Umm, doesn’t IVF coverage result in people needing maternity care? And from what I understand, IVF is far more likely to result in high risk and expensive pregnancies, while natural pregnancies tend to result in natural births of healthier babies. And we don’t need to spend so much money on trying to save premature babies. We could spend an infinite amount on incubators and the like and still not save every baby.

Scott Brown (R) is leading 48-47 in Massachusetts!!!! http://publicpolicypolling.blogspot.com/2010/01/toss-up-in-massachu...

This is the special US senate race on Jan 19th. Scott says he will vote to KILL Obamacare if he is elected. He is Republican vote #41 and blocks cloture and KILLS the healthcare bill. We have made up 30 points in the last month and are ahead by one!
Organizing for America just sent out info for a phone bank for Coakley (D) yesterday. MoveOn.org and SEIU are pouring money into the race to get Coakley elected. Bill Clinton and Kerry are going to Massachusetts to help We NEED to win this one.
Scott Brown needs our help and the national phone bank is the key. Please join today
People across the country are calling, and Tea Party and 912 groups everywhere are getting involved as well. If all of us make calls for the next 8 days with a HUGE get out the vote calls on Jan 19th then we CAN win. Scott’s vote is #41 in the Senate and KILLS Obamacare, Cap and Trade and anything else the Dems throw at us. Do NOT allow another progressive backed by SEIU into the senate!
To join the national phone bank go to:

https://spreadsheets.google.com/viewform?formkey=dDFVMGxFamFFbkFMcE...

OR
http://www.brownforussenate.com/
OR
Tea Party Phone Bank for Brown site at:

http://brownbrigade.ning.com/group/teapartyphonebankbrownbrigade

Scott was just on Hannity’s TV show and said he will vote NO which will KILL the healthcare bill.

Make this the VOTE HEARD ROUND THE WORLD!

According to the DHCFP report, infertility services is ranked #5 in total cost (including medical and administrative costs) among all the mandates, at $2.68 per member per month (0.9% of premium), which is far less than maternity, #1 at $11.18 pmpm (3.7% of premium). I think it’s fair to assume that this is one of the mandates that would be less likely to be offered were it not mandated, although before the mandate many providers and patients received coverage for some infertility-related services by unbundling them and billing them with other types of diagnosis codes. I suspect this would happen again (and probably does happen now in many self-funded plans that don’t provide infertility coverage) so I doubt premiums would decline by the full estimated cost of the mandate.

The infertility mandate generates lots of discussion, but not really that much cost. My daughter was conceived with the help of infertility services, so I’m not a neutral commentator on the value of these services. Ironically, because my family was covered under a self-funded plan at the time, we didn’t have health plan coverage for any of the services. So I understand fully the inequities between insured and self-insured plans that Amy is talking about in her post. And I also understand that employers will not necessarily voluntarily decide to cover certain services without mandated coverage (BTW, that self funded plan also didn’t cover diabetes supplies or quite a few of the other mandates).

Nancy

I wish Massachusetts could impose uniform benefits for people who have health coverage in the state but it cannot because of ERISA. The individual mandate is, of course, very tricky because of this. While I support most of the mandates, I don’t think including them all in MCC would be very wise, from a policy or political pespective. Maybe federal reform will create a uniform system of regulating health plans (although I fear we’ll sink to the lowest common denominator if it does). Until then, we’ll have to live with inconsistency and balance carefully the scope of the MCC benefits with a world in which the state cannot reach self-funded plans, and so needs to be very careful about imposing requirements on individuals for benefit designs that the state cannot enforce on employers that have self-funded plans. It creates a messy and unfair configuration of plans, for sure.

I think we’ve had more transparency about the cost of the mandates in the last year than ever before because of the analyses done by the Division of Health Care Finance and Policy. We now have pretty clear evidence, as the initial post suggests, that the mandates, despite all the arguments to the contrary are not a major reason why health insurance is expensive. (They account for about 3-4 months of the currernt trend in health insurance premiums….so we could eliminate them all and not get much relief from cost pressures…) We know that just a handful of the mandates account for most of the cost of mandates. The top four mandates–maternity, mental health, home health, and preventive care for children– account for 75% of the total cost of the mandated benefits (about 9% of premiums). My question to Senator Brown and other opponents of the mandates is: which of these mandates do we want to abolish?(Federal law requires maternity coverage, so that’s not an option.) And if we did eliminate them all, what’s your plan for cost control 3-4 months later?

As a public health person, I don’t find the fact that some mandated benefits would be voluntarily offered by some employers in the absence of state or federal mandates, to be a compelling reason to eliminate them. Most of the mandates are for services that insurers–and purchasers– have historically undervalued or which have positive effects on the health of people in the Commonwealth. I’d note, in particular, that at least half of the mandates, and maybe more, target services for women and children. To me, the mandates are an extremely important issue for the health of women and families, ensuring access to important services–at least within the insured plans that the state can legally reach.

These mandates include:
For women: maternity health care ; contraceptive services; hormone replacement therapy; scalp hair prostheses for cancer patients; cytologic screening; and mammography. Mandates that are primarily for children: preventive care for children up to age six (including specific newborn testing); early intervention services; low protein food products for inherited amino acid and organic acid diseases; nonprescription enteral formulas; speech, hearing, and language disorders; hearing screening for newborns; and lead poisoning screening.

While I might personally quibble with a few of the mandates, I think most of them reflect sound decisions by the legislature to require coverage for services that have positive externalities for all of us, and so promote the health of the public (with a strong focus on the health of women and children). The total cost of doing so is very low, and well worth it, in my opinion. And experience suggests that we cannot rely on the market to make sound public policy or public health decisions in these important areas.

The biggest cost of the mandates, to me, is that our endless discussion about them distracts us from the real work that needs to be done to contain health care costs.

Nancy

Exactly, “?”.

One can opt out of driving. Driving is , after all, a privelage. Last time I checked, existing is not. Ergo, the mandate (which exists in MA, and the other 49 states if Mr. Hussein Obama has his way) should be considered unlawful.