Rape is a "pre-existing condition"
- Thread starter DarkAudit
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S
Steven Soderburgin
Fucking disgusting.
Thank you, American healthcare system!
Dave
Staff member
I was depressed to see BCBS in this story. I've always stuck up for them. I worked there for several years and even paid claims. I have always said that the people who state we were trained to say no are wrong. But these things are hard to reconcile.
I can see them not taking her because of the HIV drugs. Insurance is all about risk-assessment. In this case if she were looking for new insurance this would show up as pre-existing. But to call a rape 17 years ago preexisting? That's insane!
I can see them not taking her because of the HIV drugs. Insurance is all about risk-assessment. In this case if she were looking for new insurance this would show up as pre-existing. But to call a rape 17 years ago preexisting? That's insane!
C
chakz
Don't encourage it.
C
Chazwozel
Don't get sick.
Don't get raped.
Don't take preventive medication.
Die quickly.
PAY MONEY!
Sounds about right.
Don't get sick.
Don't get raped.
Don't take preventive medication.
Die quickly.
PAY MONEY!
Sounds about right.[/QUOTE]
Also: be insanely rich
C
Chazwozel
Don't get sick.
Don't get raped.
Don't take preventive medication.
Die quickly.
PAY MONEY!
Sounds about right.[/QUOTE]
Also: be insanely rich[/QUOTE]
"I CAN'T HEAR YOU, MY EARS ARE FULL OF CRUDE OIL!"
S
Steven Soderburgin
Don't get sick.
Don't get raped.
Don't take preventive medication.
Die quickly.
PAY MONEY!
Sounds about right.[/QUOTE]
Also: be insanely rich[/QUOTE]
also in some states don't be beaten by your spouse or SO
I
Iaculus
Man, the NHS may have its issues, but ease of obtaining medical coverage being inversely proportional to how likely you are to need it? That, my friends, is messed up.
We do. If you're rich.
S
Steven Soderburgin
She was insured at the time of the attack, but she was uninsured for a very long period after that.
Ethically, morally - it's reprehensible.
But they are within their legal rights to count AIDS as a possible pre-existing conditions.
I ran into the whole "pre-existing conditions" issue when I switched jobs while my wife was pregnant. Usually what happens is they'll accept you but exclude (ie, deny coverage) any claims that are related to the pre existing condition.
Unfortunately they will also deny insurance altogether for some pre-existing conditions.
If she had kept health insurance through those three years she wouldn't have a problem, but for some people that's not an option.
However, the flip side of the coin is obscenely high costs. If an insurance company has to accept anyone, regardless of their condition (such as aids, cancer, etc) then everyone's costs go up exponentially. Keep in mind that even if she tested negative for aids and HIV there is a small risk that she's carrying enough of it around that she may develop aids later. A very, very, very small risk, but the actuaries have their tables and have determined it's not profitable to look into.
There are high-risk insurance pools available in many states, and the federal gov't is considering that as part of the health care legislation:
http://prescriptions.blogs.nytimes.com/2009/09/24/pre-existing-conditions-and-insurance-pools/
But necessarily these are very expensive with low coverage - there's a reason people are high risk.
Lastly, as terrible as her situation is, HEALTH INSURANCE IS NOT A RIGHT. These are private businesses providing a service in a capitalist economy.
HEALTH CARE IS A RIGHT - in that hospitals cannot refuse life-saving treatment.
But between these two there's a gulf of poor health care and huge expenses.
This whole discussion then feeds into the larger discussion of what should be done, what can be done, and what has to be left undone so that America can afford the whole thing.
But ranting against the insurance companies because they are operating on a for-profit basis is silly.
Fanning the flames with SHE'S BEING DENIED COVERAGE BECAUSE SHE WAS RAPED AND SHE'S A DOUBLE VICTIM is way over the top - she could have been taking the anti-viral drugs for many other reasons and the denial would eb exactly the same. Yes, the case is worse because the people who raped her put her in this position, and perhaps there was no way for her to get even basic continuing coverage for that three year gap, but it's not the insurance company's fault - it's the fault of the men that raped her.
-Adam
GasBandit
Staff member
See here, good sir. We'll be having none of that. Clearly it's time to scrap the world's most advanced medical system because something horrible happened to this one lady.
As for her situation, yes, it's terrible. No, it shouldn't have been counted as a preexisting condition. But I wonder if somebody else might have thought differently, that it was worth the risk of insuring her if insurance companies were actually allowed to compete... you know, sell across state lines, sell to individuals, etc.
