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June 20, 1980

Insurance Coverage for Breast Reconstruction

Author Affiliations

Blue Cross-Blue Shield of Arizona Phoenix

JAMA. 1980;243(23):2398. doi:10.1001/jama.1980.03300490016014

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To the Editor.—  Would those who advocate mandatory insurance coverage of breast reconstruction through legislation (242:2779, 1979) also advocate mandatory universal health insurance? The comparison is quite legitimate.In a free society the marketplace determines what benefits should be offered by competing insurance companies. Indeed, by the statement of Dowden and his coauthors that the pressure of the free market appears to be working, "when this survey was started three years ago there were 28 companies that denied breast reconstruction... the number has dropped to only six."It is not the insurance companies that must "gain a clear picture of the nature of the procedure [to] adjust their policies," but rather it is the consuming public that must be educated by those who would advocate the change. Those who pay the bill should mandate what they are willing to buy.Taking the argument of Dowden et al to its logical