The Savage Arithmetic of the Pre-Existing Condition

I have been a victim of the horrid pre-existing condition rules for 4 decades now.–KAS

By William Rivers Pitt, Truthout | Op-Ed

I went to the doctor
Guess what he told me
Guess what he told me…
– Sinead O’Connor

Five years ago, my wife and I took what turned out to be the longest walk in the world to Brigham & Women’s hospital in Boston to get a diagnosis for her that had been six months in the making. She was 25 years old, and her right arm had gone sideways on her over the last nine months with a collection of symptoms – numbness, tingling, and tremors of such severity that her good hand was all but useless for anything besides waving at friends – that we had run out of explanations for. Nerve damage? Carpal tunnel? We didn’t know. She had gotten an MRI two days earlier, and the doctor had called that day asking us to come down and talk about it. The conversation began with, “You have multiple sclerosis,” and that has been our undeniable reality ever since.

Multiple sclerosis, for those not in the know, is a disease in which the body’s own immune system goes to war against its own brain. My wife suffered her symptoms because the disease gnawed through the myelin sheaths of her own higher nervous system and annihilated the nerves that control her right arm. Over the intervening years, her brain has taken it upon itself to figure out some good work-arounds – to wit, when the road collapses, you build an overpass – but her hand will never again have the same functionality (until stem cell research bears fruit, fingers crossed).

I give her an injection every day to control the disease, and she takes a variety of other drugs to manage the symptoms. All told, multiple sclerosis – between the doctor visits, the MRIs, and the drugs required to keep a lid on things – costs upwards of $50,000 a year. Thankfully, she is gainfully employed with a major retail company with a stellar insurance program, so a large portion of that cost is defrayed by the insurance she pays for with every paycheck.

Without that insurance, she would be at the mercy of those who think pre-existing conditions are basically God’s funny joke on people, i.e., ha ha ha, you’re screwed.

She is not alone. I went to the doctor last month, and found out that I have pretty damned high blood pressure. The doctor had me come back four weeks later to do another check, and, yup, really really high blood pressure. I am now on two different drugs to bring it down to a manageable level, drugs that I am going to be on until they wind me in my shroud. I am on my wife’s insurance, so again, the cost of those drugs is manageable, but mine is now a house filled with pre-existing conditions.

What if she gets fired, or the company goes belly-up? She is incredibly good at what she does, which means some other company may try someday to tempt her away…until they hear about her pre-existing condition, and mine, and how much insurance coverage for those conditions will cost thanks to our truly insane for-profit health industry. If my wife leaves her company for any reason – especially if/when Scalia and his merry band of ridiculous fascists decide to curb-stomp Obama’s health care law – we are both well and truly screwed. It’s like Ayn Rand herself was allowed to draft the rules for getting sick in America.

But that’s me and my wife.

Here’s you.

According to the American Heart Association, more than 81,000,000 people in America suffer from one or more forms of cardiovascular disease.

According to the American Cancer Society, more than 11,000,000 people in America currently suffer from some form of cancer.

According to the American Diabetes Association, 23.6 million people in America currently suffer from diabetes, and the Center for Disease Control has estimated as many as half of all Americans will suffer from the disease by the year 2050, thanks to our deplorable dietary habits.

According to the National Parkinson’s Foundation, between 50,000 and 60,000 new cases of Parkinson’s are diagnosed in America each year.

According to the National Multiple Sclerosis Society, some 400,000 Americans currently suffer from MS.

That’s a pretty substantial portion of the population, with more being diagnosed with cardiovascular diseases, cancer, diabetes, Parkinson’s and MS every day.

Do the math.

It’s you, too.

Hundreds of millions of people in this country are sick at this moment, or will be sick tomorrow, the next day, or somewhere down the line. The numbers are spinning like the fare meter on a New York City taxi cab, ever higher every day. If you’re not sick, you will be one of these days: bank on it…and in the meantime, at least one person you know is in that tribe.

That’s fact.

We’re enveloped in a national debate about insurance mandates and the political leanings of nine Supreme Court Justices. That’s all well and good, but entirely beside the point.

A nation that does not care for its sick and infirm is a nation that does not deserve to exist. A nation that actively profits from the pain and suffering of those sick and infirm deserves to burn in Hell. A nation that throws those sick and infirm to the wolves is so far beneath contempt as to beggar description.

