Thursday, August 6, 2009

Health insurance and IF

You may have noticed a few people are talking about health care now. I'm a political junkie and have been following it closely. I'll even admit to having my congressman's phone number on speed dial. He hears from me often, especially since he gets lots of money from the health insurance industry.

But in all the time I've spent thinking about health care reform, there is one thing I'm not sure about. How much should we require either a public option or private insurance companies to cover IF treatments?

I work for a large employer and we get pretty good health benefits (although premiums and the deductible do keep going up). My plan will cover the diagnosis of IF, but not the treatment. We have not made the move into expensive treatment yet, but still the co-pays, deductibles, and prescriptions have totaled more than $500 out of pocket so far this year. True, that's not a whole lot of money yet, but as we think about moving forward with more expensive treatment, we get worried.

I believe we need health care reform so that everyone can have access to some basic level of high quality health care. But the question is what do we consider a "basic level?" I have a feeling my definition of basic coverage for everyone would be higher than most people, but still I still hesitate at saying it should include IF treatments. Do we have a moral responsibility to help couples have a child in the same way (I believe) we have a moral responsibility to help people who have cancer?

On the other hand, IF is a medical condition, just as there are many other non-life threatening medical conditions that we seem to think of as worthy of health insurance. We also value health care that increases the quality of our lives, not just those that extend our lives. IF treatment certainly fits that category.

Plus there are a variety of medical conditions that insurance will pay for that are really optional. For example, my cousin is a great high school athlete. She recently had a knee injury, a similar knee injury that I had in college. My doctor told me that for my lifestyle, surgery was not necessary. I've never had surgery and my activity is not inhibited at all. After an initial healing process (in which physical therapy was the only treatment), you couldn't even tell my cousin had a bad knee. She would walk, run around, do all the daily activities she used to. Except she wasn't allowed back on her basketball team. If she wanted to continue playing sports at a level where she can get a college scholarship, she needed surgery. So she had it, and her insurance paid. Why do we think insurance should pay for something that is only necessary if we want a college scholarship, but not for something that is only necessary if we want a baby?

And I can't mention this topic of elective medical treatments without bringing up one important example. Most health insurance plans will pay for viagra and similar pills. How is that any different from covering cl.omid?

So, my blogging friends, what do you think? Where do you think we should draw the line on insurance paying for IF? To what extent is your perspective influenced by whether you have insurance coverage for it?


  1. Interesting post. I'm originally from the UK and from where we stand most of us are thankful that we do not have the US system as it looks very expensive and complicated.... but that's only an outsiders perspective. I did see the film Sicko (not sure how accurate it is) and it gave a very depressing view of healthcare in the US.

    I have to say in the UK i am entitled to 3 cycles of IVF on the National Health Service. Which means I don't have to pay. But in actual fact we do pay for it in our taxes. I could also go for IUI etc on the National Health Service but there could be a wait, you have to wait until they have space for you. And that depends on your area. Sometimes it works great and other times it doesn't. But when I was a student I can't tell you what a relief if it was to know that if I had an accident or got sick I would be taken care of. Without big bills or insurance companies. In my view it's worth paying taxes for that.

    I live in Morocco now and there is only healthcare for people who can pay for it. I see old sick people outside hospitals everyday, dying. So whenever I hear people complain about the NHS in UK I just remind them what it would be like without it.

  2. I have had so many similar conversations with friends about this topic. Your points are so dead-on, and I con only agree and ask the same questions. I love that you brought this up.

  3. Clare, when people complain about the NHS, remind them of what it is like in the US! I would trade systems.

  4. There's an award waiting for you here:


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