The situations may well be, but the decisions needn't depend on morality.
If you are in dire condition, you will receive basic treatment.
If not, then you have the opportunity to pay for the expertise of trained medical professionals to help you achieve 'better' health.
There's a huge gulf separating the two, and right now the line for "morally required" is right next to "life saving treatment."
What many people are arguing is that the line should be moved far closer to "better health" and that it's immoral not to supply, for free, basic health care.
Sure, morality may well be involved in the decision, but that's wildly subjective.
The real question is: if we force insurance companies to cover people with a higher risk of requiring expensive health care, then who is going to pay for that? Or are we going to force doctors to receive no or little payment for their services?
Without pre-existing exclusions, a person may choose not to pay insurance for decades, get cancer, get insurance, and then demand the insurance company pay millions of dollars for the highest level of cancer care, when he will only be paying into the insurance system perhaps a few thousand dollars. Then he'll drop coverage once the cancer is in remission, until the next time he needs to feed off the system.
Insurance is based on the idea that you pay a set amount throughout life, and the times when you require little coverage but still pay into the system even out the times when you need a lot of coverage. It goes further and evens the bumps out for everyone in a large pool, so those people that are lucky enough to never have problems help cover those people that are unlucky enough to have continuous problems.
By dropping coverage for several years, one chooses not to participate in the whole system, and if they have a condition prior to coverage it's built into the system to look at that condition and decide whether adding them to the pool adversely affects those that have been diligiently paying into it for their whole life, even when times were good.
I'd argue that it's not moral for people to leach off the system by only paying into the system when they want more out of it.
But hey, that's just crazy talk.
-Adam
The situations may well be, but the decisions needn't depend on morality.
If you are in dire condition, you will receive basic treatment.
[/QUOTE]
You make this sound like that care is free....
It's not.
I don't think someone should have to look like
before they get health treatment.
But hey, that's just crazy talk.
GasBandit
Staff member
The situations may well be, but the decisions needn't depend on morality.
If you are in dire condition, you will receive basic treatment.
[/quote]
You make this sound like that care is free....
It's not.[/QUOTE]
You'll still get it. Which is what he said.
---------- Post added at 11:06 AM ---------- Previous post was at 11:04 AM ----------
On the one hand, we have Steinman with his calm, rational logic. On the other hand, we have Krisken flinging fallacious appeals to emotion with no context then getting snarky. Thread over, Krisken wins!
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Steven Soderburgin
Even if you can't pay. You're right. But if you can't pay, then you're driven into bankruptcy while the hospital has to increase costs to make up the unpaid bills.
You know what would prevent this? And would've also prevented this woman's plight with medical insurance?
Universal health care.
The situations may well be, but the decisions needn't depend on morality.
If you are in dire condition, you will receive basic treatment.
[/quote]
You make this sound like that care is free....
It's not.[/QUOTE]
You'll still get it. Which is what he said.[/QUOTE]
If you look at the "is healthcare a right" thread, I have consistantly said that YES, you do get the right to health care for emergent services, however it will most likely bankrupt you if you are uninsured.
So yes, we do have the right to emergent health care, but that's not the issue.
The invisible hand doesn't work in emergent health care because it isnt like a doughnut or a pair of pants, you can't shop around, you go where the ambulance takes you, or you die.
Now, insurance, yes that is a comodity where the invisible hand would work in some ways, but with the insurance companies in collusion with each other, and basically denying any claim that comes their way they are no where near a perfectly competetive market.
Insurance companies don't do what they are supposed to do. You pay them premiums and they make a profit. The problem is that they're raking in billions for their CEOs by denying the very service they're supposed to be insuring. It's the biggest scam in america right now.
Now is socialized medicine the answer? Yeah, it could be if done right, but I'm a realist and it most likely won't be.
Is regulation the answer? Again, yeah, it could be if done right, if our system weren't so corrupt from the highest levels on down.
Is a totally competetive market the answer? Yeah, it could be as well, but it shares the same failing as regulation. The system is corrupt from the top down.
Basically the uber rich have become robber barrons feeding on the working class and money writes policy in this country, unfortunately.
All in all, unless you're already rich, or happen to be one of the few lucky ones who actually get a chance to rise up past middle class, you're pretty much screwed, and that aint changing anytime soon.
Even if you can't pay. You're right. But if you can't pay, then you're driven into bankruptcy while the hospital has to increase costs to make up the unpaid bills.
