On science blogs this week: Control

BIRTH CONTROL WANTS TO BE FREE, AND A YEAR FROM NOW IT WILL BE. Seems like only yesterday I wrote about the Institute of Medicine's recommendation that contraception and several other health services, mostly for women, should be free under the new health insurance coverage. It was in fact a whole two weeks ago, but this week, bam, the government told insurance companies to make it so. That may be a record for translating an IOM report into policy — although the lead time is generous, since the edict won't take effect until August 1, 2012.

It's hard to overstate the potential impact of this very sane policy. In addition to direct effects on women's health, plus reduction of birth defects and developmental problems that I mentioned in the previous post, I can imagine salutary effects that are indirect. For instance, free birth control could — in fact, should — reduce the number of abortions and out-of-wedlock births, and help kids finish school. It might even reduce child abuse.

Details are available in several blog posts. At Kaiser Health News's Capsules, Jenny Gold says the rule applies to any contraceptive method approved by the Food and Drug Administration, including sterilization, an inclusion that is pretty interesting and not a point other discussions have much explored.

It would include condoms too, but Gold and others also say the new rule applies only to methods prescribed by docs. Do docs prescribe condoms? What might eventually be included are other forms of male contraception that appear to be in the works. Tara Parker-Pope, at the New York Times blog Well, links to a recent piece on advances in male contraceptive research. Apparently we will be hearing more about male contraceptives in October.

There is predictable opposition from some groups that worship God and Mammon. This includes the insurance industry itself, according to Katherine Hobson at the Wall Street Journal's Health Blog. At the NPR health blog Shots, Julie Rovner describes the loophole permitting religious groups that offer insurance to opt out.

At The Pump Handle, Liz Borkowski points out that contraception and the other obligatory preventive services such as STD screening will not really be free. For one thing, requiring them will increase insurance premiums a bit. But that's no argument against the new policy.

In this case, we may get very broad public-health benefits for very small increases in overall insurance costs. We're going to keep hearing calls for more and more services to be on the list of what health plans have to cover, though, and we should remember that these benefits all have costs attached.

WHAT'S IN A NAME? AMY WINEHOUSE, R.I.P. Amy Winehouse's death should have uncorked a flood of posts on addiction, but doesn't seem to have done so. Odd. It did, however, prompt three newspaper blogs to expound on the dangers of cold-turkey withdrawal from alcohol.

At the Bowery Ballroom, New York City, March 2007. Photo  by Daniel Arnold

Exactly why Winehouse died is still unknown. That, of course, has not stopped the rampant buzz that she drank and/or drugged herself to death. The newspaper blogging, however, is based on her relatives' speculation that her death was irony itself: The family argues that it was not the drinking that killed this splendid singer, but the quitting. The family's guesses were published in The Sun, Rupert Murdoch's sole remaining UK tabloid, said to be the largest-circulation paper in the UK. It was written by — I am not making this up — the tab's Deputy Bizarre Editor. Most newspapers could probably manage with just one Bizarre Editor. The Sun needs a backup Bizarre Editor as well.

At the Los Angeles Times's Booster Shots, Jeannine Stein quotes a medical expert on the need for detox supervision by...a medical expert. Ditto Tara Parker-Pope at Well, who also said Winehouse's death "cast light on a little-known problem: the dangers of alcohol withdrawal." She did in fact do some light-casting, with the most detailed explanation of the physiological mechanisms in detox and how they can go wrong. But her tame expert was pretty alarmist.

By contrast, at the Boston Globe's Daily Dose, Deborah Kotz acknowledged cautiously that abrupt withdrawal can be fatal, but emphasized that such death is rare.

WHAT DOES THE DEBT-LIMIT LEGISLATION MEAN FOR SCIENCE AND MEDICINE? The legislation Congress finally passed earlier this week, a bill that permits the government to borrow money to pay the expenses Congress has already incurred, seems like a bad deal for practically everybody. But On Science Blogs This Week is parochial, so here are a few links describing (and in many cases simply speculating about) how the legislation will affect science and medicine.

Jeff Mervis, ScienceInsider: A First Look at the Debt Agreement and U.S. Research

Joe Romm at Climate Progress: Debt and (Carbon) Taxes: Obama’s Last Chance for Climate Redemption is Just After 2012 Election

Greg Marx at the Columbia Journalism Review's Campaign Desk: The long-run deficit problem is a health care problem. Why doesn’t the debate reflect that?

Sarah Kliff at Ezra Klein's blog: What the debt deal means for health reform

Mary Agnes Carey at Kaiser Health News's Capsules: Hospitals, Nurses Group Lash Out At Debt Deal

Jonathan Oberlander at the HealthAffairs Blog: Deficit And Debt Politics: A Wake-Up Call For The Health Care Industry?

Joseph Antos, also at the HealthAffairs Blog: The Debt Ceiling Deal: Kicking The Can Down The Road

But the award for the most inventive use of the debt-ceiling fracas as an excuse to talk about pure science goes to Adam Frank at NPR's 13.7 Cosmos and Culture. He segued — not quite seamlessly or persuasively, but an impressive attempt nonetheless — from debt politics to the laws of conservation. And not laws of conservation as in biodiversity or environmental protection. Laws of conservation as in physics.

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