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Insurance Won't Cover Smartphones, When Pricey Alternatives Exist
consonant writes "The NY Times has an article on insurers refusing to cover cheaper devices such as iPhones and netbooks which may be used by the speech-impaired, and instead requires them to acquire devices that cost from 10 to 20 times as much. The reason? 'Insurance is supposed to cover medical devices, and smartphones or PCs can be used for nonmedical purposes, like playing video games or Web browsing.' From the article: 'For the millions of Americans with A.L.S., Down syndrome, autism, strokes and other speech-impairing conditions, the insurance industry's aversion to covering mainstream devices adds to the challenges they face. Advocates say using an everyday device to communicate can ease the stigma and fear of making the adjustment. At the same time, current policies mean that the government and private insurers may be spending unnecessary dollars on specialty machines.'"
No, really, it's everywhere.
A few years back, I had to have an operation on my foot. The doctor said he could do the operation in his office under local anesthetic and the whole thing would cost a couple thousand bucks (memory's fuzzy), or we could do it in a hospital where it'd be 5x more expensive. The catch? My insurance would cover the hospital outpatient surgery, but not his office (which was also a fully licensed and certified surgical center, just not attached to a hospital). So I did it in the hospital, of course; I was between contracts and couldn't afford to do otherwise even if I had felt noble enough to do it for the good of the health care system.
Misguided incentives like this are all over health insurance--just look at the varying coverage rates for preventive care vs. corrective care (like diabetes maintenance vs. amputations). If you can put off the treatment until later, there's a reasonable chance that some other insurance company will pick up the more expensive tab, and "patient outcomes? What's that?"
It's one of the strongest arguments for a single-payer healthcare system: the chance to remove loopholes that lead to these bad incentives.
Freedom isn't free; its price is the well-being of others.
Yeah, they would. I mean, sure, they'll go for the medical device if it's better, but if a simple iPhone would work nicely, they'll get you an iPhone. Mainly 'cause in Scotland at least, that sort of decision is made by the local manager in the place you actually go to see the doctor/physio etc. The great thing about the NHS is that it divorces cost from medicine. Since it's all "free" to the patient and the doctor anyway, the doctor will go for the best medical option, regardless of if it costs less or more; admittedly there is some shilling still of GP's by big Pharma trying to get them to prescribe brand X drug, but it's mostly gone, and we see a lot more brand-x-generic now, and all gratuities from Big Pharma to the GP have to be declared. In the States, even if you get coverage, your insurance co. still get shafted by doctors that will order unnecessary tests etc. just to bump up the bill, because it's not his company the money's coming from. Here, it's all the same "company", so if you need a test, you get it. If not, you don't. On the bad side, whilst they'll never turn you down for treatment, depending on where you live, and what it is, you may be waiting a while for that hip-replacement/eye-operation etc.
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That is because each state has different laws covering health insurance. There is no government regulation preventing you from purchasing insurance from a carrier in a different state, nor is there regulation preventing an insurance company from selling in multiple states.
100% false. You can deduct medical insurance premiums.
This is a separate issue, and one worthy of debate. The alternative to mandated coverages (which are much less onerous than you assume, I think) is insurers selling insurance, collecting premiums, then denying claims for seemingly random conditions. This was a HUGE problem before states stepped in to regulate the medical insurance industry. While it needs to be balanced against efficiency, there is no doubt in my mind that mandated coverages have been a big benefit to insurance buyers.
As for the first two items I addrsssed, you are either being disingenuous or are grossly misinformed. I hope it's the latter, but I'm not sure.
While I agree that over-regulation can be a problem, under-regulation can also be a problem. Letting the insurance companies do what they want will not result in a better outcome for the people who buy insurance. We've been there, and it doesn't work. My big complaint with over-regulation is that it creates barriers to entry due to compliance costs; however, there are already significant barriers to entry in the medical insurance business because of the cost of catastrophic cases (capital reserves need to be very large, which keeps new entrants out; also, bad luck could easily mean insolvency for a small insurer).
