PixelFish (pixelfish) wrote,

Pre-Existing Conditions

Today's healthcare post is about the malignancy of insurance companies who deny coverage based on pre-existing conditions. I've often worried that despite my best efforts to control it with diet, my GERD will spiral out of hand. Or perhaps those cysts in my breasts, currently benign, are the precursor to breast cancer. (I have extremely dense breast tissue according to the technician who performed my mammogram.)

In fact, I'm almost certain that while the procedure to aspirate my breasty cysts takes twenty minutes and is super easy, that's why my doc probably recommended that we not do anything. Because if we did, they'd have to charge it to the insurance, and the insurance people might either deny the claim or use it to deny me treatment further on down the line when it's more pertinent that I have something done.

Pre-existing conditions are used to deny a whole host of treatments. And by itself, it seems horrible to deny somebody coverage for something they have to have fixed anyway.

But guess what counts as a pre-existing condition for insurance companies in 9 states and DC?

Are you ready for this? I sure wasn't.

Domestic violence.


That's right. There are horrible little bean counters who make it their mission to deny coverage to a woman beaten by her husband based on the fact that he beat her before. Amanda dissects how this fact feeds further into the domestic violence cycle and how it denies women in an abusive relationship preventative care. Furthermore, it makes the woman LESS likely to report the violence early on, as she could find her care denied later.

While Obama's plan is notably imperfect in a few ways, it at least focuses on the aspect of pre-existing conditions and the way people use them to inhumanely deny somebody coverage. Any plan for health reform that is put forth that does NOT address how insurance companies use pre-existing conditions to draw out profits by putting the squeeze on people who HAVE ALREADY PAID INTO THEIR PLAN, that health reform will fall short of the goals to cover everybody.

Obama noted recently that nearly half of the people under 65 in this country have been uninsured for a period of time in the last decade. (I was one of those. It was pay rent--immediate need--or pay Cobra. I paid rent.) What often isn't mentioned is that you can be covered, paying into the plans like you are supposed to, and then whoops! loophole! we don't have to cover this operation. You could be covered "technically" and yet find out that you might as well NOT have been paying into the program all this time. Believe me, it's a calculation many people have done. (This TOO has happened to me. I had insurance, and a pain in my arm. While the docs were figuring out what was wrong, I had to have some tests done, and whaddya know, some of those tests were denied coverage after the fact. And John had a crown replaced and the insurance people said, Hey, that's not necessary work so we're not going to cover it.)
Tags: healthcare
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