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Handhelds Medicine The Almighty Buck United States

Insurance Won't Cover Smartphones, When Pricey Alternatives Exist 419

Posted by timothy
from the not-even-penny-wise dept.
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.'"
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Insurance Won't Cover Smartphones, When Pricey Alternatives Exist

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  • by EmagGeek (574360) <<gterich> <at> <aol.com>> on Tuesday September 15, 2009 @08:09AM (#29425121) Journal

    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...

    • by alen (225700)

      With iPhone OS 3 Apple is making a big push into the medical market. In March and June they demo'd the iphone running medical apps like a hospital sending patient vitals to a doctor's iphone and Johnson and Johnson is going to be making add ons so you can measure blood chemistry with your iphone or ipod touch

      • Cripple Ware (Score:3, Insightful)

        by goombah99 (560566)

        If there ever was a good excuse for crippled software then this might be it. Allow the application to lock out all the other functions of the iphone the insurance companies fear. That way you get the cost savings of a commondity device as the platform, but avoid the temptation of people to try to get phony perscriptions. I sort of doubt this temptation logic but the insurance companies probably know better than I do about how that goes. There are tonnes of shady companies pushing home health devices tha

    • by JustinOpinion (1246824) on Tuesday September 15, 2009 @08:43AM (#29425527)
      Pardon my ignorance, but why would a smartphone have to be classified as a "medical device" in order to be covered under a health insurance? Obviously policies can be arbitrarily detailed and include various restrictions... But it seems like any sensible policy (ha!) would include allowances for expenses relevant to your condition but not explicitly "medical". Like offsetting transportation costs for persons with limited mobility or a better bed for a person with a particular back condition. Does the taxi or bed have to get some special medical certification to be covered?

      I would think the limiting factor should be getting a doctor's diagnosis. If a doctor signs-off, and says "person X has condition Y" and the policy covers condition Y, then anything that does the job of helping with condition Y should be fair game. Random people can't try to claim their smartphone as an health expense: only people with conditions that the smartphone helps alleviate.

      (Of course, I'm being hopelessly naive about how health insurance works. You can tell I grew up in a country with universal healthcare.)
      • Re: (Score:3, Funny)

        by suggsjc (726146)

        You can tell I grew up in a country with universal healthcare.

        No, but I can tell that you threw in a useless addendum to an otherwise insightful post.

        • by 99BottlesOfBeerInMyF (813746) on Tuesday September 15, 2009 @09:29AM (#29426179)

          You can tell I grew up in a country with universal healthcare.

          No, but I can tell that you threw in a useless addendum to an otherwise insightful post.

          It's not exactly useless. In truth the procurement of items for medical treatment in countries with socialized healthcare is often quite different. Not always, mind you, but often. Without a financial motivation for whether or not patient obtains a device to help them, most people tend to be both compassionate and pragmatic. That is to say, rarely would a person be denied a cane as a medical expense because it is cheap and someone needs help walking. Rarely would someone be granted a power exoskeleton because it is expensive and excessive.

          With a profit motive in the US healthcare system insurance companies make more money erecting artificial barriers that prevent people from getting any assistive device. They're in a position to impose arbitrary rules to make providing such devices harder so their issuance is rarer. At the same time medical suppliers an make money by specializing in jumping through the hoops and getting certified products which make them artificially scarce allowing said companies to charge a lot of money. Even with the few expensive payouts, the insurance companies save money so they keep the policies.

          Of course you see what is missing from the above scenario. That is the compassion and the pragmatism. A normal person working in healthcare would say, "an iPhone with apps for the blind, yeah that makes sense to help a blind person and is a lot cheaper than a specialty device". Then they approve it. It is the system standing in the way, a system motivated by rules designed to maximize profits. This type of rule is a great deal rarer in socialized medicine

          This isn't to say that other healthcare systems are better in this way, just different. Profit is not the only motive that can result in arbitrary rules detrimental to individuals who need healthcare. Government bureaucrats can be just as bad implementing rules to punish groups at the expense of the masses or implement policies to mollify their special interest group in order to get re-elected. For example, rules to make abortion practically unavailable in order to appease a religious lobby or rules to refuse healthcare to overeating overweight people who are actually saving society money overall by their condition, but who much of society wants to punish for their sin.

