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.'"

Comments

Fraud-bait... tort-bait

[EmagGeek]

It'll be amazing how many people suddenly come down with "disabilities" once insurance companies start paying for fancy PDAs and SmartPhones...

Also, once a PDA or SmartPhone is declared a "medical device," it will be subject to the same approvals and liabilities as medical devices, and will therefore cost 10 to 20 times as much as they do today...

Re:Fraud-bait... tort-bait

[99BottlesOfBeerInMyF]

You can tell I grew up in a country with universal healthcare.

No, but I can tell that you threw in a useless addendum to an otherwise insightful post.

It's not exactly useless. In truth the procurement of items for medical treatment in countries with socialized healthcare is often quite different. Not always, mind you, but often. Without a financial motivation for whether or not patient obtains a device to help them, most people tend to be both compassionate and pragmatic. That is to say, rarely would a person be denied a cane as a medical expense because it is cheap and someone needs help walking. Rarely would someone be granted a power exoskeleton because it is expensive and excessive.

With a profit motive in the US healthcare system insurance companies make more money erecting artificial barriers that prevent people from getting any assistive device. They're in a position to impose arbitrary rules to make providing such devices harder so their issuance is rarer. At the same time medical suppliers an make money by specializing in jumping through the hoops and getting certified products which make them artificially scarce allowing said companies to charge a lot of money. Even with the few expensive payouts, the insurance companies save money so they keep the policies.

Of course you see what is missing from the above scenario. That is the compassion and the pragmatism. A normal person working in healthcare would say, "an iPhone with apps for the blind, yeah that makes sense to help a blind person and is a lot cheaper than a specialty device". Then they approve it. It is the system standing in the way, a system motivated by rules designed to maximize profits. This type of rule is a great deal rarer in socialized medicine

This isn't to say that other healthcare systems are better in this way, just different. Profit is not the only motive that can result in arbitrary rules detrimental to individuals who need healthcare. Government bureaucrats can be just as bad implementing rules to punish groups at the expense of the masses or implement policies to mollify their special interest group in order to get re-elected. For example, rules to make abortion practically unavailable in order to appease a religious lobby or rules to refuse healthcare to overeating overweight people who are actually saving society money overall by their condition, but who much of society wants to punish for their sin.

Ah, American insurers ...

[aeschenkarnos]

... is there anything stupid, evil or simply wrong that they will not do?

Missing the other half...

[R2.0]

What TFS leaves out is that the reason "medical devices" cost so much is FDA regulations and the higher standards to which they are held. There is no possible way an iPhone could be certified as a "medical device". If Apple were to apply for certification, they would need to make a lot of changes, such as...wait for it...eliminating the ability to run 3rd party code.

Yes, insurance companies can be stupid when applying rules against paying for certain devises or "experimental" procedures. But ask the women whose lives were cut short by Congress forcing them to cover bone marrow transplants for breast cancer.

To be expected

[FreeUser]

Customers: I've paid my insurance premiums all my life. Now that I've had this terrible accident I need you to cover some modest expenses required for me to maintain the semblence of the life I once had.

Insurers: We thank you for your custom. Your call is important to us. However, you fail to understand even the most basic aspects of our business model. We're here to fuck you, not help you. Coverage denied. Thank you for playing.

(Applicable to most forms of health-related insurance it seems)

In the context of things like this, it amazes me (as an American, no less) that the US still finds itself embroiled in the health-care debate the rest of the industrialized world successfully resolved more than 60 years ago (in some places, as long as 80-90 years ago). Even with neanderthals like the Republicans around, you'd have thought the moderate and progressive populations of the country would have dragged that country out of the stone age by now ... but I digress.

Re:nope, they follow government guidelines

[MartinSchou]

Considering what you're describing, I'd have to think that the US is by far the most corrupt industrialised country in the western world.

When private companies (looking to make a profit) can provide cheaper health care than the government (who isn't looking to make a profit), something is very wrong, and the answer to that is usually corruption.

While we tend to complain about our hospitals (usually because of staffing issues), at least we don't face interesting questions such as "would I rather lose the house or the leg. The leg costs 100 grand, isn't covered by insurance, and I'd have to sell the house. And if I sell the house, where will we live? Maybe the wife'll leave me, or maybe child services will take the kids away."

And we don't have to worry about our doctor finding out that we have some kind of underlying but undiscovered illness. Or if we get one that takes forever to fight, to the extent that we lose our job over it and have to go on welfare for a while, at least we won't be fucked when we finally get back on our feet, just because we have a pre-existing condition that requires expensive medicine to cure.

Sure, if you can afford the insurance and weather a few years of really bad luck, I don't doubt that the US can provide some of the very best health service in the world. But I'm yet to hear of anyone in Denmark or Sweden who had to declare bankruptcy because they couldn't pay hospital costs.

As an example, I spent four days in a mental institution (checked myself in). That did cost me. A staggering 320 Swedish Kronar or 46 US$. Sure, that's more than it'd cost to feed myself for four days, but not by much. And considering I have a suicide attempt in my medical history, I think I'd be excluded over a pre-existing mental condition by most US HMOs if not all of them.

So again, if the private for profit companies can do a better job than your non-profit government, you have a massive problem with corruption. Not just in government, but also in the companies that provides these bribes and get away with it. But I don't think I've ever seen any mention of this in the mainstream US media, but considering none of them seem to be providing any kind of critical thinking and instead settle for either being cheerleaders or hecklers, I can't say I'm surprised.

Re:nope, they follow government guidelines

[mcgrew]

why do people think health insurance is prohibitively expensive when bought outside an employer

Because it is.

It will get vastly worse when the government takes total control.

That's not been the case in the countries that do in fact have total government control of health care spending.

Re:nope, they follow government guidelines

[radtea]

But I don't think I've ever seen any mention of this in the mainstream US media

You have, you just don't understand the code-words. When the American media talks about "the free market" and "free market capitalism" they mean "our utterly corrupt system where corporate and Party interests have completely captured the organs of the State and use them to futher their own interests."

Americans call this system of plutocratic oligarchy a "free" market for historical reasons, although arguably "free" could also mean, "free of economic rationality, ethics and democratic oversight."

Re:Fraud or stupidity

[level_headed_midwest]

"Medical insurance" in the United States isn't really insurance so much as it is a third-party payer for the vast majority of your medical bills.

Re:Cripple Ware

[level_headed_midwest]

Insurance payment is determined by a bunch of bean counters sitting in a basement somewhere. They don't care about spite, they only care about their actuarial tables and the balance sheet. The insurance companies are willing to pay more for a device without any non-medical functions because it will end up costing them less in the long run. If they start to cover stuff like iPhones, then people who want an iPhone will lie to and badger a doctor into diagnosing them with an illness they don't really have just so they can get a "free" iPhone from their insurer.

Or, if you want me make a scenario:

1. There are 1000 patients that actually need the device. The insurance company decides to only approve the $20k medical device, so they spend $20M.

2. There are 1000 patients that actually need the device. The insurance company decides to approve $500 iPhones. They spend $500K on iPhones for the legitimate patients. Word gets out that the insurance company pays for iPhones, so 100,000 people now "need" this device. The insurance company is now out $50.5M to treat the 1000 people who actually needed the device instead of the previous $20M.

Spite has nothing to do with it; it's all about minimizing risk.