Fertility interprets regulation as damage and routes around it
Here's the results from the first-ever survey of European fertility tourism:
Hundreds of women over the age of 40 are travelling to fertility clinics in Europe to try to get pregnant because NHS clinics in the UK will not take them, the first-ever Europe-wide study of fertility tourism shows.NHS restrictions prompt fertility tourism boomThe research shows considerable movement across Europe, with women seeking out procedures that are banned in their own country. Italian women are crossing the border in droves following tough legal restrictions on IVF imposed in 2004, while large numbers of gay French women bypass a ban by seeking treatment in Belgium.
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When people shop for doctors, something is clearly very wrong.
Just where the problem is, I have no idea.
? why? If a doctor can't or won't provide, don't you have the right to find someone who will?
More correctly, infertility interprets regulation as damage. Fertility doesn't have to go transnational doctor shopping.
Infertile couples seem to be screwed in a lot of countries. Here in the U.S, anybody can seek IVF but it costs tens of thousands of dollars and isn't covered under any health insurance plan I've ever heard of.
Takuan: I think Lobster means something is wrong with a system that forces people to shop for doctors, especially across international borders.
At least in Europe it's only a few hours train trip to go shopping around... And you can't shop for a new liver/kidney like in some far east countries...
#2/#4, I'm not saying what the problem is because I don't know. What I am saying is that ideally, all doctors are equal; that you cannot shop around for doctors because they all give you the same answer.
So either the people who do provide the treatment shouldn't be, or the treatment should be available from any doctor.
This sort of highlights one of the real dangers of socialized medicine.....the governing body (not necessarily doctors...just whoever is put in charge) gets to determine the best treatment for you. There have been cases of patients being denied life-extending or life-saving procedures (like chemotherapy or surgeries) because it was not considered "cost-effective", and in some cases you are not allowed to seek care within the system even if you can pay for it out of pocket. In other words some government lackey gets to determine your medical treatment....and it's backed up by laws to prevent you from suing or seeking redress. Of course, this assumes some pretty poor laws....but governments have a bad habit of instituting some pretty poor and ill-thought out laws and regulations. That's why even with Canada's much vaunted socialized medicine thousands upon thousands of Canadians seek treatments and procedures in the United States and elsewhere. That's exactly why a lot of folks here in the U.S. are fighting the passing of a socialized medicine program here.
"Ideally, all doctors are equal; that you cannot shop around for doctors because they all give you the same answer.?"
warning! warning! danger young Will Lobster!(flail- flail)
Doctors are people. Look around you. YOU are responsible for your health, they only delay your death, if they can and if they want to. Might I make the presumption that you are still younger than the physician you usually see?
Pecoto, when I lived near the Canadian border what I saw was thousands of US citizens pouring over the border to get Canadian medical care. I never saw a Canadian come south to get access to our doctors, EVER.
So, I should believe what I saw with my own eyes, or your propaganda?
Back on topic, it's absolutely disgraceful that people seek out fertility treatment when tens of thousands of children need parents. Evolve and adopt - stop letting the little head do all the thinking for you.
#7 : There have been cases of patients being denied life-extending or life-saving procedures (like chemotherapy or surgeries) because it was not considered "cost-effective"
Thank god those private insurance companies aren't just driven by profit motive and thus never try to wiggle out of their obligations.
a canard Pecoto, I am sure you can work out for yourself why.
This happens in america also. My wife and I have been dealing with infertility treatments, and one of our doctors was telling us about a specific treatment that was banned in the US currently, but we could just go down to Mexico for.
I'm not sure we're going to do it, but still worth noting that I think this is a problem that's common anywhere regulation is involved. For better or worse, people just go elsewhere if they can get what they want, or in the case of Mexico, often at a cheaper price also.
This sort of highlights one of the real dangers of socialized medicine.....the governing body (not necessarily doctors...just whoever is put in charge) gets to determine the best treatment for you.
You mean exactly like private insurance, which routinely refuses to pay for treatments? Because that's exactly how it works. If your insurer doesn't think that it's necessary, they don't pay. All decided by bureaucrats.
