Women' groups had to fight to get mandates for state coverage of the pill and mamograms while other groups fight to include coverage of acupuncture.
http://www.nytimes.com/2005/02/22/politics/22medicare.html?thFebruary 22, 2005
Companies Fight to Ensure Coverage for Erectile Drugs
By ROBERT PEAR
WASHINGTON, Feb. 21 - Drug companies are strenuously resisting bipartisan efforts in Congress to prohibit Medicare from paying for Viagra and other drugs for erectile dysfunction.
The issue of whether Medicare's new prescription drug benefit should cover such treatments is raising broader questions of ethics, economics, politics and health policy.
"It's a huge issue," said Jonathan P. Weiner, a professor of health policy at Johns Hopkins University. "We cannot pay for everything, but, unlike many advanced industrial countries, the United States has no explicit process to analyze the cost and value of medical goods and services."
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"Erectile dysfunction drugs don't save anybody's life, but make life more meaningful," Mr. Caplan said. "A fundamental principle of medical ethics is respect for the patient's right to self-determination. If you ask Medicare beneficiaries what they want, you will find that sexual function is high on the list. Many men would say that sexual dysfunction is just as important as loss of the ability to hear or to walk a mile."