As to whether Medicaid covers abortion:
http://www.healthlaw.org/pubs/19990305reprofactsheet.html
http://www.nnaf.org/nyaaf/mission.html
[quote]
According to the National Abortion and Reproductive Rights Action League (NARAL), only 16 states, New York included, cover elective abortion services for Medicaid recipients.
It’s interesting that no one is really supporting these bills which are pending.
It also seems that most people object because of cost reasons, not philosophical ones.
If fertility treatments were cheap, then should they be covered?
I don’t have any kids, but I hope to someday, maybe in the next few years. I don’t know what I would do if I found out I was infertile, but I would probably want to explore all my options. For me, that would include looking into fertility treatments before giving up on having a biological child. I am surprised at the number of people here who look down on those who choose to have fertility treatment and not “just adopt.” Adoption can be just as time-consuming, emotionally involved, and expensive as infertility treatments. I don’t think adoption should be viewed as the “back up plan.”
I would support coverage of fertility treatments, but don’t think the government should get involved, or needs to. Maybe being infertile is not a life threatening condition or disability, but that’s not the standard most insurance companies use. Why should I pay for someone to get Viagra but refuse to help an infertile man?
Being infertile affects my quality of life, and no insurance company, or anyone for that matter, should tell me there’s no need to get fertility treatments when I can adopt.
Coverage of these treatments would have to be qualified, of course, no one is saying to hand a couple a blank check and tell them to go for it, as long as it takes. We could start by covering the most basic, proven methods with the highest success rates (after coming up with the definition of infertile, this would be up to the insurance company) and go from there. The companies could limit the number of “attempts” they would pay for.
Undergoing fertility treatments is stressful enough without worrying about depleting your life savings for it. It’s not an easy thing to choose, regardless of how much money you have, but covering at least part of it would give a lot of couples a chance.
Just out of curiosity, why are fertility treatments different than any other treatment that changes a “natural” condition? Medical advances have saved millions of lives, extended lives, and allowed babies to survive that otherwise would have died at birth. Premature babies that would surely die were nature to take its course are now able to survive. Don’t these treatments affect the population more than any infertility treatment ever would?
Birth control, on the other hand, also affects the population. I would guess that the number of babies not born because of birth control is far greater than the number that would be born because of infertile couples being able to conceive. Why accept some forms of treatment and not this one? I think that telling an infertile couple there is a reason they can’t have children, and that reason is to keep the human population under control is a little ridiculous.
One thought:
You should walk a mile in someone’s shoes before judging what you WOULD or WOULD NOT do as far as infertility treatments go.
Speaking from experience with infertility (unexplained- perfectly healthy couple-- in their late 20’s-early 30’s)— We HAVE the desire for our own offspring-- our own genetic pool…maybe some people don’t want to adopt. It’s their choice.
By the way…the person who said, “maybe it’s a way for nature to control the population…” That was baaaaaadd Karma…What comes around goes around. Sorry, it’s true.
Siemsi so what do you propose health insurance companies do about infertility coverage?
My wife and I have undergone 3 unsuccessful invitro cycles and adopted once.
After the third invitro try we were leaning toward an agency adoption before my wife was approached by an expectant co-worker and asked if we would be interested in adopting. Everything went fine and we are the very proud parents of a baby boy.
I would slap echo kitty here but she already fessed up.
Off the top of my head I can think of seven couples that that would cheerfully either adopt or do invitro (the only real infertility option open to most of them–two of the couples can’t even do that). There are of course pros and cons for each:
Some advantages of adoption
Low financial risk : agency adoption has the advantage of no money (other than relatively minor processing fees) until the child is placed. In short, if you fork over the $10-12k you will get the child. (A private adoption like my wife and I went through is higher risk–the birth mother could have taken the money provided for medical bills, expenses etc. and walked off with the baby. Perfectly legal, nothing we could have done.). Another financial advantage is the adoption tax credit which reimburses (up to (IIRC) $10,000) the adoption expenses.
Some disadvantages of adoption
No control over genetics. While most agencies let you specify ethnic background you still have little if any control over height, hair, and eye color etc. Not a big deal in most cases.
Prenatal care. You largely have to go on the word of the mother as to whether or not she (or the birth father–if she even knows) did anything that would have harmed the unborn child. I know of one case where an adopted child grew up with classic symptoms of Fetal Alcohol Syndrome. I have other friends that just buried their adopted child who died after 18 months of severe retardation and little if any sign of stimulus recognition. The birth mother-to-be admitted to taking a fetus altering drug during pregnancy (They knew that this would probably be the case going into the adoption, my respect for them can not be expressed by words).
The child isn’t genetically “yours.” Some people have a real problem with this. The fact that they didn’t carry or father the child is a barrier that they can never overcome. Personally I think that this is a non-issue with most adopting couples.
