Insurers Fight Speech-Impairment Remedy

Medicare and private health insurers decline to cover cheap devices like iPhones and netbook PCs that can help the speech-impaired, despite their usefulness and lower cost. Instead, public and private insurers insist that, if patients want insurance to pay, they must spend 10 to 20 times as much for dedicated, proprietary devices that can do far less. The logic: Insurance is supposed to cover medical devices, and smartphones or PCs can be used for nonmedical purposes, like playing video games or Web browsing. "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 spokesman for the federal Centers for Medicare and Medicaid Services. Private insurers tend to follow the government's lead in matters of coverage. Two years ago, iPhones and netbooks barely existed, so it may not be surprising that the industry has yet to consider their role as medical devices. But the health care system has long had trouble keeping up with Moore's Law, the principle that computing power rapidly increases even as costs fall sharply. Doctors must still bring a patient into their offices instead of, say, inspecting an e-mailed photo of a rash if they want most insurers to pay for the consultation. Digitizing medical records is such a vast undertaking that the government is now spending billions of dollars to jump-start it.