My Debate with A Reproductive Endrocrinologist
Posted on August 18, 2008
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Last week I attended a conference called the Arizona Perinatal Trust where they discussed pregnancy and neonatal (new born baby) issues. The second day of the conference a RE presented on recurring pregnancy loss - what causes it and how to treat it. I posed a question to the RE about what his industry is doing to reduce the occurrence of twin pregnancies. If you’ve read some of my previous posts you’d know that one of my passions/goals is to reduce the occurrence of premature birth that is the result of infertility treatments (mainly twins and high-order multiples). I fully believe in and advocate for the right and use of fertility treatments, I just want to see a reduction in the number of twins. In natural conception twins occur about 3 percent of all pregnancies whereas 30-40 percent in IVF or other ART treatments. He responded with a politically correct response and move on to the next question.
During break I approached him to discuss the problem of twin pregnancies and the risk of premature birth. I mentioned that RE’s don’t do a very good job of communicating the risks of multiple gestation pregnancies to their patients, to which he agreed but stated that it is his goal to get patients pregnant otherwise he wouldn’t be in business.
Then I mentioned that I thought that insurance coverage would help with this issue since the insurance companies could put guidelines around fertility treatments and what they would and wouldn’t cover. His response, “Insurance is the worst thing that we could do in this industry. It doesn’t work and fails in the states where it is currently offered.” Our conversation turned a little heated after this. We discussed the State of Illinois, which offers mandated insurance coverage. He said it doesn’t work there because a woman who is unlikely to get pregnant with IVF will “use” her 3 cycles and then a woman who has a chance won’t get the coverage because it was used by the first woman. I said, “Maybe the mandates were written poorly or the insurance guidelines could be changed so that it works better.” He quickly disagreed that insurance coverage of any kind would work in this “industry.”
We argued about how if I was to be diagnosed with cancer my insurance policy would pay for my treatment. To which he argued not everyone has insurance coverage or sometimes cancer is considered a pre-existing condition. Okay, I agree with that. But if my policy covers treatment options, my cancer will be treated whereas infertility treatments are not. His argument was that if everyone had cancer coverage the insurance companies would have to raise their premiums so much that no one would be able to afford insurance. To which I argued that if the rate of premature birth was to decrease from multiples that are the result of fertility treatments the insurance companies could stand to save A LOT of money. Caring for a premature baby is substantially more expensive than a few fertility cycles.
I mentioned the financial stain of fertility treatment and how it wasn’t fair that someone had to choose between adoption or an IVF cycle because they only had money to cover the cost of one of those options. And that it wasn’t fair that infertility, which is a disease, wasn’t covered like most other illnesses. His response, “The cost of an IVF cycle is less than that of a car. If people really want a baby bad enough they’ll come up with the money. It’s only 10% of the cost of raising a child, which over a child’s lifetime is minimal. People who cannot afford cosmetic surgery find the money and cosmetic surgery is more expensive than an IVF cycle.”
If you have read the book, When Nature’s Not Enough by Diane Glick, you’ll remember the stories of the couples struggling to “find” the money to continue with treatments. In that book there are two couples who lost the fight to have a child because they ran out of money. One couple spent over $100,000 trying cycle after cycle to get pregnant. Now that is a lot of money to ask a couple to “come up with.” Another younger couple could only afford to purse one treatment cycle because their jobs didn’t provide the financial means to continue “coming up with the money.”
Are you floored? I was. The debate continued. I said, “Everyone has to pay for a car, but not everyone has to pay to have a child.” He continued with, “People will find the money.” …What I wish I would have said in response is, “Yeah. But when I fork down $15,000 for that car I drive away in a car, but when I fork down $15,000 for an IVF cycle all I walk away with is hope that it works.” Not only that, people need a car to commute to work, buy groceries, etc. It’s not a valid comparison. I must admit I was shocked by the lack of care or concern for couple’s and their financial struggles in addition to their emotional stress.
We finally had to agree to disagree.
This doc is “world renowned” for his expertise and success rates. I’m sure that when you are his patient he is a very nice guy and works in your best interest to get you pregnant. He even stated that his clinic has the lowest number of multiple gestation pregnancies in the State of Arizona, which is good to hear. However good he may be, I’d be hard pressed to recommend him to anyone going through infertility treatments. His lack of concern for the financial aspect of treatments hit a cord - it was one of the points that almost lead to me and my husband divorcing during our infertility struggle. These RE’s are the highest paid docs in the business because there is no insurance component. Is it greed or true lack of concern for couples struggling with infertility?
Does anyone know how the insurance industry works? I’d love to learn about these “pools of money” I keep hearing about with regard to how one person will receive coverage while the next person won’t. Please contact me.
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» Filed Under Doctors, Infertility, Premature Births
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3 Responses to “My Debate with A Reproductive Endrocrinologist”
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Hi Kelly,
I enjoy reading your blog, you have lots of information that I need. I have been seeing a RE in Las vegas for 2 months for diagnostic and blood testing. my insurance told me on the phone and sent me a letter of authorization indicate they will cover all the testing in this RE’s office. However, as I see the RE, they refuse to take my insurance for some of the ultrasound and blood test, and their reason is: the authorization is not the guarantee of payment. about four or five years ago, the same insurance that I am using right now, paid for their patient and then 2 years later, the insurance company asking the RE’s office for the money they paid for, and after that, the insuance company taking all the money they paid before, by deducting from the new patiens payment. therefore, the RE’s office no longer wants to deal with this insuance. which doesn’t make any sense to me because they do accept my insurance for many times over the last 2 month. I just don’t get it.??????
Unfortunately insurance can cause some challenges because of issues like this. I don’t understand why the insurance co denied payment after paying for the services. Maybe ask your RE if they are going to accept an “authorization” for your actual fertility treatments. I’d push the RE to accept your insurance and then you’ll have to decide if you want to stay with that RE or find one who will accept your insurance. There are a lot of good REs, especially in Vegas where there is a LOT of competition.
Thanks for reading my blog and I’m glad you find good content here that can help you!
Another great post!! I enjoy your passionate posts the most - they are really the most compelling ones to read - regardless of what side of the fence you are on. . .