January 8th, 2008
We can make you better, faster, poorer
Our colleague Mitch Radcliffe needs a new neck.
He says he has good insurance, but the carrier won’t spring for the replacement part he wants. (They even have PDF installation instructions. Great for do-it-yourselfers (that’s a joke).)
Mitch says new discs would be better than spinal fusion, but their approval is recent, especially for those who require more than one, like him.
He worries that carriers are retarding the use of advanced technologies, and creating inequality between those who can afford to pay their own way and those who need a third party.
As I noted in August some of the new parts now being developed, like reverse shoulder implants, are actually better than what nature designed. (Put the ball on the chest end. Nature put it on the arm end.)
In my August piece I asked where such calls should be made, if they’re not to be made by insurers. It remains the right question to ask, especially as we enter a debate where some want to mandate insurance coverage.
When it’s not life-and-death, when it’s just pain-and-suffering we’re talking about, or a choice between optimal and sub-optimal care, who makes the call?
I believe the patient should make the call. Here is my modest proposal.
Mitch’s carrier should set a price it will pay for treating his condition. He should be able to apply it to whichever solution he and his doctor prefer.
He may have to waive liability if, as in his case, it turns out fusion would have been a better option, but these are risks, and choices, which belong to the patient, not the person fronting the bill.
They do it on car parts. Come in to our place and get your fender fixed, with whatever part we carry, or go to your own garage and take a set amount.
And if you are taking a set amount, Mitch, you can do the operation anywhere. It’s your neck, and should be your money. I’ve got a friend in Mumbai you can interview after you feel better.
What we’re left with is a decision which isn’t being made, a patient in severe pain, and a carrier with a future liability whose size they can’t really estimate.
That’s not good for anyone.
Dana Blankenhorn has been a business journalist since 1978, and has covered technology since 1982. He launched the Interactive Age Daily, the first daily coverage of the Internet to launch with a magazine, in September 1994. See his full profile and disclosure of his industry affiliations.
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