You know what would prevent this? And would've also prevented this woman's plight with medical insurance?
Universal health care.[/QUOTE]
You know what? Universal health care does not make the costs of healthcare just magically go away. This may come as a shock to you, but there is no such thing as a free lunch.
I don't think someone should have to look like
/pic
before they get health treatment.
But hey, that's just crazy talk.[/QUOTE]
1. Research has provided expensive end of life care to extends life expectancy well beyond 50s, 60s, 70s, and 80s. But it's very expensive, and for the most part it has to be due to the direct care received from health laborors who have spent decades learning their trade, and are subject to every spurious lawsuit regarding their care. Cancer treatment is obvious, but do you realize how much it costs to replace one heart valve, nevermind doing a complete angioplasty and replacing several valves and arteries? Are you aware of how much arthritis treatment costs? Bowel and bladder problems and the body breaks down? Skin issue? Eyesight? Mental impairment?
2. There are millions, soon to be 10s of millions due to the boomers, of people receiving left extending care that is hugely expensive.
If you believe that this person should not have gotten this bad before receiving FREE healthcare, then you are essentially volunteering to pay $800/month JUST for his medical expenses, above the $200 or more you are already paying for your own medical insurance.
Age related medical costs are EXPONENTIAL. The costs of a 20 year old are NOTHING compared to the costs of a 40 year old, which are nothing compared to the costs of an 80 year old.
If we all decide collectively to cover everything for everyone, then we all decide to spend 80% of our gross domestic product on health care for the elderly who did not contribute to healthcare when they were financially capable of doing so.
So - to ask you directly - are you personally willing to pay $800 more per month into the healthcare system so that this person, and everyone like him, could receive basic health services before they reached the stage of needing emergency care?
If so, why aren't you donating that amount RIGHT NOW to the many charity organizations that perform exactly that service?
I honestly think people are only considering things things in an abstract "morally this should be happening" way, but when the rubber hits the road, and the abstractions become cold realities they shy away. That's what's going to happen to the Obama plan. Right now people are getting warm fuzzies regarding universal health care, but when they get that first biweekly paycheck that's suddenly dropped by $200-$400 due to insurance increases, insurance taxes, etc, they aren't going to be happy.
-Adam
S
Steven Soderburgin
Right, but without bills not being paid because people are going into bankruptcy, then costs would stop increasing and actually start decreasing.
Uh, medicare already pays for the care of 80 year olds........ soooooooooooooooooooooooooooooooooooooo.......
uh....................................
Right, but without bills not being paid because people are going into bankruptcy, then costs would stop increasing and actually start decreasing.
Uh, medicare already pays for the care of 80 year olds........ soooooooooooooooooooooooooooooooooooooo.......
uh....................................[/QUOTE]
Not to mention, apparently not too expensive for health insurance companies to double their profits in a recession.
fade
Staff member
Yeah, what are you all talking about! Clearly, private companies will sort all these problems out. Why, there's no need for any intervention whatsoever. It's the natural order of things for the private company to take care of their customers, and in no way do unethical things that will increase their bottom line while slyly avoiding losing their customer base. I mean, sheesh, some of these banks and insurance companies have only had hundreds of years to solve the problem of their own accord. Surely we haven't allowed them enough! And surely, changing who pays the doctors will magically kick the legs out from under the medical establishment, disassembling it completely! Pay your taxes to a private company like me or pay them to the evil government! I know, I know. Some of you are saying that that 12000 you paid last year went partly to cover that other guy on your plan with horrible cancer, and that sounds awfully socialist. But it's okay because I'm private, and surely I won't do anything bad with your money, like help people who couldn't pay their 12000 [strike]private taxes[/strike] "premiums". Because doing that would destroy health science!
Oh and while we're at it, absolutely none of that medical research that's spectacularly curing diseases in this country is coming from those socialist pig dog university professors, because everybody knows those guys don't do anything real. Those who can't, teach after all, right?!?
I just vomited on myself.
Oh and while we're at it, absolutely none of that medical research that's spectacularly curing diseases in this country is coming from those socialist pig dog university professors, because everybody knows those guys don't do anything real. Those who can't, teach after all, right?!?
I just vomited on myself.
