Letter to Human Resources

Last year, we saw Project IF for National Infertility Awareness Week. Keiko's WhatIF video made me want to start talking about infertility to someone other than my husband and my doctor. The biggest step I could convince myself to take was to start up an anonymous Twitter account and this blog.

In honor of National Infertility Awareness Week this year, I sent the following email* to my Human Resources department. I used the template provided by Resolve and made a few edits to tailor it to my situation. It's not much and at a large employer like mine, I don't know what the impact will be. But it's not anonymous and it was time to do SOMETHING:

Dear AVP of Human Resources,

I have been an employee of This Company for over two years. This Company is a valuable asset to our community and the wider region, providing innumerable benefits to employees and community members alike. This week is National Infertility Awareness Week, and I am writing to request that you consider adding coverage for in vitro fertilization (IVF) to the health benefit packages This Company offers.

Statistics indicate that one in eight couples of reproductive age in the United States suffer from infertility. That translates to 7.3 million people suffering from a disease that receives little recognition or respect for the traumatic experience that it truly is.

Recent studies have shown that the psychological impact  of infertility diagnosis and treatment is equivalent to that of cancer. According to the World Health Organization and the CDC, infertility is a disease. For many patients, IVF is the only effective form of treatment for the form of the disease from which they suffer.

Some critics of infertility treatments and insurance benefits for those treatments claim that infertility is a lifestyle choice. While it would be disingenuous to deny that some patients seek treatment as a lifestyle choice (namely to delay child rearing to a later, more stable point in their lives), those patients represent only a small fraction of the total of those in need of treatment. This criticism erroneously assumes that age is the only factor contributing to infertility. Even patients whose age might be considered a factor may only have come to seek treatment after years of trying unsuccessfully to conceive without medical intervention.

Employers often believe that adding infertility coverage benefits will increase health care costs.  However, studies indicate that including comprehensive infertility coverage in a health benefit package may actually reduce costs and improve outcomes.

For example, an employer survey conducted by the consulting firm William M. Mercer found that 91 percent of respondents offering infertility treatment have not experienced an increase in their medical costs as a result of providing this coverage. For more on the survey, click here.

As proven in the following studies, the perceived cost of infertility treatment is typically overstated.

• Often patients select treatment based on what is covered in their health benefit plan rather than what is the most appropriate treatment.  For example, a woman having trouble conceiving because of blocked fallopian tubes or tubal scarring may opt for tubal surgery, a covered treatment, which can cost $8,000 -$13,000 per surgery.  Many patients are forced to forgo in vitro fertilization (IVF) because it is not a covered service even though it costs about the same as tubal surgery and statistically is more likely to result in a successful pregnancy.Infertility as a Covered Benefit, 1997). According to William M. Mercer, “The decline in use of high-cost procedures like tubal surgery would likely offset the cost to include IVF as a benefit and provide improved health outcomes.” (William M. Mercer,

• In states with mandated infertility insurance, the rate of multiple births is lower than in states without coverage. (New England Journal of Medicine, “Insurance Coverage and Outcomes of In Vitro Fertilization,” August 2002).  Couples with insurance coverage are free to make more appropriate decisions with their physicians based on medical necessity rather than financial considerations which often result in multiple births and a high rate of complications during and post-pregnancy. Read more here.
• Comprehensive infertility coverage may actually reduce premium expense by as much as $1 per member/per month.  According to The Hidden Costs of Infertility Treatment in Employee Health Benefits Plans (Blackwell, Richard E. and the William Mercer Actuarial Team, 2000), insurance premiums now indirectly provide coverage for “hidden” infertility benefits such as surgeries to remove scarring in the fallopian tubes for women or varicose vein removal for men, were calculated to be adequate to cover more effective and often less expensive treatments such as ovulation induction, intrauterine insemination and in vitro fertilization. 
• The cost of infertility services as a percent of the total health premiums went down after the 1987 Massachusetts mandate. (Study by Griffin and Panak, Fertility & Sterility, 1998) 
• In vitro fertilization accounts for less than three percent of infertility services. According to the American Society of Reproductive Medicine (ASRM), 85%-90% of infertility cases can be treated with conventional medications.

Additional information on issues surrounding infertility can be found on Resolve.org. I hope The Company will consider extending infertility coverage to include IVF and support our family building efforts.  Thank you for your consideration.

Sincerely,

Moi


Baby steps people, baby steps.


*All names changed to protect my privacy.
The internet is forever, after all.