On Pre-Existing Conditions and Mandatory Coverage–Two Perspectives

One of the things about the healthcare debate is contradictory examples, and the contradictory examples show why “one size fits all” is not a solution.

Scenario #1: Tom has normal health. He is self-employed and makes about $100K per year. He can afford private insurance, but he chooses not to pay for it. Tom gets cancer. He goes to get health insurance only now that he needs it. This is what people who are *against* the bill bring up for pre-existing conditions.

Scenario #2: Dick has normal health. He is also self-employed and makes about $100K per year. He can afford private insurance, but he chooses not to pay for it. He also goes through a catastrophic illness. He racks up hundreds of thousands in hospital and doctor bills with no insurance. So he a) goes bankrupt or b) lies about his income so he can get a charity waiver (a charity waiver that might have gone to someone who’s poor. Ironically, Republicans will use a story like this to say why “there’s no such thing as free healthcare” (even though Dick got it), and “people can manage on their own” (even though Dick didn’t). For those who support manndatory insurance, Dick is the guy they’re talking about.

Scenario #3: Harry has a genetic disorder. He has always had coverage through his parents or his wife. He *could* qualify for SSI, and spent some time on SSI, but he’s a conservative and doesn’t like living off the government. More importantly, he knows you can’t really live off what SSI pays, and he wants to contribute to society. So Harry works rather than go on government disability. He can’t qualify for Medicaid under his state’s regulations. He and his wife go through a period where neither one is working for more than 3 months. When his wife gets a new job, they’re outside the pre-existing condition limit, so he can’t get coverage under her insurance.
This of course is what those who support getting rid of pre-existing limits are talking about.
But Harry is also the guy that conservatives point to when objecting to mandatory coverage, since Harry can’t afford it.

As it stands, Tom and Dick are both leeching off society. They claim to be good self-sufficient Republicans, but they’re not. They claim to be exercising their freedom, but they’re doing so at others’ expense.

The whole theory of insurance is that healthy people pay into it *in case* they get sick, and those who aren’t healthy enough get the support of the healthy people without having to beg.

If the healthy people don’t pay into insurance, there isn’t enough money in the insurance pool to pay for those who are sick. If the healthy people wait until they get sick, they haven’t made their own reasonable investments ahead of time, and they’re leeching off those who’ve paid.

Of course, those who don’t have insurance by choice, and then try to weasel out of their medical bills, are also mooching off society. They’re either getting the debts discharged, at the cost of the medical professionals, or else they’re getting charity that could have gone to those who really needed it.

Our third group is stuck in the middle. On the one hand, they can’t get insurance. On the other hand, they can’t afford it if they did, unless they’re getting it through an employer program.

It is important to note that one of the reasons I chose to actively support George W. Bush during his second term was his campaign promise to provide greater incentives for employers to provide health insurance. And McCain talked about mandatory insurance, and tax credits to pay for it.

So I really don’t see why Republicans are objecting to mandatory insurance. Also, since health insurance is an interstate commerce issue (e.g., some people can’t get their insurance policies to cover out of state care) the 10th Amendment doesn’t really apply, although subsidiarity might.

The real problem with the Act, besides abortion and euthanasia-related matters, is that it was all passed as one lump, which shows it to be a powergrab by the Democrats, not a real attempt at reform.


12 responses to “On Pre-Existing Conditions and Mandatory Coverage–Two Perspectives

  1. At least Harry has an *genetic* disorder instead of a *MENTAL* disorder that could be caused by genetics. As such, SSI is still a possibility. For my Autism, it isn’t- I’m simply not low-functioning enough to be disabled *despite* the fact that I’ll go three or four days unable to work at full productivity at a stretch, and need to be confined to a dark cell. For me, SSI doesn’t consider that a disability, but the insurance companies sure consider it a pre-existing condition.

  2. That’s the same thing with Marfan, Ted. The NMF petitioned SSI a few yeears ago to list Marfan under systematic conditions. When they originally added it, they only added it under “untreated aortic dissection”–so in other words, if your aorta dissects, you qualify for SSI for the time from the dissection till you get to the hospital or die.

    (OK, there are some rare kinds of dissections that can be lived with).

    When I qualified for SSI at 19, the judge declared me legally blind since I didn’t technically qualify.

    I had that battle when trying to apply for South Carolina’s “Working Disabled” Medicaid program, where you can make up to $72K and get Medicaid if you physically qualify for SSI but work. They said, “Well, you work.”

    As for autism, I’m hoping it won’t be long before they isolate tthe physiological cause. Researchers have shown that it’s related to an inability of the body to produce oxytocin, and completely nonresponsive autistics have been almost completely “cured” by shots of pitocin, but that’s not a practical cure.

    • I doubt there is a practical cure for autism- it’s too much of a catch-all for “we don’t know what is causing these symptoms, but the symptoms are there”.

      A question- how long can you live after an aorta dissection? My mother in law applied for SSI when she got cancer- and didn’t survive to have it approved (died less than 6 months later).

