As NPR recently highlighted in the story, “Anthem Says Eye Surgeons Should Monitor Cataract Anesthesia Themselves,” Anthem, America’s second largest insurer, is once again under fire from medical and patient groups for undercutting consumer services. Based on its newly released policy, Anthem may not cover the anesthesia services associated with cataract surgeries for its policy holders in Washington, stating that “patient-specific needs should be taken into consideration.”
As long-time consumer health advocates, we agree with taking a personalized, consumer-centric approach when caring for patients if it means improvements to the quality of care they receive, but not in the name of cherry picking the covered health services at the expense of patients’ safety in a clear attempt to boost profits. The insurer’s new policy would mean eye surgeons might need to take on double duty, operating, administering anesthesia, and monitoring their patients all at once. Some patients are already taking on additional out-of-pocket expenses for this procedure. Many doctors who are unwilling to risk safety by eliminating the anesthesiologist but hesitant to perform the surgery without guaranteed coverage from the insurer are asking consumers to pay up front.
We stand with other organizations, including the American Society of Anesthesiologists and the American Academy of Ophthalmology, in calling on Anthem to stop putting profits ahead of patients, and to continue to cover anesthesia as part of this routine, common and, until now, safe procedure for a condition more than half of Americans will experience by the age of 80.