        • Re: (Score:3, Insightful)

          by sjames (1099)

          You can tell I grew up in a country with universal healthcare.

          No, but I can tell that you threw in a useless addendum to an otherwise insightful post.

          Actually, no. When it comes to avoiding actually providing services, nothing is as Kafkaesque as a for-profit corporation. Not even silly government rules can rise to that level.

      • by corbettw (214229) <corbettw AT yahoo DOT com> on Tuesday September 15, 2009 @09:18AM (#29426003) Journal
        Because insurance companies tie their definition of "medical device" to what Medicare reimburses for (one of the reasons for this is that Medicare constitutes such a large part of the market for people using medical devices that insurance companies find it cheaper to use their list than generate one of their own). And since Medicare has certain legal requirements for what a "medical device" is (including going through FDA approval), it can be expensive and complicated to get on that list. Hence, any device that is on the list is going to cost much more than one that isn't. The alternative is to let Medicare bureaucrats, who are not doctors, decide whether a device is medically necessary or not.

        So you're not naive about how health insurance works. You've naive about how government programs in the United States work. Now maybe you can understand why most of us don't want the Federal government to have anything to do with health care: they'll just make it worse.
        • Re: (Score:3, Informative)

          by jwhitener (198343)

          "The alternative is to let Medicare bureaucrats, who are not doctors, decide whether a device is medically necessary or not. "

          Those 'bureaucrats' are advised by doctors/medical experts.

          "Now maybe you can understand why most of us don't want the Federal government to have anything to do with health care: they'll just make it worse."

          75% of doctors want a single payer plan. http://seminal.firedoglake.com/diary/8141
          And it is still roughly 50% of the American people who want reform (depends on the poll/time, bu

        • Re: (Score:3, Interesting)

          by fahrbot-bot (874524)

          The alternative is to let Medicare bureaucrats, who are not doctors...

          I'm sure many Insurance Company bureaucrats in places to decide your care are also not doctors. One difference, however, may be that Medicare bureaucrats have no profit motive.

          I'm not trying to start an argument, it's something to consider.

        • Re: (Score:3, Informative)

          by Thaelon (250687)

          Now maybe you can understand why most of us don't want the Federal government to have anything to do with health care: they'll just make it worse.

          1. You don't speak for the majority, unless you're omniscient and I don't know it.
          2. You certainly don't speak for me, as I consider it a total failure for healthcare reform and a total victory for the insurance companies if the reform bill lacks a public or single payer option.
          3. I've personally spoken with citizens of other countries. Denmark has a single payer

      • Re: (Score:3, Interesting)

        by Anonymous Coward

        If a doctor signs-off, and says "person X has condition Y" and the policy covers condition Y, then anything that does the job of helping with condition Y should be fair game.

        If someone has a limp, they'd have an easier time getting around with a car. Should the policy give out free cars to everyone with a limp?

      • Re: (Score:3, Funny)

        by jandersen (462034)

        If a doctor signs-off, and says "person X has condition Y" and the policy covers condition Y, then anything that does the job of helping with condition Y should be fair game.

        Hey, what are you doing, man, talking sense on /.? Don't you know it is a treasonable offense? Go wash your mouth with soap. Or your keyboard, whatever. Just do it!

      • We don't have sensible health care coverage here. Maybe soon, but not now.

      • Re: (Score:3, Informative)

        by DragonWriter (970822)

        I would think the limiting factor should be getting a doctor's diagnosis. If a doctor signs-off, and says "person X has condition Y" and the policy covers condition Y, then anything that does the job of helping with condition Y should be fair game.

        That might be what insurance should do, but its nothing like it does do. Heck, health insurance (in the US) doesn't even cover drugs that don't require a prescription, even when they are recommended by a doctor and the most effective means of dealing with a condit

    • by Lord Lode (1290856) on Tuesday September 15, 2009 @08:45AM (#29425547)
      Indeed... And why would these devices have to be insured if they're cheap anyway?
    • Vast numbers of 20-something males have come down with severe pain: 1/3rd of the MM patients are in this demographic according state statistics. Each patient is allowed to grow six plants at one time. However this task can be delegated to a "caregiver". There are now hundred ads filling five pages in our alternative weekly advertising caregivers.
      • by sjames (1099) on Tuesday September 15, 2009 @10:18AM (#29426795) Homepage

        If, like the iPhone, marijuana was legal without a medical claim, the number of frauds would fall off.

