Yes, I would love to have a child. My husband and I would make great parents. We are going to look into options and see what can be done. (My fibroids can cause infertility).

I guarantee that if the shoe was on the other foot, we’d all be hearing the opposition whining about how their insurance doesn’t cover them.

I cannot see traditional insurance offering infertility riders. In order to have a great enough risk pool, people with normal fertility will have to be scared in large enough numbers to purchase that coverage, thereby making the cost affordable to those who need it.

In my own situation, my insurance, back by New York law, covered everything up to injectable/IUIs. The best, most medically sound choice for us, should these Femara cycles fail, would be IVF with a single embryo. IVF is not covered. And, yes, I am tempted to risk multiples on a $55 cycle instead of a $15000 cycle.

The issue of whether or not infertility treatments should be covered by insurance is something I feel deeply about. The fact is that I have a medical condition, and do not have access to the treatment my doctor thinks will resolve my condition. My mother – whom I love dearly – is obese. Her insurance company is paying for her to have a lap band surgery, and for all of the pre-anesthetic testing required. I am glad that she can access a treatment for her condition, but it burns me up that she has coverage for this – for a condition that her lifestyle did indeed cause – and so many infertiles are denied coverage. It just plain sucks.
From an economic point of view: my husband and I – and I’m sure many other infertile couples – are forced to scrimp and save every penny so that someday we may afford treatment. Those are dollars that will no longer be boosting the local economy: dinners out are on hold, as are purchasing a new car, hiring contractors to repair/remodel our home, visits to local museums and other cultural events, etc. We are no longer donating to charities or taking vacations. We are, in short spending less, which means less in sales tax revenue for our city and state. We are willing to make these sacrifices if we must, but multiplied across the many infertile couples who must do the same to afford treatment, the impact on the economy is huge. Everyone suffers when infertiles are discriminated against.

Just my two cents

“A couple of thoughts. First, about covering IF through a rider. This won’t work. The fact is, most people in the US get their insurance coverage through their employer, where you either take what is offered or don’t. There is no option to get a rider for an additional disease or procedure should you need it in the future.”

This is true. It is a good example of where the free market *should* be allowed to prevail, in that people should be able to choose a level/type of cover that suits them as an individual. For eg, I do think an opt-out/in for infertility or maternity is a good idea, also people could choose different levels of copay to share the risk according to their financial priorities/level of cash flow/taste for risk, or they could *gasp* even choose a company by themselves, like they do for other types of insurance. This whole take-what-you’re-given stuff is rubbish. So is the shop-for-a-job-with-insurance-that-suits stuff. People should be working where they work best. The insurance system should allow this.

(This is kind of a side point – really, there are strong arguments for bundling infertility with maternity cover. First of all, it’s fair, although I have no problem with splitting it up and allowing opt-in/opt-out for the infertility part if the company wants to do the paperwork for a $2/yr difference in premium to keep customers who feel that damned strongly about it happy, as long as the individual policy holder gets to choose, not the employer. But there’s also an economic argument – if you cover maternity, but not infertility, you are going to pay for it in NICU bills and people are going to die, because you promote risk-taking behaviour. You can re-balance this risk by bundling both together. No infertility – no maternity. Maternity – and infertility.)

Of course, Missy is right that free market theory assumes rational choices, and people fall short of that. But to some extent people do generally respond in certain, arguably rational ways to various situations and incentives, and to that extent it does still have a useful (limited) role to play in constructing a health care system. Letting patients choose their insurer, their level/type of cover, and their doctor puts the free market to good, efficient use. Making patients pay out of pocket for specific, arbitrarily-chosen conditions whilst covering other conditions is missing something somewhere.

Bea

Second, the problem with assuming that the free market will take care of assigning our limited resources to our priorities is that the efficient market theory assumes that people are rational actors. We are not. We make irrational decisions all the time (just look at how great the market was for assigning risk to sub-prime mortgages). There is an entire field of behavorial economics devoted to how people do not actually behave in ways that support the idea that the market knows best.

Third, the argument that some diseases are deserved and who gets to decide which those are reminds me of something a college professor told me. He studied the increasing presence of learning disabilities in the past few decades and how it is linked to income levels. In short, children who are low achieving and poor are considered slow or not very smart. Children who are low achieving and rich are labeled learning disabled. Likewise, high achieving poor kids are labeled hard-working while high achieving rich kids are labeled gifted.

How you perceive “deserving-ness” and the labels you give to people are influenced by where you sit.