For those of you who still think that insurance coverage denial is simply few and far between, here is ANOTHER outrageous story. I truly believe, once again, those opposed to insurance reform have simply NEVER been faced with serious health challenges. Is it just me, am I the confused one about the purpose of health insurance? Isn’t insurance meant to cover you when you are SICK? How many other rape victims have suffered this same “pre-existing” reason for coverage being dropped?
When Christina Turner feared she had been sexually assaulted after two men drugged her drink in a bar, she did what most women facing that situation would do. She turned to her doctor, who prescribed a month’s worth of anti-AIDS medicine to be on the cautious side.
Only afterward did she learn that her choice left her with a “pre-existing” condition that had made her practically uninsurable.The episode started when Turner accepted drinks from the men at a bar in Fort Lauderdale. She passed out and later woke up lying beside a road with cuts and bruises that pointed to a rape or a sexual assault.
Fortunately, Turner did not contract HIV, and remains free of HIV infection. However, a few months she lost her health coverage. When she sought new coverage, she was told that her treatment raised too many potential issues.
Turner, 45, worked previously as a health insurance underwriter herself, and said the insurance companies naturally checked her health records. Even after she explained the sexual assault and the precautionary nature of the treatment, the insurers declined to sell her a policy, saying that the HIV medication made her too risky. The company told her they might reconsider the decision if she could show she was still free of HIV in three or more years.
Firstly, your thread title is EXTREMELY DISINGENUOUS. This individual is an insurance risk because she was treated for HIV. NOT because she was raped.
You are being intellectually dishonest.
“am I the confused one about the purpose of health insurance? Isn’t insurance meant to cover you when you are SICK?”
I believe you are confused as to how health insurance works. If you force insurance companies to cover pre-existing conditions without expanding the population of covered healthy individuals, private insurance companies will cease to exist. It’s that simple.
SHE WAS TREATED FOR HIV BECAUSE SHE WAS RAPED!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Mando,
THAT is why you mandate coverage for all.
Well… that’s what I (and hopefully others) have a problem with.
For one thing, how do you enforce that?
But she wasn’t turned down for coverage because she was raped. There’s not an insurance company on the planet that’s going to cover someone that’s being treated for HIV no matter what the explanation is.
I believe that Elena does understand how Insurance Companies work today. They don’t work very well. We are talking about how we want them to work in the future.
Fortunately, Mando, we are going to force insurance companies to cover pre-existing conditions. It is in everyone’s interest to ensure that all Americans have access to healthcare. This is particularly true regarding treatment of communicable diseases. Should we give H1N1 flue shots only to the insured or does Government have a role in immunization? I would suggest that not treating someone with AIDES (or any other communicable disease) is a threat to our safety and national security. I would also propose this thinking scales to all diseases and illnesses since impact is personal and societal affecting families, communities, businesses, etc., etc., etc. Your argument (IMHO) supports the call for a public option (or perhaps even a single payer system) as a National Security measure.
I really don’t like operating like a third world country where the least among us are considered “dust in the streets.” When I hear free market arguments against protecting all Americans, I imagine an inhumane world where the fortunate few walk by the less fortunate who are left lying by the side of the road. We are better than that. We judge others for their Human Rights records and how they treat the least among us. We must live up to our own expectations. Fortunately, we are slowly “taking back our Government” as we move into the 21st Century and join the industrialized world in those areas where we (the leader of the free world) actually lag behind. Health care for all Americans is at the top of the list.
I am a fan of the Constitution and its enumerated powers. I also understand that it is the interpretation of the Constitution that drives legislation. Today’s technology, transportation options, and communications have tightly coupled our fifty states. Our economy now operated on a scale never envisioned even 100 years ago; however, our Constitution as written covers today’s economic realities. I believe that Article 1, Section 8 (commonly referred to as the interstate commerce clause) gives Congress the power to regulate healthcare and industry in general in this Country as these are national issues that have no respect for state boundaries. I am not a progressive. I view this as a legitimate interpretation of the Constitution as the founding fathers intended.
And she wouldn’t have been treated for HIV had she not been raped. WHO is being intellectually dishonest?
You have got to be kidding me.
Seriously Mando, are we going to play semantics here? Has she NOT been raped, she would NOT have been on the HIV meds. How does that not make sense to you. However, even if she had not been raped, she should be able to have decent insurance that will ensure decent health care!
M-H, we were typing at the same time! 😉
Actually, she wasn’t being treated for HIV. It was precautionary. Preventative.