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Because insurance companies tie their definition of "medical device" to what Medicare reimburses for (one of the reasons for this is that Medicare constitutes such a large part of the market for people using medical devices that insurance companies find it cheaper to use their list than generate one of their own). And since Medicare has certain legal requirements for what a "medical device" is (including going through FDA approval), it can be expensive and complicated to get on that list. Hence, any device that is on the list is going to cost much more than one that isn't. The alternative is to let Medicare bureaucrats, who are not doctors, decide whether a device is medically necessary or not.
So you're not naive about how health insurance works. You've naive about how government programs in the United States work. Now maybe you can understand why most of us don't want the Federal government to have anything to do with health care: they'll just make it worse.
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Wow. You must get all your new from biased sources since you have everything backwards.
Buying insurance as an individual is incredibly expensive. The reason employers get a better deal is because they have a larger pool of people and can negotiate down prices. As an individual, you do not have that leverage so you get screwed. You are also screwed no matter how much you are willing to pay if you have a pre-existing condition (like pregnancy).
A public option would allow you to take it across state lines...so I don't know what you are complaining about there.
You are already paying for coverage you never use. And on top of that, you are paying for all the profits that go to the shareholders and the large CEO salaries. There is no way that it will be more expensive than the current system.
Again, one device being preferred over the other is already in the current system.
It has gotten vastly better for every industrialized country that has a single payer system. The mantra that government is bad is stupid and childish. Too much government is bad. Too little government is bad. It is time to realize for our businesses to compete and for us as individuals to be actually getting raises instead of paying more for health care, we need to do away with the for profit business of health insurance.
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As somebody who spent a lot of time and energy helping acquire such a device for his father who suffered from ALS, I would like to highlight some important facts.
Many of the devices that the insurance companies cover are actually modified PC's. Before you say that people are better off buying a computer and having insurance foot the bill, look at the facts:
1. These PC's come modified with software and other interfaces which are specially designed based on years of research to meet the needs of the disabled for communication in the most intuitive way possible.
2. Often times the software is placed on an embedded windows system so that its harder to "break" with malware, and the like. Very few PC owners apart from the tech savy can say they've never gotten a computer virus or some form of malware. Even us techies slip up sometimes. Can you imagine if your lifeline were disabled by a virus? This is exactly what these devices are. Lifelines. People rely on them every day for the basic things we take for granted. Having the software embedded keeps the device functioning. Having functionality limited to...well....speaking...that makes the device far less daunting to those who might not be as computer savvy.
3. There are lots of different attachments available for these devices that let pretty much anyone with any level of disability use them. Each attachment is geared towards using the functionality a person has left. These are niche items that are pretty hard to come by at WalMart.
4. These computers are generally ruggedized (usually a toughbook, or something similar). The ruggedization is critical when the device goes everywhere with you.
The bottom line, really, is that these devices are designed to work any time anywhere for anyone. These are really custom solutions. Also, a whole lot of vendor support comes with the device, which is critical to making the most of it. This entire package, including the support, the level of customization in terms of input devices and software tools, and the level of quality and reliability seem to justify the high price in my eyes.
Your insurance company, believe it or not, has your best interest in mind as well as their own when they decide what is and isn't covered. These costly specialized devices are the best option for a whole lot of people. By only covering a solution like this, the insurance company knows you're getting what you need, which is tough to do if you're talking about building a system yourself.
I could have created a home-brew solution, but it would have been without the benefit of years of research into the progression of various diseases and the capabilities of somebody paralyzed from the neck down. Why should a patient have to deal with debugging a home-brew solution or trying to use a conventional mouse or keyboard when they can barely move their fingers? Being paralyzed is frustrating enough as it is...they don't need the extra stress.
On a side note, you can in fact work with the vendor and the insurance company to have an "add-on" placed in the computer-turned-medical device to allow you to use it as a computer as well. The expense is out of pocket, but is usually far less than the cost of a computer.
izm
Not quite. Medical expenses are only deductible if they exceed 7.5% of your AGi, and you need to itemize, meaning that this deduction competes with the standard deduction. Contrast this with employer provided healthcare: you get to deduct all of it, and you can still take your standard deduction.
In both cases, this favors the rich.