Hypothetical Mean

Commentary from an Actuarial and Economic Perspective

Are two Cochlear Implants Better than One?

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Research is beginning to suggest the answer: yes.

In Mr. Moore’s “Sicko”, an American private health insurance company, Cigna, denied bilateral cochlear implants for a child with degenerating hearing. After threatening the company with Mr. Moore’s name, Cigna relented and approved both implants.

Interestingly, Mr. Moore later praises the Canadian system. However, the Ontario Minister of Health claims that it has never funded cochlear implants, let alone bilateral ones. The Ottawa Citizen reports that Josee Mondoux finally did get one hospital to fund a bilateral implant procedure. However, “the costs are putting such pressure on health care budgets that decisions such as confining children to hearing in one ear to save money are being made more often by governments and hospitals, including the Children’s Hospital of Eastern Ontario.”

In Britain, another Mr. Moore favorite, you have to get your Primary Care Trust to OK a bilateral procedure. It is not necessarily easy. Mathew Harvey, 2, finally won his battle against the North Dorset Primary Care Trust, perhaps with the help of the Times.

According to Julie Brinton, head of the South of England Cochlear Implant Centre at Southampton University, “we would very much like to give Matthew two implants — it’s the right way to go. But we understand the PCT’s position. They have difficult decisions to make and they argue that if the money is spent giving one child two implants, another may not get an implant at all.”

The bottom line is that no coverage decision regarding experimental and cutting edge medicine is cut and dried. Somehow, someway, these experiments have to be rationed. This is true in America’s half-private, half-government system, and it is true in the Canadian and British systems.

Would you rather fight an insurance company with a lawyer and potential allies in the state insurance departments, or would you rather fight the government? That is the question Mr. Moore should have been asking.

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Written by Victor

August 3, 2007 at 4:36 am

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