I think this issue deserves a serious discussion, not soundbites, scare tactics, lies, and ignorance.
This is the first of my August Recess posts about health care reform.
I have a daughter with Down syndrome. I knew that she would have Down syndrome and a serious heart defect before she was born, because my employer-subsidized health insurance paid for excellent prenatal care and testing and I chose to use them.
Did you know that Down syndrome can be considered a "pre-existing condition" and that without government regulations mandating coverage of pre-existing conditions, my family might not be able to find health insurance?
Allowing insurance companies not to cover children born with disabilities encourages women to have abortions for fetuses the INSURANCE COMPANIES deem "imperfect." It also narrows society's acceptance of differences and makes us all the poorer for it.
I don't want an insurance company determining the value of my child's life. I don't want to live in an eugenics-loving Gattaca society.
Reference: Candidates’ healthcare fixes: tax credits vs. more federal spending. (The US spends twice as much on healthcare per capita than other nations but still trails in access to care.)
"Ensuring that everyone has access to care has become a full-time cause for Ms. Demko. She and her family have been without insurance since her daughter was born four years ago with ... Down syndrome. Her husband is a self-employed contractor so the family had relied on her job as a substance abuse counselor for their health insurance.
But Demko said she couldn’t keep working full time with an infant with special needs. When she quit, she didn’t realize that would result in her family’s being unable to get health insurance.
Ohio does not require insurance companies to cover children with disabilities considered to be preexisting conditions....
The Demkos’ income is nearly three times the poverty rate. That’s too much for their daughter to qualify for Ohio’s SCHIP plan and not enough to qualify for another state-sponsored program.
She’s gotten quotes for family health plans that start at $3,000 a month, which is almost as much as they earn.
For too long, she believes, insurance companies have been allowed to put profit before people, selling lower-priced plans to the healthy and at the same time charging exorbitant rates for people who have healthcare needs or just denying them coverage."
Second Reference. (There are some extremely compelling examples, here.)
Discussion.
This is an example of a situation in which the "free market system" must be checked by government regulation. And the proposed health care plans currently before Congress would do this.
"Government regulation" is thrown about like it's a bad word, but it isn't and shouldn't be. Drinking water should be safe. Food packaging plants should have to meet certain standards. Convicted pedophiles shouldn't work in day care centers.
And we shouldn't let profit-driven insurance companies decide whose life is worth living.
Part 1 - Down Syndrome is a Pre-existing Condition
Part 2 - It Pays to Work for the Insurance Company
Part 3 - But We're the Best! Why Fix What Isn't Broken?
Part 4 - What Does "Reform" Really Mean?
The President's Plan for Health Care Reform
17 comments:
As usual, great information. I wasn't aware that Down syndrome could be considered a pre-existing condition. It's scary how much power insurance companies have.
Thanks, Kathy. I only recently became aware of this myself because it hasn't touched us directly.
My company was GREAT about keeping us on their insurance roles until after Ellie's heart surgery (my allowing me to stretch out my official last day of work) and Paul's company was great about taking us on and covering all the follow-up care.
But not everyone works for benevolent Big Companies like we did.
This is a fantastic post, and so, so true. My son was born at 33 weeks due to preeclampsia. I had to deliver via emergency C-section at a foreign hospital, with a doctor I had met only four hours beforehand. My regular OB was regularly ignoring my complaints of headaches, my obscenely high blood pressure, and my mom (an RN) agreed with my decision to go get a second opinion. That doctor decided to induce labor that night.
As a preemie, my son was sent to the NICU. He received top-notch care for eight days, until he was released. We received a bill for $10,000 for the NICU care. My insurance (through my employer, a multi-national corporation that has won awards for its efforts to provide excellent working mother benefits) refused to pay for the NICU. I got all kinds of crap reasons, from the fact that it wasn't a pre-approved pediatrician (hello, emergency C-section? I didn't get a lot of choice about the pediatrician while I was hooked up to ketamine), that the NICU was considered a separate division from the hospital and therefore not covered, blah blah blah.
