viagra and medically necessity

john over at notyourtv blogs about viagra's inclusion in medicare's prescription drug benefit. the article includes comments by medicare's spokesman gary karr, reassuring us that viagra will only be covered when "medically necessary."

"necessary" implies requirement and absolute need. i've always thought that a drug is only medically necessary when it is required to save one's life, and although i'm no doctor it seems unlikely that impotence is a life-and-death situation. it's not clear what plausible alternative definition could exist for "necessary."

in reality, karr's statement simply means that viagra will only be covered when there are no alternatives. using the former, broader, interpretation of his statement is more fun, and a better brain exercise regarding the point of medicare. should medicare cover anything not required for survival? are preventative drugs, such as statins and even vitamins, included in that case? if that's so, then perhaps healthy food should be as well. i know, us damn libertarians and our slippery slopes.

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