Posted Friday, July 13, 2012, at 11:35 AM
People take out loans to buy a car or a house or to send a child (or themselves) to college. And these days, more and more people are also taking out loans to create babies. It makes sense: A single cycle of IVF can run about $12,000, which, for most people, is A LOT of money. Responding to the growing IVF market, companies that give loans to fund fertility treatments are sprouting up across the country.
The Today Show’s Dr. Nancy Snyderman recently filed a report about the dozens of these fertility finance companies that are changing the way couples think about their options for having children. In theory, they’re just like any other loan company—except that they’re dealing with a population of borrowers who are often far more emotionally vulnerable than your average home buyer, and many of these lenders seem totally comfortable taking advantage of that fact. There are some that charge exorbitant interest rates, and others that are engaging in something far more unethical: Snyderman reports that some lenders are giving fertility doctors kickbacks or a stake in the company in exchange for sending customers their way. Ugh.
Snyderman spoke with Jules Segal, who runs a fertility lending company called Capex MD. He says they charge less than a credit card would for their loans, and they employ people who understand the language of fertility treatments—in fact, some of them have gone through IVF themselves. That made Jill Clinton, who took out a loan for an IVF cycle her insurance didn’t cover, feel at ease. Clinton told Today about the process:
They understood the language, the terms that I used that were associated with fertility and I took comfort in that. We didn’t have to look any further and that filled the gap and allowed us to do the final cycle.
Hey, you know what they say when it comes to financial decisions: It’s always better to follow your heart than look for a better deal …
Clearly, these fertility financers aren’t in the business of counseling people to do what makes sense medically; they’re in the business of making money. That’s why it’s especially troubling that the very doctors who are performing IVF for their patients have a financial stake in the loan process. This doesn’t seem to bother Dr. Robert Stillman, who runs a fertility clinic and has a less than 2 percent equity ownership in Capex MD. He’s sees no conflict, only the upsides of being able to direct his patients to the loan company that he totally coincidentally recommends.
The more patients we can see, if we can be successful, then we would make more income. So, that’s a win. But it’s also a win for the couples because they have a family.
Even the clients don’t see anything wrong with it. Clinton’s husband Tom summed up his feelings this way: “They get the money, we get the kids. That's a great deal, I think.” Yes, everyone is totally winning—except, of course, those couples who dig themselves tens of thousands of dollars into debt and end up with no baby because IVF doesn’t always work and maybe they weren’t even particularly medically well-suited for it in the first place—information that may be withheld from them should a doctor want that kickback.
Arthur Caplan, who heads up NYU Langone Medical Center’s division of medical ethics, laid out for Snyderman why this practice is not the least bit ethical:
When someone comes and says I can make this possible for you and I can make the financing possible, you really have to be a little bit careful because you’ve got vulnerable, desperate people who want to hear that there’s an answer to their prayers. I’m worried they’re not going to hear the failure and success rate, the interest rate, and what the risks are of the treatments.
Caplan and Snyderman both warn that people seeking money for fertility treatments should approach the loan process as all-business—not an easy task when all you can think about is the future pitter patter of two little feet. (Or multiple little feet, thanks to IVF.) Think about what happened when predatory mortgages were being handed out like candy. And a house doesn’t have nearly the emotional pull that a potential human being might.
Obviously, the fertility loan market is on a much smaller scale, but it’s still worth considering the long-term consequences of allowing lending companies to prey on the infertile, turning doctors into salesman who might not only push the loans but perhaps even unnecessary procedures on a very vulnerable patient population.