Samhita mentioned in her "What We Missed" yesterday the latest in the series of shockingly horrible pre-existing condition injustice stories in the news recently. A woman went uninsured for three years because she sought treatment after she was raped, was prescribed a anti-AIDS medication as a precaution, and later found it was impossible to find an insurance company that would cover her .
In case you've lost track (because I know I did at one point), let's recap. Being a victim of domestic violence can be considered a pre-existing condition. Having had a previous C-section can be a pre-existing condition (unless, of course, you get sterilized ). Just being pregnant can be a pre-existing condition (or, if you're lucky, maybe you'll be able to buy an expensive rider for maternity coverage). Seeking treatment (for mental health problems or HIV/AIDS) after a rape can be a pre-existing condition. And if you've managed to get coverage after all that, you'll probably have to pay more for your plan simply because you are woman .
The National Women's Law Center has launched a stellar campaign, Being a Woman is Not a Pre-Existing Condition , to call attention to these gender disparities and mobilize women to support health care reform that meets their needs. The website and accompanying report are worth a read. They include some pretty outrageous stats--such as the fact that in most states a female non-smoker is charged more for health insurance than a male smoker and only 13% of health plans offer maternity coverage. The message is loud and undeniable: health care reform is clearly a feminist issue.
Inevitably, in reporting on the NWLC's campaign, some have framed it as Battle of the Sexes . Which, of course, is silly and inaccurate. A lot of the problems with our current health insurance system are gendered. And women are getting really screwed over. But it's important to remember that the solutions--God willing--won't be. As usual when we're talking about gender equality, when women win, everyone--women, men, and whole families--benefits.
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Many, many people (among them Cara at Feministe and amandaw) have pointed this out and said it more eloquently than I will, but I think it bears repeating: all "pre-existing conditions" exclusions are equally baloney. Yes, it is deeply outrageous that a woman can be denied coverage for being raped or abused or pregnant and so on. Yes, it is absolutely not her fault and is not grounds to be denied insurance. But it is not less her fault than, say, having a congenital heart problem is, or suffering from chronic pain is, or having schizophrenia is, or having any other pre-existing condition that regularly gets people denied health insurance is.
As much as I think it is legitimate to be furious that women are being denied health insurance for being women, framing it as "Being a Woman is Not a Pre-existing Condition" seems to indicate that "Pre-existing Condition" is a legitimate reason to deny a person health insurance -- "being a woman" just should not fall into that category. In fact, "being a woman" seems to be just as legitimate a reason for denying someone health insurance (that is, totally one hundred percent not legitimate) as denying someone health insurance for any other "pre-existing condition" that might mean they'll use health care.
I absolutely agree that the whole concept of pre-existing conditions is completely fucked up and should have no place in our health care system. And as you said, amandaw and Cara said it very eloquently. For those who haven't read it, here's the link to Cara: http://thecurvature.com/2009/10/08/all-denials-of-coverage-for-pre-existing-conditions-deserve-equal-outrage/
I do think it's worth noting though that there are more ways women can be denied insurance because of pre-existing conditions in the current system. And the existence of gender rating in most states means that even when they can get insurance, women consistently pay more than men for the same coverage.
For me, these examples just highlight the absurdity of the system in general. Hopefully, Congress will pass a bill that eliminates gender rating and prohibits discrimination based on ALL so-called "pre-existing conditions."
What is fair about denying healthcare or charging more for people who do have "pre-existing conditions" anyway? I have crohn's disease which I have due to genetics. I have no control over that. Most "pre-existing conditions" are a result of things people have zero control over. Do I and people like me deserve to suffer and die? Is that the mentality at work here? I guess I find that kind of confusing since I have this overwhelming desire to, you know, *live*.
I guess my point is, and you'll pardon the language I hope, "denying coverage for pre-existing conditions is bullshit and fuck privatized health insurance providers rectally with something both spiky yet somehow rusty for punishing people for no damned reason other than because they can".
bitsy, I totally agree with the sentiment and get the anger but that was a pretty violent rape-y image. Could we not, please?
I certainly apologize. Paying over a thousand dollars per month just to be able to function day to day (and sometimes I still wind up in the hospital) has left me with a lot of anger that has no place to go. Sorry for the offensive imagery.
denying coverage for pre-existing conditions is bullshit and fuck privatized health insurance providers rectally with something both spiky yet somehow rusty for punishing people for no damned reason other than because they can".
Why do we have to sodomize? Can we just jail them indefinitely? I mean, really, crimes against humanity and all that.
There is so much misinformation out there about health insurance. Making this into a gendering issue actually distorts debate further. The actuaries don't make up the risk factors anymore for health insurance than they do for car insurance, but car insurance usually favors women.
Pre-existing condition exclusions are a necessary part of our existing health insurance system, because people will game the system. There was a woman who wrote in Slate that she waited until she wanted to get pregnant before purchasing insurance. This is gaming the system.