Like Dr. Chaos (sic) said in Jurassic Park (the movie):
"Life will find a way!"
Solution: Rethink your need to breed.
In the UK a body called NICE (National Institute For Clinical Excellence) has the unenviable job of deciding what drugs and procedures are available on the National Health Service. They use some pretty complex stats involving quality of life indicators and cost-benefit analyses to make their decisions. Needless to say, people get pretty pissed off when they want a potentially life-saving treatment which has not been approved. In reality, this happens pretty rarely, although the stories inevitably make good human interest stories for the sort of newspapers which are bought by people who want to be told what to think.
However, there is, in UK absolutely nothing preventing anyone from (1) taking out their own top-up health insurance; or (2) paying for private treatment themselves.
To say that socialised medicine is a failure because it cannot provide every person with every possible treatment, irrespective of cost is a rather bizarre assertion, to say the least.
The coastguard doesn't always save people. As an organisation, it's a failure. Manchester United doesn't always win a game. As a football team, it's a failure.
What criteria would you set to judge an organisation or an individual a success?
To anyone who has lived in a country with a socialised medical system, it's truly surreal to hear the Republicans discussing this. None of them seems to believe that this has ever been tried anywhere in the world before. Like, er, in the European Union, or Canada: it's somehow a great experiment that will end in disaster.
Yes, it will be very expensive. And it will have its problems in terms of allocation of resources, and it will have problems with bureaucracy, although I suspect that the amount spent on administrative and other non-medical activities in the NHS is significantly lower than the amounts spent on bureaucracy etc. per capita in the U.S.
My typical visit to the doctor involves telephoning the surgery, arranging an appointment (same day if urgent, within a week or so, if not), going to surgery, waiting for half an hour or so to be seen, talking to the doctor and receiving appropriate treatment, and then walking out afterwards. No bills, no forms, no disclaimers, no consent forms. I come across precisely zero bureaucracy on a typical doctor's visit. How, exactly, is a bureaucrat coming between me and my doctor?
At root, of course, this explains why many Americans regard Europeans and Canadians as thinking themselves smugly superior. It is, quite simply, because we live in countries where we don't allow the poor to die owing to lack of suitable medical care, or go hungry, or lack shelter (ok, so our systems aren't perfect), but it would be electoral suicide for any party to suggest slashing spending on providing these basic needs to our poor.
To provide that safety net to our less well-off fellow citizens is, we consider, a fundamental indicator of civilisation. For the richest country in the world to fail to provide for its needy in this way is something it should be ashamed of. We do regard ourselves as more civilised and superior to America in that regard, and rightly so. And we will continue to do so, until America shows the willingness to do something about it.
pecoto: So, now that you've described an American HMO, what was your beef with socialized healthcare?
@ mypalmike #15:
Solution: Rethink your need to breed.
Thank you, mister sensitive. My wife and I will take that into consideration.
In the meantime perhaps you'd like to convince all those salmon to just ignore every fiber of their being and stop swimming upstream.
I've got your fertility clinic right here.
Ladies.
Simply put, when a health insurance company wrongs a patient (refuses a treatment), the government can step in - if the government wrongs a patient (refuses a treatment), who can step in and help the patient?
One thing I think many would agree with - politicians shouldn't be involved with medical decisons PERIOD. I don't want my life-saving proceedure to be refused to help close a budget gap, and I don't want elective services provided at my expense because it shores up a politican's position with a special interest group.
On the off-chance I haven't pushed a hot-button topic yet, let me give an example of an "elective" service that I feel shouldn't be covered under a broad-based insurance plan: fertility treatments of any kind. Have a condition that prevents you from getting pregnant, save up and pay for your own treatment (or adopt, or go without). Wait too long to have children without intervention, same thing. Have a lifestyle that prevents you from have a life partner of the opposite sex? Same thing. But, those services should not be denied anyone, ever, for anything other than medical risk.
I look at it like elective plastic surgery - if your ears jutt out, you can either pay for a procedure out-of-pocket, grow your hair long, or not worry about it.
