Men pay 1268 kroner in deductible to sterilize themselves through the public sector. For women, the price is 6079. There is a price difference of as much as 4811 kroner. – The high prices particularly affect vulnerable groups such as immigrants and people with low incomes. The Midwives’ Association believes this is an unheard of practice from a gender equality perspective. That’s what Hanne Charlotte Schjelderup, who is the leader of the organization, says. – Women are overrepresented in low-paid occupations, she points out. But despite the fact that it is cheaper for men to sterilize themselves in hospital, they risk having to go to northern Norway to have the string cut. Helse Nord is one of the few health regions that prioritize sterilization of men in public hospitals in Norway. WENT TO THE NORTH: 23 patients went to northern Norway to have sterilization performed through the public health service in the period 2018-2021, according to Helse Nord. Photo: Siri Saugstad / news Interventions on men 2018-2021: Health North: 589 Health Middle: 17 Health West: 3 Health South-East: 3 Total: 612 * Several contract specialists who are affiliated with the regional health authorities, as well as private actors who have approval from the State Administrator, performs interventions. There are no statistics for these. 20-year-old prices The sterilization rate was decided by the Storting in 2002 after two public committees in the 1990s. They concluded that sterilization should be among the lowest priority health services in the public health system. The rate for women was meant to cover about half of the real costs, and the deductible for men was meant to cover everything. But despite the fact that the prices of almost everything else in society have changed in 20 years, the deductibles for sterilization are the same. Sterilizations in general The Sterilization Act gives everyone over the age of 25 the right to sterilize themselves, as long as they are competent to make a decision. Other cases must go through a tribunal. Complaints are sent to the Sterilization Council. Today, more than 1,000 female sterilizations are performed per year. About half of the sterilizations are performed in connection with childbirth, usually at the same time as a caesarean section. The reporting of performed male sterilizations is still very deficient. The introduction of an increased deductible for sterilization in 2002 led to a clear decrease in the number of female sterilizations. In previous status reports and to the Norwegian Directorate of Health, the Sterilization Council has expressed its concern that the high deductible for women may be unfortunate for certain groups, e.g. immigrants and financially or socially disadvantaged people. In a letter to the Ministry of Health and Care Services dated 12.09.2017, the Norwegian Directorate of Health recommends that the patient payment for sterilization be gender neutral, and thus an equally available contraceptive alternative for women and men. The Norwegian Directorate of Health has not taken a position on the level of payment, but believes that sterilization must be an available contraceptive – regardless of financial ability. For men, there is a very limited offer at public hospitals, so a significant part of the sterilizations take place with privately practicing specialists with or without an agreement with a health trust. Source: Report from the Sterilization Council for the years 2015–2017. A new report will be available in the summer of 2022, but there does not appear to be any major discrepancies, news is informed. news has tried to get in touch with Minister of Health and Care Services Ingvild Kjerkol, and has asked a number of questions by e-mail. She has not responded, but the Ministry of Health and Care Services has chosen to make a statement. – Since the real costs of the two different interventions are different, it has been considered that the scheme is not in violation of the Convention on the Elimination of All Forms of Discrimination against Women, they state in the e-mail. Read the full comment to the ministry here: The two public committees that in the 1990s considered priorities in the health service (“Salary I committee” and “Salary II committee”) concluded, among other things. that sterilization should be among the lowest priority health services in the publicly funded health service. On this basis, a deductible for sterilization has been introduced since 2002. It is more costly to sterilize women than men. The deductible introduced in 2002 was therefore such that the patient would cover about half of the real costs. The deductible for men was assumed to cover the entire cost. Since the real costs of the two different interventions are different, it has been considered that the scheme is not in breach of the Convention on the Elimination of All Forms of Discrimination against Women. Sterilization of men is now carried out almost not in the publicly funded health service, but in the private one. The cost there is about 6,000 kroner, ie about the same as the deductible for sterilization of women. Private offers are found to a lesser extent in northern Norway than in other parts of the country. The hospitals in the north therefore offer sterilization. – Not okay The Midwives’ Association does not agree that the rates should be different based on resource use. They propose a deductible of NOK 375 for both sexes. – Today’s practice can not be defended in a gender equality perspective. It must be up to women and men who will sterilize themselves, not the cost. – Women who have medical reasons for performing sterilization, get this covered. The same applies if they perform the procedure during a caesarean section or birth. Is not that good enough? – No, we do not think that holds. We see that there are relatively strict criteria for covering sterilization. It is not good that public rates are so high, they have to go down. The experience is that far more women than men also bear expensive costs for hormonal contraception, Schelderup points out. PAYS MORE: Not only is sterilization more expensive for women, hormonal contraception can also lead to expensive costs for women, Schelderup points out. Photo: Norwegian Nurses’ Association Believes the deductible for men must go up – Ideally, prices should be the same, but there are two completely different interventions. It’s like comparing apples and pears. Urologist and head of the sterilization council, Morten Andersen, points out that the procedure performed on women is more extensive and requires more resources. Therefore, he is not surprised that it is much more expensive for women. The problem is rather that it is too cheap for men. – The solution is that the deductible is increased considerably for the man, also in the public sector. Then you can talk about equality. It should be on the same level as the woman. – So instead of the woman getting her deductible down, should the man get his up? – Yes absolutely. He is critical of the fact that the authorities have not adjusted prices in 20 years. TOO CHEAP: Urologist and head of the sterilization council, Morten Andersen, has performed thousands of procedures on men. He believes prices must rise for it to be profitable. Photo: Private Will not be prioritized in the south In 2021, the Ministry of Health and Care Services asked for information about the treatment offered to men who wanted to sterilize themselves. The answer was that male sterilization is not considered a priority task in the public sector. Cancer and other diseases come first. Sterilization is put to private actors. But private offers exist to a lesser extent in northern Norway than in other parts of the country. – Helse Nord has therefore ensured that the hospitals in the health region offer sterilization for men, even though the procedure is not given high priority and has a relatively long waiting time. This is stated by Helse Nord’s press officer in an e-mail to news. FASTER PROCEDURE: Urologist Morten Andersen is concerned that one does not undercommunicate how extensive it is to sterilize men. But generally it does not take more than an hour with local anesthesia. Photo: Carolina K. Smith – Norwegians can afford Urologist Andersen believes that in practice hospitals can not afford to perform sterilization on men, as they are not covered by the state. It is therefore considered a deficit project by the health trusts. Private players pay around NOK 6,000. Something Andersen thinks is a more realistic price. – The vast majority think that the payment that is under private auspices is perfectly fine. There are very few who complain about it. Norwegians can afford it. And it costs like changing the tires on a car, Andersen believes. Do you have any feedback? Hi, I’m writing this case. I have previously written about: Do you have any tips or suggestions for this particular case, or other cases? Feel free to contact me 🙂
ttn-69
Sterilization is five times more expensive for women – news Nordland
