August 17, 2009 by D Stack
The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.
– Sarah Palin, Facebook Post
There’s a lot of myths going on in the health care debate. The truth on this one is that the death panels are indeed real. But not in their presence in the plans currently being discussed. The source of that provision is to allow doctors to be reimbursed for their time consulting with patients on end-of-life issues. Currently there is no requirement that they be so reimbursed for such conversations, which happen every day in doctor’s offices, hospitals, and clinics.
But I said the death panels are real. They exist in our health care system today, a health care system whose proponents describe as the “envy of the world”.
Right now I receive health care through my employer. No change in my health status can make me lose my insurance, just change in employment status. And my employer is enormous, meaning no insurer is going to drop all members from my company’s health care plan.
But suppose that were not the case. Suppose instead I was purchasing insurance in the free market. Perhaps I’m self-employed, a part-time worker, or a worker at a company which does not provide health insurance. Now suppose I come down with cancer. A treatable cancer, but an expensive one. My insurer, as per the dictates of the free market, has every incentive to drop me. They do this by rescinding my health insurance policy. What they do is scour all of my records for any inconsistency, typo, etc. Perhaps in my medical history I forgot to mention I was I had acne and a rapid heartbeat in the past or did not think it relevant. Well when that cancer comes, goodbye policy. To quote an NPR story:
One of Barton’s constituents, Robin Beaton of Waxahachie, Texas, did know that her health history included acne and a rapid heartbeat. But she didn’t think they were relevant to her current health and left them off her application.
After she was diagnosed with breast cancer and was scheduled for a double mastectomy, her insurer cancelled her policy, leaving her devastated.
“I had to completely refocus on what to do, where to turn, because my insurance canceled me,” she said. Beaton called Barton’s office, which started a series of phone calls to her insurer. It took a call from Barton himself to get her reinstated.
Committee investigators found a total of 19,776 rescissions from three large insurers over five years. The rescissions saved the insurers $300 million.
Further investigating the case of Robin Beaton, as reported by CNN:
The reason? In May 2008, Beaton had visited a dermatologist for acne. A word written on her chart was interpreted to mean precancerous, so the insurance company decided to launch an investigation into her medical history.
Beaton’s dermatologist begged her insurance provider to go ahead with the surgery.
“He said, ‘This is a misunderstanding. This is not precancerous. All she has is acne.’ … He said, ‘Please don’t hold up her cancer surgery for this,’ ” Beaton, 59, said as she testified at a House subcommittee hearing on the terminations of individual health policies by insurance companies.
Still, the insurance carrier decided to rescind her coverage. The company said it had reviewed her medical records and found out that she had misinformed them about some of her medical history.
Beaton had listed her weight incorrectly. She also didn’t disclose medication she had taken for a pre-existing heart condition — medicine she wasn’t taking when she originally applied for coverage.
I don’t think anyone would dispute an insurance provider’s right to protect itself from fraud. But these are not cases of fraud. These are cases of, to use Sarah Palin’s word, “evil”. This is looking for a way to save money at the cost of letting people die. As the LA Times reports, there is evidence that insurers encourage and reward those who cancel such policies:
The state’s largest for-profit health insurer told The Times 18 months ago that it did not tie employee performance evaluations to rescission activity. And executives with Blue Cross parent company WellPoint Inc. reiterated that position today.
But documents obtained by the House Committee on Energy and Commerce and released today show that the company’s employee performance evaluation program did include a review of rescission activity.
The documents show, for instance, that one Blue Cross employee earned a perfect score of “5” for “exceptional performance” on an evaluation that noted the employee’s role in dropping thousands of policyholders and avoiding nearly $10 million worth of medical care.
The committee investigation uncovered several rescission practices that one lawmaker called egregious, including targeting every policyholder diagnosed with leukemia, breast cancer and 1,400 other serious illnesses. Such investigations involve scouring the policyholder’s original application and years’ worth of medical and pharmacy records in search of any discrepancies.
I would submit that the free market does not guarantee the best care. And competition does not help the consumer. The argument is that someone who is unhappy with his insurance will just go to some other insurer. But all of the insurers have a common interest in not paying out money, especially in these very expensive cases. And someone who already has cancer is not going to be touched by any insurer. So once you are dropped, you are looking at treating your cancer with your own personal savings. Good luck with that one.
The solution is, as I (and countless others) have stated, universal coverage. No one can be denied or charged more for pre-existing conditions. Counterbalancing this would be the requirement that you must, should your finances permit, have insurance coverage. No signing up for insurance the day after you are diagnosed with a brain tumor. Employers would be given financial incentives to cover their employees’ insurance costs. And those whose incomes were too low would be given subsidies. Yes, this does indeed mean using your and my tax dollars to pay for the insurance of poor people. Sorry about that. Kind of like how tax money goes to pay for roads you never drive on or schools despite the fact you have no kids or they are out of school.
Note this has nothing to do with whether a public option is implemented. I think it is a good idea to do so, but the truth of the matter is the death panels already exist today. They are not a possibility, they are a fact. Today.