SEIU - Service Employees International Union - Domestic violence is a "pre-existing condition"? (http://www.seiu.org/2009/09/domestic-violence-victims-have-a-pre-existing-condition.php)


Insurance companies have used the excuse of "pre-existing conditions" to deny coverage to countless Americans. From cancer patients (http://www.seiu.org/2009/08/robin-holland-my-brain-tumor-wont-wait-for-reform.php) to the elderly suffering from arthritis, these organizations have padded their profit margins by limiting coverage to patients deemed "high risk" because of their medical condition. But, in DC and eight other states (http://www.healthreform.gov/reports/denied_coverage/index.html), including Idaho, Mississippi, North Carolina, North Dakota, Oklahoma, South Carolina, South Dakota, and Wyoming, insurance companies have gone too far, claiming that "domestic violence victim" is also a pre-existing condition.
Words cannot describe the sheer inhumanity of this claim. It serves as yet further proof that our insurance system is broken, destroyed by the profit-mongering of the very companies whose sole purpose should be to provide Americans with access to care when they need it most. In 1994, an informal survey conducted by the Subcommittee on Crime and Criminal Justice of the United States Senate Judiciary Committee revealed that 8 of the 16 largest insurers (http://ruralhealth.hrsa.gov/pub/domviol.htm) in the country used domestic violence as a factor when deciding whether to extend coverage and how much to charge if coverage was extended.

Is this true? How can it be??

I fear for my community, they are just discovering health insurance... I can almost imagine these same headlines in our newspapers.

Just a question, and I'm not defending anything here so don't jump down my throat just yet, but what's the difference between a pre-existing condition arising from domestic violence and any other pre-existing condition?

I believe that if there is evidence that a woman is in a violent relationship she can be denied medical insurance.

What's the general definition of "pre-existing condition" as per the insurance companies?

what's the difference between a pre-existing condition arising from domestic violence and any other pre-existing condition?Hello Steve:

None, in fact. What you point out is how stupid discrimination against ANY sick or injured person is.

excon

I know, I know and that's the argument for health care being a right and all that jazz. But since insurance companies are in business to survive and make a profit, why should they cover pre-existing conditions? If I buy a car with a crunched fender should my insurance company pay to fix it? And by the way, since most people get coverage at work there are generally no exclusions for pre-existing when they sign up during open enrollment or as a new employee.

Interesting country you have where being beat up makes you ineligible for healthcare insurance.

How accurate is this claim? I don't know.

I will say this... in his speech to Congress last week Obama mentioned a woman who had been denied coverage because of the pre-existing condition of "acne". What Obama failed to report is that her "acne" was not normal acne, but rather a pre-cancerous skin-condition that appears similar to acne. The woman hid a condition that would have warned her of her own cancer. Furthermore, she understated her weight in order to qualify for a lower premium rate, and she didn't report prescription medications she was taking for a heart condition.

Scott Harrington: Fact-Checking the President on Health Insurance - WSJ.com (http://online.wsj.com/article/SB10001424052970203440104574409501904118682.html)

In other words, while what Obama said was the truth, it was NOT the whole truth... and the parts he left out change the entire picture of why the insurance company dropped her.

So... how do we know that what this article is stating... that these women have been dropped because of "preexisting conditions due to domestic abuse" is the full story? What else do we not know about in these cases?

Don't jump to conclusions, NK. Investigate further before you make a judgement. The writers may turn out to be right... and if that's the case I would be rather upset myself, because I have in the past done some charity work with abused women and children. But I have a feeling that there's more here than meets the eye.

Elliot

Speech please tell me you are not comparing human beings to used cars.

Speech please tell me you are not comparing human beings to used cars.Yes, he just did.

why should they cover pre-existing conditions?Hello steve:

Making a profit by cherry picking only healthy people is good for them, but bad for us... That's because we ALL have pre-existing conditions including tonsillitis which I had when I was two. And, we're ALL going to get sick one day and ask for care...

Plus, deciding who get's care and who doesn't, even if based on pre-existing conditions, is a DEATH PANEL, isn't it? And, we're ALL going to have to face 'em one day, aren't we?

You support death panels?? I didn't know.

excon

hello steve:

Making a profit by cherry picking only healthy people is good for them, but bad for us... That's because we all have pre-existing conditions including tonsillitis which i had when i was two. And, we're all going to get sick one day and ask for care....

