No Plan, No Worries by Pat Conrad MD

(Note to readers:  This piece is not about the morality of birth control/abortion, nor do I in anyway intend to offer an opinion on that topic.)    
Yesterday, the beneficent central government decreed that the “Plan-B” morning after pill may be sold to those 15 and older.  In late 2011, HHS Secretary Sebelius “said some girls as young as 11 are physically capable of bearing children, but shouldn’t be able to buy the pregnancy-preventing pill on their own.”  Why, Sec. Sebelius, is a 15 year-old allowed to fly solo in the pharmacy, but not an 11-year old?  Clearly you have not dealt with a lot of the tragically ignorant 19- and 21-year olds whose frequent visits to my ER are within the purview of your wisdom.  In a fit of Orwellian hilarity, Sen. Patty Murray, D-Wash said, “It’s also a decision that moves us closer to these critical availability decisions being based on science, not politics.”
I appreciate that the country is now little more than an emotion-driven mob, senator, but please don’t expect me to buy this doublespeak.  This entire move is WHOLLY about politics, and whether or not it agrees with science has never been relevant to you vote herders.
As a physician, who has written a few late-night Plan-B scripts, with pity for the young lady and hope to do good for all concerned, I would be appalled at the further diminishment of my profession, and the loss of ability to help protect patients…if I weren’t so numb to daily such occurrences.  In earlier years, I would protest that the minor girl must have an available adult guardian, and that these are serious medications with real adverse reaction potentials, however infrequent.  I would point out that there is no mandated national data base to judge whether said adolescent is buying a Plan B several times a month, as a prophylactic.  I would wonder at the number of undiagnosed teen pregnancies that will then be unwittingly subjected to the drug, and what the effects might be.  Will there be a new mandatory screening question in ER’s to determine whether the patient is aware of this option, and will documenting such become a future core measure?  Government patients now crowd ERs and urgent care centers for scripts for Motrin in order not to have to pay for it themselves; will this be the preferred access to Plan-B?
As a libertarian, I would wonder about the magic of the number 15, and what this says about our society’s fluid standards regarding statutory rape.  Are males 15 and older allowed to purchase, or just the girls?  If a girl buys Plan B ahead of time, does this in anyway mitigate future criticisms of an amorous 17-year old male who was lured in with foreknowledge?  If  a girl opts not to purchase, does this excuse the bio-father from any further child support liability?  Have we given up on the idea of religious exemption, or will Plan-B not be available for government patients?
As a beaten, callous taxpayer, I might hope for fewer unplanned pregnancies with which to populate the Medicaid rolls.  And as a justified cynic, I note that the very federal government which designs to provide good health care to all and guarantees  its confidential delivery, has now come between doctor and patient once again.
33850cookie-checkNo Plan, No Worries by Pat Conrad MD