March 23, 2011

4 Myths Debunked About Mandated Infertility Coverage

As I mentioned last week, Maine could potentially become the sixteenth state to mandate insurers to cover infertility treatments. The bill, LD 720, will be heard before the Joint Committee for Insurance and Financial Services at the Maine State House (room 220) in Augusta at 1pm today. There will be time for brief testimony to be shared with the committee. If you live in Maine and you've got the time- please make it to the State House today. Your support is vital for this bill to gain any continuing momentum in the Maine legislature. Complete details regarding this bill and the public hearing today can be found on RESOLVE of New England's Maine Advocacy Alert page.

Believe me when I say your support is critical; there is already a lot of opposition for this bill. Just ask Anne Beldon, a devoted RNE volunteer up in Maine who sent in an excellent Letter to the Editor of the Bangor Daily News. Some of the reader comments, aside from being quite misinformed, are downright cruel. It is a stark reminder of just how lucky I am to live in Massachusetts, where we lead the nation in mandated coverage.

Some of the biggest complaints from commenters were that they shouldn't have to pay for the lifestyle choices of others and that overpopulation is a global problem, so perhaps infertile people should take the hint. Oh, and have you considered adoption?

*facedesk*

I almost don't know where to begin.

Let's start by addressing four of the myths about mandated infertility coverage we hear all the time (as reflected in the reader comments to Anne's letter) about why infertility treatment shouldn't be covered.

Myth #1: Infertility isn't a disease; it's a lifestyle choice.
Reality: The World Health Organization would beg to differ. The inability to conceive or carry a pregnancy to term is a medical condition, not a choice.

Myth #:2 I shouldn't have to pay for someone's expensive, elective IVF treatment.
Reality: IVF accounts for less than 3% of all infertility treatment, according to the American Society for Reproductive Medicine. ASRM also states that IVF accounts for 0.07% of U.S. health care costs (Source, ASRM). In fact, infertility is a treatable disease, so it makes sense that insurers provide coverage for its treatment.

Myth #3: Providing infertility coverage will drive up everyone's premiums.
Reality: Employers who provide infertility coverage can see as much as $1 per member per month in premium reductions (Source, American Journal of Obstetrics and Gynecology). And take a look at what happened in Massachusetts: infertility expenditures made up less than 1% (0.81%, specifically) of all insurance expenditures in 1986, a year before the mandate was made into law. Less than 10 years after the mandate was in place, infertility expenditures as a percentage of total expenditures actually decreased to nearly haf that number, at 0.41% (Source, Fertility and Sterility, 1998).

Myth #4: The world is overpopulated. Why don't you just adopt?
Reality: The first issue is that you attempt to deflect the issue at hand by making "overpopulation" the focus of your rebuttal; this is commonly known as a straw man argument. But I'll bite and turn this question back to the reader. Why don't you just adopt? Why must adoption fall solely in the arms of the infertile? Instead of having your own biological children and thus contributing to overpopulation as you claim, why not adopt yourself?

5 points to remember when responding to the infertility coverage critics out there:
  1. Educate yourself. People will want sources. (I've provided them all here.)
  2. Don't feed the trolls. They're a hungry lot, and it's easy to fall into their traps.
  3. Pick your battles. You can't win over everyone.
  4. Agree to disagree; like the point above, you can't change all hearts and minds.
  5. Don't lose sight of the bigger picture and keep fighting the fight!
That last one is important. It's easy to get bogged down in trying to respond to every thoughtless, ignorant comment, to try and make each of your comments a teachable moment. In reality, the bigger issue at hand - getting mandated infertility coverage - is the goal. You can't lose sight of the forest for the trees.  Stay tuned for my post about Infertility and Raising Awareness, where you can find out more about how to be your own infertility advocate.

What are some of the comments you've come across, either in person on as a response to a blog post or article, and how did you respond?

9 comments:

Hope said...

I really appreciate the advocacy tutorial. Reading your post made me think about why advocacy tends to be difficult for me, and I think that it's partly lack of practice, partly lack of preparation, and partly personality. Staying calm under pressure is something that comes easier to some people than others. But if I ever get the chance to advocate for mandated coverage in my state, your suggestions here will probably be really helpful. :-)

ICLW #32

Rebecca said...

I wish the military would cover even a portion of the cost of IVF. I'm getting so tired of folks telling me to adopt or do foster care. Yes, it is something I've considered but I would like to know the joy of caring a healthy baby to term too.

Sushigirl said...

It's almost the same - but still slightly different - arguments with countries where healthcare comes from taxation rather than insurance. Here it's more "if we pay for IVF treatment then the state will run out of drugs for cancer patients". There's some sort of unwritten law that cancer patients are all saints and also completely discrete group from infertility patients.

It's fascinating to read advocacy stuff from the other side of the pond.

Garden Variety Mama said...

Thank you for posting this! It hasn't been very widely publicized here in Maine (or I'm more oblivious than I thought) and I had no idea. This goes right along with so much of the healthcare debate where people make me crazy.

You present some really great arguments here; thanks again for a well-reasoned and informative post.

ICLW

Anonymous said...

I'm from Canada, and this is one area where we are NOT progressive. My pregnancy, from routine health care to blood tests to birth and beyond was totally free of cost. But infertility treatments are only covered in ONE province.

This needs to change.

Especially since Canada actually encourages immigration because we need more people!

Unknown said...

All of the arguments against gets my blood boiling. I always need to step away but then when I come back, it gets to boiling again :)

P.S. - I saw your video for the first time the other day. Thank you so much for making it.

ICLW #97

ART said...

I love your IF video! It was so inspiring. Inspiration in the midst of IF is so refreshing. And your blog title is brilliant!

Tubal Reversal said...

Yeah this is great..
now in this modern world nothing is impossible..
Tubal Ligation Reversal is now become very secure..
but remember successions of this operation depends upon the doctor's moves.so be sure that Doctor is experienced in this field.

CS said...

I'm so against this. Sorry. I feel so many docs push IF ladies towards IVF right away, without pause for an actual diagnonsis. Perhaps I've got it all wrong, but I see this as a way for REs to make more money, without doing the hard and thankless tasks of figuring out what is wrong with us, causing us not to get pg. Our natural state it to be able to get pregnant, IF signals something is wrong. Unless your tubes are blocked (in which case I'm all for IVF), something else is up. And it typically takes 3-4 tries to get it right - long odds. Lots of drugs. I would rather funding for alternative therapies.