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Massachusetts Medical Society




In the national debate about who should have health insurance, surprisingly little attention has been focused on what medical services health insurance itself should cover. Historically, discussions of this topic have centered on concepts such as basic health care or medically necessary care. When the power of medical diagnosis and treatment was limited, these terms had boundaries as well. As physicians' diagnostic prowess has increased, however, especially in the area of genetics, such terms have become open-ended. To avoid predictable conflicts over benefit coverage, much more precise definitions will be required, so that patients and health care providers can understand what is and is not covered by the patient's health insurance plan.


From The New England Journal of Medicine, George J. Annas, When Should Preventive Treatment Be Paid for by Health Insurance?, Volume 331, Page 1027 Copyright ©(1994) Massachusetts Medical Society. Reprinted with permission.

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