Mandates of Insurance Coverage for Infertility Treatments in Georgia

1746 words (7 pages) Nursing Assignment

28th May 2020 Nursing Assignment Reference this

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According to Insogna and Ginsberg (2018) 7.3 million women in the United States have sought treatment for infertility. Hence why I chose to look at the mandates of insurance coverage for infertility treatments, specifically for the state of Georgia. As I prepare to speak with Senator Chuck Hufstetler about this, I will use this assignment to look at an overview of this concern as well as my proposed solution, I will identify communication techniques that could be used to discuss this with the Senator, and I will evaluate my video presentation about my topic.

Overview of Healthcare Concern and Solution

According to the CDC, infertility is the inability to get pregnant after one year or longer of unprotected sex (Infertility / Reproductive Health / CDC, 2019). According to a study done by Insogna and Ginsburg (2018) the World Health Organization defines infertility as a disease. Infertility treatments can include ovarian stimulation drugs, intrauterine insemination, and in-vitro fertilization. Infertility treatments follow a three-level standard of treatment.  According to Mastroianni (2016) level one treatments include medications that stimulate the ovaries. This is done for approximately six cycles, in most cases this is accompanied by various labs as well as ultrasounds to monitor the ovaries response to medications. Level two treatment includes the addition of another type of medication an injection to further stimulate the ovaries with the added option of intrauterine insemination, again the options is used for up to six cycles (Mastroianni, 2016). Level two also involves labs and ultrasounds as part of the treatment as well. Finally, level three involves various types of assisted reproductive technology (ART), most commonly in vitro fertilization (Mastroianni, 2016). In vitro fertilization involves, oral medications and injections as well as labs and ultrasounds, and can include surgeries with additional complications involved. According to Mastroianni (2016) as well as Bitler and Schmidt (2011) the cost of these treatments for level one and two can be anywhere from $200 to $3,000 per cycle (and each can be six or more cycles), level three treatments which may require surgery can range from $10,000 to $15,000 per cycle as well as cost of surgery, potential hospital stay and additional complications. ART procedures have an added layer of additional cost after fertilization due to the risk of multiple births and complicated pregnancies.  In the state of Georgia in 2016 there were approximately 5300 cases of assistive reproductive therapy cycles (IVF cycles) at a cost of anywhere from $12,000-$17,000 per cycle (“Assisted Reproductive Technology”). According to Resolve.org (Number infertile by state, 2014) in the state of Georgia in the years 2006-2010 there were 2,073,006 women who had difficulty getting pregnant or carrying a pregnancy.

This is the reason that I have selected infertility benefits as my healthcare concern for my state. Georgia currently does not mandate insurance benefits for infertility treatments, while currently sixteen states do mandate coverage (“Discover Infertility Treatment”, 2019). According to Mastroianni (2016) of the sixteen states that have already put regulation in place for coverage, there are three types of coverage, first universal mandates that cover IVF treatments, second restricted coverage that only covers specific types of ART, and last there are a few states that only mandate that coverage is offered to the policy holders. Cintina and Wu (2019) simplify the types of coverage a little more into two categories: “mandate-to-cover” (p 562) and “mandate-to-offer” (p 562). Mandate to cover guarantees coverage of infertility treatments as a benefit in all group health plans. (Cintina and Wu, 2019). Mandate to offer just requires that this benefit be available for purchase in some policies (Cintina and Wu, 2019). My selected solution would be a mandate to cover type policy, as I think that it gives the most benefit.

If insurance mandates were put into place in the state of Georgia it would provide more affordable treatment options, therefore granting more access to care for those individuals that cannot currently afford treatment, it also as seen previously would decrease the number of multiple order births associated with IVF due to the decreased need to succeed with the first attempt.

Identification of Communication Techniques

 I have selected Senator Chuck Hufstetler to discuss my selected topic and proposed solution with. Senator Hufstetler is a healthcare worker himself, he is a practicing anesthetist.  He also is a member of the Health and Human Services Committee. Senator Hufstetler is also a very financial savvy individual and a previous business owner. I feel like his healthcare background as well as his financial background will help him to easily understand this issue as well as the financial impact this disease has on a family, and how insurance coverage could help ease that financial burden.

