahead of time, once you are exposed you have to go in and get more shots (in the 70’s when my mom was exposed it was 14 in the stomach, I’m sure the number is less now but there is a series.) Those shots you recieve are the vaccine. And as long as you get them early enough they are super effective.

    So I’m sure that it could be the same for HPV.

  80. The thing is, our health insurance system is not currently disaster-based (when I was bare-boned self-insured, mine was, but at my age–and this is true of most people I know in their early 20s–the options are no health care, get insured by an employer, or beg your parents; most of us cannot afford a “health care plan” that actually provides for maintenance). So, for those of us who are, say, in graduate school, if our insurance does not provide for annual exams, prescription co-pays, or vaccinations, WE DON’T GET HEALTHCARE. Period.

    It’s not a matter of “we don’t want to spend money.” It’s a matter of health care being expensive–precisely because of our insurance system–and many people in the 18-30 age bracket being too poor and debt to afford health care unless an emergency arises, in which case we suck up the debt (an ex-roommate of mine spent years with a couple cracked molars, until they finally shattered, got massively infected, and became too painful for her to continue to function–fortunately, she had a very kind dentist who barely charged her anything. But people with good jobs and/or healthcare can take care of that thing BEFORE it turns into a massive infection).

    I am eternally grateful to the graduate student union at my university for ensuring that our health care plan doesn’t suck (it covers Gardasil and has a decent copay for prescriptions, including birth control). I haven’t been this well-insured since I was on my parents’ plan as a minor. And yes, it’s called a “health care plan,” if not using the word “insurance” makes it more palatable. Arguing semantics is stupid.

  81. “Gardasil can significantly decrease your risk of cancer by preventing all of them”

    Oh wow a friend and I were trying to look up why sex was related to cancer and none of the sites we visited actually linked sex=> HPV => cancer. They all just seemed to go Sex=> cancer!
    That was kind of off topic but I just wanted to express my thanks in finally having that cleared up ^^;

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