The vast majority of the times I've gone to the doctor in my adult life have been to keep up my birth control pills. The vast majority of the prescriptions I've had filled in my adult life have been for birth control pills. The vast majority of claims I've submitted to my insurance have been for birth control pills. If I could have gotten sterilized on demand when I first became sexually active, my entire burden on the health care system in my adult life would probably be about 25% of what it has been so far. (More like 10% if it weren't for Gardasil, which is pricy and required four appointments).
We know that 10 million Canadians use prescription contraception. What would the burden on the health care system be like if all those who never wanted to have children (ever or again) got sterilized?
The first page of Google results rather vaguely suggests that just under 20% of the population is childfree. Given that some childfree people are already sterilized, and given that some childed people might want to be sterilized but not be able to (perhaps because they're young, perhaps because they only have one child, etc.) let's work with the assumption that 10% of the people using birth control would like to be sterilized. So that's 1 million people who would like to be sterilized. So let's sterilize them. Snip, snip. Now what happens to the health care system?
I use up one standard annual appointment slot a year for my birth control needs. If we assume that everyone has simple birth control needs and only needs one appointment a year (a very low estimate, since some methods require 4 appointments a year and some people have to try a number of different methods before they find the right one) that would open up one million appointments across the country. The first page of google results gives numbers between 2.4 million and 5 million for Canadians that don't have a family doctor. But in any case, one million free appointment slots would make a significant dent!
Other factors that I have been unable to quantify:
- How many free doctor appointment slots = room in the doctor's practice for a new patient?
- Sometimes unwanted pregnancy occurs, even with birth control. Getting an abortion surely takes up more medical resources than simply maintaining contraception, and carrying the baby to term anyway would take up even more, plus produce a whole nother human being who is also going to need medical resources.
- A lot of people, if they don't need to go to the doctor for their birth control every year, aren't going to get a pap smear every year. Come on, we all know it's true. How would this affect overall public health? And how would it be affected by the introduction of Gardasil, once enough of the population has been innoculated to wipe out the major strains of HPV?
- Would the reduction in the number of people taking hormonal contraception (which can increase blood pressure) have any appreciable impact on the instances of heart disease in the general population?
- With the baby boomers, the issue of contraception has recently become/is about to become moot for a huge chunk of the population. Would that make the impact of sterilization on demand negilgible? What would the impact have been if it were available as the baby boomers were starting to become sexually active? (And as an aside, is the fact that this huge chunk of the population no longer requires contraception going to have an impact on the sexual health of the overall population? I once heard the boomers described as the generation that had the drinking age (in the US) lowered to 18 so they could drink when they were in college, then had it raised to 21 so their kids couldn't. Are they going to do the same thing with birth control now that they no longer need it? Although it might be too late for that now anyway - I'm the child of boomers who started their family relatively late, and I'm far too old for my parents to be interfering in my contraception.)
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