Existing as a pre-existent condition
Many apologies for the radio silence the past week, I’ve been tending to both personal matters and trying to deal with the creeping chest crud. I’m still coughing like I have a two pack a day Lucky Strike habit, but I’m probably recovered enough to go back to my regular posting schedule.
I’ve been avoiding talking about health insurance reform here, mainly because I’m not sure there’s anything new and original I can bring to the discussion. I support the public option, and it’s likely I’d be preaching to the choir here. Not to mention the fact that it’s become such a polarizing issue, revealing a depressing, even frightening amount of racism, classism and intolerance at its core, that I’ve been avoiding much of the media surrounding it. It just fills me with a profound sense of despair and anger, to the point where I hope that the next person I hear say something so stupid as “Keep government out of Medicare” has good health insurance, because I will stab him or her in the fucking face.
However, I felt this story could no go unremarked upon. The next time your conservative grandfather or Libertarian co-worker claims that the health insurance crisis would be solved if people just got off their duffs and bought some proper health insurance, tell them about the provider that canceled a 17 year-old girl’s policy after designating her case of celiac disease as a pre-existing condition.
Their saga began in the summer of 2008 when Dale Rice lost his job as a business consultant. The family had group health insurance through his employer at the time, but decided continuing that coverage through COBRA was too expensive.
The couple consulted an insurance broker, who suggested Brianna apply for coverage with American Community. On Brianna’s application, the Rices noted no prior medical problems, and Brianna was granted coverage starting Nov. 1, with a monthly premium of about $130.
After the teen’s diagnosis in February, American Community reviewed her medical files and found reports of dizziness, elevated cholesterol levels, ongoing fatigue and a persistent cough.
On May 12, the firm sent the Rices a letter saying it was rescinding coverage.
“The coverage you applied for would not have been issued for Brianna if we had known this medical history at the time of application,” the letter said.
Dale Rice said the insurance company cherry-picked from various doctors’ visits, and that none of his daughter’s health problems were ongoing. He attributed the dizziness to dehydration, the fatigue to his daughter staying up late surfing the Web, the elevated cholesterol to an inaccurate test, and said the cough is now gone.
None of the issues were serious medical problems, and none stuck out in his mind when he filled out the application, Rice said. He sent the Problem Solver a copy of Brianna’s July 2, 2008, physical, which showed no major health concerns.
“[Insurance companies] look for anything that they could say ‘you didn’t tell us about,’ ” Rice said. “They hope that people just lay down and die and don’t fight.”
Just to clarify, American Community, despite implying that the policy was canceled due to the Rices withholding information about Brianna’s medical condition, wouldn’t have covered the teenager in the first place, because she was allegedly already under a doctor’s care for a previously diagnosed illness. This is what’s known as a “pre-existing condition,” and it’s a term that strikes fear in the hearts of anyone who deals with everything from irritable bowel syndrome to epilepsy when it comes to time to apply for new health insurance. In the simplest terms, insurance companies don’t want to cover anything that was wrong with you before you came to them for coverage, even if it’s a condition that may only require an occasional visit to the doctor and some prescription painkillers. Pre-existing conditions can cover anything from migraines to depression to obesity to fibromyalgia, and pretty much everything in between. As I mentioned in a previous post, I was declined for health insurance coverage by a previous employer because I was pregnant.
It doesn’t just stop with medical issues, though–in some states it’s legal for health insurance providers to deny coverage to police officers, firefighters and construction workers, deeming their high risk professions as being too much potential for expensive payouts. If you like that, you’re gonna love this: in eight states, plus Washington, DC, it’s legal for health insurance providers to deny coverage to victims of domestic violence. I think that bears repeating, with some emphasis: in eight states, plus Washington, DC, health insurance providers have the right to deny coverage to someone if they have been a victim of domestic violence. The reasoning is clear and cold as the proverbial witch’s tit: domestic violence victims go to the emergency room a lot. Emergency room visits are expensive, and most health insurance providers bear the brunt of that cost. Women and men who get beaten up by their partners cost insurance companies too much money.
One of the biggest myths of this debate is the notion that health insurance companies are benevolent beings whose job it is to help their customers in times of need, and how dare Obama and his band of merry socialists try to deprive us of that service? Health insurance companies don’t exist to pay your medical bills. They exist to not pay your medical bills, and they will use any loophole they can find to avoid paying them, even for something as minor as a misspelling on an application. As insurance premiums increased an astonishing 131% in the past ten years, the restrictions on what policies will and will not cover become ever more limited. It’s ludicrous to believe that health insurance companies are there to help. They’re businesses, and businesses can’t exist if they don’t make a profit. That profit comes from making decisions on whether or not someone will get medical care, or at least, be able to get it without getting stuck with hundreds, perhaps thousands of dollars in bills afterwards. It’s someone’s job, and that someone’s expertise more likely lies in finance rather than medicine, to decide what procedures and treatments will get covered and what won’t, and it all comes down to how much money the company stands to earn or lose. Occasionally, these decisions lead to someone not getting treatment they desperately need, and that person dies, such as 17 year-old Nataline Sarkisyan, who died after her health insurance provider declined coverage for a liver transplant. Their reasoning? The procedure was “experimental,” with a low success rate. In layman’s terms, they didn’t feel it was worth the cost, since she would have likely died anyway.
I probably shouldn’t paint all health insurance providers with the same tainted brush. I’m sure there are some who are a bit more generous with their decisions. My point is, these people who shout and raise their fists, claiming that Obama is going to kill their grandmothers and make people stand in line for hours at a time just to get some hemorrhoid cream are kidding themselves if they believe that health insurance companies are the “good guys.” They’re part of the same big business that has always worked against the needs of the people, where we’re all just dollar signs, and our lives and well-being are measured in degrees of profit and gains.