I choose fertility treatments as my example, but there are manifold procedures that fall into this same catagory - rhinoplasty, breast augmentation, hair plugs, or gender reassignment surgery... You may feel wronged by nature, but it is not the responsibility of everyone else to share in paying for your so-called "corrective" procedure.
Cleft Lips and Palates are examples of things that should be covered, they are birth defects - a big nose is a gift from your parents.
Tim, you speak from ignorance.
Sorry Tim,
Your logic says that cleft lip is a cosmetic problem, and surely you know that most nose jobs on the planet have been covered under 'deviated septum' stories?
Also, please think about your fertility arguments. Given that 95% of the population can and often does reproduce 'accidentally' how is the inability to do so not an injury or defect in otherwise optimal conditions?
Oh, and these services should be denied based on finance? I see your priorities here.
You want more Octomoms, you got it: Clomid and the like costs the same as birth control pills. (She's lying about IVF) So the cost to her to have a half-dozen is the same as having none. But when she has the multiples, and she's poor, the whole state pays, whether or not she keeps them. Unintended consequences are a bitch.
It would definitely be much easier to ride that high horse if the expensive procedure was the one more likely to be a problem.
Also, to the 'adoption' crowd -- you need to be upper middle class to adopt, it takes years before the birth parents can't take them back at a moment's notice, and there is a huge segment of society that refuses to view your adopted children as yours (ie. Angelina Jolie has 6 children, but only carried 3, so according to a lot of media, she only has 3)
Not that any of that is a reason not to work for it, just obstacles to make it almost impossibly difficult.
I mean, yeah, who would ever want to adopt a kid? Uuugh...
Nah, best spend a fortune of someone else's money on IVF.
#7 - The weaknesses in your argument have been pointed out very succinctly by others above me, but I have to add: what HMO/Plan do you belong to where any and every treatment would be covered and allowed? And is it an affordable plan??? Must be NeverNeverland.
#20 - Tim, you decry having politicians in charge of medical decisions (which would be far from the truth with any socialised care in the U.S. anyway,) yet you feel perfectly valid in deriding other people's choices and desires for healthcare. Must be nice to be so all-knowing......
Having experienced healthcare in the US and to some degree in the UK, I prefer the UK version. Moreover, the cost and burden of providing healthcare as an employer or purchasing it as either an employee or privately is already one of the biggest problems in the economy; and it will only grow worse unless some basic, universal healthcare is offered (and yes, this requires regulation by the government). Why do we in the U.S.A. always want the government to step in to fix (i.e. regulate) everything else - roads, bridges, disaster cleanup, work safety, crime education, pregnancy and care of the dead - yet when it comes to keeping our bodies healthy and giving everyone some level of care, we become frightened, stingy, and selfish (I refer to the common attitude of if I have health insurance then I can't think about/care about those who don't). I see it changing as more and more people are pinched by health insurance costs or denied proper care; and hopefully soon the majority will recognize reasonable, basic healthcare for all could be good for the country.
I am against public funding of elective procedures, and fertility falls into that category for me.
That's why I put the following in boldface - so it would be clear:
My issue was funding, not about the procedures themselves.
gender reassignment surgery?
Seriously, you can't google it?
"addadicktome" - I tried to be nice, but you forced my hand. (Granted, I didn't put up much of a fight ;^)
you are saying sex changes are "elective"?
So a cleft palette is a birth defect that should be covered by insurance, but a fallopian tube or seminal vesicle that's a little out of whack is not? Why should the reproductive system be the only bodily function that isn't covered by private or public health care plans?
Screw y'all. Tim, pray you never have to deal with the pain and disappointment of infertility.
Annonymous (if that is your real name) found the energy to type:
A cleft lip or palate are birth defects, that is not how the body should form, and as suchshould be corected. That people defraud insurance companies is not really a strong argument against right and wrong.
Why? If the only way to have a child was through medial intervention (i.e. adoption didn't exist as an option), a case could be made, but there are other avenues to parent. You seem to think there is an implied promise somewhere that everyone has the right to reproduce - I'm not sure where you got that.