Luckily, my employer went to bat for me, and it was covered -- but not before I started getting collections notices and now have a late notice on my credit record.
Your example about the parents who can't get coverage because of Downs Syndrome being a pre-existing condition is BS, and was heartbreaking. No one should have to go through that kind of nightmare.
People need healthcare. They're paid to provide it.
Period.
Brigid, that's a scary story.
The absolute LAST thing you should have to worry about when you have a new baby - especially a sick baby - is paying medical bills.
I had my insurance company on my list of "people to call" right after my babies were born. "Hooray, you're an aunt!" "Come by the hospital to meet your new goddaughter!" "Please add our new addition to our family health plan."
Something's wrong with this picture . . .
Lots of people think the leading cause of bankruptcy is people living outside their means and buying huge flat screens. But if I recall correctly, medical bills are a much bigger part of the problem. And they're much harder to control and plan for!
Your post comes on the same day that a rally for autism insurance reform is announced, noting:
"Of the top 10 neurobiological disorders, AUTISM is the only disorder for which insurance companies refuse to cover treatments. Parents are losing coverage as the insurance industry claims this is a pre-existing condition, or that the treatments are “experimental”. "
If you, your child, or even parent is ill (disease, disorder, disability, whatever it may be) and not covered properly under insurance, your chance of financial ruin seems strong, and the patient's chances at being healthy, both mentally and physically, appear slim.
I think of the people I know, and most families have somebody with special needs, or a medical condition, or even an aging parent that requires treatment. Each of them probably has a story about denial of benefits or having to fight for treatment. If this is more the norm these days, then the healthcare/insurance system is not set up properly. It should not be so very hard to access the tools that allow you to live your life as healthy members of society. In my opinion.
I know what is scarier than change. Your vague, political "educational" posts that are filled with stale liberal talking points that you parrot while still trying to come off as original and informed, and always managing to come off as pretentious and pompous. A few trips to HuffPo and your other pathetic political "information" (read: propaganda) haunts, and you have a post! Then when anyone writes in and argues, you go into extreme controlling, annoying bitch mode, do absolutely anything to try to give them their "come-uppance," and sometimes even attempt to edit their posts for spelling and grammar. While you're writing these posts, please make sure that along with all of the misinformation, false statistics and propaganda you insert a bunch of stories intended to pull at the heartstrings of the average dim-bulb Democrat. Oh never mind, you already have that covered with this post!
Oh wait, I know something just as scary as your political posts...it's that people are actually writing in saying you're educating them on the matter. Because apparently they're so immersed in People Magazine and The Biggest Loser that they aren't even aware enough to have memorized the stale liberal talking points on health care. You know, the ones that are outright lies and ignore any valid economic and international statistics unless they are collected by the Moonbat Foundation for Political Research?
Go ahead and delete this, as your ego can't take it. The the only way your ego can take it is if you spend enough time away from your kiddies to compose just the right, grammatically correct, snobbish-sounding post you think counteracts it and puts it down in its place.
Flatflo, I agree.
I know families who have had to sacrifice A LOT to pay out of pocket for occupational therapy and other treatment for kids with autism. It's awful.
ShutThe, I am your liberal demagogue for the day, then? Your comment is certainly in no way related to what I've posted here or to me personally.
I've not quoted The Huffington Post, for example. The References I cite above are from the Christian Science Monitor and the Center for Children and Families at Georgetown University Health Policy Institute, neither hotbeds of runaway liberalism.
Here you've resulted to personal attacks and discrediting the personal experiences of people who've struggled with finding health insurance - yet you've not offered a single substantive critique or alternative suggestion.
This is how you respond to my suggestion for meaningful dialogue? This is how you seek to persuade me that I'm wrong?
We just found out our insurance premiums are increasing 20%!!!
