Today, after a much-anticipated wait, U.S. Senate Finance Committee Chairman Max Baucus laid out a health care reform plan. One of the key features of this plan is that it would prohibit private insurance companies from denying insurance to people because of preexisting conditions that they may have, and from discriminating against them because of their health status. The way in which the U.S. government has allowed private health insurance companies to get away with such discrimination and denial in the past is appalling, and must be stopped if the U.S. is to realize the right to health by ensuring that healthcare is available to everyone.
President Obama highlighted the practice of discrimination in coverage and denial or removal of insurance outright in his health care speech to Congress on September 9, 2009. He illustrated the point with examples of actual Americans that had died or suffered grave consequences because of this practice, such as the story of a man from Illinois whose insurance company took away his coverage in the middle of his chemotherapy treatment because he hadn’t reported gallstones that were unknown to him; this man died of cancer as a result. President Obama went on with the illustrations, describing a woman from Texas on the verge of receiving a double mastectomy for breast cancer, whose insurance company canceled her policy because she had not declared a case of acne, a move that resulted in a doubling in size of her breast cancer before she was able to get her insurance reinstated. Obama rightly described this situation as “heartbreaking” and “wrong.” It is clear that in these two examples, the insurance companies were looking for any excuse not to pay for expensive, but necessary, cancer treatments. Unfortunately, until now U.S. law has allowed such practices to stay in place. These examples demonstrate that letting profit motive rule American healthcare has amounted to the sanctioned killing of sick people.
Even more ridiculous is that in eight states and the District of Columbia, being beaten by your partner is considered a pre-existing condition for which insurance companies can deny you coverage. Ryan Grim writes for the Huffiington Post that the logic of the insurance company is that, if you are currently in a relationship with someone who physically abuses you, you are more likely to be physically abused in the future than other possible insurance holders, and so insuring you is too much of risk. Hence, being a victim of relationship violence counts as a “pre-existing condition” in insurance terms. So far, this classification is legal. Grim reports that Democrats tried to end the practice in 2006, but that 10 Republicans on the Health, Education, Labor and Pensions Committee voted against Senator Pat Murray’s proposed amendment, resulting in a 10-10 tie and a failure for the amendment. Grim points out that one of those no votes was issued by Senator Mike Enzi, who is currently one of the six Finance Committee members tasked with developing a bipartisan bill. Senator Enzi defended his vote against the amendment at the time, saying that prohibiting the denial of coverage on the basis that being a victim of relationship violence is a pre-existing condition would increase the price of insurance, taking it out of the reach of even more people.
This logic is incredibly faulty. If there is a government cap on how much insurance companies can charge individuals, mandating that all individuals receive coverage cannot increase the price above that cap, and so insurance holders will not face prohibitive prices. Not to mention that this logic leaves everything—the final decision about who receives health care—in the hands of the insurance companies. This means that all the insurance companies have to do is decide that something, anything at all, makes you more predisposed than the average person to be ill in some way, and then they can deny you coverage, claiming that if they gave it to you it would drive up the price for everyone else, and then even more people would lose their insurance. If anyone truly thinks that private insurance companies in the U.S. are at risk for profit loss to the point that they can not operate as a successful business, then we not only have an agreement not to regulate their criteria for providing insurance, we have also ignored their finances. They are not in any risk of sinking if they take on people experiencing relationship violence or continue to provide chemotherapy to patients that have been paying their insurance premiums for year. But more importantly, the focus on the bottom line of the insurance companies is exactly the wrong focus. It is not the American government’s job to protect the pocket books of private insurers only, and at the expense of ordinary citizens. Their job is to make sure that everyone in the country has health care, and is not left to illness and death because preventing or treating their illness would dip into the profits of the insurance giants. While it is true that the medical sector accounts for 1/6 of the U.S. economy, and so the government would be right to facilitate its continued success and thus the success of the economy as a whole, this does not have to be done, but more importantly should not be done, to the detriment of American health.
The U.S. often holds itself apart from the rest of the world, and it has certainly stood apart in not providing health care when all other countries of comparable wealth and development have done so. Lest Americans think that health care as a human right is a “foreign” idea, President Obama’s speech reminded them that the campaign to make it universally available began with President Roosevelt in the 1940s. In Roosevelt’s January 11, 1944 State of the Union address to Congress, he stated that “true individual freedom cannot exist without economic security and independence,” and declared “the right to adequate medical care and the opportunity to achieve and enjoy good health” as a fundamental right within the U.S.. While the U.S. has a highly developed understanding of freedom and the right to life, people often overlook that life without healthcare is a shorter, more painful life; in the examples given in Obama’s speech, we can see that life without healthcare can quickly result in death that may have been prevented by the timely and adequate provision of medical care.
Americans should carefully scrutinize the proposed health care reform plan that is being released today. It must truly make healthcare an option for everyone, and to do so, it must reign in the unchecked profit motive of health insurance companies that have allowed them to deny people coverage or drop coverage in the middle of medical treatment. Only a plan that places human health above the interests of corporate insurers will deliver the change that is urgently needed.