Intrusive. The state and anyone else overseeing the adoption process gets really personal about your personal, financial, and home affairs. You have to nearly bare all to satisfy the bureaucrats.
Some advantages of invitro
It gives hope to people who otherwise could not have kids.
Avoid the disadvantages of adoption (see above).
Some disadvantages of invitro
Expense. This is the whole issue of the OP (sorry for the hijack). You plunk down in excess of $10k for a 1 in 3 chance that it will work. It is typically not covered by insurance.
Health of the children. Multiple births are more common when doing infertility treatment. This is largely due to the prospective parents wanting to maximize the potential of the procedure working (if the costs of infertility treatment were to significantly come down the percentage of multiple births would also lower). Multiple births (especially three or more) give rise to lower birth weight and the inherent problems therewith.
Health of the Mother. This is physical as well as mental. For invitro the doctors hyper stimulate the reproductive system. Things can and do go wrong.
Having said all that I would finish by stating that I am against requiring insurance (or the government) to require infertility treatment. It is an elective procedure. If companies want to provide this as a service, fine, that is their choice.
Oops, my bad. I meant echo22 not echo kitty.
Now I should be slapped.:smack:
Honest mistake Threadkiller, and I was well aware of who you were talking to.
Suffice it to say I have not walked in those shoes, so my slaphappy comment was rather insensitive.
However, I am not the only one here that deserves a slappin’…… I’ll officially take my stance, as you, that it is an elective procedure, therefore should not be required of insurance companies to provide such coverage in their policies.
Why? I’m never going to be a farmer in Montana, nor am I ever going to “walk a mile” in the shoes of a Montana farmer. Should I keep silent on the issue of farm subsidies, or should I be allowed to write my Congressman on the issue?
I’m not in the military and I’m too old to be drafted. Am I disqualified from the debate on war with Iraq?
As for fertility, I have no idea whether I’m infertile or not, and, not having a spouse, I have no idea whether or not my future spouse will be infertile.
I am opposed to the mandated coverage of fertility treatments, because the effect will be to increase premiums, which means that less people will be able to afford any medical insurance.
I hope that I have the self-respect and integrity to remain opposed to mandated coverage of fertility treatments even if it turns out that I or my future spouse need them. I don’t think I should support bad public policy simply because it will benefit me.
Sua
There are all kinds of treatments necessary to correct medical problems, some of which are potentially disabling or life-threatening, that are not legally required to be covered by insurance. (Bone marrow transplants spring to mind, but there are lots of others.) If the law doesn’t require insurance to pay for those, why should infertility treatment coverage be legally required? At least the patient won’t die or be disabled without it.
Insurance is a contractual issue; you get what you pay for. My state (Illinois) requires payment for infertility treatment, but I’m not convinced that they should in an age where there is no legal requirement that, say, insurance pay for organ transplants.
None of this takes away from my sympathy for infertile couples; I just think that requiring insurance to pay for it is extremely hypocritical.
You’re right, in a way. It’s been our experience that reproductive medicine practices that have the highest success rates are the least likely to be covered by insurance.
Fertility treatments will never be cheap. That’s like saying cheap surgery. It just gets more and more expensive.
Sua
as I said, I’m not all that familiar with US insurance. I’m used to a system where some fertility treatment is available on the public health system or some is available privately. I think some insurance policies do cover it here but not everyone has private health insurance. It’s not callousness – it’s unfamiliarity with your system.
The two countries I’ve lived in also are virtually impossible to adopt in. International adoption is hard and very expensive. I’ve known people to be on the waiting lists for adoption for a dozen years here and in NZ.
If insurance companies CHOOSE to offer a rider that covers infertility treatments, and that rider is completely optional and subsidized by its own costs, that’s all fine and dandy. But for the government to require coverage for non-lifethreatening stuff when they don’t require coverage for transplants, vision care, or dental care is pretty damn unfair. You may WANT to have a kid, but I NEED to be able to see well enough to not walk into walls. Unless, of course, you want to support me because I’m unable to work.
I did the “baby dance” for years, never conceiving through everything but IVF, (AI, IUI, spermwashing) which was simply beyond our financial grasp.
After giving up on ever having a child, figuring that there was just something wrong that we didn’t know about (and couldn’t even properly diagnose, because, again, insurance wouldn’t even allow me to find out what was wrong with my body) and that we were just going to have to live with it, we looked at adopting. We were, at the age of 35, going to end up disqualified by our age, because we weren’t going to get to the top of the waiting list before we maxed out chronologically. Nice.
Finally I ended up with a completely non-reproductive health problem which necessitated an ultrasound. During that, we found out that my problems were very likely caused by a small (though obvious) and completely fixable defect in the one fallopian tube that I was born with. (Another thing that we never knew because insurance wouldn’t let us know.) Because the only reason for repairing this defect in my body was to make it possible for me to conceive a child, again, insurance wouldn’t cover it. I could’ve privately paid for the surgery, but it was surgery, and if anything had gone wrong while I was having off-plan medical care, insurance wouldn’t cover me for those complications. It was just too risky. We have some money, but not enough to pay for, say, unlimited care if some idiosyncrasy had left me paralyzed or otherwise screwed up.