And even worse, my daughter has stage 4 gastric cancer and had to give her resignation, at the school where she so loved her students, so she can qualify for disability and get Cobra as her sick leave and all the allowed shared sick leave has been exhausted. So her income is cut at least in half and the Cobra will be about $500.00 a month. She does not qualify for Medicare until she has been disabled 15 or 18 months...I can't keep up with it. She is 46 years old and this was never ever expected.
The hatred expressed by the nasty commenter is typical of the people who are opposing change. They are just awful and one of them married into my family and I avoid contact as much as possible.
Oh, Joann, I'm so sorry to hear about your daughter. That's just awful.
A friend and co-worker of mine had stage 4 colon cancer a few years ago. Our boss said it was one of the worst things she'd ever had to do in her life, firing a sick girl because her medical leave was exhausted. The whole thing still makes me feel terrible to think about, not least because it's not supposed to happen to someone who's 25. Or 46!
I'll be thinking of your daughter.
I doubt anyone who has read your blog for any length of time is fooled by your phony plea for "meaningful dialogue." It's more like your attempt to educate what you see as the unwashed, backward masses. As previously stated, you handle comments in opposition to yours (especially related to politics) by answering in a snippy, condescending manner that insinuates they just aren't as smart as you obviously think you are. If they have the persistence and confidence to argue further, you become more obnoxious, i.e. the time you resorted to correcting the spelling, grammar and word choice of one kind yet unfortunate woman's comment as if it was a poorly written manuscript submitted to you for an editing job. I've seen it enough times that I'm not bothering to be kind or even polite to you. What's the point?
Your recent global warming post was a joke that must have relied on heavily biased "information" gathered about circa 2007. Never a mention of the increasingly growing number of some of the world's most prominent environmental experts who are braving the hostile, lefty-cluttered waters and coming forward with their questions and doubts about the causes and proposed solutions to the problem. You had the nerve in that post to say something to the effect that you didn't have time "lecture" the person in disagreement with you. As if you and your "science teacher father-in-law" are some intellectual tour de force regarding climate change and its causes.
Similarly, in this post you linked to an article from the Christian Science Monitor, but it's a biased, moldy one from back in October of 2008. You say that the CSM is no "hotbed of runaway liberalism," yet you neglect to acknowledge that at least one person the article quoted is with The Commonwealth Foundation, a private yet partisan organization fighting for Obama-ordered, deceptively wonderful sounding health care solutions for all, usually without resorting to discussing the way it will be funded in our poor economy or any other nagging details.
Since most news articles these days are either pointedly biased toward the left or the right, if you want to put up slanted articles like that to the left, fine. But how about putting an equal number of articles slanted to the opposing view, or would that be too much for you to take in your educational efforts? Obviously you don't see much of the opposing view since you think that citing the CSM article that includes the now antiquated and debunked figure of "45 million uninsured" is relevant. Even though some lefties are still throwing that dubious figure around, many people on the left have since admitted the number is vastly inflated because of the number of illegal American residents receiving our elite health care at taxpayers' expense, as well as the millions eligible for affordable state coverage plans but are uninsured by choice. Even the Census Bureau has since disputed that laughable figure. But I suppose you acknowledging that the massive health care costs your side whines about could be drastically cut just by requiring that people who receive health care are actual American citizens would be racist, mean...or too logical or something.
You talk about being fortunate enough for your family to be employed by companies who gave you adequate coverage, but you are apparently not following the logical progression of fewer companies being able to continue such plans after even a year of Obama's proposed plan. In fact, such companies are lucky to even stay afloat in this cut-throat economic mess that keeps growing due to out-of-control spending, bailouts and handouts. Once that incredibly important stimulus plan kicks in, maybe affordable insurance policies will start growing on trees! I'm sure it's just a matter of time.
