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Norplant approval in Michigan unmarred by controversy.

It went smoothly and, surprisingly, quietly.

Efforts by legislatures and school districts to provide the contraceptive Norplant to low-income, drug-addicted or teen-aged women have been marred by considerable furor in other states, but Michigan's program sailed sedately through the Legislature.

The Michigan Legislature approved $755,600 for family planning programs last year, and allocated $500,000 of that amount this session to provide through its clinics the synthetic hormone, Norplant, which prevents conception and is released by thin capsules surgically implanted in a woman's arm.

In contrast to Michigan, lawmakers in 13 states have sought measures encouraging and, in some instances, requiring Norplant for low-income women, drug-addicted or with many children. Proposals regarding the contraceptive have been met with furious cries of genocide and social engineering in such areas as Baltimore, the District of Columbia, Kansas, Louisiana and California.

In Michigan, however, there was little perception that the contraceptive would become an instrument of coercion forced on women because of their poverty, race or criminal record.

"This program is totally voluntary," points out Senator Vern Ehlers, chair of the Senate Appropriations public health subcommittee who was instrumental in getting the program funded.

Adding that the program does target prostitutes, addicts and teen mothers who are likely to opt for abortions, Ehlers says it was "developed strictly on the standpoint of rights--every child has a right to be born normally.

"If a mother deliberately shook a kid, hit the kid against the wall and caused brain damage, she would be prosecuted for child abuse. We want to stop child abuse before a child is born," he explains.

Ehlers also points out that the contraceptive program makes fiscal sense.

The cost is about $565 per implant--$365 for the capsules and $200 for insertion and removal. However, Ehlers says, the state is negotiating with doctors and Wyeth-Ayerst, maker of Norplant, to try to bring the cost down to $500.

"Right now, women using public health clinics are eligible for free birth control pills. Since Norplant is effective for five years, the cost of pills for the same number of years would be more than $500," Ehlers points out.

"The program not only costs less |than birth control pills~, but saves an incredible amount of money when it comes to the hospital costs for an unwanted crack baby born to an addict who could have opted for a Norplant implant. The special education costs for children born to addicts can also be considered in the fiscal picture of funding the Norplant program," the senator adds.

"We've seen that for every dollar spent on prevention and family planning, we save $18 down the road in other health care costs," says Stephanie McLean, spokeswoman for Michigan's Planned Parenthood clinics, which have offered Norplant for some time.

Although Medicaid pays for Norplant, many states are deciding they should subsidize the contraceptive for women too poor to pay the full cost, yet who cannot qualify for Medicaid.

Norplant has been found to be 99 percent effective in preventing pregnancy, but it will not protect a woman from HIV or other sexually transmitted diseases. With that in mind, the Michigan Legislature earmarked approximately $150,000 of the $755,600 for teen-age health centers to promote sexual abstinence and $105,600 to fund teen pregnancy prevention.
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Title Annotation:On First Reading; family planning program
Publication:State Legislatures
Date:May 1, 1993
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