Outrageous pre-existing conditions

(Originally posted a month ago at three rivers fog; in the meantime, news also came out that things like acne were considered pre-existing conditions as well: consider any and all further outrage well and fully included in the subject of this post.)

You’ve undoubtedly heard the news already. A history of domestic violence or C-section are considered, by private US health insurance companies, to be “pre-existing conditions,” which are used as a basis for denying coverage, rescinding coverage, charging higher rates, or other discriminatory practices.

Of course, this is outrageous. Why should a woman who has been beaten by some asshole be denied health care coverage? It isn’t fair.

But there’s something wrong here. And not just with this discriminatory practice — but with the people breathlessly reporting it.

Because, you see, it is being reported, not as:

Pre-Existing Condition Exclusions Are Morally Wrong, but as

How Dare They Treat DV Victims and Mothers the Same Way They Treat Women with Depression, Diabetes and Cancer!

It is being reported as different from “normal” pre-existing condition exclusions. It is being reported as being especially wrong. As being worse. A true moral violation, taking things to a new level.

But why?

Here’s the thing. Insurance companies refuse coverage to people with pre-existing conditions (anything from asthma to leukemia) because they know these people will be highly likely to incur greater costs than healthy patients. The entire rationale for excluding them is because they cost more money.

If you have had a C-section once, you are much more likely to end up having another one if you ever give birth again. If you have a history of domestic violence, you might end up with an abusive partner again, and end up needing care.

Yeah, it’s complete bullshit that these people would be refused health care. It’s downright immoral.

But why is it especially immoral to refuse health care to these women — but not to women with osteoporosis or an anxiety disorder or back pain? Or Ehler-Danlos Syndrome or food allergies or heart disease or lung cancer?

How is it any different?

Victims of domestic violence don’t deserve to suffer consequences for something that is not their fault. This is truth. It contributes to the very popular cultural myth that victims are somehow to blame for the abuse they suffer — that they must have done something to provoke it, or that they should have left, etc. All this stuff is highly damaging.

But that doesn’t make it different than telling a woman with lung cancer that she can’t have care because her disease is somehow her fault. Which contributes to the very popular cultural myth that people with medical conditions are somehow to blame for them — that they must have done something to earn them, that it’s their own fault they ended up that way, and therefore they lose rights to certain things because they are inflicting the costs of their mistakes on the rest of us.

Because if you haven’t done anything wrong, you won’t ever end up sick. If you do end up sick, there must be something you did wrong.

Maybe that woman smoked. And maybe that other woman slapped her boyfriend first. And that woman who was raped wore a short skirt and flirted with the man first. That does not make this violation her fault. This is basic feminist theory. “Blaming the victim.”

Health care is a human right. We all deserve basic health care that respects a person’s dignity and integrity and humanity.

So why are these things different? Especially outrageous?

I can’t identify any reason except one.

Because they apply to healthy women.

It’s understandable why health insurance companies would refuse care to women with arthritis. It makes sense that they would deny care to women with psychiatric disorders.

Because we, as a society, think it is OK to deny quality of life and societal access to people with medical conditions, disabilities and chronic illnesses. We have determined that it makes sense to discriminate against them. We get why these things are done. And they’re done to those people. Over there. Not to me and mine.

But C-sections? Why, one-third of mothers in the US will have a C-section instead of a vaginal birth! That affects me and mine. Therefore, it is especially outrageous — that we would be treated like we treat them.

Oh, but that’s not how you think?

Really?

What justification is there for acting as though these practices are any worse than the practice of denying coverage to women who have lupus?

There isn’t any that isn’t rooted in a deeply ableist bias.

How about we get outraged by the fact that there is any such thing as a pre-existing condition exclusion at all? I can get behind you on that one.

16 Comments

  1. Even a relative who works in the health insurance industry thinks that pre-existing condition clauses are ridiculous. Admittedly, one could argue that she’s biased because I have pre-existing conditions that are entirely genetic (and therefore only my fault if you want to say I should’ve known better than to be born with that set of genes – how dare I?) and she’s seen how much lack of care can really mess with my entire life. (I mean, with appropriate treatment, I’m more or less able to live a ‘normal’ life for an adult. I could work a normal week with minimal restrictions, have a social life, participate in community functions or volunteer, etc. Without it, I sometimes end up spending a week or more at a time basically stuck in bed, not able to work or contribute to the community – it probably costs MORE to not treat me, if you look at it in a global sense, than to provide treatment so that I can work and pay taxes and so on.)

  2. yes, pre-existing condition clauses are all unjust. however, i find the C-section clause particularly outrageous. why? because far from being a drain on society, the stereotypical reason on this issue to discriminate, women who are giving birth are continuing the human race. we should be rewarded for that on principal, not be punished for it.
    any thoughts?

  3. Yes J, but do you understand how that positions pre-existing conditions clauses for PWD as perfectly okay, that we’re not contributing to the human race but are merely a drain on society?

  4. As a person with Ehlers-Danlos Syndrome, I am in perpetual fear of losing my health insurance. Once I were to lose it, it would be a very fast slide downhill – without my medications, I cannot function. Without functioning, I could not go to school. Without school, I would not have the student loans I live on. Without the student loans, my boyfriend and I could not afford the house we live in.

    So on and so forth. Losing my health insurance would have devastating consequences.

    And yet, it would take so little to lose it. As a matter of fact, at this exact moment, because of a bureaucratic error, I have no health insurance. It will only be for a week or two, but it’s a terrifying image of what-could-be.

