12. Who's Paying the Bill?

The Mirena IUD embeds a hormone inside a plastic T. Inside the uterus the hormone both suppresses the uterine lining and thickens mucous in the cervical canal, while the "T" triggers an inflammatory response. A three-act contraceptive, good for five years. At about $500, that's $8 a month for very effective birth control. So L. has a Mirena inserted, paying just a $15 copay for the office visit. Three months later she and her husband decide to try for another child and has the IUD removed. The IUD of course is discarded. How will health care reform fix this?

11. It's Not About the Money

After the delivery, I returned to the ER: J. is 34 and childless, with two weeks of pain and fever and a large pelvic cyst which is probably a tubo-ovarian abscess. With antibiotics and the cyst drained, she'll be okay. She just can't pay a hospital bill that may reach $10,000, which the hospital will just pass on to its insured patients, leaving J. with a bad credit rating. So? It's not like she's in the market to buy a house. But let's say that health care reform would give her access to outpatient health care. Would she have gone in earlier? Would earlier invention have protected her fertility, which I expect is now non-existent? Health care reform is not about money, it's about health.