Comment by gruez

Comment by gruez a day ago

3 replies

>Isn't "stuff that most people can't afford but would help with healing" the stated purpose for health insurance?

I thought the operative term was "medically necessary"? "would help with healing" can theoretically cover everything from protein shakes for knee injuries, to iPads to help with stroke recovery. A CPM machine is on the far end of this, closer to "medically necessary" than the other examples, but you have to draw the line somewhere, so some reasonable-but-theoretically-optional equipment gets excluded.

tombert a day ago

Sure. I guess I would draw the line in a different place.

There are plenty of things that aren't strictly "necessary" but are still provided by insurance. My wife's painkiller medication isn't strictly necessary, she wouldn't die without it and the leg would probably heal the same way, but they covered that because obviously they should cover that. I feel like a piece of medical equipment like a CPM machine is more necessary than painkillers.

  • elcritch a day ago

    Well first question to my mind is does a CPM actually help? There's a lot of waste in American Healthcare on expensive but fairly useless treatments.

    My guess was that a CPM might fall into this category (I did PhD research in bio mechanics in MatSci). So I googled it and it returned a quote:

    > Do doctors still use CPM machines? > The machines are no longer widely used because of the multiple studies that found CPM following knee replacement surgery has minimal benefits. However, some surgeons still recommend CPM following knee surgery when the limited pros outweigh the cons in a particular case. (1)

    From an insurers perspective it makes sense not to cover a marginally useful piece of equipment. The better use of resources would probably be covering PT where there's movement and weight on the joint.

    1: https://www.verywellhealth.com/do-i-need-a-cpm-following-kne...

    • tombert a day ago

      Fair enough. It was still prescribed by the doctor and I would rather have not paid for it.

      Even if its benefits are marginal, they’re probably still more tangible than acupuncture and chiropractic, both of which are apparently covered by my insurance, and the CPM machine probably doesn’t cause a stroke like chiropractic does.