Pre-Existing Condition Problem Is Greatly Exaggerated

If the Supreme Court rules this month that ObamaCare is unconstitutional, a big question will be how to ensure people with pre-existing conditions can get health care coverage.

Last year, the White House painted a grim portrait, saying that if ObamaCare is overturned, "129 million Americans with a pre-existing condition could be denied coverage."

Even conservative Republicans say they want to preserve this provision, whatever the health law's fate, since it's one of ObamaCare's more popular features.

"We've got to make sure no American gets turned back for pre-existing conditions," Rep. Allen West, R-Fla., said recently.

And presidential hopeful Mitt Romney says his reform plans will "prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage."

But the pre-existing condition problem affects fewer people than many politicians claim, and there are other ways to tackle it that could be more flexible and effective than banning insurers from considering applicants' medical history.

Many insurance companies deny individual coverage for people with metabolic syndrome, insulin resistance and/or Type II diabetes even if the person seeks a very high deductible like $5,000 or $10,000. It is still up for debate whether these diseases are caused by lifestyle or genetics. It is in every generation of my family all the way back to my great grandmother who was born in the 1870s!

The scary thing is that people age 50 and up are the group who have been hit very hard by unemployment and are having difficulty finding a job. These are the same people who tend to have or be developing the above mentioned conditions.

And yes, the number of people denied coverage because of pre-existing conditions may be small. But they tend to be the ones who have paid into the insurance system their entire life and suddenly find themselves without health coverage and unable to qualify for state plans because of savings or whatever. All it takes is one catastrophic health event and they are suddenly in a huge amount of debt.

This is something I wish we could figure out how to fix. I understand the business of insurance and actuarial tables and why they deny coverage, but there has to be a clever company out there somewhere who could figure out how to cover them.

Don’t bother trying to educate the fools around here who do not understand the actual problem. The “it’s like trying to buy car insurance after an accident” platitudes have worn rather thin.

You are correct that the people typically shoved out the door are those who have responsibly paid into the system for their entire lives. The lowlifes just show up at the emergency room for treatment, having NEVER bought insurance.

Case in point: My Mother. She and my Father were paying close to $20,000 per year in premiums (being self employed) because they had reached the “golden age” where insurance companies rape and pillage their clients. That would be over age 60, but before they qualified for Medicare. Both were generally healthy, Mom took a low dose of meds for high blood pressure.

Anyway, when they were 62, Dad was diagnosed with an aggressive cancer...he died three months later...there really was no “treatment” available.

Anyway, after he died Mom decided to see about having Dad dropped from the policy since he was...you know...DEAD. They had carried a Blue Cross/Blue Shield policy for 30 years at that point. They would not lower her premiums, or do anything else for her....OTHER than to offer to write a new policy that excluded her high blood pressure. To add insult to injury, they also wanted to exclude “mental health issues.” You see, she had been given a prescription for several days worth of Xanax by the Mayo Clinic on the Friday afternoon that my Dad was diagnosed with terminal cancer before they sent them home for the weekend so Dad could “get his affairs in order.”

So, she continued to pay that ridiculous premium for several years. Her story would be far more typical than some lowlife loser who had never purchased insurance attempting to purchase it “after the fact.”

Also, in my business, I often deal with clients who have been forced to stop working because of health issues (advanced MS, for example)...guess what? They have no way to afford Cobra, and often are involved in the arduous process of qualifying for disability. We meet them because they have filed bankruptcy, or are selling off their belongings to pay for medical bills.

The worthless, useless, illegal, and judgment-proof, continue to get treatment and never pay. This is an untenable situation, and if people do not want single-payer care, there had better be some solution offered that addresses these and other issues.

re: “I wish we could figure out how to fix”
A few possibilities for discussion:
- Let people die. Yes, cold hearted on the surface.
- Government subsidize the insurance premiums of privileged groups. If that happens, watch politics, not science, determine who gets on that list.
- Private not-for-profits subsidize insurance premiums...or healthcare directly.

Isnt’ the latter what we had for hundreds of years? Catholics, Luterans, Jews, Methodists, Baptists, etc opened hospitals that they subsidized. Those who could pay did. Those who could not pay still got treatment. Not just through church, but through Lions, Kiwanis, CoC and dozens of poorly organized groups with no names would raise money for their neighbor. In the 60s and 70s I repeatedly gave amounts of money for the direct care of casual acquaintances, as did many of my neighbors.

Similarly shouldn't an insurance company have the option of not renewing your coverage if you develop an expensive to treat disease?

If someone gets in a car wreck, the insurance company may decline to renew one's coverage, but doing so would not excuse the company from paying for future costs associated with the wreak. If "medical insurance" were actually insurance, the same principle would apply to major illnesses. For example, if someone had a cancer policy and developed cancer while the policy was clearly in effect, the policy would cover all lifetime costs associated with the cancer treatments indicated in the policy. Declining to renew the policy for someone who developed cancer wouldn't help the insurer, since it would still be on the hook for treating the person (note that if the policy is only required to treat people with the methods indicated therein, it should be possible to reasonably predict the expected lifetime cost per patient who develops cancer; of course, the vast majority of policy holders wouldn't develop cancer, so the costs of paying for those who do would be divided among the much larger pool of those who don't.

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