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Comment by toomuchtodo | Hacker News Reader

I help folks in r/sterilization who have obtained permanent birth control navigate and appeal their insurance. ACA compliant plans require this be covered at 100% as preventive care, so it’s building a workflow to check the boxes in the Rube Goldberg system to get to the outcome (full coverage per statue) insurance is constantly trying to avoid.

This project is helpful and is going into the case management workflow right away. Fight slop with well crafted, guardrailed slop.

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@toomuchtodo - you probably won't see this, but I'm very interested in this cause. If you happen to want an extra brain to help out, email is in my profile

Why the interest in sterilization? Because ACA makes it a very simple use case?

Out of curiosity, does ACA require coverage if the doctor refuses?

Because it is the most aggressive way at almost no cost to empower someone’s reproductive rights in an adversarial socioeconomic system, while each avoided unwanted child is a net positive. Cost benefit ratio is enormous. ~40% of annual pregnancies (both US and international) are unintended, $330k cost 0-18 (2023 dollars), limited to no support for parents, etc.

ACA coverage is for the procedure, doctors who won’t refuse can be found at https://childfreefriendlydoctors.com/

If you want kids, Godspeed. If you don’t, I am building systems to radically empower that outcome. “Build something people want.” or something like that. Essentially a suffering reduction flywheel.

> ~40% of annual pregnancies (both US and international) are unintended

how many are unwanted though? unintended doesn't necessarily have the negative connotation that /r/childfree folks make it out to be.

To be fair, even if 5% are unwanted I would think this is a good investment of effort. I have no data though

Sure, honestly I have no problem with people wanting to sterilize themselves, although I do somewhat support the idea that what you want at a younger age isn't necessarily what you want at a later point in your life, so sterilization should be handled at least somewhat seriously.

That said, I do take umbrage with people using suspicious statistics in unusual ways to push an agenda. If your cause is just, there is no need to use misleading statistics to inflate its importance. I argue this for causes I support as well as those I don't support.

I don’t know why you’re getting downvoted, I feel you’ve expressed your views very well. I especially like

> If your cause is just, there is no need to use misleading statistics to inflate its importance.

I absolutely love this, and appreciate you calling it out. We need more of this.

https://www.pewresearch.org/social-trends/2024/07/25/the-exp...

https://www.axios.com/2024/07/25/adults-no-children-why-pew-...

> 64% of young women say they just don't want children, compared to 50% of men.

Unfortunately, the dataset for unintended pregnancies doesn’t also ask if it was unwanted, leaving us to infer preferences via various datasets.

My wife and I have struggled greatly with infertility. But nobody wants to help when you can’t conceive. Certainly not the ACA.

I suspect there’s often an anti-natal bias at work: unwanted children have a very low negative value (like toxic waste), while wanted children are a luxury good.

You mentioned a cost-benefit ratio. How does this calculate the pain of not being able to have more desired children?

Several states require insurance cover IVF and there are always children available for adoption.

People who want kids are not my TAM, I cannot speak to their unmet desires. We all must grieve that which we want but cannot have. Life is inherently unfair. I can speak to the burden of unwanted children though.

I am sorry to hear of your struggle and wish you well.

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