“Sex never dies. It’s a part of life”
Till recently Medicare was paying for the coverage of Vacuum Erection Systems (VES) prosthetic devices and related accessories, when reasonable and necessary. The vacuum tubes seem to have been the second best option after the blue pill. Although little awkward and not very romantic, Vacuum Erection Systems can be very effective.
On July 1st,2015 however, Medicare stopped covering vacuum erection devices, the result of legislation Congress passed in December 2014. Since 2006, Congress has banned Medicare Part D coverage of medications for erectile dysfunction, too. That leaves millions of men with no Medicare option for what we used to call impotence, except for the more expensive penile implant surgery.
Erectile dysfunction is a common problem. About 60 percent of men older than 60 — and 70 percent of those in their 70s — have trouble getting or maintaining erections, often because of diabetes, cardiovascular disease or prostate cancer treatment. Not all of them want treatment, of course. A large proportion of older men have lost sexual interest, don’t have a partner or have other illnesses that preclude sexual activity.
Moreover, some men who opt for treatment can afford to pay out of pocket for Levitra, Cialis or Viagra — the last has a wholesale price of $38 per pill, according to Pfizer — or for vacuum erection systems that retail for $125 to $500. But it is fair to say that many thousands of modest-income Medicare beneficiaries will now forgo treatment for erectile dysfunction, and fair to ask if this policy makes sense.
Many men and women remain sexually active in later decades, given the opportunity. The National Survey of Sexual Health and Behavior, for instance, showed that almost 40 percent of men in their 60s and more than 28 percent of men older than 70 had engaged in vaginal intercourse within the previous month, with smaller and larger percentages reporting other sexual behaviors.
Among older women, nearly half of those in their 60s and more than 20 percent of those in their 70s had been sexually active in the previous six months, University of Pittsburgh Medical Center researchers reported recently. The biggest obstacle was the lack of a partner; among those married or cohabiting, the proportion reporting sexual activity rose substantially, to 68 percent and 41 percent. (Women older than 80 reported having sex, too)
“Prevalence of sexual activity definitely goes down with age,” said Dr. Holly N. Thomas, an internist and the lead author of the study. “But the proportion is still considerable, and certainly higher than many physicians and the public would ever guess.”
To answer the obvious question, Medicare covers women’s hormonal creams, rings and suppositories for a “medically accepted indication,” like vaginal atrophy. There are multiple, multiple studies showing a strong link between good sex and quality of life in both younger and older individuals. But when it comes to financing this particular facet of health care, older adults are pretty much on their own.
One might argue that maintaining patients’ ability to have sex should be a low priority, given the other demands on the Medicare program. A number of private insurers still cover erectile dysfunction drugs and pumps. Sexual health is widely considered part of overall health. Sex is a pleasure. It’s not everything, but it’s very important for older people as well.
Source: The New York times