Sam Uretsky

Pre-Existing Conditions for the Rest of Us

There are lies, damn lies, and electoral politics. What other explanation is there when a politician says or does something that is almost guaranteed to get an airing on The Daily Show? Most likely they’ve analyzed the number of people who have been paying attention and concluded that between the true believers, who will accept anything, no matter how self-contradictory, and those who are paying attention, the don’t know and don’t care contingent is in the majority. We have laws that prohibit people from lying to the government, but it seems to be okay for the government to lie to us. Of course it could be simple ignorance – we set a higher educational standard for an elementary school teacher than we do for a United States Congressman, or a Governor. This may not help us if we’re a contestant on Are You Smarter Than A 5th Grader, but it explains a lot about the condition of the United States today.

Sen. Ron Johnson (R-Wis.) wrote an op-ed for Rupert Murdoch’s Wall Street Journal, describing his daughter’s heart defect: “Some years ago, a little girl was born with a serious heart defect: Her aorta and pulmonary artery were reversed. Without immediate intervention, she would not have survived.” Sen. Johnson continues “She wasn’t saved by a bureaucrat, and no government mandate forced her parents to purchase the coverage that saved her. Instead, her care was provided under a run-of-the-mill plan available to every employee of an Oshkosh, Wis., plastics plant.”

Sen. Johnson’s essay goes on at length to conclude that private insurance is better than government sponsored insurance, and that therefore the Affordable Healthcare Act should be repealed. There’s not much logic there, since the Affordable Healthcare Act was written to induce people to buy private insurance, but never mind – Sen. Johnson is reviving the notion of death panels, the claim that once the government gets involved in health care, people will have to stand before a tribunal which will decide whether they live or die. The problem is, there already are death panels, but they’re the creation of the private insurers. In some cases it’s the lifetime cap on costs of care – the policy specifies how much the insurer is willing to pay to keep you alive. In other cases, it’s the pre-existing condition clause, where the insurer gets to exclude any part of you that has ever been sick. If you’ve had a urinary tract infection, they have no hesitation about refusing to treat renal failure 50 years later, and if you don’t tell them about the urinary tract infection on the application, then you’ve lied, and that’s the end of you.

Sen. Johnson’s daughter was born with transposition of the great arteries, of which the Mayo Clinic web site says “Having a baby with transposition of the great arteries is naturally worrisome to you as a parent, but with proper treatment, the outlook is promising.” While Sen. Johnson’s daughter was able to get care for her heart condition, the Tracy family of Crowley, Texas, had a different experience. When their son, Houston, was born with transposition of the great arteries, he was denied coverage by Texas Blue Cross because it was a pre-existing condition. The Fort Worth Star-Telegram quoted the father as saying “How can he have a pre-existing condition if the baby didn’t exist until now?” Publicity induced Blue Cross to reverse itself and pay for the procedure. The pre-existing condition refusal will be illegal under the Affordable Healthcare Act, but hasn’t been implemented yet.

The Denver Post told the story of another infant who was refused health insurance – for being overweight. Although the baby was completely healthy, he was in the 99th percentile for weight, and according to the paper, insurers turn down infants above the 95th percentile. The child’s father was quoted as saying “I could understand if we could control what he’s eating. But he’s 4 months old. He’s breast-feeding. We can’t put him on the Atkins diet or on a treadmill.”

Sen. Johnson had many good things to say about the United States’ healthcare system – all true. Once you get into the system, American healthcare is the most modern and sophisticated in the world. It’s also the most expensive, which is why health insurers are so anxious to find mays to keep sick people out. Although the United States has more neonatologists and more neonatal ICU bassinets than Australia, Canada and the United Kingdom, its newborn death rate is higher than any of those countries. According to the latest international comparison, United States ranked 30th in the world for infant mortality. Either Sen. Johnson knows what’s going on the area of health insurance and doesn’t care, or he cares, but doesn’t know. Either way, we’d be better off with somebody else determining our health policies.

Sam Uretsky is a writer and pharmacist living on Long Island, N.Y. Email sdu01@mail.com.

From The Progressive Populist, May 1, 2011