The health care discussion seems to assume that for most Americans the big issues are either lowering cost or covering the uninsured. But to me, the part of the health care system most people seem most bothered about is the common practice of denying coverage based on pre-existing condition. If you have cancer or diabetes or any other illness that's either chronic or recurring, you are treated as a pariah by the health care system. A job loss goes from being damaging to devastating. Those most in need of insurance--the sick---are the least able to get it. It's the most inhumane part of the system.
The biggest news of the debate so far is that the health insurers have pretty much agreed to eliminate this provision as part of a broader reform. In our focus on the issues that still divide, we should pause to reflect on that monumental development.
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I often fantasize about what Dante would have done with the individuals who came up with the idea of denying insurance based on pre-existing conditions. Cancer for all eternity? Endless staph infections?
You have it right that it's all about pre-existing conditions for many of us.
Even more basic, however, is the idea of insurance -- pooling risk. That principle is disregarded when we allow medical underwriting -- screening for pre-existing conditions and risk factors. Everyone who has been screened out (or placed in an expensive high-risk pool) will have a very negative opinion.
The flip side, of course, is that if all the "sick" people are included in the pool, rates will go up for everyone, especially the healthy and young.
The ethical necessity of this kind of "sharing the wealth" (risk) is not well accepted in this country. That's what may sink health insurance reform.
Mr. Waldman,
Here's an interesting article with polling data:
http://news.yahoo.com/s/ap/us_health_care_poll
I don't understand why the pro-lifers aren't raising hell over pre-existing conditions. Can't prenatal and pregnancy issues fall under pre-existing conditions? I guess $$$ are more important to Blue Cross and Blue Shield than babies.
The health insurance companies are terrified that they're going to lose their cash flow. As well they should - they are a stain upon a supposedly Christian nation.
However, just because they say they'll eliminate pre-existing conditions doesn't mean they actually will. Never underestimate the probability that corporations are lying through their spokespersons' teeth.
It does not make business sense to insure people with pre-existing conditions. Does it make business sense for an insurer to provide coverage for a house on fire? Does it make good business sense to provide coverage to a pyromaniac? The only way insurance companies can provide full medical coverage for those with pre-existing conditions is to raise the premiums for all. This rush to provide full coverage for those with pre-existing conditions sounds very much like populist nonsense like the government mandating banks lend to people who cannot qualify for a loan. This is precisely the muddled thinking that contributed heavily to our current recession and housing slump.
Patrick
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