A place for two of our editors to debate a chosen topic.
Question: Should insurance companies cover the cost of plastic surgery?
Pro - jaeeun
According to the American Society of Plastic Surgeons, 13.5 billion dollars were spent on plastic surgery in the U.S in 2015. But the fundamental question here is, who is paying for this cost? Who pays for the surgery costs really depends on your insurance company and the plan you are abided to. Moreover, there are different kinds of surgeries, varying from the most well-known cosmetic surgeries to the reconstructive surgeries that you would get because it was essential for your body to function. So, what is the boarder line for the insurance companies to cover?
Unfortunately, cosmetic surgery is not one of the things covered in most health insurance plans due to the fact that it is optional and not usually considered as necessary to maintain quality of life or body functioning. However, the insurance companies should be covering the cost for the plastic surgeries that is required to preserve the healthy functioning of the body. Then, it would no longer be called “cosmetic surgery”. Procedures following car accidents, major accidents, or situations where your body needs to be repaired so that you may resume quality of life and body function. For instance, my mother’s friend got into a car accident and broke her nose bone. She had to get nasal surgery in order for them to reshape the bone bridge. If it hadn’t been repaired, then she would have had a problem with breathing for the rest of her life. In these type of cases, plastic surgery is needed. There may be cases where people take advantage of this and receive one for their own good. So I think this is the border line: If a doctor identifies a procedure as necessary to live properly, this would likely not be considered cosmetic. If they say it’s necessary, then it should be payed for by the companies.
Con - Paul
The term “plastic surgery” is very broadly defined, as it means a surgery for “defects due to birth disorders, trauma, burns, and disease” and for “enhancement of the appearance of a person through cosmetic surgery” according to MedicineNet. From the definition alone, it is easy to perceive that the surgery is not usually compulsory to sustain life, but is rather voluntary as the main objective is to alter the physical shape of the body whether it is due to damage or cosmetic purpose. Now that I gave you some insight of what plastic surgery is, I will delineate the possible risks that will accompany when health insurance companies are forced to cover fees for plastic surgery.
The insurance companies have several duties that they have to follow. These include “fair deal, general duties, insurance contract, and duty to defend” according to Chron. It is likely that the customers could abuse these duties for their personal benefits. Based on the “fair deal,” the insurance company has to go in accord with the customer’s “best interests”. This means that the customers could simply have plastic surgery solely for cosmetic purposes and request the insurance company to cover their fee. On top of that, if the contract regarding the plastic surgery is vague, the customer could take it to court, making the job for the insurance company more distressing. If more people find a way to have their cosmetic surgeries covered by the insurance company, the money that should have been used for more serious surgeries will be allocated for plastic surgeries since the insurance company has a limited budget. Of course, I’m not saying that all plastic surgeries are unnecessary, as there are occasions of which plastic surgeries are vital for the patients who need them in order to restore their body from damage. In this case, the insurance company is free to classify the surgery under “reconstructive procedures,” as referred in Verywellhealth, and which also concurs with the “fair deal” for patients.