    ~Kali
    http://www.brilliantmindbrokenbody.wordpress.com

  5. I’m there with you. I was just denied twice this last month for health insurance because my asthma is a pre-existing condition. So, um, I literally don’t deserve to breathe? That’s what these insurance companies are saying? I’m currently waiting for my next rejection, and wondering how I’m going to be able to afford my medicine for the next year even if they do accept me–if I am accepted, I’ll still have no coverage for the most important things for a year. My meds cost as much as my rent–there’s no way I can afford them on a regular basis (which is why I haven’t had them for the last six months in the first place).

    I saw an op-ed today that suggests that Congress should lose their health insurance if they can’t get reforms together by the end of this session. I’m all for that.
    .-= stacy´s last blog ..Tu Publishing update, anthology contest =-.

  6. stacy, have you looked into your state’s high risk insurance pool? It’s not a great option, but if you are being repeatedly denied coverage, at least you will get some insurance which they can’t deny you or boot you out of. Also a fellow asthmatic currently surviving on free samples of meds handed out like candy by drug reps at my doc’s office…have you swung by a local clinic to see if they have samples (at least of rescue inhalers!) they can give you as a stopgap?

  7. I couldn’t agree with you more. It is OUTRAGEOUS to imply that some pre-existing conditions are worse than others. And the fact that anyone can be discriminated against for being the victim of domestic violence OR being the victim of a mental illness … well it makes me sick to my stomach.

    God I hope Obama’s health care reforms get through.

    I’m watching from half a world away, but, as a survivor of cancer and a sufferer of depression, I cannot fathom living in a first world country which would deny me medical care when I am most vulnerable. The same thing would happen to me, here in Australia, if I lost my private health insurance, as I have a history of needing very expensive hospitalisation and treatment. I would, however, be able to fall back upon a public health care system which, while not perfect, would allow me top-class care without charge.
    .-= Fe´s last blog ..Breaking the first rule of divorced parenting… =-.

  8. Well said. Thank you.

    I suffer from fibromyalgia and hypermobility-type Ehlers-Danlos, and while the research and care for both conditions isn’t great over here, at least I don’t get idiots denying me any care at all. I would hate that. I love your country, but I don’t love its medical and political systems all that much, I’m afraid. Especially not if it means people can get away with horrific discrimination like this…

  9. Geez. Way to go, insurers; first take out the people who REALLY need the care, because *gasp* taking care of them costs too much! Never mind the toll it takes to get people from a “flare”, if you will, with no meds, to someplace approaching a decent quality of life. Now let’s see if we can weed out any of those inconvenient people who were careless enough to have ANYTHING wrong with them. Oh wait, that includes a lot of people you didn’t realize? Guess what, insurers: SO DOES THE FIRST GROUP.

  10. I didn’t even think about the ableist implications of pre-existing conditions. Thank you for bringing them to my attention!

  11. Yes, all pre-existing condition exclusion are outrageous, but I for one find classifying victims of DV as having “pre-existing conditions” especially heinous because — and this is the key bit — it is something inflicted upon them by others. Cancer, allergies, heart disease, chronic pain and the host of other conditions which the insurance industry uses to deny care lack agency. No one ‘deserves’ to have them, but neither has anyone made a decision to cause them, either. Classifying DV as a pre-existing condition is like classifying a non-domestic assault as one.

  12. LS, that is a completely meaningless distinction. People keep saying this, and I just don’t get it. We are saying that no one deserves to be denied health care for having a medical condition. The only time people bring “But another person caused it!” into this (which, by the way, isn’t true for all the other things people are raising outrage over, like acne) is … in order to insist that it’s especially bad to deny health care to an otherwise healthy set of women, but not as bad to deny health care to sick women.

    Sorry, but there’s a word for this. It’s called rationalizing. You might append another important word to that. It’s called privilege.

  13. Respectfully, amandaw, I disagree. And I’m having trouble putting this into words because I do agree wholeheartedly with your statement: no one deserves to be denied health care for having a medical condition. The thing is, cancer is a medical condition. Acne is a medical condition. (People are outraged over that (over and above denial for any reason)? Really? Eep.) Having been assaulted is not a medical condition. So it’s two sets of outrage at the insurance companires: How dare you deny coverage to people who need it? AND How dare you classify this as a ‘condition’?

  14. How dare you classify this as a ‘condition’?

    You really don’t see any ableism there?

  15. I used to answer phones for CIGNA and I was disgusted to discover that there were conditions or circumstances that could deny people medical coverage and medical care. Born and raised in Nova Scotia and covered by MSI at least even if I’m not working/a student/whatever, I had never come across the existance of pre-existing condition limitations. I found (and find) them completely abhorrent, and whenever the topic comes up all I can think about is how PECLs would deny care to so many of my friends and family – because of asthma, rape, diabetes, cancer, depression, a whole host of things.

  16. My mother recently convinced me to go and get tested for some autoimmune diseases that run in the family. “Do it while we still have insurance,” she told me. And then I did get the test, and then it came back positive.

    And I realized what a huge fucking mistake that was. I should never get tested–I should never know I’m sick because then I’ll lose my insurance when I get sick and need insurance. NEVER GET TESTED FOR A PRE-EXISTING CONDITION. Even if you think it’s going to kill you–because once you get rejected, the condition is going to kill you anyway. Wait until you think you’ve settled into a long-term career to look for diseases. And if you’re one of the unlucky millions that that will never find that career? Well… no one lives forever, anyway.

    And I think you’re right about the abuse and C-section being someone *I* could be, being someone a “normal” person could be. Normal people might get a C-section or get into a bad relationship. Only freaks, only *those people* end up with lupus or asthma or anxiety disorders. (And I say this with irony, I am one of “those people”).