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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.'"
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...
... is there anything stupid, evil or simply wrong that they will not do?
At the same time, current policies mean that the government and private insurers may be spending unnecessary dollars on specialty machines
That's the point, isn't it?
On the one hand, devices have to go through insane amounts of certification to pass as an official medical device. On the other hand, I'm sure medical device manufacturers really don't want cheap (or even reasonably priced) software on commodity devices eating their lunch.
I suspect the regulations are doing their work for them, but if they weren't, they'd be colluding with the insurers to make damn sure they didn't support commodity devices.
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.
"As God is my witness, I thought turkeys could fly." A. Carlson
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.
I never thought I'd see an article that would refer to the iPhone as "cheap."
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.
The Future of Human Evolution: Autonomy
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.
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.
Free Martian Whores!
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."
Blasphemy is a human right. Blasphemophobia kills.
People gripe about the NHS, and like every medical system in the world, it does have its problems, but I've seen worse reports about far worse hospitals and systematic medical abuse in the US. Indeed, google "malpractice", "medical abuse", and "nursing home abuse" and you'll find the horrors in the American system dwarf those of most of the rest of the industrialized world, not just in number, but in severity.
As someone who has used both the American and British systems (as well as the French and German system by the way), I can unequivocably say that the NHS is as good as and often better than the American system by every metric, including timliness of treatment, quality of treatment, professionalism, cost, you name it. Unlike most of the right-wing ignoramouses here I've actually travelled beyond the borders of my country and indeed lived many years abroad, and have seen different systems first hand. Wait times in the US for privately insured patients are, contrary to myth and right-wing propoganda, at least as long as they are in the UK (where I currently reside), and longer than in France and Germany (both of which also have what Americans call "socialized" medicine).
And before my fellow countrymen start chanting "Best in the World" to themselves, they really ought to stop and ask themselves why the richest Russians, Chinese, Arabs, and Europeans all tend to go to France, Germany and the UK for their treatment rather than the US (not always, but more often than not). Hell, even Farah Faucette ended up travelling to Germany to treat her cancer because she couldn't get the proper treatment in the US (and lived for years longer than expected as a result). Why do so many travel to France, Germany, and the UK rather than the United States? I'll give you a hint: it isn't about money (these people are richer than God), nor about getting a Visa (these people belong to the moneyed elite and can buy their way into anyplace, be it the European Union, the United States, hell, even Switzerland). These people go where they believe they'll get the best medical treatment bar none, at any price, and more often than not, it isn't the United States. And that will probably continue, no matter how often we lie to ourselves about being "the best in the world." We're not, in many things, most especially medicine, and it's high time we recognized this and remediated it.
The Future of Human Evolution: Autonomy
"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.
Just "gittin-r-done," day after day.
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.
Just "gittin-r-done," day after day.
Wow. You have anger issues, my friend. But regardless, perhaps it would be wise if you took a Valium and then went back and read the article in question. Nowhere is it suggested that insurers pick up the tab for things that their customers currently pay for. The issue is that they are currently paying $8,000 for equipment that could be replaced with $500 worth of off-the-shelf kit, and that kit would be more effective and useful, to boot.
Your argument seems to be that insurance companies shouldn't actually pay out on claims, because that would make their customers "irresponsible" and "helpless twits", and you're absolutely correct that if all insurance companies refused to pay claims, then the price of insurance would surely plummet. But there's some sort of logical flaw in your argument that I can't quite put my finger on...
I believe the high cost of insurance is largely due to insurers wasting money, rather than insurers not telling their customers that they should just buy it themselves. But that's just me.
But in all seriousness, if you're ever in the market for insurance look me up. You would be a dream customer.