        • Re: (Score:3, Informative)

          by Lost Engineer (459920)

          Given that California, at least, allows MM treatment for virtually any condition, including depression, I find it hard to accuse basically healthy people who use it of fraud. There is no provision that says that other treatments must be tried before marijuana, nor a provision that you need be deathly ill to take it. Nor should there be if you ask me. And if there's some hippie doctor out there who'll recommend it to anyone then so be it. It's basically harmless. For every one of him there's a hundred "

    • by Ash Vince (602485)

      It'll be amazing how many people suddenly come down with "disabilities" once insurance companies start paying for fancy PDAs and SmartPhones...

      Guess the Republican mods are out in force because this is utter rubbish. How the hell are you going to fake having Downs Syndrome? Surely any half decent doctor would see through this a mile off. You do usually have to see a medical doctor in person to make an insurance claim don't you?

      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...

      More rubbish here too. Dedicated medical devices cost more than generic devices due to this thing called "Economies of Scale". The idea is the the more of a particular product you can produce, the cheaper you can produce it. The medical devices you talk about being 20 times more expensive are like that because they only appeal to a niche market. Iphones have much more universal appeal so have a manufacturing run many times the size. This means they can be produced far more cheaply. This is what mass-production is all about.

      • by corbettw (214229) <corbettw AT yahoo DOT com> on Tuesday September 15, 2009 @09:21AM (#29426041) Journal

        Guess the Republican mods are out in force because this is utter rubbish.

        Seriously? Have you never known someone who got a handicap placard from an agreeable doctor, even though they didn't need one? Or what about the ease of getting a prescription for marijuana in California? There are clinics in LA where you just have to tell the doc you have "occasional headaches" and they'll write a script for pot. Are you trying to claim there won't be ANY doctors who would write a script for an iPhone for some reason or other?

    • by izm (592666) on Tuesday September 15, 2009 @11:51AM (#29428099) Journal

      As somebody who spent a lot of time and energy helping acquire such a device for his father who suffered from ALS, I would like to highlight some important facts.

      Many of the devices that the insurance companies cover are actually modified PC's. Before you say that people are better off buying a computer and having insurance foot the bill, look at the facts:

      1. These PC's come modified with software and other interfaces which are specially designed based on years of research to meet the needs of the disabled for communication in the most intuitive way possible.

      2. Often times the software is placed on an embedded windows system so that its harder to "break" with malware, and the like. Very few PC owners apart from the tech savy can say they've never gotten a computer virus or some form of malware. Even us techies slip up sometimes. Can you imagine if your lifeline were disabled by a virus? This is exactly what these devices are. Lifelines. People rely on them every day for the basic things we take for granted. Having the software embedded keeps the device functioning. Having functionality limited to...well....speaking...that makes the device far less daunting to those who might not be as computer savvy.

      3. There are lots of different attachments available for these devices that let pretty much anyone with any level of disability use them. Each attachment is geared towards using the functionality a person has left. These are niche items that are pretty hard to come by at WalMart.

      4. These computers are generally ruggedized (usually a toughbook, or something similar). The ruggedization is critical when the device goes everywhere with you.

      The bottom line, really, is that these devices are designed to work any time anywhere for anyone. These are really custom solutions. Also, a whole lot of vendor support comes with the device, which is critical to making the most of it. This entire package, including the support, the level of customization in terms of input devices and software tools, and the level of quality and reliability seem to justify the high price in my eyes.

      Your insurance company, believe it or not, has your best interest in mind as well as their own when they decide what is and isn't covered. These costly specialized devices are the best option for a whole lot of people. By only covering a solution like this, the insurance company knows you're getting what you need, which is tough to do if you're talking about building a system yourself.

      I could have created a home-brew solution, but it would have been without the benefit of years of research into the progression of various diseases and the capabilities of somebody paralyzed from the neck down. Why should a patient have to deal with debugging a home-brew solution or trying to use a conventional mouse or keyboard when they can barely move their fingers? Being paralyzed is frustrating enough as it is...they don't need the extra stress.

      On a side note, you can in fact work with the vendor and the insurance company to have an "add-on" placed in the computer-turned-medical device to allow you to use it as a computer as well. The expense is out of pocket, but is usually far less than the cost of a computer.

