Tag Archives: insurance

A Somewhat Different Insurance Issue

I’ve written in the past (before the long hiatus–can I start saying “BH”?) about issues around ART and insurance.   There are a lot of tough questions around this.   ART is expensive.   It is health care.   Is it/should it be covered by insurance?   Does the need for ART have to arise from medical infertility rather than social infertility?

(These are tricky questions/categories.   A lesbian couple where at least one woman has fully functioning reproductive systems is sometimes said to be socially rather than medically infertile. But how is this different from a woman  with a fully functioning reproductive system who is partnered with a man who cannot produce sperm?  She is also socially infertile, I think?)

Anyway, I’m not going to review all that here.    I am sure these issues will arise again and I will discuss them as needed.  You can always dig around in the older entries, too.  (This reminds me–I have not been using tags, but I think I will start to do so again.)

So to today’s thoughts, spurred by this article from the morning paper.  (There’s a slightly more detailed version here, but I can only access page one of two.)    Erin and Marianne Krupa are a married lesbian couple who live in Montclair, NJ.  (This happens to be my hometown.)   They want to have a child.   But Erin Krupa, who they decided would carry the first child, has stage 3 endometriosis.   That means she is infertile.  And here I do mean medically infertile.  She has a medical condition that prevents her from conceiving/carrying a pregnancy by ordinary means.   It has nothing to do with the health or sex/gender of her spouse.   Continue reading

Rationing Health Care/Rationing Parenthood

There’s a discussion current in the UK just now about access to IVF under the UK’s National Health System.  This little commentary is a reflection of that larger discussion, and I’ll use it as my taking-off point. 

The question currently raised in the UK is whether the NHS should cover IVF.   IVF, like a lot of assisted reproductive technology, is fairly expensive.   Health care resources are limited.   Given these circumstances, perhaps it is reasonable to discuss whether IVF should be covered as necessary medical care, or perhaps doled out on some discretionary basis. 

In the view of the commentator, the problem is that some (many?) people need to resort to IVF because they chose to wait to have kids.  In other words, need for IVF is the logical consequence of free choice.   The implication is that a woman who wants to use IVF because she chose to wait is less deserving (and hence, should be further back in the line) than a woman whose need for IVF is unrelated to her choices in life.    Continue reading

The Flip Side of Regulation is Access

I seem to have wandered into a discussion on the regulation of ART. Or perhaps it is a discussion of the regulation of reproduction generally.  Or maybe it’s parental status.  Look back at some of those posts and you’ll see a lot of different ideas floating around.

By regulation I think I’ve generally meant restricting access to ART.   A regulation might say that one or another group of people cannot use ART, or perhaps can only use it under certain conditions.  This worries me, as I’ve discussed.   (The helpful comments included with that post don’t allay my fears, but instead multiply them as I realize there are a number of groups that could be disfavored if we move to regulate ART.   To be clear, this doesn’t mean I think ART needs to be unregulated.  I just think we’d need to move very carefully if we were to go in that direction.)

Anyway, here I want to look briefly at what I think is the flip side of regulation–that would be access.   As regulation restricts the ability of people to use ART (or to become parents more generally), access would ensure the ability to use ART (or to become parents more generally.)

Now I think the primary regulation of ART in place at the moment is economic.    It’s very expensive.  If you cannot pay for it, you cannot have it.   It is rarely covered by insurance.   Continue reading