I have a friend who has a prosthetic. Sure they could live their life in a wheelchair. But this guy goes hiking, and acts like a fully capable walking person. The quality of life is huge. It really gives back their life.
Yep. It’s absolutely insane they wouldn’t cover it.
It’s honestly unethical as shit.
Unethical and counterproductive. Having a prosthetic limb would almost invariably lead to a less sedentary lifestyle, which is strongly correlated with better health. Paying for a prosthetic today has to be cheaper than paying for a heart attack or diabeties later.
Depends on how you measure productivity. The hope is that by the time long term care is required for things like diabetes or heart disease, the patient would be eligible for Medicare.
That or the sedimentary lifestyle will so negatively affect the more than likely diabetic patient, that they go into renal failure and qualify for disability through social security. Effectively removing their cost onto a socialized network.
Paying for a prosthetic is much cheaper in the long run, but not for private insurance. The vast majority of the cost of not providing a prosthetic will be absorbed by Medicare.
They are saying it’s not “medically necessary” to have any quality of life. As long as you’re breathing, you’re A-okay in their book.
This is what insurance in the US has come to mean.
From a purely “medical necessity” viewpoint even, having a properly-functioning prosthetic helps him keep the rest of his body healthy! (Although I suppose they’d figure on denying claims for hospital treatment when his unhealthy heart caved in!)
(Although I suppose they’d figure on denying claims for hospital treatment when his unhealthy heart caved in!)
The long term goal of this type of policy is to not only reduce immediate cost, but to offload the cost of long term care onto a socialized network like social security.
The majority of amputees are already diabetics, if you remove their ability to remain active and mobile, you substantially increase the chance of renal failure. Patients who require dialysis because of renal failure get enrolled for disability through social security.
