Lulu Gould: Put shoe on other foot

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Given the confusion many of us feel concerning the proposed health care reform, I would like to address just one of the extremely important issues that are crucial to any reform package signed into law this fall. It is a problem that most of us don't even worry about until it is too late: pre-existing conditions. Events from my life experiences connect me deeply to this issue, but there is no doubt that this topic has, will, or is currently affecting almost everyone or someone in the lives of everyone reading this.

My father was killed in a high-speed car chase. He was on his way home to his family when he was tragically struck by a car being pursued by police in unmarked vehicles. My mother was widowed at the age of 36 with five children. Our health insurance through his employer was almost immediately terminated. My mother, who was diagnosed and living with Type 1 diabetes since age 15, was never able to obtain health insurance on her own, as that is considered a pre-existing condition. In these toughest of times, we were on our own.

My mother was then diagnosed with lymphoma when she was 43. She put up the most valiant of fights, undergoing every treatment available so that she could raise us and see us achieve our dreams. When she died 10 years later, my siblings and I, all of us only in our 20s, scrambled to pay all of her medical bills, which took us almost five years to complete.

How many of us have stories like this? Even if this doesn't apply directly to you, it is time for all of us to look beyond the tips of our own noses and come to grips with the reality of the many others struggling with their health issues and then going bankrupt just trying to stay alive. You, your child, your neighbor or anyone else could be next.

One of the hallmarks of all proposed health care reform bills being debated in Congress is to require insurance companies to cover pre-existing conditions so all Americans, regardless of their health status or history, can get comprehensive benefits at fair and stable premiums. Patients will be able to make health care decisions with their doctors, instead of being blocked by insurance company bureaucrats. It will require coverage of preventive services, including cancer screenings. For example, did you know that if you are diagnosed with one type of cancer and you have the misfortune of having it metastasize, which is not uncommon, your insurance company has the ability to rule it as a secondary and separate disease, thereby being able to deny coverage because you now have a "pre-existing condition."

All these brave warriors who put up the fight the first go around are simply pushed out of the system when their cancer recurs years later. Far too many people are canceled by their insurance companies at the time when they need it most with the explanation of "Sorry, but you have a pre-existing condition." Sorry, but this is absolutely unacceptable.

My youngest child has the misfortune of inheriting the Type 1 diabetes gene from my mother, and he will live attached to an insulin pump for the rest of his life. Although great advances have been made in medicine, I fear my own child may never be afforded health insurance for his own future family because of his "pre-existing condition."

Comprehensive health care reform is imperative for my son and the millions of Americans who struggle exponentially just living with these diseases or injuries. As citizens of this country, each and every one of us deserves the right to affordable and dependable health care. Regardless of which side of the political spectrum you stand, it is time to turn the page on the failed practices of the current health care system while keeping the components that are successful; and we must have reform that will do just that.

If you care about the future of this great country, I urge you to contact your senators and tell them to support affordable and dependable health care for all Americans.

Comments

beentheredonethat 5 years ago

It should become a moral obligation of this country to provide health coverage to all of it's citizens. Not to accept this responsibility is a sin against humanity. It should be intolerable to all Americans, that health insurance companies are allowed to profit off of anyone such as described in Lulu's letter.

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Tim Scannell 5 years ago

If eliminating the pre-existing condition restrictions were the goal of our representatives, it could be done tomorrow with the stroke of a pen. State governments require auto insurance and mandate minimum coverage's. Medicare sets the minimum standards required in Medicare gap insurance policies. The Federal government could require that pre-existing condition limitations be eliminated and all health insurance companies would do it tomorrow - and price that change into the premiums we all pay. Unfortunately that doesn't seem to be the goal of our representatives. They are proposing a dramatic overhaul and government take-over of the current system. Most people would support a change to the pre-existing condition rules and other changes to improve the system, but according to the polls, many more American's are not in favor of a government takeover of the healthcare system. Medicare spends 24% more per person served in overhead then private insurance companies. A government mandated solution will cost us all more and restrict our options. beentheredonethat - I respect your opinion about health coverage being a moral obligation. Your belief that healthcare is a "right" creates an obligation for me to pay for your right. The proposed healthcare legislation limits my rights to choose how I receive and pay for healthcare. Your "rights" end up restricting mine and require that I pay for yours - where are my rights?

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ybul 5 years ago

beenthere - Why not work towards fixing the problems of health care.

Ask the question why are we spending so much more.

Which expenses are rising the most? If litigation work towards tort reform. If Diabetes, what is the cause and try to eliminate that. If Cancer, what is causing the rise. If that rise is attributed to toxic emissions, then impose a tax on those emissions, pesticides, etc. that have been associated to help cover the costs of that expense. Have the government internalize those costs of production so that free market principles actually work. Where all the costs of production are included. This way, coal fired power plants which have high mercury emissions and have caused acid rain, either treat their emissions when exiting their stacks, or pay a penalty. Raising their cost of production to levels that incorporate all production costs, that way, alternative energy sources do not need subsidies as they would be more competitive. Facilitating free market principles to allocate capital to the best form of production, as opposed to today, where the coal plants get by on a taxing society with toxic emissions.

Work to fix the underlying problems that are causing health care woes in the States. Do not think that providing universal coverage is fixing the problem as it simply treats the symptoms of our underlying problems.

If your desire is to ensure the poor are covered, would not paying for their insurance do the same job. (which I do not propose) But make sure that those individuals have some way to encourage them to stay healthy, or it will simply drive up health care costs.

For those that fear they will lose their coverage when they change jobs. Maybe, simply putting forth a system where all age groups pay the same amount, with no preexisting clauses.

Why is it necessary to have a single payer system run by the government? Who will regulate them to make sure there is no waste of fraud.

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JLM 5 years ago

With all due respect to the author and with empathy for the terrible tragedy she has lived through, the emotion aroused is simply not pertinent to the issue of the provision and cost of health care.

Pre-existing conditions (which are simply specific environmental conditions unique to an individual) are a typical business consideration in every type of insurance.

At the end of the day, insurance is simply a pooling of risk and risk adjusted pricing for the privilege of being in that pool. This pooling and risk adjusted pricing blunts the total cost to an individual in the event of a specific tragedy by sharing it with the entire buying pool.

If you live in a hurricane zone, guess what, you are offered risk adjusted pricing for the perceived risk of a hurricane causing extensive damage to the dwelling.

If you drive an expensive car, guess what, you are offered risk adjusted pricing for the perceived risk of the car being stolen or damaged and its attendant higher cost of repair.

If you have a bad driving record, guess what, you are offered risk adjusted pricing for the perceived risk of your driving record.

If you buy life insurance, you receive a physical examination and must provide a medical history, guess what, you are offered risk adjusted pricing for the perceived risk of your current health status.

Why would any reasonable person expect a health insurance company not to be as cautious in deciding who to insure and how to price that insurance? The real issue is simply the PRICING!

In group insurance this is even more important as the group is going to pick up the extraordinary cost of the pre-existing condition in their premiums.

The more pertinent and thoughtful way to deal with such matters is to create an "assigned risk" pool not unlike flood insurance or terrorist insurance or repeat speeding ticket drivers.

It is time to stop demonizing the insurance companies and simply force the solution into basic business logic --- example, how about a standard form state by state and nationwide insurance contract which would allow insurance companies to standardize coverages and to spread the risk wider and farer. This is possible today without government intervention.

There is no way that the government is going to make the cost of insuring pre-existing conditions go away by mandating a public option. The cost does not disappear.

BTW, this is one of the things which COBRA (Consolidated Omnibus Reconciliation Act of 1986) dealt with. It does, in fact, deal with it.

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