  • by aeschenkarnos (517917) on Tuesday September 15, 2009 @08:13AM (#29425179)

    ... is there anything stupid, evil or simply wrong that they will not do?

    • Re: (Score:2, Funny)

      by Anonymous Coward

      I haven't heard of them eating puppies yet, but that's only because they haven't found a way to monetize it.

    • as such why do people think health insurance is prohibitively expensive when bought outside an employer, granted its not cheap through an employer either.

      Government regulations, read mandates.

      Its not legal to buy health insurance across state lines, you can't even take individual health policies across most lines, all unless your covered by your employer. Your employer gets a tax deduction for your insurance that you cannot get if you buy your own. when you go to buy it you get soaked because each state p

      • by MartinSchou (1360093) on Tuesday September 15, 2009 @08:51AM (#29425643)

        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.

        • by radtea (464814) on Tuesday September 15, 2009 @09:07AM (#29425863)

          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."

      • by mcgrew (92797) * on Tuesday September 15, 2009 @09:04AM (#29425817) Homepage Journal

        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.

      • by Red Flayer (890720) on Tuesday September 15, 2009 @09:16AM (#29425975) Journal

        Its not legal to buy health insurance across state lines, you can't even take individual health policies across most lines, all unless your covered by your employer.

        That is because each state has different laws covering health insurance. There is no government regulation preventing you from purchasing insurance from a carrier in a different state, nor is there regulation preventing an insurance company from selling in multiple states.

        Your employer gets a tax deduction for your insurance that you cannot get if you buy your own.

        100% false. You can deduct medical insurance premiums.

        when you go to buy it you get soaked because each state piles on its mandated coverage to the already onerous federal mandates

        This is a separate issue, and one worthy of debate. The alternative to mandated coverages (which are much less onerous than you assume, I think) is insurers selling insurance, collecting premiums, then denying claims for seemingly random conditions. This was a HUGE problem before states stepped in to regulate the medical insurance industry. While it needs to be balanced against efficiency, there is no doubt in my mind that mandated coverages have been a big benefit to insurance buyers.

        As for the first two items I addrsssed, you are either being disingenuous or are grossly misinformed. I hope it's the latter, but I'm not sure.

        While I agree that over-regulation can be a problem, under-regulation can also be a problem. Letting the insurance companies do what they want will not result in a better outcome for the people who buy insurance. We've been there, and it doesn't work. My big complaint with over-regulation is that it creates barriers to entry due to compliance costs; however, there are already significant barriers to entry in the medical insurance business because of the cost of catastrophic cases (capital reserves need to be very large, which keeps new entrants out; also, bad luck could easily mean insolvency for a small insurer).

        • Re: (Score:3, Informative)

          by schnablebg (678930)

          Your employer gets a tax deduction for your insurance that you cannot get if you buy your own.

          100% false. You can deduct medical insurance premiums.

          Not quite. Medical expenses are only deductible if they exceed 7.5% of your AGi, and you need to itemize, meaning that this deduction competes with the standard deduction. Contrast this with employer provided healthcare: you get to deduct all of it, and you can still take your standard deduction.

          In both cases, this favors the rich.

      • by brkello (642429) on Tuesday September 15, 2009 @10:19AM (#29426797)
        Wow. You must get all your new from biased sources since you have everything backwards.

        Buying insurance as an individual is incredibly expensive. The reason employers get a better deal is because they have a larger pool of people and can negotiate down prices. As an individual, you do not have that leverage so you get screwed. You are also screwed no matter how much you are willing to pay if you have a pre-existing condition (like pregnancy).

        A public option would allow you to take it across state lines...so I don't know what you are complaining about there.

        You are already paying for coverage you never use. And on top of that, you are paying for all the profits that go to the shareholders and the large CEO salaries. There is no way that it will be more expensive than the current system.

        Again, one device being preferred over the other is already in the current system.

        It has gotten vastly better for every industrialized country that has a single payer system. The mantra that government is bad is stupid and childish. Too much government is bad. Too little government is bad. It is time to realize for our businesses to compete and for us as individuals to be actually getting raises instead of paying more for health care, we need to do away with the for profit business of health insurance.
    • Well, I guess technically if there was something stupid, evil or simply wrong that requires them to pay money for, they'd probably try to weasel out of it :P

  • by Dr_Barnowl (709838) on Tuesday September 15, 2009 @08:14AM (#29425189)

    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.