One way to get around PEC exclusions is to force everyone to buy health insurance, just as we do for car insurance. So the Baucus bill does that, but it only has a $200 fine for not buying it. That's less than the fine for car insurance, and we all know how many uninsured drivers there are out there. This will dramatically raise costs for everyone else.
Fortunately the Baucus bill will not be anything close to the final draft.
You're right Aleks, but I think it had the most aggressive penalty, and the highest penalty I've seen floating around is $750. You aren't going to have affordable health care if you eliminate Pre-Existing Conditions but then don't make everyone pay in. The estimates are that it will raise costs $4K per family...And that would be about the only thing that would be worse than what we have today.
Suppose you're poor. Now you're told you need to buy health insurance or pay a $750 fine. If the cheapest insurance you can find costs more than $750 (which is likely), you may well decide that you're better off swallowing the fine and going insuranceless.
How does that help anything? The government has effectively fined you $750 for no reason.
Every plan on the table includes subsidies for the poor to buy insurance.
If the problem is health care costs being too high, then we should focus on lowering those costs. Otherwise you're treating the symptom rather than the disease, if you'll pardon the pun.
So either make health coverage to be so cheap that poor people can afford it without subsidies. Cool, I'll see your prayer and raise you a leech and a recommendation to exercise more.
It's not unreasonable to believe that costs can be greatly reduced. After all, virtually every other service in the economy has seen real prices decline over the last few decades, even as customer service improves, and service becomes more personalized to individual tastes. There's a lot of room for improvement in the health sector.
And the examples of other countries — many of which achieve better results per dollar than the USA — are also encouraging.
Where do you see unsubsidized prices for medical care so low the poor can afford it? The system is inefficient and should be streamlined (ideally by squeezing the HMOs to reduce overhead with a strong public option) but you're never going to make any kind of major operation affordable for everyone without help.
The only way costs will ever come down is through competition. Guaranteeing business to HMOs through a public option will do just the opposite, especially if it's accompanied by more regulatory complexity, which creates higher barriers to entry (thereby reducing competitive pressure on prices).
I agree that major operations are simply too expensive to pay out-of-pocket, but there are many simple and routine procedures that can be "streamlined" (as you put it) into the realm of affordability.
The longer answer: Poor people get sick. If you're fortunate enough not to know that yourself, take my word for it. Now, post-HCR, when poor people who haven't purchased subsidized and unrestricted (no Pre-existing condition exclusions, even for teh womenz) still happen to get sick, should they be denied care? If not, then that non-compliance fine wasn't "for no reason," it was their contribution to the program that exists for everyone.
I'd love to not pay premiums or do paperwork and still have coverage when I needed it, but . . .
Bradley-You're precisely right which is why the insurance companies are pulling out of the agreement. The fine probably needs to be on the order of $3K-$5K, and taxpayers would have to subsidize insurance for the poor. I'm all for universal healthcare, but I'd prefer an outright tax for it, then this shuck & jive method of sneaking it in that will dramatically raise premiums for existing insuranceholders.
As far as reducing costs in health care, I'm not so optimistic. We have an aging population that will consume ever increasing resources, meanwhile our supply of DRs is largely fixed (since it takes 30yrs to 'grow' them). I know other countries have universal health care, but I don't know that any have successfully curbed inflation without the drastic rationing which the right wingers harp about.
This is America. We don't do taxes. We do gimmicks or put it on the credit card.
I have Crohn's too. They don't want us to suffer and die, they want to make money, they don't care either way. They're not sadists, they're business men and women. In a somewhat free markety system the incentive is to deny us coverage, because you and I would predictably cost more than we'd pay. If you ran a restaurant, would you sell sandwiches for less than the cost of making them? You wouldn't stay in business long. The players may well be fuckheads, but we're only ever going to win by changing the game.
The campaign has definitely been rubbing me the wrong way for the reasons the previous commenters mentioned. Sure, the message is simple and direct, but it's also misguided.
We can use the incidents mentioned in the OP to highlight the absurdity of the current health insurance situation, absolutely. Those incidents help paint a picture of what's wrong with American health insurance. But I can't support anything that lends any legitimacy to the idea of excluding pre-existing conditions from coverage.
Thank you, thank you, thank God for you.
Properly caring for a pregnant woman and for a diabetic person of any gender are both expensive, and the HMO's won't do either if not forced (and subsidized) to. Acting like the gendered one is bullshittier than the other is silly and inaccurate battle of the sexes nonsense.
Health Care Reform terrifies me on a couple fronts. Firstly, I sincerely don't trust the government enough to reform enough to stop everything that needs to be fixed with this legislation. If we have a public option, AWESOME. I'm all for it and have been a fan of Public Health Care since I was, like, 12. I think it would be a step in the right direction.
