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Comment by elastic_church | Hacker News Reader

On that subject I wanted to ask:

Are the services that Planned Parenthood provide so economically unviable that they require the life support and political will of the US Government?

Why can't a competitor or even a Bill Gates philanthropic initiative be a private sector version of the same thing?

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Here's a case that proves Planned Parenthood's unique function. PP offers rapid HIV testing. I get a test every year because you catch that shit early, the available treatments give you a nearly normal life.

Now this last year, I didn't go to PP for my annual lady check up for reasons that are long and boring.

So I asked my primary care physician during the annual everything else check up for a rapid test. She didn't have it and was surprised PP did. So instead of a finger prick I got a blood draw and waited. Weeks later I got a test report for everything else tested for (liver / diabetes / etc.) except the HIV and other STD tests. I ended up having to call to get the results.

So compare the 10 minute HIV test with immediate results versus the 8 week odyssey for finding out my sexual health status.

Planned Parenthood is brilliant at what they do. They do it well. Primary care physicians are shiat at reproductive health.

Yeah, the advantage of PP is that (1) they are specialized and (2) they have a large patient volume that allows them to negotiate medical products in bulk. That allows them to provide reproductive health care cheaper and more efficiently with just as good if not better patient outcomes than any other service.

Okay, that sounds like a user experience problem, of which federal funding has nothing to do with?

A private organization could offer the same thing without needing to be "in network" like your PCP? I'm guessing

Normally, out of network means not covered by my insurance. Or covered at a greatly reduced rate.

If there were a private organization that was as earnest and competent at providing full service reproductive care up to and including abortive treatments, I would definitely consider them as an option. Such an organization does not exist as of today. I can't postpone medical care until such time an organization like that exists.

Ah! I have another story that demonstrates how awesome Planned Parenthood is. So I came back from overseas and needed a non-emergency but urgent visit. I had insurance. Overseas insurance. I called around to OBGYNs around town without having a local PCP. Obviously having just come from overseas, I didnt' have a local doctor. Nobody would take me. I told them I would pay 100% cash. Still no takers. Planned Parenthood did. They took my appointment, gave me a price, I paid 100% of the charge, and they filled out my foreign insurance paperwork in a foreign language.

Why is Planned Parenthood so much better at providing reproductive care and so much more accessible than OBGYNs?

Typically companies that can depend on the state to keep the lights on offer worse service.

Conceptually.

This sounds like a user experience situation, a commitment to customer service, that has nothing to do with their federal funding. Yes they would have to adjust or find a real revenue stream, but I think it is mutually exclusive, unless it just simply is economically unviable.

I would totally hope there is no disruption in service. I'm just trying to understand what advantages Planned Parenthood actually has in the marketplace - outside of being a political football - that prevents alternatives from being available.

They have presence in every state. Granted in North Dakota, they may have only 1 office. Anywhere in the country, I'm traveling in and out of network, or find myself as an edge case with a weird situation, raped on a business trip in an unfamiliar city, I know they are there for me with unbiased medical service & care.

https://www.plannedparenthood.org/about-us/local-state-offic...

I can't think of any other reproductive service public or private that has such nationwide coverage.

(Edit: sort of an afterthought... Planned Parenthood isn't the political football, it's the women in this country. I never hear about special restrictive legislation affecting the men who rely upon Planned Parenthood.)

I'm still scratching my head a little, so lets reframe it another way:

Why isn't it news that Planned Parenthood has a monopoly on this health service contract? (Perhaps their extended operational history made them the most qualified)

Why is the only part of that contract in question related to one of the services they provide?

I'll skim wikipedia, I suppose. I understand the convenience they offer and I don't expect to get the answers here. I think it will be non-news after they get defunded and continue operating on a fraction of the budget, I mean, or not.

I found this for you...

https://www.plannedparenthoodaction.org/blog/how-federal-fun...

PP doesn't have a monopoly on federal funding. In Oregon, at least, one provider for Medicaid services is Providence Hospital. Providence is a Catholic hospital which means they don't provide surgical or medicinal abortions. I can get a routine OBGYN check through Providence but if I'm pregnant and don't want to be, then Providence will refuse care.

On a personal note, I have a medical condition called endometrial hyperplasia which can be treated with an progesterone infused IUD or difficult-to-manage progesterone pill treatment taking only some days of the 28 day cycle. Due to the need for routine biopsies, I ultimately decided to go with the pill (although I'm 2nd guessing the choice because it's so easy to screw up the pill dosing). I could tell the Providence doctor was really uncomfortable with the idea of providing an IUD. Many Catholics believe the IUD is an abortive type birth control and refuse to provide it. I may be going back to PP if I decide that an IUD is the better way to handle my condition. If I were more stupid or less able to deal with remembering odd calendar based dosing regimes, the IUD would be the only solution.

(Edit: I'd also recommend reading this article about the oversized impact of Catholic hospitals in Washington State.

https://www.propublica.org/article/catholic-hospitals-grow-a....

Apparently PP was paid $2million to open a branch across from a hospital being taken over by Providence! Also note lack of emergency contraception for rape victims and mismanagement of miscarriages in Catholic hospitals.)

thanks! that was very insightful

Additionally federal funds at least in 2009 were about 1/3rd of PP's budget. http://www.factcheck.org/2011/04/planned-parenthood/

so defunding it is symbolic at best

competitors can exist, and I'm assuming might already?

Wellll, 33% of your revenue being cut means a lot of people get fired and services degrade so I would not say it's symbolic.

Abortions also count for only about 3% of their spending. Yes, they are a lightening rod for controversy.

Yes, this place seems to be a competitor but not sure what the costs and such are: http://www.realoptions.net/

No, that place is a Crisis Pregnancy Center (an anti-abortion facility set up to look like a real repro health clinic). You can tell from the scaremongering about abortion they do here, for instance: http://www.realoptions.net/options/abortion/

They are not an alternative to Planned Parenthood, they are a vile unethical pretend-clinic taking advantage of the confusion of desperate women.

I had visited that page and kind of suspected that. I just was fairly shocked that such a thing would exist in the heart of Silicon Valley (Mountain View, aka the home of Google).

I wish these people would put all this "love of life" energy into actually taking good care of all the unwanted children that already exist... From what I have read and heard from people in the know our foster and adoption systems are beyond broken.

> Wellll, 33% of your revenue being cut means a lot of people get fired and services degrade so I would not say it's symbolic.

And if they have borrowed, then immediate bankruptcy

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