    • Think about how many people won't get any such device because the 'medical ones' suck. Maybe a commodity device isn't as reliable ( though that's debatable ) but it's a hell of a lot more reliable than nothing at all. And before you start blaming the sick - well if you needed to be able to communicate that bad then you wouldn't mind carrying a clunky 'I've fallen and I can't get up' button everywhere you go, how is choosing to accept a risk like that different than choosing to eat some greasy pizza rather
      • by idontgno (624372)

        Speaking of which, that might not be a bad idea: Kibbles and Bits for humans. If you eat the measured amount of this per day, and nothing else, and drink nothing but water then you will get very decent nutrition given the current state of medical knowledge

        I hear we make great pets.

  • by R2.0 (532027) on Tuesday September 15, 2009 @08:16AM (#29425217)

    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.

    • by Thornburg (264444)

      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.

      This can't possibly be true. There are already "medical devices" that are just small x86 computers running WinCE (or even full Windows) and a proprietary app.

      No special lockdown, just no obvious way to run another app (if you don't know where to look or what to do).

      Since these devices qualify, we can infer that the most that's required is hiding the ability to run other apps, not disabling it.

    • >>cost so much is FDA regulations and the higher standards to which they are held

      So is that why my wife's first insulin pump failed, was replaced, failed, was replaced over and over? From failed motors, the crappy plastic they used that broke, to the fact she spent over $5000 on a water proof device (to something like 6 feet) to "oops, we were wrong, sorry"? Where is the FDA here?

      She switched to another vendor and it was the same story. The again, the pump motor would fail after several months,

  • Now wait for it to be a government agency denying you instead of an insurance agency. We can replace one insensitive bureaucracy with another, equally insensitive one! Hope and... change?

    It reminds me of transit benefits, and how you're only allowed to use them for getting to and from work - God forbid that we take public transit for personal trips - it would be a tragedy... also, it reminds me how the Aptera is ineligible for auto-industry loans because it only has three wheels and the law says an auto h

    • Re: (Score:3, Interesting)

      by maxume (22995)

      A big contributor to the lack of choice in health insurance is that employers treat it as a benefit, rather than compensation (if all those people were shopping with the dollars their employer is currently spending to cover them, there is some chance that there would be better options available, and probably even pools that were slightly easier to get into).

      Of course, another issue with employer provided insurance is that there is small scale socialism going on (employers are willing to employ people with c

    • Hey look! I take "subject of TFA" plus "current events" plus "car analogy" (well, auto industry subsidy analogy) to comment on the likely future outcome of related matters, and what thanks do I get? I'm moderated down to Flamebait oblivion! How dare I imply that the government takeover of health care which our current administration seeks will be anything less than a perfect utopia? It will be so good that everyone will get an iPhone for free, not just the people with speech impediments!

      There's some insi

  • can govt pay for my ATV? The alternative is a really expensive wheel chair...

    sheesh, no wonder insurance rates are skyrocketing

  • by amplt1337 (707922) on Tuesday September 15, 2009 @08:25AM (#29425333) Journal

    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.

    • In all fairness, I think a single payer system will also have bad incentives in place.

      • I agree, but a single payer has the ability, and incentive, to effect changes.

        With multiple payers, you have an enormous Mexican stand-off, with no-one willing to change the system. No-one wants to offer preventative care in case it ends up more expensive than treating the outcome. If an insurance company is being hit hard by a particular care segment, no problem, they'll just adjust their policies to stop covering it, instead of trying to prevent it.

        With a single payer, responsible for all healthcare expen

    • by Richy_T (111409)

      Far better just to remove the loopholes that are at issue than wholesale replace the system with a different and more cumbersome system that will have loopholes of its own.

    • Re: (Score:3, Insightful)

      by mcgrew (92797) *

      Here's another misguided incentive -- drug coverage. I had a vitrectomy [slashdot.org] last year (I've been asked to warn people that the link supplied can be upsetting) and was prescribed some antibiotic eyedrops afterward. Wanting to hold costs down, I called around for the best price. The tiny bottle of drops retail price varied from sixty dollars to eighty dollars. The sixty dollar option was 20 miles away, the eighty dollar option was less than a mile.

