Dr. Craig Sweet, August 10th 2011 |
The National Institute of Medicine finally suggested that women obtain contraceptive care with full insurance coverage and without large co-pays. From one perspective, it was about time. Nearly half of all pregnancies are unintended and families should be expanded when there is true intent and not because contraception was not available. Also, since men have medications for erectile dysfunction covered by insurance, it's seemed only fair.
That stated, there might be a downside. Since no co-pays will be obtained, will the insurance companies increase payment to make up the difference (doubtful) or will the physician’s office loose the income in an already existing atmosphere of dwindling reimbursements (more likely)?
Will the frequency of unwanted pregnancies and abortions really fall? Even though condoms have been made available at some clinics for free, having the contraception easily available didn’t mean it was used at all or used correctly. When one provides something for free, is as appreciated as when one has to pay an amount, no matter how small, to increase personal responsibility?
When care becomes free or nearly free, there is almost always an increase in utilization. Is contraception one area of medicine that we would welcome increased utilization? Most, except the religions that do not believe in contraception, will agree this is ultimately a step in the right direction. Even so, there is no free lunch. Will insurance companies increase the premiums to pay for the office visits and the contraceptive medications and pass the costs to everyone else? We suspect the answer is probably yes.
At first glance, requiring insurance companies to pay for female contraception seems like a great idea but there is the issue of unintended consequences. Please share your thoughts on our Facebook pagewhere we've started the discussion. We’d love to hear from you!
admin, April 13th 2010 |
Since the healthcare reform bill does not address specific diseases, infertility is not addressed in the bill. However, in 2014, small businesses and individuals will begin to purchase health insurance under the state-based American Health Benefit Exchanges so it may be included in these policies. Also in 2014, an “essential health benefits package” will be drafted. The intent is to include a comprehensive list of services, but it cannot be more extensive than a typical employer plan. Since this plan has not yet been drafted, the details are forthcoming.
Currently, several states have mandates requiring insurance coverage for the diagnosis and treatment of infertility. Florida is not among those mandated states. The plan does not specifically address state mandates so this will be an issue to watch.
On a positive note, the elimination of lifetime caps is a benefit for fertility patients. Patients who have a premature birth or need specific prenatal or neonatal care can often exceed the lifetime caps set by insurance companies.
In addition, the elimination of pre-existing conditions exclusion is also a plus for fertility patients. In some cases, patients have been denied coverage due to their pre-existing condition of infertility. Under the new reform bill, companies can no longer deny coverage based on pre-existing conditions.
The National Infertility Association, RESOLVE, has been monitoring the health reform discussions since they began and has met with Members of Congress to convey the needs of infertility patients in the U.S. While RESOLVE did not endorse any specific healthcare reform legislation, as a member of the National Health Council RESOLVE does support the Council’s Campaign to Put Patients First, a campaign which has identified five health care principles that must be part of meaningful healthcare reform. As the new reform law is implemented, RESOLVE will continue to advocate for the millions of Americans with infertility to ensure their voice is heard.
For more information on fertility treatments or health reform, visit www.dreamababy.com or call 239-275-8118.
admin, April 9th 2010 |
It was an honor to meet Dr. Snyderman at the American Medical Association's National Advocacy Conference.
This was taken up in Washington DC on Tuesday evening, March 2, 2010, at the AMA National Advocacy Conference.
Going from left to right:
Kelli Sultan; Shahid Sultan, M.D., President-Elect, Lee County Medical Society; Nancy Synderman, M.D., Chief Medical Editor, NBC News; Craig R. Sweet, M.D., President, Lee County Medical Society; and Vicki E. Sweet, R.N.