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Why some women who want to be pregnant are going to work for Starbucks
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Starbucks is one of a handful of companies that offer insurance that covers fertility treatments for women who are trying to get pregnant. - photo by Jennifer Graham
For couples having trouble conceiving, in vitro fertilization offers hope with a hefty price tag. The procedure can cost $15,000 or more for each attempt, and it's rarely covered by employer health plans.

The notable exceptions include a world-famous purveyor of coffee with a name inspired by Moby-Dick.

IVF is a whale of benefit for Starbucks employees, as CBS News recently reported.

The Seattle-based company covers up to $20,000 for IVF treatment and medication, even for part-time baristas who earn half of that in a year.

"It's just been part of who we are, that if you work here and you put in the time, you're going to get the benefits that make you a full partner," Starbucks executive Lucy Helm told Anna Werner, a correspondent for CBS.

"It is really important to everyone, and I think it's something that we're all very, very proud of. People fall in love with working for our company once they become a partner here."

Werner interviewed Shannon Iagulli, a new mom in Lambertville, Michigan, who said that she and her husband had tried unsuccessfully to have a baby for four years. After she learned about Starbucks' IVF benefit, she went to work as a barista, and now, with a little help from her employer, the couple has twins.

Iagulli no longer works for Starbucks, but she's part of a Facebook community called Starbucks IVF Mommas. The group, which is closed to the public (meaning you have to apply and be approved to see its posts) has 428 members, and its main page shows an ultrasound image of a fetus drinking from a Starbucks cup.

For the record, the American College of Obstetricians and Gynecologists says that although some studies indicate a correlation between caffeine and miscarriage, the results are unclear, and that it's generally believed that one 12-ounce cup of coffee a day during pregnancy about 200 milligrams of caffeine is safe.

Who needs IVF?

The first baby born with IVF technology was Louise Brown, deemed the world's first "test-tube baby" when she was born in England in 1978. Now 39 years old, Brown recently met the first IVF baby in the United States, Elizabeth Carr, born in 1981.

The women are among about 6 million people alive today who were conceived in a petri dish. Doctors collect eggs from a woman and mix them with sperm from a man, and when embryos develop, they implant one or more in the woman's uterus. About 1.5 percent of all babies born in the U.S. are conceived using this technology that translates to 65,787 babies born in 2015, according to the Society for Assisted Reproductive Technology.

IVF can help couples who were unable to conceive because of poor sperm production, uterine fibroids, damage to the woman's fallopian tube or other conditions.

But the process is expensive, especially in the U.S., so much so that some couples are using crowdfunding websites to try to raise money for their ART (assisted reproductive technology) treatments.

Part of the problem is the cost of the drugs used to stimulate egg production, SHAPE magazine reported in July. "Gonadotropins, the hormones used as the foundation of infertility treatments, are ridiculously expensive in the U.S. These medications can tack several thousand dollars onto the price, and most aren't covered by insurance," Charlotte Hilton Andersen wrote in SHAPE.

Andersen reported that some doctors, including Dr. Paul Magarelli at HQA Fertility Centers in Colorado, are aggressively undercutting market prices, offering IVF for less than $6,000.

"Bargain hunting for babies, picking out fertility treatments like you would sandwich fixings at Costco, may raise a few eyebrows. But it's time to change how we think about infertility because 10 to 12 percent of women will struggle with it," Andersen wrote.

Who covers IFV, who doesn't

Under the Affordable Care Act, pregnancy and childbirth is one of the 10 essential benefits that all health insurance policies must cover.

Getting pregnant, however, is not part of the deal.

More than 1 in 10 American women who are trying to conceive meet the standard for infertility: not being pregnant after one year of unprotected sex.

According to HuffPost, 15 states have laws requiring insurers to cover infertility diagnosis and treatment, but only five Illinois, Massachusetts, Rhode Island, Connecticut and New Jersey require that policies cover IVF.

Many insurers cover only artificial insemination, in which sperm is implanted in a woman's uterus or cervix.

A March study from Washington University School of Medicine in St. Louis showed that women using IVF were more likely to conceive if their health insurance covers the procedure. But with Republicans seeking changes to national health care policy that could end mandatory maternity coverage, infertility coverage is not likely to improve anytime soon.

However, some companies are helping their employees pay for the procedure, even if the companies don't want to talk about it, according to a report in MarketWatch.

