If individuals can get surgeries to "affirm their gender identity" paid for by Medicaid, Medicare and, in some states, by private insurers mandated by law to cover all "gender affirming surgeries", then any female who wants breast, hip or buttocks implants or facial or other surgeries to "affirm" her sense of herself as a woman should be able to get those paid for by Medicaid, Medicare and by state mandated private insurance. Why not?
Sounds like just a matter of time before Ontario citizens can demand taxpayer-funded ear, nose etc piercings, and tattoos, on the basis of unbearable Fashion Identity "dysphoria" in not keeping up with extreme fashion, provoking suicide risk. Until a World Professional Association of Piercers and Tattooists (WPAPT, no qualifications required for membership) deem that "medical necessity" for extreme piercings and tattoos must be depathologised, and required Fashion Identity treatment be supplied On Demand.
A well written and reasoned argument. I’m reminded of similar issues over a rights based reason for men to be allowed into women’s sport vs ethical considerations of fairness and safety for the women. Just goes to show the Trans ideologues chose a winner in their human rights strategies in recruiting human rights lawyers to draw up the Yogyakarta principles.
I think the full Divisional Court decision went beyond the strict wording of the Schedule of Benefits in its ruling. It said the plain wording was sufficient. However in what I (perhaps incorrectly) think lawyers call an *obiter dictum*, the Court also said that even if the plain wording test had failed, it would still have required OHIP to pay on Charter of Rights and Freedoms grounds that guarantee personal integrity or some such. So tightening up the wording in the SOB may not be sufficient to spike the next request.
You mentioned the black art of medical necessity. Decades ago, medical necessity was what doctors sitting down to talk about something agreed was reasonable to improve a patient's health. Tissue audit committees at hospitals would scrutinize surgical operations to ensure "unnecessary" hysterectomies, C-sections, and tonsillectomies weren't being done by unscrupulous surgeons bilking patients out of their hard-earned money. Cosmetic surgery was never audited for medical necessity because if the patient wanted it for appearance, that was good enough. The audit committee would never say, "Her breasts looked fine before. What business did you have making them bigger?"
Nowadays of course, "medical necessity" means exactly, and no more than, what insurance payers are willing to pay for. ("Experimental" just means they aren't willing.) Something gets written as a benefit in the SOB (or on private insurance menus) as medically necessary when insurance becomes willing to pay. It is therefore logically unsupportable to argue that a procedure listed on the SOB as eligible for reimbursement (under whatever conditions specified) can ever be medically unnecessary. If it was medically unnecessary, or "experimental", it wouldn't be billable to OHIP at all. The Ministry removes obsolete procedures and services from the SOB all the time, meaning that doctors must charge the patient for them (or do them for free if they want to.) So the Ontario Ministry of Health made its bed. It can now lie in it while it figures out how to spend its tax money sensibly on actual sick people and deal with trans activists screaming at it.
If individuals can get surgeries to "affirm their gender identity" paid for by Medicaid, Medicare and, in some states, by private insurers mandated by law to cover all "gender affirming surgeries", then any female who wants breast, hip or buttocks implants or facial or other surgeries to "affirm" her sense of herself as a woman should be able to get those paid for by Medicaid, Medicare and by state mandated private insurance. Why not?
"...no equality but a position of exceptional privilege." Exactly. Great article!
Sounds like just a matter of time before Ontario citizens can demand taxpayer-funded ear, nose etc piercings, and tattoos, on the basis of unbearable Fashion Identity "dysphoria" in not keeping up with extreme fashion, provoking suicide risk. Until a World Professional Association of Piercers and Tattooists (WPAPT, no qualifications required for membership) deem that "medical necessity" for extreme piercings and tattoos must be depathologised, and required Fashion Identity treatment be supplied On Demand.
A well written and reasoned argument. I’m reminded of similar issues over a rights based reason for men to be allowed into women’s sport vs ethical considerations of fairness and safety for the women. Just goes to show the Trans ideologues chose a winner in their human rights strategies in recruiting human rights lawyers to draw up the Yogyakarta principles.
I think the full Divisional Court decision went beyond the strict wording of the Schedule of Benefits in its ruling. It said the plain wording was sufficient. However in what I (perhaps incorrectly) think lawyers call an *obiter dictum*, the Court also said that even if the plain wording test had failed, it would still have required OHIP to pay on Charter of Rights and Freedoms grounds that guarantee personal integrity or some such. So tightening up the wording in the SOB may not be sufficient to spike the next request.
You mentioned the black art of medical necessity. Decades ago, medical necessity was what doctors sitting down to talk about something agreed was reasonable to improve a patient's health. Tissue audit committees at hospitals would scrutinize surgical operations to ensure "unnecessary" hysterectomies, C-sections, and tonsillectomies weren't being done by unscrupulous surgeons bilking patients out of their hard-earned money. Cosmetic surgery was never audited for medical necessity because if the patient wanted it for appearance, that was good enough. The audit committee would never say, "Her breasts looked fine before. What business did you have making them bigger?"
Nowadays of course, "medical necessity" means exactly, and no more than, what insurance payers are willing to pay for. ("Experimental" just means they aren't willing.) Something gets written as a benefit in the SOB (or on private insurance menus) as medically necessary when insurance becomes willing to pay. It is therefore logically unsupportable to argue that a procedure listed on the SOB as eligible for reimbursement (under whatever conditions specified) can ever be medically unnecessary. If it was medically unnecessary, or "experimental", it wouldn't be billable to OHIP at all. The Ministry removes obsolete procedures and services from the SOB all the time, meaning that doctors must charge the patient for them (or do them for free if they want to.) So the Ontario Ministry of Health made its bed. It can now lie in it while it figures out how to spend its tax money sensibly on actual sick people and deal with trans activists screaming at it.