Sunday, February 17, 2013

It's a tragic tale

Five year old Carson is deaf.  His family wants to get him some cochlear implants but the $250,000 cost is not covered by their current health insurance plan.  They can't afford it out-of-pocket.  The parents have started a petition on Change.org to try to pressure the insurer to change its policy in this area.  Not just for Carson so he can get his "robot ears", but for all people who need cochlear implants.

There is a very valid argument in the letter they sent out asking for people to sign the petition.  Their current insurer was purchased by a larger carrier, that will pay for cochlear implants for covered individuals who have a medical need.  They argue that since the owner of their provider covers them, it should change the policy to cover them.  It's a valid argument.

But should an insurer cover any and every procedure, no matter how expensive?  Cochlear implants aren't cosmetic, but where does the line get drawn?  A woman who has had a radical mastectomy deserves to have breast reconstruction covered by her insurer.  Does a woman who just wants bigger breasts deserve to have the same insurer pay for augmentation?  Penile implants?   Will viagara be followed by Spanish Fly? 

Wellpoint is a major insurance carrier in the U.S., providing health insurance of one type or another to over 34 million people.  Now if it were having to aborb the cost of just 10 or 15 cochlear implant procedures, over those 34 million odd individuals, it would be pennies per month per person to recoup the expense.  But people don't want just cochlear implants.  They want the latest, most expensive, cutting-edge treatments; even when they are not yet proven to have any benefit.  An anti-cancer medication that costs $1,000 a day and has been proven to have benefits that may provide a cure, a better quality of life, or just merely extend life is worthwhile for an insurer to be providing.  No matter how old the person is.  But an experimental drug that costs $20,000 a day that has yet to be proven to do anything belongs nowhere but in drug trials.

If there were an unlimited pot of money to pay for healthcare for everyone, that would be wonderful.  It just isn't the case.  I feel bad for Carson.  I'd pony up a buck or two if his parents decided to try to just raise the money and I'm sure we could find another 249,999 folks also willing to pitch in.  That would solve his individual problem.  But it wouldn't solve the real problem.  We  can't afford the healthcare system people want.  We don't have any way to pay for it.

Before I dismount my soapbox with a double-twisting backflip, let me leave you with one thought.  $1,142.  That's how much was spent, per person in this country in FY2012, just to pay the interest expense on the national debt.  To pay the cost of what we've already borrowed and can't repay.  You don't want to know what your individual share of what's actually owed would be.  It's even more frightening. 

It's a tragic tale.