It's time once again to open up the can o'worms known as "medical necessity." This caused an interesting kerfluffle some years ago when we discussed it as regards IVF. Yet here we go, once more into that (metaphorical) breech.
Last week, Bob wrote about "free" prescriptions, and their true cost. In that post, he noted that the "Institute of Medicine wants women to get free birth control pills ... [w]ith some pills running $90 per month."
That's just shy of $1,200 a year for a "medication" with but one purpose, to prevent a potential consequence of an easily avoided behavior, and for which numerous other "therapies" are available.
Now, it's true that these "meds" are sometimes used for other purposes (eg endometriosis), but again, all of these alternative - "off label," if you will - uses are easily (and often more effectively) substitutable by other protocols.
To put it another way: there is no justifiable medical reason for birth control pills to be covered by insurance. And, quite frankly, asking the 50% of the population who gain no benefit from these little pills to subsidize their cost is unfair, and unjustifiable.
But there's a larger issue here:
"The Obama administration seems ready to force insurance companies to include birth control coverage in their plans. So much for the president's promise of bending health care costs downward."
In fact, it gives HHS Secretary Shecantbeserious the "authority to compile a list of female preventive services that all new health insurance plans will have to cover without employing deductibles or charging co-payments."
These are known as "first dollar" benefits, meaning that there is no deductible, co-insurance or co-pay required of the recipient. It's "free." So much for "skin in the game," as well: we already know what happens to costs when benefits incur no out-of-pocket costs. And again, who's punished by this?
You'll notice that I don't advocate that plans cover Viagra, or prostate exams, or Rogaine. At all.
Those, too, increase costs, and only one can be considered medically necessary. But if we're going to go down this road, how about a little fairness?
Last week, Bob wrote about "free" prescriptions, and their true cost. In that post, he noted that the "Institute of Medicine wants women to get free birth control pills ... [w]ith some pills running $90 per month."
That's just shy of $1,200 a year for a "medication" with but one purpose, to prevent a potential consequence of an easily avoided behavior, and for which numerous other "therapies" are available.
Now, it's true that these "meds" are sometimes used for other purposes (eg endometriosis), but again, all of these alternative - "off label," if you will - uses are easily (and often more effectively) substitutable by other protocols.
To put it another way: there is no justifiable medical reason for birth control pills to be covered by insurance. And, quite frankly, asking the 50% of the population who gain no benefit from these little pills to subsidize their cost is unfair, and unjustifiable.
But there's a larger issue here:
"The Obama administration seems ready to force insurance companies to include birth control coverage in their plans. So much for the president's promise of bending health care costs downward."
In fact, it gives HHS Secretary Shecantbeserious the "authority to compile a list of female preventive services that all new health insurance plans will have to cover without employing deductibles or charging co-payments."
These are known as "first dollar" benefits, meaning that there is no deductible, co-insurance or co-pay required of the recipient. It's "free." So much for "skin in the game," as well: we already know what happens to costs when benefits incur no out-of-pocket costs. And again, who's punished by this?
You'll notice that I don't advocate that plans cover Viagra, or prostate exams, or Rogaine. At all.
Those, too, increase costs, and only one can be considered medically necessary. But if we're going to go down this road, how about a little fairness?
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