I have a friend* who is about to get a vasectomy, and it turns out, it's a ridiculously involved process, presumably because of Religionists.
First, you have to get not one but two "mental health" exams, because the assumption is that if you are under 40, single, don't have kids, and don't want to have kids, you must be crazy.
Then, you can either spend many thousands of dollars at a private practice (apparently when you add up all the fees that insurance doesn't cover it gets absurd), or do Planned Parenthood. It turns out that San Francisco is some kind of mecca for men's health -- you can get your prostate examined on any street corner, and sometimes they'll pay you -- but not men's reproductive health, go figure.
So Planned Parenthood says, "Well, we only do this once a month, so let's find the next available date... how about eight months from now?" I guess this means there's only the one guy in the country who knows how to properly use the tiny scissors on his Swiss Army Knife, and he spends all his time traveling from town to town snipping nuts, like it's the Old West, or a Toshiro Mifune movie or something. Wait, no, it sounds more like Eversmile, New Jersey, that Daniel Day-Lewis movie where he plays an itinerant dentist traveling through South America on a motorcycle, dealing out the rough justice of fillings and extractions. (It's a great movie.)
* Honestly, these are not my nuts that are on the table here.
Odd. I just sat down with my doc, talked for 2 min and booked a date. I wounder if your friends issue is all of CA, because both here in TN and in CT I've never heard of having that much bull to go through.
Yeah, no big issues in NC, either. I was under 40, no kids. I was married, but I didn't have to get my wife's permission, or even tell her. Compared to the Hell they give women wanting to get their tubes tied this was a (very slow, careful, with ice) walk in the park.
Heck, insurance even covered almost all of it.
No significant challenges here in the red, red state of Texas. I was unmarried, no kids, and 34 when I got mine. The only frustrating thing for me was that (recommended) Dr. Dick Chopp wasn't in-network for me, and I had to use a different doctor.
Same here in FL. I was 25 & unmarried but it was a breeze and insurance covered almost all of it.
I was warned that some docs won't do it, not because of anything political but because docs are so afraid of getting sued 20 years later by men who regret making the decision and are no longer able to have the procedure reversed. But a 5 minute conversation with my doctor about why I don't want kids and how yes I'm sure my opinion will never change was all he needed.
Clearly the fact that the laws are different - and worse - in California is a result of the extreme Republican and Religionist domination of politics in that state.
[ NB I am not a Republican - I just dislike posts that start a big rolling rant with an unsupported presumption. ]
FWIW, I am under 40 (albeit barely) and just did this through the urology practice at UCSF. Anthem Blue Cross PPO covered it (well, they claimed to -- we'll see what kind of disaster happens when actual billing ensues), and I was required to do nothing more onerous than sign a stack of forms in which I attested that I was aware of what a vasectomy is.
The folks at Dr. Smith's practice were awesome; I recommend them highly: http://urology.ucsf.edu/faculty/facSmith.html
(although per the comments below, it may be relevant that I (a) have a child, and (b) am not legally married, so whatever awful legal/best-practice requirements are in place for people in the opposite side of either axis there may not have been flagged in my case.)
Actually the assumption (at least in my experience) is not that you're crazy, it's that you're an asshole. Lots of dudes think they can have condom-free sex throughout their 20's and "just get it reversed", ignoring all the realities of no protection against STI and that it's only about as effective as a condom, anyway.
There is also the problem of dudes getting one on the down-low, that they want to avoid.
How is this even remotely the doctor's business?
it's not, but presumably they want to avoid any sort of liability.
It's 2 decimal orders of magnitude more effective: http://en.wikipedia.org/wiki/Comparison_of_birth_control_methods#Effectiveness_of_various_methods
I don't usually comment but having had this procedure done, I'm going to open my mouth:
1) Your buddy has shit insurance. I live of California. I have pretty crappy Anthem insurance. I had this done at a wonderful University of California hospital by the former department chair (who had clearly done this job a few thousand times before). All said and done about $500. Even without insurance, the top-level bill was maybe 3k. Your friend better not get sick or hit by a car or he's fucked. Maybe he should check in at UCSF's urology clinic?
2) Your anti-religion / anti-right ferver is typically well placed but this has only to do with lawyers. I have more kids than I wanted and the state required at least a 30 day wait. Also, my wife had to sign, or I'd have needed additional evaluation. No joke. However, as I found out, this is not to promote religion. It is to supress lawsuits.
The logical extension is something like amputating an arm or a leg. It's my arm, let me do whatever the fuck I want with it and fuck you for asking. It is a perfectly safe procedure. But lawyers don't like that, and you'd need at least several evaluations before you've amassed enough clearance to get it done, if you could get it done.