Plus, deciding who get's care and who doesn't, even if based on pre-existing conditions, is a death panel, isn't it? And, we're all gonna have to face 'em one day, aren't we?

You support death panels??? I didn't know.

Excon

24589

Hello steve:

Making a profit by cherry picking only healthy people is good for them, but bad for us... That's because we ALL have pre-existing conditions including tonsillitis which I had when I was two. And, we're ALL going to get sick one day and ask for care....

Plus, deciding who get's care and who doesn't, even if based on pre-existing conditions, is a DEATH PANEL, isn't it? And, we're ALL gonna have to face 'em one day, aren't we?

You support death panels??? I didn't know.

excon

Then it's a good thing that if your health insurance denies your coverage due to a pre-existing health condition there's a way to get health care on your own.

Whereas in a government single payer system, if they deny you coverage, you're screwed because there IS NO OTHER OPTION.

One more point:

What percentage of people who have health insurance are denied by their health insurance because of pre-existing conditions of any sort? Anybody know?

Because if we're thinking of scraping the entire health care system in this country, I'd like it to be for more than just a couple of people.

Anybody have any statistics on this one?

Elliot

I do find it interesting the DC ,a liberal bastion and partly under direct control of the Federal Government would allow such provisions.

So far have traced the claim to a publication called Nowhere to Turn: How the Individual Health Insurance Market Fails Women from the National Women's Law Center.
http://action.nwlc.org/insurance

I would be interested in seeing the specific state laws about this . Since they provide no other proof to the claim.

Steve has a point. Suppose I am the victim of a mugging . Can I realistically expect an insurance company to cover my injuries related to the mugging after the fact ?

Whereas in a government single payer system, if they deny you coverage, you're screwed because there IS NO OTHER OPTION.
There is no such thing as being denied for "pre-existing conditions" because pre-existing conditions is not an issue - you are covered from the day you are born.

Steve has a point. Suppose I am the victim of a mugging . Can I realistically expect an insurance company to cover my injuries related to the mugging after the fact ?Sure, why not?

Steve has a point. Suppose I am the victim of a mugging . Can I realistically expect an insurance company to cover my injuries related to the mugging after the fact ?Hello tom:

Steve DOES have a point. However, you forget that when we gave the insurance companies the "gift" of a law requiring ALL drivers to be insured, we also require them to insure ALL the drivers. EVERYBODY is covered.

So, if the results of your mugging are life threatening, or even if they're not, you SHOULD expect health care...

excon

Ex ;not true , insurance companies deny drivers all the time. That is why many states have a risk pool coverage .

Keep in mind... insurance is regulated . If this is an issue in the states involved ,it is up to the states to change their existing laws. Evidently most states have written provisions into their laws to deal with this.

Insurance companies are pure evil and care only about profit, this sadly doesn't surprise me at all.

Interesting country you have where being beat up makes you ineligible for healthcare insurance.

If the issue is denying coverage over the potential of future violence based on past history then that's just wrong. But I believe the issue is denying coverage/treatment for pre-exisiting conditions period. The example from the HRSA site you referred is this:


... the Women's Law Project reported that a woman from rural Minnesota was beaten severely by her ex-husband. After remarrying, she applied for health insurance and was told that should would not be covered for treatment relating to the abuse-related pre-existing conditions of depression and neck injury.

It says nothing of denying coverage but excluding coverage for the pre-existing problems - which happen to be related to domestic violence. Feel free to argue the merits of denying coverage of pre-existing conditions, just don't misrepresent the issue.

Yes, he just did.

No I didn't, I compared insurance scenarios. You guys wouldn't think twice about saying an auto insurer shouldn't have to pay to 'treat' a pre-existing condition would you?

No cause you bought the car that way. No one bought their bodies and said Look at that one it is riddled with cancer lets get that one.

Keep in mind... insurance is regulated . If this is an issue in the states involved ,it is up to the states to change their existing laws. Evidently most states have written provisions into their laws to deal with this.

Speaking of states, some are beginning to push back (http://news.yahoo.com/s/ap/20090912/ap_on_re_us/us_health_care_pushback) on Obamacare...