I am becoming more convinced we need total over haul in the insurance industry, the more you say Mando. You are solidifying things for me.
Even people in Africa get treatment for HIV, are you suggesting if you have an illness you should be allowed to suffer because it costs too much?
No kidding. Joint outrage here. I bet if it was something that only happened to men we wouldn’t be having this discussion.
Standing ovation for Opinion. Well put.
And the only way to force the insurance companies to cover pre-existing conditions (and stay in business) is to force everyone to buy insurance.
How are you going to do that?
The implication is:
EVIL INSURANCE COMPANIES ARE TURNING DOWN RAPE VICTIMS!!!!
To the Bat Cave!
I find that a very ominous statement.
@Mando
Who said they have to “buy” insurance to receive health care? Ever heard of Medicade?
correction – Medicaid ( to correct spelling – typing on my Blackberry occasionally results in errors).
“are you suggesting if you have an illness you should be allowed to suffer because it costs too much?”
At some point, yes. Particularly when drug prices are so high, artificially high, in this country.
@Opinion
So you want govt. to run health care subsidized by the taxpayer?
Otherwise, for insurance companies to insure the uninsurable, they’d have greatly expand their customer base to spread the risk and cost. They’re not turning down those with pre-existing conditions to be evil or because they’re unethical. They’re turning them down to stay in business and in doing so ***they insure the vast majority of US citizens***
You have loft ideals but I really don’t think you understand how the health insurance industry works.
@Mando
If the free market doesn’t step up to its ethical obligation to provide insurance for all Americans (reference earlier discussion on business ethics), I believe Government should step in. In that scenario, yes, I want the government to run health care subsidized by the taxpayer. Note that the Government does run health care for a large segment of our population: the Veterans Administration, Tricare (for active and retired military), Medicare and Medicaid (to name but a few).
I do understand how the health insurance industry works. It works poorly, is driven by greed, and has no problem allowing people to suffer and die. You may think that’s ok. I don’t. Fortunately, Congress is passing some form of my lofty ideals as we speak.
For folks who would really be more comfortable in a truly free market, unregulated environment, I have several travel brochures to emerging third world nations and will make them available upon request. Immigration requirements are surprisingly easy to meet… as one would expect in a truly free market.
Mando,
You shared in a previous thread, if I understand your comment correctly, you chose to suffer through four different bouts of kidney stones because it had been so expensive after going to the hospital/doctor the first time.
People shouldn’t HAVE to suffer because getting care is cost prohibitive. You can make that choice for yourself, but if you have a child, you can’t allow THEM to suffer. In a civilized society, people should not be made to suffer because insurance is unable to cover them.
What I don’t understand is your resistance to admitting that OTHER countries do it better. No system is perfect, that is simply not possible, but THIS system is broken. I can’t get life insurance, but that is not going to impact my present health, NOT being able to get health insurance is wholly different.
I don’t think people are generally evil, I think they can be greedy, like Madolf, he didn’t INTEND to ruin so many people’s lives, he just didn’t care or didn’t think he would ever get caught. Insurance mogels aren’t evil, they just operate in their own little bubble. Multi million dollar bonus’s, while people are dying, due to denial of health coverage, just is NOT an acceptable paradigm to me.
Maybe a trip to Somalia for example?
Insurance companies are …companies. Their ceos do not need to make 10 million bucks a year. No one needs to make that much.
Somehow insurance companies have become an us against them relationship. That needs to change.
Elena, anyone who really likes free markets will LOVE Somalia! Personally… Not so much.
Mando is correct on this one, but let me add some more info for you. First, being uninsured for a period places you at higher risk when you apply for insurance. You don’t state what other risks she had. High Blood Pressure, recent cancer, etc. that would add to her risk assessment. Due to the high cost of HIV treatment, that is not a risk most insurers welcome. And if she relayed the story of how she came to be raped to the insurance company, that she was in a bar, accepting drinks and passed out, this is risky behavior. If you have several accidents, DUI’s and tickets, good luck getting affordable auto insurance.
But here’s where this person got into trouble. The gap. If it is more than 90 days, a whole bunch of things happen to your risk. It is absolutely necessary to maintain your insurance with no gap. Life, Health or Auto.
If she quit her job or was fired, Cobra should be available to prevent a gap. After Cobra benefits are exhausted, you can – by law – obtain coverage with any carrier you want, there are no pre-existing conditions and you may not be turned down for coverage.
When you leave a job, are terminated or laid off, you receive this information.
Virginia provided Cobra coverage for employees that had their company go out of business.