So that ship has sailed, right? Except that
1. We're getting more and more life extending treatments
2. The above 80 population is growing
3. Their life expectancy beyond 80 is growing (ie, they are living longer, thus requiring medical care for longer).
The medicare system is BROKEN. Everyone who understand basic economics and has looked at the projections for medicare understand that it is irretrievably, unavoidably going to fail in the near future.
Medicare is not only not a solution, it's part of the problem, and rather than deflating slowly it's going to hit like a broken hoover dam when it fails.
Please note that I'm hardly arguing against universal healthcare. I'm simply pointing out that while this woman's plight is terrible, health insurance companies are not required to cover her, and there are very good, basic economic reasons why this is the case.
Universal healthcare has been on the US agenda since the early 1900's, and it still hasn't come through. The whole healthcare system has to be completely changed for this to work, otherwise universal healthcare will either fail to be passed, or fail to make significant changes, or fail to be funded and thus people will still fall through the cracks.
-Adam
S
Steven Soderburgin
Ah, yeah. Well, Medicare and Social Security both definitely need to be restructured. I didn't mean to imply that they don't.
A a sarcastic rant I give you a 6.5 out of 10.
For the implication that it's the responsibility of private companies to pay for medical care for people who are NOT their customers, I give you a squenched up face and a 13 second long raspberry.
The question is:
Who is failing the poor in terms of health care?
I can see several possible culprits:
1. Doctors. They have made healthcare way too expensive. They shouldn't be paid $100k/year - even the neurosurgeons aren't worth that much. (their patients are, of course, worth far more but not the doctors with their skills and diagnostic expertise)
2. Insurance companies. They are taking your money, investing it, and paying out insurance claims. But they are being paid far too much. Give them minimum wage, and tell them they have to invest the money more smartly so they make more, and lower our premiums because we shouldn't have to pay for our healthcare. If they invest poorly and lose money, bankrupt them and give me my money back.
3. Government. Has a moral imperative to pay for medical care in the absence of insurance. Who cares that I smoked 2 packs a day for 40 years, I demand that someone pay for my lung transplant and 50 million dollars of cancer therapy over the last ten years of my life.
4. Citizens who sue. Juries have been giving out multi-million dollar 'pain and suffering' suits because the doctor, more often than not, did their level best but failed in some small manner. Doctors have to pay for insurance, and they pass that along to their clients, even though I've never sued them myself. But heaven help the doctor that makes a mistake and my breasts are permanently uneven, although it was a cosmetic surgery and I knew the risks beforehand. I will make him pay!
To make universal healthcare possible, we have to either lower the costs, or raise taxes.
If you've looked at the number of people who are uninsured, and the projections for the cost of insuring them to a 'basic level' of healthcare - it's staggering. It's not "just a few dollars more per taxpayer per year."
They are currently HIDING the costs by passing them along in the form of taxes and fees to #1 and #2 above - but that's merely going to shift down the line right back to the consumers. The money can't come from a vacuum.
The part of the rant about how much money the CEO and so forth are making in insurance companies is entirely misdirected. That is not an artifact of the insurance system, but an artifact of the stock market. I'm not going to go ahead and explain how that works, but suffice to say it's another circular market that is either rising or falling due to its own success or failure, and that feedback loop makes for really high highs, and really low lows.
-Adam
M
makare
My mom's best friend's son (counts on fingers.. yeah that's it) has some heart condition they can't figure out. Even though he has health insurance they are going to have to declare bankruptcy because they can't afford the bills. They were hoping you could just declare medical bankruptcy so they had me ask my professor about it but no.
I am staying out of the general conversation in this thread and I am not arguing for universal healthcare. It is just weird how I am in the middle of researching bankruptcy related to medical care and it was mentioned here. All in all it is really just plain sad.
I am staying out of the general conversation in this thread and I am not arguing for universal healthcare. It is just weird how I am in the middle of researching bankruptcy related to medical care and it was mentioned here. All in all it is really just plain sad.
Yes. Even great medical insurance has "term" and "lifetime" limits. After you reach a certain payout they will reduce coverage.
Then the family has to fight to get good medical care (because once the doctor's office sees the bills aren't getting paid they stop scheduling appointments that can be put off), and they have to start paying out of pocket for that care, and when they can't pay the bills go to collections, and ruins their credit rating, starts court suits, costs money for lawyers, etc.
Bankruptcy is only the start. They were hoping to declare "medical bankruptcy" so that they can stop paying medical bills without affecting their normal finances or credit rating.
But you can't give up on your child either, no matter the cost.
It has to be heart rending to go through that experience.
-Adam
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