Susan's Place Transgender Resources

Should the Government Pay for a Sex Change?

http://www.usnews.com/news/articles/2015/12/04/government-contemplating-when-medicare-should-cover-gender-reassignment

US News/By Kimberly Leonard Dec. 4, 2015 | 7:07 p.m. EST

"The Obama administration is considering whether Medicare, its health care program for older and disabled adults, should regularly cover sex reassignment surgery.

The Centers for Medicare and Medicaid Services is requesting public comments over the next month to aid officials in determining whether a standard that would require coverage for such surgeries is warranted. Spurring the process is a request to the agency by Nehael Jae Shields, 53, who says she has been trying for several years to receive a range of surgical procedures for treatment related to being born intersex, a condition when a person is born with an anatomical makeup that doesn't fit the typical male or female definition. "

I thought the article approached it from an economic point of view.  Is your question from a moral one? Just wondering. If I added up all the medical costs associated with the consequences of my dysphoria, it would have been cheaper and healthier to have transitioned to begin with. Now I get to spend for both. A waste of time and money, which is amoral.


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Quote from: Gertrude on December 05, 2015, 04:06:39 PM
I thought the article approached it from an economic point of view.  Is your question from a moral one? Just wondering. If I added up all the medical costs associated with the consequences of my dysphoria, it would have been cheaper and healthier to have transitioned to begin with. Now I get to spend for both. A waste of time and money, which is amoral.


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the government is asking the public for help in deciding Medicare coverage

Quote from: stephaniec on December 05, 2015, 01:03:49 AM
Should the Government Pay for a Sex Change?

http://www.usnews.com/news/articles/2015/12/04/government-contemplating-when-medicare-should-cover-gender-reassignment

US News/By Kimberly Leonard Dec. 4, 2015 | 7:07 p.m. EST

"The Obama administration is considering whether Medicare, its health care program for older and disabled adults, should regularly cover sex reassignment surgery.

The Centers for Medicare and Medicaid Services is requesting public comments over the next month to aid officials in determining whether a standard that would require coverage for such surgeries is warranted. Spurring the process is a request to the agency by Nehael Jae Shields, 53, who says she has been trying for several years to receive a range of surgical procedures for treatment related to being born intersex, a condition when a person is born with an anatomical makeup that doesn't fit the typical male or female definition. "

Hi Stephanie, didn't you say that Medicare approved SRS coverage for you?

yes it does, but I still nee supplemental   insurance

Quote from: stephaniec on December 05, 2015, 06:51:48 PM
yes it does, but I still nee supplemental   insurance

What is that

Quote from: kittenpower on December 05, 2015, 06:56:29 PM
What is that

Medicare covers only 80 percent of covered medical costs and is not very good to cover hospital stays. It wasn't always this way. Somewhere along the way we decided that it would be nice to let capitalism in on the gig. These plans are known as "Advantage Plans" and you see them advertised like crazy on the tube all the time. What they do is handle the paperwork and the government reimburses them for the fees they pay out. And for that privilege, people on Medicare get to pay extra. It can get pricey too. So, if you are receiving $800 a month in SSA payments, you get to take up to 75% of that and purchase additional coverage, which the government pays for anyway. Don't you look forward to retirement?

Cindi

Quote from: Cindi Jones on December 05, 2015, 07:11:37 PM
Don't you look forward to retirement?

It's that I don't look forward do going on social security which I have to do next year. I will continue to work after that and I need to work two years after that just to qualify for full social security. I am one of those baby boomers who reaches full retirement at 66 but sill needs to sign up of social security at 65.

At least the GCS was taken care of a long time ago so I don't need to worry about what the government decides.

In Canada (mostly) they do, but I don't think that was your question, but Gertrude brings up a good point, about the costs of untreated dysphoria, and it's more then that, the productivity lost due to depression, suicide etc.
in Canada they have done many studies on this, it's actually cheaper and better for the economy if everything is covered, even medication, in the end, it is cheaper for everyone, but try to convince people of that... you know, research, science, it's so confusing... :P


my 2 cents (and that's 2 cents Canadian, so about 1.4 cents US)
xox, Candi

I put the GCS on hold because of an assortment of problems. The doctor I would have do the GCS will do I t with the supplemental , but that doesn't cover the genital electrolysis There  a lot of things to consider in the planning stage especially if your on Medicare.

why not? I read this article saying that it wouldn't cost a lot for trans in the military.

Transgender transition care will cost the military this much

http://fortune.com/2015/08/13/transgender-military-cost/

Fortune/by Claire Zillman  August 13, 2015, 10:50 AM EST

for me personally there are other issues besides the costs That I have to seriously take into consideration.

Considering the way the government throws money at anything and everything, why not.  I would much rather they spend the money to help me and others over 65 rather than give a million dollar grant to some professor somewhere studying whether walking in the rain gets you wetter than running in the rain or some similar silly nonsense.

Considering all the other stuff it pays for why not? It can be argued that it benefits mental health and the fact they they didn't in the first place was border line discrimination.

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For Obamacare and the government requiring GCS coverage and denying it to Medicare sounds rather like age discrimination. Transition coverage has been shown to be cost effective. Is this the beginning of the "death panels" deciding what should be covered for Medicare beneficiaries. For the government to pay for some and not others violates the equal protection clause.

Besides I have some skin in the game. If I wasn't able to afford transition by the time I went on Medicare (5 years), I was counting on Medicare coverage. It was one of the few things giving me hope for the future.

