Friday, January 26, 2007

The absurdity of health insurance...

There are many people who are turned down for health insurance because they've been diagnosed with one medical condition or another.

Let's say you once had a bout or two with cancer. You conquered it years ago, now it's in remission. But despite that, you are denied health insurance because of the cancer. This means that if you have to take prescriptions for say--high cholesterol, urinary tract infection, an antibiotic for the flu, or perhaps prevacid for your acid reflux--you can't get insurance to cover it because you had cancer. You are denied insurance to cover basical medical care. Say you were standing on a ladder painting something and you fell off and broke your leg--you have no insurance to cover the broken leg or doc visits because you had cancer and were denied coverage. Perhaps your feet have really been hurting you and you think you might have plantar fasciitis (fallen arches) and you want to go to a doc so they can help you--you can't because you once had cancer. Maybe your knee is hurting you because you turned it wrong at one time while you were playing football? You can't go to the doc and have it x-rayed because you can't afford the insurance because at one time you had cancer.

Why should a person be denied the opportunity to purchase health insurance because they are diagnosed with an illness? Why should that one illness prevent them from being insured for care that could relate to any number of unrelated illnesses? Imagine having strep throat and not being able to see a doc because you once had a major illness that had NOTHING to do with strep!!

I have a friend who has a daughter in her 20's who was once diagnosed with some ailment relating to her heart but as it turns out it was a misdiagnosis and the daughter doesn't have it. Beacuse it's part of her medical record, she cannot get insurance. Here she is, a college graduate with a 6 year old daughter and she cannot get health insurance for herself because of a misdiagnosis. If she doesn't have adequate health insurance how can she take care of herself so she can be healthy enough to take care of her daughter?

I think that an "ala carte" plan would be neat. Basic packages for certain age groups would be a great idea. Younger people need a different kind of care than middle aged folks and they need a different kind of care than the elderly. Why should a woman who is beyond child-bearing age or who does not want children have to pay for insurance that covers obstetrics? Hey it's her choice. If she does have a baby and is not insured, she pays for it, but she's at least insured for other things that she did opt for. Why should a young 20 something man pay to be insured for prostate exams? Something he wouldn't deal with until he is in his forties?

I say everyone should at least be able to purchase affordable health care to cover the BASICS which includes bloodwork once a year and physicals. Imagine if every person in America had a physical once a year, how many potential problems could be treated before they became major illnesses? Smoking cessation, weight loss and alcohol abuse treatment programs should be available. Ever wonder why a person can't get insurance to cover a program to stop smoking but yet if they develop a smoking-related illness, the insurance kicks in and covers it?

Ok maybe my ideas seem simple but that's how great ideas start...


  1. Anonymous1/27/2007

    The way I see it is that the basics are not the problem. It is the catastrophic that is the real problem. Most people can afford to go to the doctor for a simple strep throat, ear infection, sprained ankle type issue. It is only when we start having cancer, heart attacks, and various and sundry diseases that the cost sky rockets. For example, when Robert was unemployed we always went to the doctor and took our children as well when it was necessary. We paid for all of this out of our own pocket. We never signed up for medicaid. As long as nothing catastrophic happened we were able to manage. Now we have health insurance that costs more per month than we ever spent on doctor bills. We pay $130 every two weeks for health insurance. Of course, Robert's employer pays the rest of the premium. It is a very good health care package and given Paige's handicap it is well worth what we pay. The point is, the insurance premium is far more expensive than what it would cost to pay for the basic health care out of our own pockets.

    I understand why the insurance has to be so much. Everyone that works with Robert pays the same premium as us. Most people don't use their insurance enough to pay for it, but then you have people like us. I guess you could call us a drain on the system;) You have to calculate all the medically needy in when you figure the total costs.

    I agree with you about pre-existing conditions. That is an issue that must be dealt with. Business (ie. insurance companies) don't want to take anymore risks than they have to. We are fortunate that Robert is a Federal Employee. All of their insurances must cover pre-existing conditions.--ST

  2. I think that the basics and catastrophic both contribute. Preventive measures by way of annual physicals, bloodwork and such could alleviate the burden on the system caused by preventable illnesses. Many people can't afford to see a doctor as the basic office visit rates are over $100. If it's food or rent vs. doctor, most will opt for one of the first two.

    The catastrophic illness are another thing and needs to be addressed. I know what you've been through with Paige so I see your point. I am not sure how to reform that but you are right though, many families face catastrophic illness, and in many cases lifelong disabilities that need constant and expensive care.

    I am thankful you guys have such great insurance especially because of Paige's condition.

    I wish I had the answers!