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Got Some Pimples? No Insurance for You!

THIS is why we need healthcare reform (among other things...):

According to an article by David S. Hilzenrath in yesterday's Washington Post, health insurance companies have sought to deny coverage to people for a host of reasons.

Health insurers have issued guidelines saying they could deny coverage to people suffering from such conditions as acne, hemorrhoids and bunions. One big insurer refused to issue individual policies to police officers and firefighters, along with people in other hazardous occupations. Some treated pregnancy or the intention to adopt as a reason for rejection.

The article states that, "Proposed legislation would prohibit insurers from denying coverage to individuals with preexisting conditions or charging them higher premiums because of their medical history -- practices known as medical underwriting." The article also quotes a PacifiCare Medical Underwriting Guidelines document from 2003 that not only lists being pregnant as grounds for denial of coverage, but also being an expectant father. The guidelines also called for denying coveage for any symptom experienced in the preceding year for which a physician was not consulted. Now that's convenient, isn't it? - that could mean anything from a hangnail to a hangover.

The article qoutes a health insurance company representative as saying, "Underwriting enables insurers to adequately assess risks, keeping premium costs lower for more consumers." This, of course, is another way of saying, "We want to insure as many heathy low-risk people as possible."

This is exactly the problem: There is an inherent conflict of interest in the pursuit of profits and the provision of the needs of the sick and injured. Ideally, an insurer would gleefully take your premium payments and figure out a way to never pay a single claim. This would be a maiximization of profits. If you're trying to "make" money, the last thing you want to do is write somebody a check.

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