Quote from: traci_k on December 07, 2015, 02:31:29 PM
For Obamacare and the government requiring GCS coverage and denying it to Medicare sounds rather like age discrimination. Transition coverage has been shown to be cost effective. Is this the beginning of the "death panels" deciding what should be covered for Medicare beneficiaries. For the government to pay for some and not others violates the equal protection clause.

Besides I have some skin in the game. If I wasn't able to afford transition by the time I went on Medicare (5 years), I was counting on Medicare coverage. It was one of the few things giving me hope for the future.

Most therapists refuse to accept Medicare. Dental, vision, and hearing (all problems for the elderly) are downright ignored by Medicare. And there is a political party out there that really is pushing to deny more services. Vote for your own interests folks.

Cindi

In my mind the ACA needs to morph into Medicare for all, universal coverage. Of course it should cover TG treatments  of all sorts. In the long run, i believe we become happier adjusted members of society and that ends up costing less to all the rest of the insured.

Quote from: Candi.Krol on December 05, 2015, 08:55:30 PM
In Canada (mostly) they do, but I don't think that was your question, but Gertrude brings up a good point, about the costs of untreated dysphoria, and it's more then that, the productivity lost due to depression, suicide etc.
in Canada they have done many studies on this, it's actually cheaper and better for the economy if everything is covered, even medication, in the end, it is cheaper for everyone, but try to convince people of that... you know, research, science, it's so confusing... :P


my 2 cents (and that's 2 cents Canadian, so about 1.4 cents US)
xox, Candi

Like Candi says, for the most part it's covered but just getting to the starting point takes the patience of a saint! There is only 1 place in all of Ontario (CAMH) that can say yes or no to publically funded SRS and they also handle I think 2 more provinces so you can see the back log just to be seen! I applied in March 2014. All I received was a letter saying that it had been received and the wait time was about 18 months. That was just to be seen it didn't say anything about the length of time to get approved nor the waiting time for the surgery. Even if it's approved, I don't think I can choose my surgeon because there are only 2 in Canada and they won't cover a flight to the other side of the country so it narrows it down which violates my right to choose my own surgeon.

In any event, many people are against the province paying for SRS as many don't see it as necessary unlike say other surgery. It is still seen as a "choice" surgery. Problem is that 99% of the public just do not understand what it's like to be trans.

Love,
Clare

Considering that we are such a small percentage of the population to begin with and even then not all of us intend to have surgery, combined with SRS being a one time thing, the cost of covering surgery would be nominal. By comparison, around 50% of the population are able to bear children at some point in their lives and they pay for that.

SRS: Assuming 5% (the actual number is likely a lot lower) of the population had SRS at a cost of $20,000 itemized over 65 years (Birth to Medicare eligibility), that works out to $1.28 per month per person. If the number were closer to 2%, it would be 51 cents per person per month.

Maternity Care: Assuming 50% of the population are able to bear children and 52.4% (as of 2015) will have an average of 1.9 children in their lifetime at a cost of $12,000 to $17,000 per birth, that works out to $7.66 to $10.85 per person per month. That is 6 to 21 times the cost of covering SRS.

Quote from: RobynD on December 08, 2015, 05:27:42 PM
In my mind the ACA needs to morph into Medicare for all, universal coverage. Of course it should cover TG treatments  of all sorts. In the long run, i believe we become happier adjusted members of society and that ends up costing less to all the rest of the insured.

I wouldn't mind (though I sadly suspect it would become a slippery slope to full single payer) a catastrophic fund that would cover the expensive stuff (Hospitalization, Surgery including SRS and certain FFS, etc...), while preventing the insane delays for basic/routine care seen under the British or Canadian systems by keeping the private healthcare system.

Quote from: Cindi Jones on December 08, 2015, 05:23:40 PM
Most therapists refuse to accept Medicare.

This is because Medicare doesn't want to pay them anything to speak of (some doctors have said they actually lose money on each Medicare patient and that accepting it is in effect charity) and if they accept even one Medicare patient, the government sticks them with a bunch of rules/requirements.

Quote from: lisarenee on December 11, 2015, 07:26:24 PM
I wouldn't mind (though I sadly suspect it would become a slippery slope to full single payer) a catastrophic fund that would cover the expensive stuff (Hospitalization, Surgery including SRS and certain FFS, etc...), while preventing the insane delays for basic/routine care seen under the British or Canadian systems by keeping the private healthcare system.

I've gotta ask, because I don't know, are the systems in the UK and Canada inherently inefficient with basic care, or is it that there are too few medical personnel to handle the need? Personally I'm a big fan of single-payer because it gets  insurance companies out of the equation. Full disclosure: I'm old and my healthcare needs are met through Medicare. It's not an entitlement because I paid into it every working day of my life, in case you were wondering.

And another thing, referring to this as "government pay for sex change" has got it backwards. Reality is we, through our tax dollars, provide money that the government uses at our direction (provided our congressional representatives do their jobs) for things we the people feel are worthy. The government is the administrator of the money we give it. It's not creating money to do whatever it pleases.

Quote from: diane 2606 on December 11, 2015, 09:27:05 PM
I've gotta ask, because I don't know, are the systems in the UK and Canada inherently inefficient with basic care, or is it that there are too few medical personnel to handle the need?

My guess would be that it is less profitable and as a result less people enter the profession. Here in the US, Medicare (which is essentially single payer for those 65 and over) pays doctors next to nothing and saddles them with extra rules/requirements, which is why many doctors won't accept Medicare.