Now, what happened was, this lady failed to follow the rules, had a gap and is finding out the consequences. And just because one company turned you down, does not mean another will not take you. When you have a 90+ day gap, you are going to pay FAR more.
Under Obama Care, this lady would face a fine. I don’t know the details of the bill, but I am sure she would face some sort of punishment from a Public Option.
I am sorry for what she is going through, but to the Insurance Company, we have a person that dropped her insurance for whatever reason, engages in high risk behavior by drinking so much she passes out and something terrible happened to her. She goes to a bar apparently alone, drinks until she passes out, and I assume she would have driven her car home had she not passed out. And she was so drunk, how can she be sure it was rape? Is there liver involvement from Alcohol? Hepatitis? Is she a drug user?
Yet you want my tax money to pay for this person’s risky and irresponsible behavior. Nice.
This is actually a great argument on NOT having a public option.
South Africa is one of the largest recipients of US foreign aid to help fight HIV/AIDS and tuberculosis, to the tune of over $500 million a year just for those diseases. Thanks to your tax dollars, a huge and very profitable black market has developed around the sale of these antiretroviral drugs–not for HIV treatment, but to get a cheap high when the drugs are ground up and smoked. Wonderful, isn’t it?
How much does it cost for an American to receive 30 days of antiretroviral drugs? About $1100.
I’m with Rick on this issue. Something is seriously wrong here when our tax dollars are essentially creating overseas ARV junkies.
That is horrible Emma. How many people are being denied life saving medicine due to this abuse, just awful.
Maybe an essential element of reform should be to prioritize taking care of our own first. A possible rape victim in this country should not have to compete with a South African who either has no intention of changing risky behaviors or is gaming our good intentions. We shouldn’t be giving away what we can’t afford to provide for our own people, especially when so many of our tax dollars go toward R&D of these drugs that are given away overseas.
Emma, I fully understand your perspective. I am personally going through an “evolution” wondering why a life across a border or an ocean is worth less than a life of someone who happened to be born on the same continent. As I mention quite a few times, technology, air travel, and communications advances have pretty much “shrunk the planet” to the point that we now interact with people from every part of the planet on a daily basis. More to the point, a child not treated for H1N1 in Somolia (for example) might be on a plane for New York as we speak with the virus thus propigating the pandamic among “our people”. AIDES is also an international epedemic (pandemic?) for the same reason. I’m sure many other examples come to mind.
Bill Gates has the right idea. He just committed $1.4 Billion to developing better agricultural techniques for Africa (1 billion people are estimated to be hungry in the world at the moment) and is working very hard to give away another $40-50 Billion of his money to help others. It is interesting to note that the most successful businessmen on the Planet (Gates, Buffet, and others) are using their resources to make the world (not just the United States) a better place. They understand that in today’s environment, we must think globally. This is also particularly important since local solutions are clearly not the answer to our environmental issues. Again, we must act globally.
I don’t have the answers and sympathise with most people’s natural tendancey to “Take care of our own people”; however, I’m coming to the conclusion that “our own people” includes everyone on the planet.
Opinion has hit the nail on the head. We must think world, not country when we talk about disease, hunger, jobs, wealth. Most of the wars since the beginning of time have been over wanting something someone else has or God.
We can’t have the discussions about who has what disease without being willing to treat the disease. The shrinking world syndrome will not go away.
On the other hand, Rick is right about Americans having to pay way too much for drugs. I understand that we put are paying for much of the R & D. Perhaps that is the job of the stock holders.
I don’t think all aids is brought about by irresponisible behavior. All those kids with HIV in Africian countries haven’t been irresponsible.
Opinion, I in no way believe that “a life across a border or an ocean is worth less than a life of someone who happened to be born on the same continent.”
What I do believe is that we shouldn’t be giving away what we apparently can’t (or won’t) afford to give (or sell more cheaply) to our own. How can anyone possibly justify a cost to an American of $1,150 a month for lifesaving drugs that we either give away or sell cheaply overseas? And there is a serious oversight problem when these valuable drugs are being used to profit from selling a cheap high while others are dying.
Opinion, in case you’re interested, “pandemic” refers to widespread geographical distribution, regardless of total numbers of cases. “Epidemic” refers to large numbers within a specific geographic region. I’m a bit of an epidemiology nerd.
Thanks for the clarafication on pandemic (I really wasn’t sure). I am very interested in learning new things. So, that makes AIDES a pandemic? Is a pandemic, by its nature, also an epedemic (in a local context)? Interesting stuff I never really thought about.
