Jen posted,

<< I think it's completely unreal that my insurance will not cover a pump....I
 almost am thinking about writing a nasty letter and mentioning
 discrimination. >>

Fundamentally I have to agree with Lucy on this one.  If we want infant
feeding to be non-medicalized, then we need to swallow the fact that medical
insurance may not be the people responsible for footing the bill.  I'm
perfectly happy to demonize the HMOs and other insurers on other issues (just
being rhetorical here folks, don't flame me!) but on this particular one they
have a good point.  They aren't normally responsible for food, or for the
cost of obtaining food, even if it is really really healthful food.  (I'm
talking about when you're at home, here -- I think many insurers will
actually pay for a pump while your baby is hospitalized, in which case
getting milk for him/her is more comparable to the costs of hospital food for
everyone else which is always paid for.)   Is human milk for your healthy
baby a medical intervention, or is it just natural life?   Hard to have it
both ways.  I write this knowing that some insurance folks are members of the
lactnet community -- fair is fair, I think.

On the other hand, I also do agree with the very sensible post (which I've
deleted so I don't remember who sent it, sorry) that talked about making
people aware that they, too, will benefit if you pump.  Here's a strategy to
use in that area.  Try calling not the normal customer service person but
instead the person responsible for the perinatal care program.

 Most insurers now have such a program -- it's the person who calls you
solicitously to inquire about your prenatal care etc.  I have seen a couple
of cases in which that person -- usually an RN -- has "waived in" care from,
say, midwives who were not listed as in-network because it turned out that
there were no midwives -- and the customer pointed out how much cheaper the
overall health costs for this healthy dyad would probably be with midwifery
rather than OB care.  This is a feather in the program's cap, because it
saves the insurer money overall, and also obviously these are medically
rather than bureaucratically trained people so they are truly more supportive
of things that help you and your family stay healthier.

You could try the same argument here -- that it's not only better for you and
your baby but also cheaper for the insurer to pay for the pump than for the
ear infections etc.   They might prefer to decide that it is "really" part of
the package your employer paid for, if it seems that they will be paying out
fewer benefits overall because of it.

Elisheva Urbas
NYC

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