  3. On autism: I have done a lot of study into the endorphine-dopamine-oxytocin cycle, which relates to ADHD, Autism, and to some other disorders, such as Postural Orthostatic Tachycardia (POTS–my wife has both ADD and POTS). I think that’s a big area. But pitocin is a massive shot of artificial hormone designed for childbirth, and while it allows the autistics to “come out of their shells” temporarily, it cannot be used as a daily drug.
    Since oxytocin is the “trust hormone,” there is also concern that developing a practical oxytocin drug would result in a perfect “mind control” drug.

    I’ve also read that the dietary supplement/amino acid Tyrosine has been shown to be more effective than Ritalin in treating ADHD, because it’s the natural amino acid that triggers that cycle.

  4. On aortic dissection: I’m not sure exactly, but usually only a couple hours, if that. All your blood is leaking out of your aorta and into your chest cavity.

  5. Also, the interstate commerce clause, due to certain issues rich people had with subsidiarity between 1776 and 1796 in this country, was specifically designed to *destroy* subsidiarity in the United States, by taking away from states the right to enact tariffs on interstate trade.

  6. Interesting. On the one hand, elimination of tarriffs is one of the first stages of alliance between sovereign powers, so the interstate commerce clause makes sense. On another hand, the interstate commerce clause has always been used to justify offenses against subsidiarity.

    But I’ve never given it much thought beyond that. Permitting tarriffs between states might actually be the solution to the ‘What about poorer states’ issue. Consider Malta, which has a near perfect, publicly funded, health care system, and their tax base is entirely on tarriffs.

    • Border Tariffs and Local Subsidies are absolutely necessary to any economic system that respects subsidiarity. They are the *ONLY* defense local companies have against larger international corporations that use economy of scale to reduce costs and undersell local merchants.

      Without local tariffs and local subsidies, a state government cannot protect it’s citizens from economic attacks from other states.

      Thus, the apple crop in upstate New York rots on the trees, while 90% of the apples sold in New York City are flown in from Washington State.

  7. What’s wrong with passing HCR as one lump?

    Seriously, what difference would it make if it were a series of smaller bills?

    Besides, because of the crazy Senate rules of debate (filibusters) and the Republican lock-step refusal to participate, the bill can only be passed at this time–reconciliation, you know.

    By the way, ALL big government programs like this are power-grabs. Creating the CDC and FDA and USDA were power-grabs. The flight to the Moon was a power grab. Sometimes it’s GOOD for government to grab some power. To deal with the things the free market cannot handle. Like national defense. And, licencing nuclear power plants. And, manifestly, like heath-care!

  8. Precisely because it might have been harder for Republicans to show “lock step resistance” if it were handled issue-by-issue.

    Further, if Republicans supported the more sensible parts of the bill, while opposing others, they wouldn’t be able to cast the Republicans as lacking compassion so easily.

    Right now, it’s “Republicans want to deny health coverage to sick people.” If at least some Repulicans had supported a *separate* measure on pre-existing conditions, the Democrats wouldn’t have that card.

    Right now, some conservatives are making themselves look like idiots by taking a passage of the act meant to regulate pacemaker computers and saying it indicates the government wants to put tracking microchips in everyone. If that had been passed as a separate law, the Democrats wouldn’t have that satisfaction.

    Yep. The CDC, FDA and USDA do a fantastic jo of protecting the little guy from big business.

    Why can’t states license nuclear power plants?

  9. It is not the CDC’s, FDA’s, USDA’s job to protect “the little guy” from big business. It is their job to protect consumers from being poisoned.

    RE:”Why can’t states license nuclear power plants?”

    States, Feds, it’s still government. But since you ask, I’m not sure I feel comfortable having say Oklahoma or Kansas or these neanderthal states licence anything as complicated as a nuclear plant.

  10. Doesn’t protecting people from being poisoned count as “protecting the little guy”? All they do is sell out to big Pharma and big Agra. They don’t protect people from being poisoned at all. Ever hear of RU-486? Poison in a pill? Let women hemorrhage to death? What happened to the “I’m going to tweet about RU-486” girl who complained of bleeding then suddenly stopped? What’s poisonous about the ClearPlan NFP machine that’s available in Europe but not the US and predicts fertility to near 100% accuracy?
    What about the perfectly acceptable Japanese Rubella vaccine that has been in use for 40 years but the FDA won’t let it in as an option to vaccines derived from fetal tissue??

    No, it’s not “all government.” You see, if you could actually comprehend a thought that fit outside your narrow minded 8th grade education, you’d understand that not all conservatives think alike, and you’d understand that I’m not lying when I say that,
    a) I believe in something called the United States Constitution, which was supposed to be an agreement between the states to protect their mutual interests while defending the parts against undue interference by the whole,
    b) I believe in a principle called subsidiarity, which states that things should be handled at the lowest levels of society possible, because the more power is held at the top, the more corruption there is.

    Therefore, unlike many died-in-the wool Republicans, I am willing to accept a lot of things at the state level that I do not accept at the federal level.

    And “neanderthal states”? Really?

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