Tubal Ligation vs. Essure: A Comprehensive Comparison

Question
Hello.  I am comparing tubal ligation and Essure for sterilization.  So, I have a couple of questions for you.  Which is more effective, tubal ligation or Essure?  Which is safer?  Which is more cost effective?  Are both covered by Medicaid?  Which is the most effective in preventing pregnancy?

Answer
The people that market Essure claim that it's more effective, but it hasn't been around as long.  Different studies show a little difference in effectiveness, but both procedures are well over 99% effectiveness, which means that of 1000 women, maybe 1 will get pregnant in a year after Essure, and maybe 5 will get pregnant in a year after tubal ligation.  Essure is probably safer, as long as it's done by someone with enough experience doing it.  Essure is cheaper (maybe half), which makes it more cost effective.  I believe both are covered by Medicaid in most states.