Really, IRS? Agency doesn’t recognize breastfeeding as form of preventive medicine
Posted October 28th, 2010 by Michelle BrandtIn my year-plus of writing for the Scope blog at Stanford’s School of Medicine, and in my numerous years of covering medical and health issues before that, few things have enraged me as much as something I encountered in yesterday’s New York Times. But David Kocieniewski, if you’re reading, it’s not you – it’s what you reported on. It’s that the Internal Revenue Service, in determining which products qualify for those tax-sheltered health care spending accounts, ruled that breastfeeding supplies don’t qualify. And it’s that – get this – the agency based its decision on its belief that breastfeeding “does not have enough health benefits to quality as a form of medical care.”
Come again? Study after study has shown that breastfeeding brings significant health benefits to both mom and baby. Research has linked breastfeeding with a child’s decreased risk of, among other ailments, sudden infant death syndrome, asthma, leukemia, type 1 diabetes, and obesity. Kocieniewski references a papershowing that breastfeeding can prevent the premature death of 900 babies a year – and that same study showed that $13 billion could be saved annually if 90 percent of moms were able to breastfeed exclusively for six months. (The figure comes from the costs associated with all those diseases that breastfeeding helps prevent.)
As Kocieniewski reports, the new health law has a goal to “control medical costs by encouraging preventive procedures like immunizations and screenings.” You would think breastfeeding fits in nicely with said goal, but the IRS, upon request by theAmerican Academy of Pediatrics to reclassify breastfeeding supplies as a medical care expense, refused to recognize breastfeeding as a preventive tool. Instead, it continues to consider breastmilk a food that can promote health (like pomegranate juice?), and:
…Because the I.R.S. code considers nutrition a necessity rather than a medical condition, the agency’s analysts view the cost of breast pumps, bottles and pads as no more deserving of a tax break than an orange juicer.
The IRS’s decision is unlikely to affect the number of women who breastfeed; after all, those of us who choose to do so learn to overcome various challenges (the high price of those breast pumps being just one of them). But the ruling does two things I find so terribly troubling: It ignores the medical literature, which clearly shows that breastfeeding can improve childhood health and save lives and money; and it sends a message to moms that what they’re doing for their child isn’t really about health or medicine after all. It feels like a slap in the face.
Some of the women quoted in the Times story struck a hopeful tone – saying there has been a lot of progress over the years in how the public and policy-makers view breastfeeding. That may be true, but I don’t feel very hopeful this morning. I just feel mad.
This blogpost originally appeared at Scope, blog of the Stanford University School of Medicine
** Editor’s note: For more information and resources on breastfeeding and the workplace, click here.
8 Comments
December 10, 2010 at 11:25 am by Jean AlfordYes, breast milk is food. So what. The IRS could use the same argument to not cover medical supplies needed for tubefeeding. If you need medical supplies to fulfill a normal human function they should be covered. I need a brace in order to walk like a normal person. That should be covered and is.
What about erectile dysfunction pills? The age group that uses them the most is long past having children. They are using the pill for entertainment purposes only. But again it is a normal human function and should be covered. By the way, the wives and husbands of the people who made this decision at the IRS might want to make them sleep on the couch until this issue is resolved.
I hope La Leche League stages some big protests on this one. There’s nothing like hordes of publicly breastfeeding mothers accompanied by irate grandmothers for getting media attention. Officials usually find it unpleasant to be perceived, accurately in this case, as attacking motherhood.
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December 9, 2010 at 10:27 pm by TulipwoodLooking at the decision from another perspective … Breastfeeding doesn’t carry any benefits at all – it’s just normal!!
The real issue is that infant formula causes disease and disability to the infants fed it and their mothers. This is serious stuff and is what they should be looking at – taxing artificial feeding implements very highly, and requiring that infant formula only be provided on a prescription written by specially qualified doctors who know the risks and are able to assist the mothers and babies who must use it.
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November 2, 2010 at 1:49 pm by JessicaWhat about the obesity issue (in moms)? Breast feeding promotes weight loss following pregnancy. With 2/3 of American adults overweight or obese this is also a potential health promotion effort to reinforce for the mothers.
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November 1, 2010 at 9:16 pm by EileenI breastfed my 2 sons and really experienced & felt the benefits. Women need to be placed on the top of the list. they’re the ones who carry the baby for 9 months. give us a break. wake up!
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November 1, 2010 at 3:30 pm by Delores MillerBreastfeeding has so many benefits. I do not know the facts but it also helps in preventing breast cancer. We are going against nature to not breast feed our babies atleast for 6 months. A woman will benefit from breast feeding because it gets the mother’s body better back in shape faster because of that was the plan of nature again. I believe babies that are breast feed should not be required to have so many baby shots so early. I think the baby shots cause more harm than good as long as the Mom breast feeds the baby. I feel there needs to be more study into the baby shots that are required to save babies. Every shot a child gets affects their immune systum I have been told so are we giving shots so the drug companies make more money or saving lives they they claim.????I use to trust the government but not anymore.
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November 1, 2010 at 3:17 pm by Adam FiksoThe research en masse is essentially incontrovertble– going back at least 70 years. (Who reads that old stuff?)
But how often has the IRS been sympathetic? A logical case could be made for it being medical. But are preventive medicine costs deductible? A vacation?
Historically… occasionally.
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October 29, 2010 at 11:21 am by TRReading just the verdict without the IRS’ reason didn’t bother me, because I figured it’s food, and these accounts don’t cover food or even vitamins.
It’s unfortunate that they got into the health benefits debate, though. I hate the breast vs. bottle argument. There’s a bunch of us in the middle.
So if you’re advocating that this is to be covered, what other foods should be on the list? Big can of worms.
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October 28, 2010 at 6:56 pm by Sophia Yen MDWow. This is very uncool!! What can we do about this? Whom can we email or fax or complain to?
perhaps they should have some MDs on whatever panel decides about HSA? I agree that bottles shouldn’t be on there b/c you need bottles if you are pumping or if you are not. But there should be incentives for breastfeeding given all the health benefits associated with it e.g. it is the only PROVEN way to prevent obesity!! and infections, etc…
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