What The Great Divide Over IVF Coverage Can Tell Us About The Future Of Other High-Tech Interventions

This new post by Eli Adashi appears on the Health Affairs Blog as part of a series stemming from the Sixth Annual Health Law Year in P/Review event held at Harvard Law School on Tuesday, December 12, 2017.

One is hard pressed to conjure up a more fundamental right than the right to procreate. It is a right “baked” into human DNA, a right inherent to the very existence of the species, and a right enshrined now 70 years ago in the Universal Declaration of Human Rights of the United Nations. In principle then, the precept of procreative liberty is all that is necessary and sufficient to undergird the right to infertility care in general and to in vitro fertilization (IVF) in particular. In support of this premise, the World Health Organization (WHO) defined infertility as a disease. Just as importantly, the WHO included Infertility in its International Classification of Diseases replete with the billing codes thereof.

However, the promise of procreative liberty and all that flows from it has yet to be fully realized. For one, the aforementioned principles have not been uniformly embraced by all member states of the United Nations including the United States. For another, access to IVF remains compromised by high procedural costs, widening income disparities, extensive underwriting gaps in both the public and private sectors, deep-seated sociocultural clefts, and fundamental moral discords. To those seeking to build a family, the confluence of these hindrances is nothing short of prohibitive with the net effect being access all but denied. None of this is surprising of course. Access, after all, equals affordability, which is unlikely to improve anytime soon given growing price pressures and widening income disparities. […]

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