Your Tax Dollars At Work

The New York Times reports today that people who suffer from ALS (Lou Gehrig’s disease), and who require a technological device to assist them with speaking, may be able to get their insurers to spend $8,000 for a Medicare-approved, dedicated computer that has all functions other than speech assistance disabled, but they can’t get an insurer to spend $450 on an iPhone with a speech app.  Medicare won’t approve iPhones because they can be used by people who aren’t ill.  (Strictly speaking, it’s up to private insurers to decide what to do, but many of them follow Medicare’s lead, according to the article.)

This sure sounds like a classic example of excessive “command and control” regulation where a “standards” based regulation would serve everyone better.  If an insurer will cover specific device at a certain costs, I’m hard pressed to understand why the insurer and its patients won’t be better off if the insurer approves any cheaper device that performs the same function.  Could this be some of the “waste, fraud, and abuse” that President Obama hopes to squeeze out of the health care system?

I suppose insurers are afraid of fraudulent claims by patients who really just want free iPhones.  But with a cost difference of over $7,500, insurers could spend a couple of thousand dollars investigating each claim and still come out way ahead.

Or are we just offended at the thought that insurance would buy a sick person something that everyone wants anyway?  I don’t know how many patients need this kind of device, but if we could save $7,500 apiece I’d be happy to get over my annoyance.

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3 Responses

  1. Carolyn Blakelock says:

    I agree that there are a lot of not very sensible decisions being made, and I hate to be the one defending this one, but unlike the $7500 dollar dedicated device, the iPhone is a multifunction device that has a recurring cost (the phone/data connection). Who pays for that?

  2. Jon Siegel says:

    Hmmm . . . good question. Inasmuch as the needed functionality for ALS sufferers is not the phone but a speech app on the phone, I would say that the insurance should just pay for the device and the app and then if the user wants to use the device as a phone as well, it’s up to the user to pay for that service.

  3. Umm, iPod Touch?

    Also, this same problem afflicts copyright law. The provisions allowing reproductions for the blind and disabled require the use of “a specialized format exclusively for use by blind or other persons with disabilities,” i.e. a deliberately broken one. Of course, there’s it at the behest of copyright owners.