Should experimental or unproven medical care be covered by insurance

The truth is, of course, up until now, just about everything that works to any degree has been covered in the United States.

Some levels of purely experimental, untested, and completely unproven care have initially not been covered by either governmental or private payers in this country, but even those entirely experimental procedures tend to become a covered benefit in America as soon as they are proven to work at even the most modest performance level.

The question of whether unproven, untested, highly experimental procedures should be covered is a serious, sometimes painful, and often challenging policy and ethical dilemma because it often is true that no standard care approaches that are available to the caregivers will work for some dire-need patients.

Many of the patients in those fairly rare but sometimes highly visible situations do have a high probability of death with little hope that any "proven" treatment will work.

Paying for experimental care directly creates a form of "experimental treatment" tax for payers.

When an experimental procedure is covered, the new cost is simplyspread across all people who pay premiums or pay taxes depending on who the payer is.

From the perspective of economic incentives, it often seems a little strange that the media covering those cases almost never notice when the caregivers who are proposing to do the procedure are sometimes personally receiving a lot of money to do the "experiment."

Both the pure ethical high ground and the financial motivation assessment in those cases are sometimes eroded a wee bit by caregivers who say, "I won't save this patient until someone pays me to do it. I will let them die unless you pay me."

Then, when they have drawn their own clearly finance-based personal line in the sand, they sometimes publicly say that the payer who doesn't choose to write the check to them, for "experimental" care is actually the party in the situation who is "making an economic decision" about the life of a patient.

Interesting thought process. In many cases, of course, the recommended procedure involves teams of people and the whole funding stream is a lot more complicated than that. But sometimes it isn't.

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Should experimental or unproven medical care be covered by insurance

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