Re your comment on the cost (or disparity in the cost) of drugs, I tend to agree. The free market folks would say it’s ok to charge whatever you can get away with; however, I believe there’s an ethical consideration in this scenario.
It would appear that the drug companies are, in fact, “means testing” their pricing. They are letting the developed nations pay for research, overhead, and profit (which, ironically, goes to shareholders… which is us… I’m guessing most of us own mutual funds in our 401K’s or direct drug company stocks) while pretty much giving away the same drugs overseas. Humm… now that I think about it, there’s an argument for that model. I don’t know enough about the drug company’s pricing structure to really weigh in (other than the free market considerations).
Are you proposing that the drug companies are wrong for giving away medical treatment to folks who can’t afford it while charging those of us who can? There’s an argument to be made that drug companies are living up to their ethical responsibility to the world by helping third world countries. Some folks beat up businesses for not doing enough… we appear to be beating them up for doing too much. I would be interested in your opinion (to help me form mine).
Sorry, I’m still processing this. Aren’t the drug companies actually contributing to the safety and security of the industrialized nations of the world (which include us) when they reduce the incidence of communicable diseases in third world nations? Doesn’t that actually contribute to our personal safety and that of our families? Do we really care if they do it for free? In fact, perhaps there’s an argument for our tax dollars paying for this as a matter of national security. I’m beginning to think I’m ok with paying more in order to subsidize treatment for those who can’t pay at all; however, I would really be interested in arguments to the contrary.
“Are you proposing that the drug companies are wrong for giving away medical treatment to folks who can’t afford it while charging those of us who can”
Can we afford them? If so, then why the need for healthcare reform?
Hi Elena, I noticed something that caught my eye when you said this:
“I truly believe, once again, those opposed to insurance reform have simply NEVER been faced with serious health challenges.”
To tell you the truth I don’t know of a single person ‘opposed to insurance reform’. I know of a bunch opposed to they way it’s currently being done, but not a sole that opposes reform all together.
This goes along the exact same lines as immigration reform. If someone is again amnesty or something like it you use your rubber stamp on them as someone who ‘opposes immigration reform’. Neither issue is black or white but for some reason those on the left see it that way, why is that?
against a public option = you oppose insurance reform (which use to be called health care reform but insurance reform sounds better I suppose).
against amnesty = you oppose immigration reform.
@Emma
Point taken although as mentioned earlier the Government is in the health care business. It does step in when threats like a pandemic presents itself. The problem is the numerous “cracks” that people fall through in our system regarding other health care issues. It’s about more than just drugs (although they are certainly important). I believe one goal of healthcare reform is to fill those cracks… and I do believe that we need healthcare reform.
We can always find the few stories that are very bad and I really do feel for these people. But why do we change everything for a few? And BTW I am still paying off over 60,000.00 worth of treatment and tests. Not once have I asked someone else to pay these bills for me! It might take me yearssssssssssssssss to pay them off but I am! So once again, I am not willing to pay for someone elses health insurance.
The problem is that these are NOT isolated instances. People, ALL the time, are forced to declare bankruptcy due to overwhelming health care costs, WE are ALL paying ALL the time anyway. People who can’t afford coverage, use the ER as preventative care, WE ALL pay for that anyway. My health care cost rise EVERY year and yet I get covered for less and less. I imagine YOU are experienceing the same phenomenum.
Did you have insurance? 60,000.00 is quite alot of money. If you did not have coverage, would you mind sharing why? Was this a choice because you preferred to have no coverage and THEN got sick?
Not SPLC, you are very fortunate that you were allowed to pay them off. For years people with those kinds of medical bills have been forced into bankruptcy.
Most people would rather have their insurance pay for those kinds of bills.
“It’s about more than just drugs (although they are certainly important).”
Of course I agree with you. I zeroed in on the ARV’s because they had to do with the thread topic. As a healthcare professional, I definitely believe in healthcare reform. But I don’t support the current version, and I especially don’t support the new tack of taking the discussions behind closed doors because they believe it has been publicly debated enough already. They are deciding how to spend OUR money, they work for US, and unless they are discussing issues of national security, their efforts should be entirely transparent.
SPLC,
How long have you been paying this off? If it is payed off, how long did it take you?
Does anyone know how the Medicare prescription plan was developed? How transparent was that process? Additionally, how was it paid for, the ultimate cost of 600 billion?
@ Emma
On those opints, we certainly agree. Thank you for your service as a health care professional.
Nice of you to say that, Opinion 🙂
Opinion is a gentleman and a scholar. 🙂