      But the co-pay was $26 regardless of where I bought the drug (whic

  • If the devices cost so little to begin with, why bother with insurance or money claims?

    If i had a disability, i'd say 400 dollars is money well spent... and it would probably last you for a couple of years.

    • by Richy_T (111409)

      If you have a disability, there's a good possibility you are unable to work and are living on a subsistence income.

      Not everyone will be in this position but the ones who aren't will just buy the stuff anyway

  • Wow (Score:4, Funny)

    by Sterrance (1257342) on Tuesday September 15, 2009 @08:27AM (#29425361)
    I never thought I'd see an article that would refer to the iPhone as "cheap."
  • To be expected (Score:5, Insightful)

    by FreeUser (11483) on Tuesday September 15, 2009 @08:30AM (#29425393)

    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.

    • Re:To be expected (Score:4, Insightful)

      by FooAtWFU (699187) on Tuesday September 15, 2009 @08:35AM (#29425447) Homepage
      Have you tried getting the Canadian | British | French | $EUROPEAN_NATION's government to cover an iPhone for a speech impediment or other similar communications-related disability? Please, try it and let us know exactly how much better socialized medicine is in this regard.
      • Re:To be expected (Score:5, Informative)

        by Wizard Drongo (712526) <wizard_drongoNO@SPAMyahoo.co.uk> on Tuesday September 15, 2009 @08:46AM (#29425561)
        Yeah, they would. I mean, sure, they'll go for the medical device if it's better, but if a simple iPhone would work nicely, they'll get you an iPhone. Mainly 'cause in Scotland at least, that sort of decision is made by the local manager in the place you actually go to see the doctor/physio etc. The great thing about the NHS is that it divorces cost from medicine. Since it's all "free" to the patient and the doctor anyway, the doctor will go for the best medical option, regardless of if it costs less or more; admittedly there is some shilling still of GP's by big Pharma trying to get them to prescribe brand X drug, but it's mostly gone, and we see a lot more brand-x-generic now, and all gratuities from Big Pharma to the GP have to be declared. In the States, even if you get coverage, your insurance co. still get shafted by doctors that will order unnecessary tests etc. just to bump up the bill, because it's not his company the money's coming from. Here, it's all the same "company", so if you need a test, you get it. If not, you don't. On the bad side, whilst they'll never turn you down for treatment, depending on where you live, and what it is, you may be waiting a while for that hip-replacement/eye-operation etc.
        • That was, in fact, informative. Not sure exactly why the question was marked flamebait, but I guess it wasn't you who went and did it, so... Thanks.
        • Re:To be expected (Score:4, Insightful)

          by Rich0 (548339) on Tuesday September 15, 2009 @10:28AM (#29426907) Homepage

          From what I've heard cost-cutting has a big impact. I know a guy who had some breathing problems in the UK, and the problem was handled with tiny little escalations until it became untreated Pneumonia and he was out of work for a month. It took a week before they gave him an x-ray, and it took a week to get the x-ray interpreted. Then it took about a week before they prescribed him an antibiotic.

          I had a friend with similar symptoms in the US. They went to the ER at 10PM with difficulty breathing. They were x-rayed within about 15 minutes, and despite it being late at night the test was interpreted within an hour. Antibiotics and steroid nebulizer were immediately administered, and by about 1-2AM they were headed home with a prescription in hand. They still had a few symptoms the next day, but within 48 hours all symptoms were gone and they finished their prescription over the next week. No work/etc was missed aside from sleeping in a little the next morning.

          In this case the UK actually shot itself in the foot since the patient in question missed a month of work - which was a huge net cost - just so they could try to save a few dollars on treatments that have been around for 50+ years. However, sick pay/etc doesn't come out of the NHS budget...

          Somewhere there is a balance. The US is a mess, but so are most health care systems - they're just messy in different ways, and by different metrics.

          • Re: (Score:3, Insightful)

            by mikael (484)

            But did the antibiotics cure the problem or did the steriod nebulizer. Did the doctors attempt to diagnose what the illness was or just take the shotgun approach? Shooting off antibiotics all over the place is just leading to more antibiotic resistant strains of bacteria.

