Tuesday, October 27, 2009

Better late than never

I missed this when it first came out and perhaps everyone else knows about it, but even at this late date I thought it worthy of mention as a perfect example of the fucked-up-edness of our health care system.

On October 15, a woman name Peggy Robertson testified before the Senate Health, Education, Labor, and Pensions (HELP) Committee.
I have two boys ages ten and three[, she told the Committee]. Shortly after my youngest son was born, my husband and I began to research independent health insurance options because our current policy was increasing in price every year. My husband is self-employed and we are unable to get access to a group policy.
They applied to the astonishingly misnamed Golden Rule company, part of UnitedHealthcare, only to be told that they wouldn't cover her. Why? Because she'd had a C-section when the three-year old was born.


Y'see, having had one C-section increases the chances of having another in a later pregnancy and the company didn't want to have to pay for it in the event she got pregnant again. Put another way, the company is essentially saying that her being fertile is a pre-existing condition.

What's more, it turns out that discriminating against women in coverage or rates because of a previous C-section is legal in 45 states.

Oh, but Golden Rule was not completely hard-hearted, oh, no. They told Ms. Robertson - in writing - that they'd be just dee-lighted to cover her. All she had to do was get sterilized.

Yup, that's what they said. In writing. And it's legal. In 45 states.

But the good times don't stop there. The Robertsons had previously applied to Humana only to be told their younger son couldn't be covered because he was a "breath holder," a condition that they were afraid would later cause him to have seizures - which of course could involve some treatment and they can't have that because treatments mean claims and claims cost money. Come back in a year, they said.

Well, there were no seizures and so the next year they go back and get told, again, he won't be covered, this time because he's "too small."

So a few weeks ago we had the story of a baby who couldn't be covered because he is too big, now we have one who couldn't be covered because he is too small.

Just like Goldilocks, insurance companies only want the ones who are "just right." And if you think for a moment that what they're really interested in is your health rather than your wealth, you're the one living in a fairy tale.

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