So anyway, just FYI, there are real hoops to jump through even if you have kids. You don't just show up and out comes the swiss army knife. And since you might not be aware, given what I assume is zero contact with kids (except for punks trying to sneak into your club): nothing is more litigated than reproduction and small kids when it come to health care. And your buddy is definitely pushing five sigma with his opinions, so expect the lawsuit-averse industry to react accordingly. The doctor has to go into court when he's sued, a court of people who probably have kids, and explain why he didn't ask questions about an out-there belief as he was required to.
So, hate the lawyers.
I'll just go ahead and read that as "Let them eat cake."
Funny but not a joke - this is better for the insurance company all-around: pregnancies are expensive, kids get covered no matter what, no matter how many you have, and so on. So this is one of those "completely in the interest of the insurance company" procedures. My wife's HMO would have done it to her for free (literally, zero out of pocket).
...because of course everybody has insurance. Leave your bubble.
Uh, if your buddy has no insurance that's a different story, isn't it? But you wrote about "fees not covered by insurance," so he must have insurance. Elective surgery costs without insurance are not up for discussion here. In case you missed it I agree with you and think the hoops are ridiculous. But I understand what lawyers do, and short of blowing it up not sure how we solve it -- not even a country of all democrats solves that one. Except your friend would be compelled to buy insurance. So I guess the price discussion wouldn't be happening?
Insurance is not an option for many Americans.
I'm 36, never married, not in long-term relationship, and got mine in Oct in SF. There was a 30-day waiting period, but that's it. Dr. Reginald Rector. Also, my insurance did pay, so my out-of-pocket was only $500.
This male birth control where they fill your nuts with a polymer looks promising: techcitement.com/culture/the-best-birth-control-in-the-world-is-for-men/
Yes, that's why I never post "Previously" links, and even if I did, I'd strongly discourage anyone from clicking them!
Damn, I thought I was being useful, but laziness has thwarted my efforts once again.
It's also been looking promising for the better part of a decade now. Holding your breath for it to become available in the next 5-10 years is not recommended.
Polymer? I can have real-life truck nutz?
I had mine done in Santa Cruz about 11 years ago when I was 31, childless and just dating someone. I don't recall signing any forms. My primary care physician had to refer me to the doc where I had one appointment. He pointed out that it was permanent which I pointed out was the point. Gave me a valium to take when coming back (shaved) the following Thursday when he did the procedure (and wouldn't let me play my Gameboy during it either).
After some period of time and number of ejaculations I had to bring in a sample so they could check it was all clear. Had to do that twice. The total cost to me was $50 while insurance covered the rest claiming the total (including the labs) was $500.
It is fairly clear from the comments that the price has been stable, and the whole process doesn't have to be insane even in California. Obviously that won't stop an over the top bureaucrat injecting their own personal beliefs or doing lots of make work.
I should hope you have to at least fill out the "please snip my junk" form.
"Nurse, I said slip off his spectacles!"
just had mine done in January in San Diego. All I had to do was chat with the operating doctor for a few minutes first, and then we got right to it. Disclaimer: I do not have shit insurance.
I had mine done in Oregon when I was about 37, married and two kids. No waiting period, no signature from the wife. They did ask, "You know this is mostly permanent, what happens if one of your children died?” To which I replied, “And not having this done would magically bring them back to life?” They had no other questions. The insurance covered the entire cost except for the standard copayment.
The Canadian perspective; getting snipped costs nothing, but reversal is expensive. I only had to tell my GP I wanted one, then confirm that with the urologist, and we were ready to go. After care was a scrip for T3s (which I didn't need) and a suggestion to stock up on frozen peas. This was at age 30 with no kids.
Holy shit, that's actually a real thing. Apparently not on nefflix. To the torrents we go.
I was fortunate to be insured, Anthem Blue Cross in Colorado paid for everything but the regular dr-visit co-pays. Sucks that there's such a wait for the PP-funded ones.
Oh, and have your friend read Sperm granuloma ahead of time so he doesn't go running back to the doctor wondering WTF since apparently they happen 60% of the time.
Wait, I read the Wikipedia entry, and I still have no idea what's going on.
I think that entry just said that after a vasectomy, you sometimes have clumps of dead sperm cells build up in your balls, and they can sometimes be painful.
All these guys saying "I got it snipped somewhere else and it was easy" makes me wonder if it's the sort of thing you can get done in Vegas, ideally by a man dressed as Elvis.
I'm popping to the doctor tomorrow, so I'll try and remember to ask how much bother it is to get done on the the NHS over here.
In Saskatchewan, Canada (each province has its own slightly different system), I had mine done when I was 32 -- single, living with partner, no kids.
I was worried the doctor wouldn't do it without giving me a hassle over not already having kids (as I'd heard the stories) but he said it wasn't a problem. Booked a few weeks later, done with a needle (not a knife; fish the vas deferens out through the needle hole with the needle, tie a knot, put it back in) under a local. Walked home from the hospital.
So a vasectomy costs thousands of dollars in the US? For the same money, you can make a trip to the netherlands, get the thing done at casa clinics for about $300, and you're done. Plus you get to see some of yurp too.