You want to address some issues? Let's talk about this quote from the incoming President of the Canadian Medical Association, Dr. Anne Doig. "We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize...We know that there must be change, we're all running flat out, we're all just trying to stay ahead of the immediate day-to-day demands." found here http://www.google.com/hostednews/canadianpress/article/ALeqM5jbjzPEY0Y3bvRD335rGu_Z3KXoQw and here http://washingtontimes.com/news/2009/aug/18/finding-no-buyers-for-the-snake-oil/?feat=home_headlines
That last article also includes a quote from a British columnist who says "Consult any American who has encountered the National Health Service," he writes. "Often [visiting Americans] cannot believe ... the squalor, the looming threat, the long waiting lists and especially the target that patients in 'accident and emergency' should be expected to wait for no more than four - four! - hours...Most Americans, let's face it, are used to much higher standards of health care than we enjoy." This is not American partisan "sound bites" or "fear mongering," these are people who live with these systems every day. The same systems Obama is trying to eventually emulate. Why don't you talk about that for a bit in your series of educational posts? Other articles of interest are here http://www.forbes.com/2009/08/17/obama-utopian-policies-opinions-columnists-richard-a-epstein.html and an interesting opinion article here http://online.wsj.com/article/SB10001424052970204683204574356802422957272.html
All of these articles you will find are not only slanted toward your opposition, but they are two things that seem to be lacking here so far in your political blog summit: timeliness and economic common sense. Oh, and I'm not trying to persuade you that you're wrong. I have enough sense to know that I'd have better luck trying to walk on water on the back of a unicorn.
One of the main problems in journalism today is slant and polarization. People on the far left and right don't even share a common language in which to discuss many hot-button issues, and biased sources of "news" reporting further this divide.
Another problem is the attempt by some media outlets to present "both sides" of an issue without qualification. It's certainly worth noting when one outlier is weighted against the preponderance of scientific evidence and opinion, rather than giving the impression that the two "sides" are equally weighted.
I am not interested in being a reporter, biased or otherwise. Welcome to my sand box! Please play nicely.
How does your acknowledgment that some of the uninsured living in America are illegal immigrants change the overall picture? An upcoming post in my series on health care will discuss the impacts of people without insurance driving up costs.
I do think that tattooing "I'm a legal American. Please treat me at your ER" on every citizen's forehead is a bit nuts. But we'll get there later.
We can't afford to live in a fantasy. This is our reality. Our health care system is broken and needs to be fixed.
As long as it's legal for private insurance companies to deny coverage based on "pre-existing conditions" and there's no public alternative, we have a situation that's unacceptable to me.
If we say that we want to decrease the number of abortions in America - and the vast majority of Americans say that we do - then we need to address some of the barriers we throw in the paths of parents.
To come: posts that address costs, spending, and relative "quality" of health care. It's beyond the scope of this post, however, to address all those issues.
Right now I'm focusing on a single issue - where do families go to find affordable insurance when for-profit insurance companies refuse to cover them? (Note that the sources to which I linked above were to document this particular problem.)
If there were only one family in this situation, it would be one too many.
What can we do about that? This is a serious issue on which reasonable people can disagree respectfully. But denying the problem, redirecting the conversation to other issues, and belittling those who fall through the cracks does not further the discussion.
Wow!
I don't think a blog has any reason to present all sides of a story. It's more like an editorial page--one person's opinion. If you don't like the opinions expressed, find someone else's blog to read.
people act out of love or fear. it sounds like shut the is terrified. we have lived too long in a culture of fear. may compassion and hope win!
ps. i love you sandbox, i find it a nice place to play :)
We are self-employed, my daughter has Down syndrome. While NY State requires insurance companies to cover preexisting conditions on group policies, they can still charge an arm and a leg for it. Right now we are paying $18,000 per year for health insurance. The "company" pays for the health insurance before our salaries, so what's left is enough for my kids to qualify for free lunch at school. Going without is not an option, what with the risk of pneumonia (2 hospitalizations already) and leukemia.
Kathy G, that's definitely what this blog is all about!
Thanks, Grace.
And thinking of compassion . . .
Datri, that is chilling!
No bill currently being considered Congress has got it right. But we desperately need to do SOMETHING and fast.
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