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Most people live long lives these days but many of them also develop chronic health problems, despite the pace of medical advances.We are living longer than ever, but not necessarily better.Dunn even felt as though she no longer resembled herself.
This makes it difficult for people who want to have surgery for conditions that fall in the gray zone between cosmetic and medically necessary, difficult for the doctors who take care of them, and a challenge for insurers whose goal is to minimize their expenses.
At the core of this issue is how we define the terms cosmetic and medically necessary.
In addition to irritated skin tags, insurers also often don’t want to pay for steroid injection treatments for the painful overgrowing scars known as keloids, for the autoimmune hair loss known as alopecia areata, and even for painful cysts that form in the underarms or folds in the skin (hidradenitis suppurativa).
These conditions and others can deeply affect an individual’s quality of life.
The traditional distinction is that cosmetic treatments are merely enhancements that improve appearance, while medically necessary treatments address a disease and are necessary for health or survival. Further complicating matters is the role that health care plays in our lives.
One important role, to be sure, is to preserve and extend people’s lives or, in the language of medicine, to reduce mortality and morbidity. But health care should also strive to improve something that’s less easily defined: quality of life.More and more I find myself arguing with insurance companies to cover treatment of my patients’ skin conditions that are seriously affecting their quality of life.I fill out countless prior authorization forms and regularly talk peer to peer with medical representatives, advocating for my patients.I find it ironic that performing an extra evaluation (at extra cost) to confirm that the skin tag was benign adds credibility to my claim that its removal was medically necessary.At what point does performing a biopsy of tissue that is conspicuously normal, in the service of taking care of patients, become fraud? I don’t want to miss a skin cancer, and though it’s rare, I’ve seen normal-looking skin lesions turn out to be cancers.Some argue that cosmetic surgery is positive for some patients. For example, Gabriel Winger, was diagnosed with cancer when she was five years old. ...y Hills Cosmetic Surgery, Los Angeles Plastic Surgeon, Breast Augmentation, Facelift. Cosmetic surgery has become increasingly more popular. Debra Dunn decided to have cosmetic surgery to fix a bump she had on her nose as a result of a childhood injury. After having two nose jobs and spending thousands of dollars, she was so dissatisfied with her results that she was embarrassed when she left the house and avoided mirrors. It’s entirely reasonable to create a set of priorities for how we spend our health care dollars.However, I think insurance companies’ priorities on what they will pay for do not necessarily match what can make real differences in people’s lives.