Lawmakers in eight states, only half of which are controlled entirely by Republicans, have filed proposals this year to ask voters to amend state constitutions to prohibit what they bill as restrictions on a person's freedom to choose a private health care plan, mandatory participation in any given plan and penalties for declining coverage. Similar measures were considered in two other states, though they wouldn't have been decided by voters. And lawmakers in three other states say they plan to file similar ballot proposals in the coming months.

No cause you bought the car that way. No one bought their bodies and said Look at that one it is riddled with cancer lets get that one.

No, but the insurance principle is the same. Insurance companies are naturally averse to taking on known risks. How can anyone be surprised or shocked by that? They don't mind eliminating pre-existing clauses under a mandate though, because they'll have a bigger pool of customers which spreads the risk and allows them to better predict their costs.

If they are adverse to taking on risk why are they in a risk based business? There is nothing more risky then someone's health. The fact is an Insurance company is nothing more then a middle man they do not offer any goods or services. Their entire business is to pay a hospital or Dr when someone who pays them for their service gets sick. Yet they don't want to do that half the time. So they don't want to take on risk and then when you file a claim you have to jump through hoops to get them to do what you are already paying them to do.

If they are adverse to taking on risk why are they in a risk based business? There is nothing more risky then someones health. The fact is an Insurance company is nothing more then a middle man they do not offer any goods or services. Their entire business is to pay a hospital or Dr when someone who pays them for their service gets sick. Yet they don't want to do that half the time. So they don't want to take on risk and then when you file a claim you have to jump through hoops to get them to do what you are already paying them to do.

What I said was taking on "known" risk. Of course they are in the risk business but they have to minimize or otherwise account for that risk or they go out of business. That's why life insurance is higher for smokers and auto insurance is higher for drivers with tickets and at-fault accidents on their record.

The purpose of insurance is to insure against catastrophic loss, it was never meant to pay for unlimited services.

I see your point about insurance being in case of something. Hence why we need to reform health care completely.

So far what we have here is a special interest group quoting another special interest group citing state laws that do not restrict insurance companies from denying insurance due to domestic violence "preconditions" . What I have not seen is underwriting policy from any insurance company or even ancedotal examples where this has happened. I have been searching since this op was posted and come up blank.

Now I'm not saying it doesn't happen ,but my best guess is if I may make the comparison... is the same as when we say that since there is no specific language to prevent illegals from participating in the HR3200 plan ,that there is nothing to prevent them from doing so .

As you recall , we took some heat and was accused of distortion and outright lies for making such claims.

Is this then a comparable case where the absence of provisions to prevent the insurance companies from denying coverage is the equivalent of the insurance companies actually doing so ?

Ex ;not true , insurance companies deny drivers all the time. That is why many states have a risk pool coverage . Hello again, tom:

It's as I said. ALL insurance companies are required to take part in this high risk pool. Tell me. What insurance company in their right mind would choose to sell to this HIGH risk group if they didn't have to??

excon

Hello again, tom:

It's as I said. ALL insurance companies are required to take part in this high risk pool. Tell me. What insurance company in their right mind would choose to sell to this HIGH risk group if they didn't have to?????

excon

Depends on what they're getting paid to take the risk.

Remember, PROFIT is the greatest mitigator of risk. If you are getting paid enough to take the risk, then you'll take it. If not, you won't.

So... in answer to your question, excon, if the insruance companies are making enough money to take the risk, if the risk/reward analysis is in their favor, why wouldn't they take the risk? I would... if the price was right.

Money talks, BS walks.

Elliot

Insurance companies make truckloads of money every day whether it be auto insurance, home insurance, life insurance and yes, health insurance. They just have a very hard time parting with any of the money. They use any and every excuse not to. They just dreamed up another excuse I see.

Depends on what they're getting paid to take the risk.

Remember, PROFIT is the greatest mitigator of risk. If you are getting paid enough to take the risk, then you'll take it. If not, you won't.

So... in answer to your question, excon, if the insruance companies are making enough money to take the risk, if the risk/reward analysis is in their favor, why wouldn't they take the risk? I would... if the price was right.

Money talks, BS walks.


Indeed . My question is that if a high risk pool works for auto insurance then why wouldn't it work for health at the state level ?

Oh wait... it does.
Health insurance risk pools -- state-sponsored programs for the medically uninsurable (http://www.healthinsurance.org/risk_pools/)