In the MarketWatch story, written by Sarah Elizabeth Richards, the president of an infertility advocacy nonprofit called Resolve said that the group wanted to give an award to a "fertility-friendly company" but was turned down by eight companies that qualified.

I cant even tell you how shocked I was. I wanted to say, We want to tell the world how awesome you are. Some of them had the most amazing benefits, but they didnt want to make them public, Barbara Collura said.

The website FertilityIQ outed some of the companies, anyway. Its list of "best companies to work for as a fertility patient," included Bank of America, Boston Consulting Group, Spotify, Discovery Communications, Chanel, Conair and Johnson & Johnson.

Starbucks got only an honorable mention.

That doesn't deter Iagullis, who left Starbucks after getting pregnant and will likely return when she wants to have more kids.

This creates another ethical issue surrounding IVF, in addition to the dilemma of what couples should do with leftover embryos: Is it wrong to work for a company only long enough to get a benefit you want?

Starbucks, which also offers employees up to $10,000 to help them adopt, benefits from the policy, too, said Craig Garthwaite, who teaches at Northwestern University's Kellogg School of Management, to CBS.

"In the end, Starbucks is a for-profit, publicly traded company. They're not doing this out of the goodness of their heart; this is part of a cohesive strategy they have for how to attract and retain talent and also to advertise to their customers that they are 'a good company,' one that you want to spend a certain amount of money buying coffee at when you could get that coffee potentially cheaper somewhere else."
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From the book 'Outliers' comes proof that good health is more than just genetics
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Friends Jim Young, left, Mike Natale, Jeff Natale and Ryan Kiernan were on Greenwich High School football team together and Jim and Mike were captains. Jim, who was the youngest in Sherry Young's family, was welcome in the homes of the other three boys who still had siblings around and grandparents near. - photo by Sherry Young
As I look back on my life and the lives of others, both personally and in the reading I have done, I am convinced of the necessity of positive human contact in our lives. We are doubly blessed when we are able to make good friends or are a part of a family where we are accepted and loved.

Malcolm Gladwell in his book Outliers tells of a time in the 1950s when Dr. Stewart Wolf met a physician who practiced in the area of Roseto, Pennsylvania. Roseto was settled by a group of Italian families from Roseto, Italy, who re-created their life again in America.

This was in the 1950s before drugs and measures to prevent heart disease became important. In their conversation the physician said, You know, Ive been practicing for 17 years. I get patients from all over, and I rarely find anyone from Roseto under the age of 65 with heart disease.

Wolf was surprised by these words as, It was impossible to be a doctor, common sense said, and not see heart disease.

Wolf enlisted the aid of a sociologist and friend John Bruhn to help him. They found, There was no suicide, no alcoholism, no drug addiction, and very little crime. They didnt have anyone on welfare. Then we looked at peptic ulcers. They didnt have any of those either. These people were dying of old age. Thats it.

They checked into diet, genetics and possibilities of something in the foothills of eastern Pennsylvania but nothing made sense.

What they found was that Rosetans visited one another, stopping to chat in Italian on the street, say, or cooking for one another in their backyards. (Researchers) learned about the extended family clans that underlay the towns social structure. They saw how many homes had three generations living under one roof and how much respect grandparents commanded. They went to Mass at Our Lady of Mount Carmel and saw the unifying and calming effect of the church. They counted 22 separate civic organizations in a town of just under 2,000 people. They picked up on the particular egalitarian ethos of the community, which discouraged the wealthy from flaunting their success and helped the unsuccessful obscure their failures.

What they found eventually convinced the medical establishment to look beyond the individual and understand the culture people are part of their friends, families and town they came from. They determined that the people we surround ourselves with and the values of the world we inhabit have a profound effect on who we are.

Likely, this study could have been done with other ethnicities. However, my family's experiences with the Italian families in Connecticut ring true to the study. Our hungry and growing sons, especially our youngest son, Jim, who was left home alone with two beady-eyed parents, all had some memorable experiences being fed and loved in the Cos Cob multigenerational families. Proof of the African proverb, It takes a village to raise a child.

We live in an age when the contact we have with people often is on the internet, and many of us live among strangers. Unless we make the effort to reach out, we will become isolated, especially as we age. The Rosetan study is proof that reaching out and communicating may be good for our health.
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