 There are various communication options available to present this concern and solution to Senator Hufstetler, which could include email exchanges, phone conversations, social media platforms or face to face conversation. While email exchanges and phone conversations have been the preferred method of communication to set up our meeting and to explain the need for the meeting, my preferred communication method for the presentation is face to face communication. We are all busy individuals and are easily distracted when having a conversation via phone or may miss some information in an email exchange. If you are face to face with an individual, you will likely have their full attention and be able to engage in conversation about the topic at hand. Egan (2017) identifies that face to face conversation allows you to drive a conversation the direction you want and gives you the opportunity to ask follow up questions. Egan (2017) also identifies that with a face to face conversation you can assess body language. He also states that face to face or one to one conversation carries a level of trustworthiness and genuineness to it, that does not happen with email or social media exchanges.

Self-Evaluation of Video Presentation

 I think that in my video presentation I identified myself and my topic as well as my solution very clearly, I took the approach of using my own personal story to explain infertility treatments and the associated cost. I think that adding that personal touch to this presentation helps to really show the true impact of this topic with real numbers that I experienced myself. I debated whether my personal story should be shorter to allow time for additional data as far as the impact on the State of Georgia, but I believe that I was able to convey both my story and the numbers for the state fairly well. For the method of delivery, I think that my grammar was correct, and I stayed connected with the audience watching my video. I do think that I say “um” and somewhat fumble my words and that I could work on that piece of my presentation. For the style of delivery, I tried to have constant eye contact, I know that I did not do well with this, mainly because I was looking at myself on the screen and I hate seeing myself or hearing myself talk so I tended to look away often. I feel like my appearance was good and that my surroundings were not distracting to my audience. I am not sure that I spoke as clearly as if I was talking to someone in person again because I was distracted by myself on the screen somewhat. I do feel like I speak clearer in person.

Conclusion

 In my video as well as this paper, I have presented my healthcare concern of lack of infertility benefit mandates in the state of Georgia and my proposed solution to that concern, mandating insurance benefits. I have discussed choosing Senator Hufstetler as who I would like to present this concern to and why I feel like he is a good choice to discuss this with. I have talked about several communication techniques which include face to face, phone, email and social media and that my chosen method of communication for this presentation is face to face and why I think that is the best method for this. Finally, I have provided a self-critique of my video including both things that were good and things that I could work on.

References

  • Assisted Reproductive Technology (ART) Data Assisted Reproductive Health Data: Clinic | DRH | CDC. (n.d.). Retrieved from https://nccd.cdc.gov/drh_art/rdPage.aspx?rdReport=DRH_ART.ClinicsList&SubTopic=&State=GA&Zip=&Distance=50
  • Bitler, M., & Schmidt, L. (2011). Utilization of Infertility Treatments: The Effects of Insurance Mandates. doi:10.3386/w17668
  • Cintina, I., & Wu, B. (2019). How Do State Infertility Insurance Mandates Affect Divorce? Contemporary Economic Policy,37(3), 560-570. doi:10.1111/coep.12416
  • Discover Infertility Treatment Coverage by U.S. State. (2019). Retrieved from https://resolve.org/what-are-my-options/insurance-coverage/infertility-coverage-state/ 
  • Egan, J. (2017). Face-to-Face Communications Is Powerful, Postdigital Communications Tool. Natural Gas & Electricity,34(2), 21-26. doi:10.1002/gas.22004
  • Infertility / Reproductive Health / CDC. (2019, January 16). Retrieved from https://www.cdc.gov/reproductivehealth/infertility/ 
  • Insogna, I. G., & Ginsburg, E. S. (2018). Infertility, Inequality, and How Lack of Insurance Coverage Compromises Reproductive Autonomy. AMA Journal of Ethics, 20(12), 1152-1159. doi:10.1001/amajethics.2018.1152
  • Mastroianni, M. A. (2016). Bridging the gap between the “have” and the “have-nots”: The ACA prohibits insurance coverage discrimination based upon infertility status. Albany Law Review,79(1), 151-181.
  • Number of Infertile by State – RESOLVE: The National Infertility Association. (2014). Retrieved from https://resolve.org/what-are-my-options/insurance-coverage/coverage-at-work/number-of-infertile-by-state/

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