Premiums vs. Equality: Which has greater value?

by Davina Fankhauser
President - Fertility Within Reach

Some people have no interest in supporting health benefits for fertility treatment because they don’t understand why they should have to contribute toward a medical condition that wouldn’t apply to themselves.  First let me say, thank goodness for them.  And aren’t we fortunate the rate of infertility is only 1 in 6 couples.

Those of us who have insurance, pay premiums which provide benefits for all kinds of conditions we hope we will never be inflicted with (diabetes, asthma, cancer, plantar warts, etc.).  Do these complaining individuals resist paying premiums so their coworker with Type II Diabetes receives insulin or someone else has a procedure to remove skin cancer?   Not likely.  So why is infertility so different?  Is infertility considered by the public to be preventable?  No, that couldn’t be the reason, because there are similar assumptions made about Type II Diabetes and skin cancer and those benefits are still (and should be) considered necessary.

Do people baulk about infertility health benefits because they assume insurance premiums will dramatically increase if infertility treatment is provided?   Perhaps.  So let us reassure these individuals with some facts.

  • Comprehensive infertility coverage may actually reduce premium expense by as much as $1 per member/ per month.
  • Mercer, et al. found unnecessary medical procedures such as tubal surgery could be eliminated.
  • The cost of infertility services as a percent of the total health care premiums went down after the 1987 Massachusetts mandate, with total infertility costs making up only 0.41%      of the premium
  • 900 companies were surveyed in a 2006 employer survey conducted by consulting firm William M. Mercer.  Of those that offered infertility coverage, 91% said they had NO INCREASE in healthcare costs as a result of adding this benefit.
  • A ‘Comprehensive Review of Mandated Benefits in Massachusetts’ reported in July 2008 that primary state mandates, including infertility coverage, appeared to be cost effective. 
  • With infertility health benefits it is estimated there would be a reduction in:
    • The use of mental health benefits
    • Complications resulting from pregnancies with higher order multiple
    • Less preterm birth/NICU expenses

Let’s say infertility health benefits did add $1 to an insurance premium?  What is the value of a child?  What is the value of family?  While some people question, “Why should I have to cover infertility?” I ask, “Why in the world wouldn’t you cover infertility?”

To Fertility Within Reach, supporting infertility health benefits, goes beyond economics.  It is humane and a direct stand for equality and justice within our country.  For a condition considered a disability by the Supreme Court, it seems only just that everyone should have an opportunity to afford the treatment needed to overcome their condition.  Equal access to infertility health benefits can lead to more births and help ease health disparities.

So we ask you to become familiar with the facts pertaining to the benefits of infertility health coverage.  We encourage you to talk openly about infertility and the importance of having access to timely and appropriate care.  The change we seek begins with each of us doing our part.

Many thanks,
Davina

 

What is the value of a child?

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Davina Fankhauser

President - Fertility Within Reach

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