Doctors say it all started eight years ago, when a urology clinic in Oregon ran promoting the benefits of scheduling a vasectomy in March.
鈥淵ou go in for a little snip, snip and come out with doctor鈥檚 orders to sit back and watch nonstop basketball,鈥� the voice-over promised. 鈥淚f you miss out on this, you鈥檒l end up recovering during a weekend marathon of 鈥楧esperate Housewives鈥�!鈥�
Copycat ads followed. Now a in Washington, D.C., has an annual Vasectomy Madness contest, where the prize is a free vasectomy.
Here鈥檚 how it works: Three guys come on the air to make their cases for getting snipped. The announcers ruthlessly roast them, and then listeners vote on their favorite.
鈥淎ll right, let鈥檚 bring in our next contestant,鈥� a host said. 鈥淚 believe it鈥檚 Abe from Warrenton, Va. So tell us your story. Why are you here?鈥�
Abe has three kids, ages 9, 6 and 3.
鈥淎nother one 鈥� surprise! Due in July,鈥� Abe said. 鈥淚 was shopping after the third for a vasectomy and, like a dope, dragged my feet.鈥�
There鈥檚 Mike, also expecting his fourth child 鈥� also a surprise.
鈥淢y wife and I have had enough,鈥� he pleaded. 鈥淲e need help to stop the flow.鈥�
And then there鈥檚 Charles.
鈥淔our kids. Three different women,鈥� Charles said, inspiring a roar of jeers from the hosts.
Procrastination can be so common with the 鈥淏ig V鈥� that it takes a panel of sports jocks offering a free procedure for some guys to finally let a doctor take a scalpel to their nether regions.
That may be one reason vasectomy rates are low: About of women rely on their partner鈥檚 vasectomy for contraception, unchanged from a decade ago. The Centers for Disease Control and Prevention鈥檚 National Survey of Family Growth compares that to of women who have had a sterilization procedure, even though women鈥檚 surgery is more invasive and more expensive.
鈥淢en are culturally the providers. It鈥檚 hard for them to seek care,鈥� said聽, a California urologist. 鈥淭hey don鈥檛 know how to be a patient.鈥�
Turek has in San Francisco and Beverly Hills. He sees an uptick in vasectomy visits during March Madness, and he鈥檚 also noticed more guys coming in together.
鈥淥ne group came in from a tech company in a limousine,鈥� he said.
Last year, five college buddies scheduled a group vasectomy in March. They live all over the U.S. now, and one of them had an idea to reunite in San Francisco and undergo the outpatient procedure together.
鈥淚 gave 鈥檈m a deal,鈥� Turek said. 鈥淚 closed the doors. We had sports TV on. They were having fun.鈥�
As each guy returned to the waiting room, he was greeted with fist bumps and high-fives. Then the men hobbled back to their hotel to bet on the games and yell at the television together.
Turek made an interesting observation during that bro basketball weekend: The friends聽seemed to recover faster than his typical patients.
鈥淭hey had no complaints,鈥� he said. 鈥淭hey were back at work sooner. They took fewer pain pills. It was the best anesthesia, having their buddies with them.鈥�
Turek gives all his vasectomy patients a certificate of honor for 鈥渦ncommon bravery and meritorious performance.鈥�
There is another theory about why vasectomies aren鈥檛 more popular: the cost. The Affordable Care Act requires insurers to without charging out-of-pocket costs. But vasectomies聽weren鈥檛 included in the rule. The procedure costs about $500, but some doctors charge up to $1,000.
That鈥檚 why Charles subjected himself to the free vasectomy contest at the D.C. radio station. His insurance covers a portion of the procedure, 鈥渂ut I鈥檇 still have to pay my deductible, which is, like, a thousand bucks.鈥�
Vasectomy was overlooked in Obamacare because, under the law, birth control was considered a women鈥檚 health service.
鈥淩ight now the policy says to a couple: Your insurance will cover birth control without any out-of-pocket costs on your end, as long as it鈥檚 the woman who鈥檚 using it,鈥� says , senior policy manager at the
Last year, 12,000 people signed a asking regulators to cover vasectomy without cost sharing. Doctors鈥� groups even drafted language to this effect to add to the regulations.
But when the Trump administration took over, it told the groups to stop trying, according to Aaron Hamlin, executive director of the
鈥淭he birth control benefit has been under pretty much continual political attack since the ACA was enacted,鈥� said Sonfield.
So for now that leaves guys like Charles, Mike and Abe vying for a free March Madness vasectomy. The winner in the end?
Abe 鈥� one of the guys expecting his fourth child.
His prize came聽with a catch, though. He will have聽to let one of the sportscasters come to his appointment, to broadcast a 鈥減lay-by-play.鈥�
This story is part of a partnership that includes , and Kaiser Health News.