It was a hard fight to get insurance companies to cover dedicated text-to-speech devices for speech-impaired patients, but it finally happened in 2001, according to a report in The New York Times. Now the fight is on to get insurers to pay for cheaper devices and software that they claim work just as well or better.
The Times report highlights one patient's struggle: Kara Lynn, an ALS, or Lou Gehrig's disease patient, used to use a PC with text-to-speech software loaded on it because that's what her insurance would cover. The computer had to be stripped down of all other capabilities to be eligible for coverage -- no web browsing, email -- nothing. As you might imagine, however, Lynn wanted to "take her voice with her" where ever she went, which wasn't possible with a PC. Instead she bought an iPhone and an iPhone application that she believes works better.
The iPhone, of course, does much more than text-to-speech, so insurers won't cover it, according to the New York Times report.
It may be a slippery slope to allow multifunctional devices like the iPhone or a generic PC to become included under insurers coverage, however, the Times points out that almost in all cases consumer devices like the iPhone are much more cheaper than the dedicated ones. The Times pegs the cost of dedicated devices at 10 to 20 times the price of the iPhone. Accessories to these dedicated devices are also marked up 2,000 percent in some cases. A Bluetooth-enabled headset for one text-to-speech device, for example, had a 2,000 percent mark up over a generic Bluetooth headset compatible with mobile phones, according to the report.
"We would not cover the iPhones and netbooks with speech-generating software capabilities because they are useful in the absence of an illness or injury," said Peter Ashkenaz, a spokesperson for the government agency that runs Medicare. Private insurance companies tend to follow the government's lead and so in this case they appear to share that rationale. The New York Times concludes that the case shows how policymakers and the health care industry are failing to keep up with "Moore's Law, the principle that computing power rapidly increases even as costs fall sharply."
What do you think? Should non-dedicated devices be covered? What would be the best way to determine a device's eligibility? Are insurers -- private and government alike -- capable of keeping up with Moore's law? In the case of a mobile phone like the iPhone, should insurers pay for the person's data plan too?