What kills me is that if a fallopian tube had ruptured as a result of having pelvic inflammatory disease (usually caused by untreated STDs) I would’ve been home free. Insurance would’ve paid for the repair without blinking. If I had lied and run to the hospital complaining of outrageous pelvic pain which led to the discovery of the defect, no problem. But because I was honest and hadn’t gotten an STD, I was a 6 millimeter tear away from possibly conceiving and couldn’t get any help.
I finally got the defect fixed when I had my appendix out two and a half years ago. (Since she was “in the area” my doctor, who knew about the problem, made the repair gratis, because she’s lovely. It simply required 12 microscopic stitches.) As many of you know, Mr. tlw and I had a baby girl earlier this summer.
There are, as has been noted, varying degrees and causes of infertility, and varying fixes. When you’re not whole, when your body doesn’t do something that it’s naturally supposed to do, you think that medicine can help you. You rely upon medicine to help you. When bureaucracy and red tape and decisions made from on high solely because of cost-benefit analyses and fears of outrageous spikes in claims (which could easily be avoided by simply capping benefits) makes it impossible for medicine to help you unless you’re rich, it’s frightening.
My infertility was easily understood. Many cases are not. But if infertility treatments are brought into plans, it will behoove the insurers to try to work to figure out if there is anything that can be done to prevent all of these rampant problems. (20% and rising should scare everyone.) Perhaps then we might see someone working to find out what it is that has so many reproductive systems screwed up – is it hormonal, is it something in the food we eat or the water we drink, something in the environment? Right now we don’t know, because infertility treatment is the province of the non-aligned, unorganized, bastard children of medicine.
I agree with Velma.
It IS a medical condition. And I think some should be covered by health insurance companies.
Again, the “shoes” I was referring to are “infertility shoes”…not a farmer/rancher in Montana.
I respect all your opinions…and I, too, once thought that way, until I met the man of my dreams and wanted to have children with him. THEN the tables are turned. Just a thought…
Siemsi,
I have been in your shoes. So has threadkiller. It isn’t respecting someones opinion to say “but if you’ve been where I’ve been you’d change your mind.” They might. They might keep their opinions.
And I’m with CrazyCatLady and Eva Luna. There is so much insurance doesn’t cover but really should. Infertility is way down on my “I think insurance should cover it list.” One of my former co-workers had a little boy with severe hearing loss. Insurance didn’t cover his hearing aids or speech therapy. I’m going to support covering a 2 year old’s hearing problems before I jump to pass legislation requiring coverage of infertility.
Want infertility coverage? Buy an infertility rider. There are plans out there that do cover infertility - our lovely market economy has made sure they are out there.
Would have been nice if it did for me. It didn’t. But I wouldn’t pay higher premiums for it. Hell, we elected not to go IVF because we wouldn’t pay for it (and other reasons, but the cost/risk not working out was a big one). If I don’t think IVF is worth is for me out of my budget, why should Sua pay for it.
tlw does have a point - more research does need to be done on infertility and its causes (I’m sick of hearing “you just waited to long” - I was in my 20s! or “it was just stress”) However, it isn’t the job of insurance companies to fund this research.
How about this rational, which I got from the onfertility website resolve.org:
“Supporters believe that infertile couples pay premiums for health benefits they are unable to use, such as maternity services, therefore, infertility benefits also should be covered by their health plan.”
Reading more posts does clarify for me why people are against infertility treatment being added to insurance plans. Call me naive but I had not realised that there were so many things not covered. I had this idea that insurance = coverage for medical conditions and only extraordinary conditions were excluded.
Everyone pays premiums for health benefits they are unable to use. Are men being discriminated against when their group insurance plan covers such things as treatment of female reproductive cancers (after all, no man has a uterus - why should HE have to cover someone else’s endometrial cancer therapy)? Are women being ripped off if prostate surgery is covered by their health insurance? For that matter, what about those people who’ve been electively sterilized, or who’ve undergone fertility-destroying therapies such as hysterectomy - should they get some additional benefit in their insurance to make up for the ‘useless’ (to them) maternity benefits they are helping to pay for? Sorry, but insurance doesn’t work that way - nor is it supposed to. The goal is not to provide everyone with “equal benefits” (which would be impossible in any case, since individual people vary so much with regards to their health), but to spread the financial risk of a serious illness over a large population, so that those few people at any given time who DO develop a serious problem will have the resources they need to treat it.
I’m not sure yet where I stand on the issue of requiring insurance coverage of infertility treatments, but I do know the above argument is completely bogus!