There are many reasons why a couple can't conceive, and honestly for many (but certainly not all) it has to do with either partner selection or timing - neither of which are medical conditions.
I explicitly said a person should be able to get anything they want medically, but for elective procedures, yes, the onus is on the patient to pay for the procedure. If large numbers of people feel that they want to support those procedures, start a charity, kind of a reverse planned parenthood if you will.
The "octomom" issue isn't that she has the children, it is that she felt comfortable having that many, knowing that the government would facilitate her personal whim and funnel resources to her and remove any disincentive for her to stop having children. She's entitled to every child she wants, but she also takes responsibility for them. The governemt should not be encouraging her behavior.
As I understand it her only medical condition is that humans weren't "designed" to have litters of children - she can't have children fast enough naturally to suit her desire.
Makes no difference, the cost isn't the issue, it is the responsibility that is the issue. Cost is how that responsibilty mainfests itself.
You like to cite boundry cases, so here goes: Angelina Jolie has had three children and has six children. It is intellectually dishonest to act as if all six came out of her body, but that in no way lessens her role as a mother and a parent.
That the adoption process is hard is a shame, but it is a legal issue, not a medical one - society owes you IVF because it's to hard to get a child that's already been born? Seriously?
BTW, it is stories like this that help make adoption hard. Is this the norm, absolutely not - but it gets a lot of press and sets adoption groups back every time...
(It doesn't look too good for co-housing groups either...)
Takuan are you saying sex change operations are medically neccessary?
Brainspore - I didn't lump private health care into my position, you did. I was speaking about public health care insurance.
I can think of no reason why a private insurance policy should be prevented from covering such procedures, in fact it goes right to my bolded line of text:
Private insurance would be a way to afford such procedures, as would a rich uncle, a good-paying job, big-fat inheritance, winning the lottery, etc.
At the end of my 12:47 PM posting the last statement (Work on the legal issues - that's the solution to this problem, not medical intervention.) got included in the "blockquote" mistakenly, that is my statement, not anonymous's - sorry for any confusion.
yes, they are. You didn't know this?
Indeed. I have a cousin who almost died of gender confusion. God bless the doctors who saved his/her life.
Timothy Hutton #32:
Brainspore - I didn't lump private health care into my position, you did. I was speaking about public health care insurance.
I lumped them together because virtually every private insurance plan considers IVF an "elective" procedure, just as you do.
What I object to is the notion that the only non-life-threatening medical conditions that should be subject to coverage are the ones that are easy to see (like the aforementioned harelip).
Yes, many people live happy and productive lives without children. But many people also live happy, productive lives without the ability to hear or walk. That doesn't mean I want my healthcare provider (whether public or private) to withhold potentially life-changing treatments just to save a few bucks.
#3: "Fertility doesn't have to go transnational doctor shopping."
Fertility has to go doctor shopping. I had to go through several to get my vasectomy.
Takuan - here is the definition of "Medically Necessary" from Cigna's website:
CIGNA HealthCare Definition of Medical Necessity for Physicians
"Medically Necessary" or "Medical Necessity" shall mean health care services that a Physician, exercising prudent clinical judgment, would provide to a patient for the purpose of evaluating, diagnosing or treating an illness, injury, disease or its symptoms, and that are:
a) in accordance with the generally accepted standards of medical practice;
b) clinically appropriate, in terms of type, frequency, extent, site and duration, and considered effective for the patient's illness, injury or disease; and
c) not primarily for the convenience of the patient or Physician, or other Physician, and not more costly than an alternative service or sequence of services at least as likely to produce equivalent therapeutic or diagnostic results as to the diagnosis or treatment of that patient's illness, injury or disease.
And here are their coverage requirements IF Gender Reassignment Coverage is available (it typically is not).
I'm not quite sure Gender Reassignment is an "illness, injury, or disease," the key criteria for "Medically Necessary - the linked-to document clearly sets out that this procedure is an attempt to correct a mental disorder.