But, if it's done wrong, what would the consequences be? Would small businesses then drop health insurance because of the Medicaid for All option is cheapest and they're paying into that through Federal taxes anyway? Would the whole idea of "competition" be voided out because only Big Companies would be able to afford insurance that isn't through the government and then it becomes a class issue because only The Super Rich can get private insurance?
And, when everyone gets health care -- how do we get more doctors? Primary Care Physicians and Internists have been dwindling over the past 3 decades. We'd need a way to get people back into Primary Care before we'd dream of being able to get everyone adequate care.
Then, those of us with pre-existing conditions (whether congenital, insurance-company-imposed [ie womanhood], or contracted), we're guaranteed insurance, which is nice. But, what does that mean with cost deferment? Who flits the bill because we're more expensive -- or will we all just fall into Medicaid for All?
I think that these issues -- the real human consequences of getting everyone health care -- need to also be addressed because, in all honesty, it will create so many problems it could negate getting health care to begin with. If you have a 6 month waiting period for any physician anywhere (which is common where I am, but we're also VERY well insured in Massachusetts thanks to our coveraging laws), won't that then burden Emergency Rooms because people can't see their physician when they need to?
And then, with insurance companies in general, who's going to regulate them? How do we take a company to court when they have to readjust their entire business model to new federal laws (like removing the monopoly exemption)? How long do we give them to do that?
I'm not trying to sound like a tin-foil hat conspiracist or a wing-nut, but these concerns are the practical thoughts I have which have been addressed by no one, really. It's the implementation of all of these programs which really worries me -- not the idea of "oh God! our health system is imperfect!"
There's so much that needs to be changed in the Health Care System that I'm honestly afraid it'll make things much, much worse because of lack of foresight and planning.
AGAIN?
In case you've lost track (because I know I did at one point), let's recap. Being a victim of domestic violence can be considered a pre-existing condition. Having had a previous C-section can be a pre-existing condition (unless, of course, you get sterilized ). Just being pregnant can be a pre-existing condition (or, if you're lucky, maybe you'll be able to buy an expensive rider for maternity coverage). Seeking treatment (for mental health problems or HIV/AIDS) after a rape can be a pre-existing condition. And if you've managed to get coverage after all that, you'll probably have to pay more for your plan simply because you are woman .
The people with these situations are deemed to be more expensive to take on as patients. The insurance companies will lose money by taking them without charging especially exorbitant rates. That's the same way they treat people with diabetes, the same way they treat me with Crohn's Disease, the same way they treat people with any condition that will increase the likelihood of them requiring expensive treatment. The problem is running health care as a for-profit numbers game, not the gender of some of those who suffer from the rules that make that game work.
There is so much misinformation out there about health insurance. Making this into a gendering issue actually distorts debate further. The actuaries don't make up the risk factors anymore for health insurance than they do for car insurance, but car insurance usually favors women.
Pre-existing condition exclusions are a necessary part of our existing health insurance system, because people will game the system. There was a woman who wrote in Slate that she waited until she wanted to get pregnant before purchasing insurance. This is gaming the system.
One way to get around PEC exclusions is to force everyone to buy health insurance, just as we do for car insurance. So the Baucus bill does that, but it only has a $200 fine for not buying it. That's less than the fine for car insurance, and we all know how many uninsured drivers there are out there. This will dramatically raise costs for everyone else.
Great story. Makes it so apparent that so many pre-existing conditions target women. The worst part about it for me, is that even people who ar willing to pay for individual insurance, cannot get it because of pre-existing conditions. So millions are basically told that even if we pay, we cannot get medical care.
This is pure and utter nonsense.
1) All of the major disabling psychiatric conditions strike men much much harder then they strike women. Try checking Bipolar disease diagnosed in men vs. bipolar diseases diagnosed in women. Try Schizhoprenia diagnozed in men vs schizoprhenia diagnozed in women and so on.
2) Not having insurance is not the same as being unable to get health care. However, your insurance company will not provide, you will have to pay on your own.
2) Not having insurance is not the same as being unable to get health care. However, your insurance company will not provide, you will have to pay on your own.
Unless of course you can't afford to pay out of pocket. If you're endlessly wealthy, or have no expensive medical needs, then lack of insurance doesn't equal lack of care.
Being human isn't a pre-existing condition either. I love folks acting like this is so outrages when we told you it was happening and you didn't listen.
Pre-existing condition clauses could never effect you, right? Wrong. This makes prefect sense in a for profit industry.
Are you waking up now? Now that PWDs aren't the only ones targeted, are you ready listen?
I am not a pre-existing condition either, but this post gives me the vibe that other clauses are okay and just.
The "vibe" I get from this recurring post is that discriminating against sick people is mean and uncharitable, and they're against that. But discriminating against women is SEXIST and injustice - there's nothing wrong with being a woman! How can female medical issues be in some way comparable to disabilities?!!? (Answer: They cost money to treat.)
Good point. It's kind of like "This is bad, but this other thing right here is so much worse, because "regular" women aren't those other weird people."
This is just the same shit on a different day.