    • Totally Wrong (Score:3, Interesting)

      by tjstork (137384)

      Insurance is about risk management. It's a financial product, not a health one. I pay someone x amount of dollars to provide me the right get y amount of money back based on a risk. By demanding that insurance companies provide all of these things that have absolutely nothing to do with risk, you've screwed this country up. You've basically, like all liberals, twisted something else an excuse to go steal some money.

      If you want to have money for people with chronic conditions, make them a federal problem a

      • by FooAtWFU (699187)
        What I always thought was the stupid part about using health insurance to redistribute wealth is that it's basically like paying for other people's health insurance with a tax on... health insurance! Not only is that recursively-stupid (making health insurance *less* affordable) it's also regressive in nature, since poor people will spend a larger portion of their money on health insurance. It's kind of hard to find a real winner under this scheme.
    • by Richy_T (111409)

      Google "NHS in crisis" then tell me that it's successfully resolved.

      • by FreeUser (11483) on Tuesday September 15, 2009 @09:44AM (#29426357)

        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.

  • People also need food, shelter, clothing and heat to stay healthy. Should we expect health insurance to pay for that?

    There should be a principle like the legal de minimus rex that puts a floor on health-related expenses that we expect health insurance to cover.

    Indeed, if we had stuck with the catastrophic major medical only policies that used to be the only kind of health insurance, our medical care would be much more affordable today. People would pay for routine doctor bills, and if doctors charged more

  • by Satanboy (253169) on Tuesday September 15, 2009 @09:01AM (#29425779)

    I have 2 cousins who are deaf. They have been using smart phones for a long time rather than TTY devices. In addition, they are all over the net as a means of communication.

    They have always paid for this out of pocket. Amazingly, they never had insurance companies to pay for their TTY devices in the first place (those devices cost around 400 bucks about twenty years ago) so I think they are happy just paying for a cheaper service.

    I think getting closed captioning added to all televisions was the biggest savings for them. I know my aunt and uncle paid about 20 bucks a month or so and a couple hundred bucks up front for closed captioning devices about 20 years ago.

    I'm not sure what insurance you would have that would have paid for these things in the past. I'm sure there are some plans, but honestly, for most 'normal' folks without great insurance plans, these things were just expenses that everyone paid for and just looked at as part of the expense of raising a child, no different than medicine, food, and clothing.

  • Um, what? (Score:2, Insightful)

    by ZekoMal (1404259)
    Okay, so if I coded some software that had some sort of medical use on my computer, would everyone also get all up in arms if insurance companies wouldn't cover my PC that I use almost entirely for entertainment purposes?

    The ONLY way that an insurance company should be able to insure a phone is if the phone has everything stripped of it except for the ability to dial 911 and use the medical software. Why the hell is anyone assuming that slapping an iBandaid program on something means that if your dumb ass

  • US medical system (Score:4, Interesting)

    by valentyn (248783) on Tuesday September 15, 2009 @09:07AM (#29425851) Homepage

    As the Obama healthcare reform is also international news, I read an analysis of the US medical system here in the local newspaper in The Netherlands. The US as a country spends twice as much for it's healthcare as Germany and France, while only 83% of the US Americans have an insurance.

    This is because US healthcare is not about health; it is about the caring industry. There's no room for prevention (as there's no profit from prevention), there's only room for Care.

    TFA seems just like another example of it.

  • by nimbius (983462) on Tuesday September 15, 2009 @11:36AM (#29427905) Homepage
    "For the millions of Americans with A.L.S., Down syndrome, autism, strokes and other speech-impairing conditions"

    down syndrome...wait...what?

    the kids retarded, not mute. im pretty sure i heard him say "i can count to potato!" the last forty or fifty times. no iphone required.

    Autistic people granted are broad, but are either completely incapable of conversation, or theyre found annoying when they attempt it through mirroring an entire episode of sesame street in a bank or church. nothing requiring an iphone there.
  • typical (Score:3, Insightful)

    by speedtux (1307149) on Tuesday September 15, 2009 @12:32PM (#29428637)

    Do you really think that insurance companies would have much power or money if healthcare became really cheap and successful? For companies passing money along, their own profits usually end up being a percentage of what flows through them. That's why insurance companies actually don't mind the cost explosion in the health care system; they don't pay for it, you do, they just take a cut.

The reason that every major university maintains a department of mathematics is that it's cheaper than institutionalizing all those people.

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