Two years ago, Republican Mike Huckabee compared people with pre-existing conditions to houses that have already burned down. Just the other day on the Leno show, likely GOP presidential nominee Mitt Romney voiced a very similar opinion.
They both have awesome health insurance.

Do you? Forever?

One of these days, you are going to have a pre-existing condition.

Hope for the best, but expect the worst. “The worst” is exactly where we are headed, if matters continue as they have.

Straightforward stuff, folks.

Think it over, while you can.

We’re on borrowed time, after all.

How are you feeling today?

This article is a Truthout original.

William Rivers Pitt is a Truthout editor and columnist. He is also a New York Times and internationally bestselling author of three books: “War on Iraq: What Team Bush Doesn’t Want You to Know,” “The Greatest Sedition Is Silence” and “House of Ill Repute: Reflections on War, Lies, and America’s Ravaged Reputation.” He lives and works in Boston.

About eslkevin

I am a peace educator who has taken time to teach and work in countries such as the USA, Germany, Japan, Nicaragua, Mexico, the UAE, Kuwait, Oman over the past 4 decades.
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2 Responses to The Savage Arithmetic of the Pre-Existing Condition

  1. eslkevin says:

    Broccoli and Bad Faith
    Published: March 29, 2012

    Nobody knows what the Supreme Court will decide with regard to the Affordable Care Act. But, after this week’s hearings, it seems quite possible that the court will strike down the “mandate” — the requirement that individuals purchase health insurance — and maybe the whole law. Removing the mandate would make the law much less workable, while striking down the whole thing would mean denying health coverage to 30 million or more Americans.

    Fred R. Conrad/The New York Times
    Paul Krugman

    Blog: The Conscience of a Liberal
    Related News

    Few Minds Are Changed by Arguments in Court (March 29, 2012)
    Related in Opinion

    More on Health Care »
    Given the stakes, one might have expected all the court’s members to be very careful in speaking about both health care realities and legal precedents. In reality, however, the second day of hearings suggested that the justices most hostile to the law don’t understand, or choose not to understand, how insurance works. And the third day was, in a way, even worse, as antireform justices appeared to embrace any argument, no matter how flimsy, that they could use to kill reform.

    Let’s start with the already famous exchange in which Justice Antonin Scalia compared the purchase of health insurance to the purchase of broccoli, with the implication that if the government can compel you to do the former, it can also compel you to do the latter. That comparison horrified health care experts all across America because health insurance is nothing like broccoli.

    Why? When people choose not to buy broccoli, they don’t make broccoli unavailable to those who want it. But when people don’t buy health insurance until they get sick — which is what happens in the absence of a mandate — the resulting worsening of the risk pool makes insurance more expensive, and often unaffordable, for those who remain. As a result, unregulated health insurance basically doesn’t work, and never has.

    There are at least two ways to address this reality — which is, by the way, very much an issue involving interstate commerce, and hence a valid federal concern. One is to tax everyone — healthy and sick alike — and use the money raised to provide health coverage. That’s what Medicare and Medicaid do. The other is to require that everyone buy insurance, while aiding those for whom this is a financial hardship.

    Are these fundamentally different approaches? Is requiring that people pay a tax that finances health coverage O.K., while requiring that they purchase insurance is unconstitutional? It’s hard to see why — and it’s not just those of us without legal training who find the distinction strange. Here’s what Charles Fried — who was Ronald Reagan’s solicitor general — said in a recent interview with The Washington Post: “I’ve never understood why regulating by making people go buy something is somehow more intrusive than regulating by making them pay taxes and then giving it to them.”

    Indeed, conservatives used to like the idea of required purchases as an alternative to taxes, which is why the idea for the mandate originally came not from liberals but from the ultra-conservative Heritage Foundation. (By the way, another pet conservative project — private accounts to replace Social Security — relies on, yes, mandatory contributions from individuals.)

    So has there been a real change in legal thinking here? Mr. Fried thinks that it’s just politics — and other discussions in the hearings strongly support that perception.

    I was struck, in particular, by the argument over whether requiring that state governments participate in an expansion of Medicaid — an expansion, by the way, for which they would foot only a small fraction of the bill — constituted unacceptable “coercion.” One would have thought that this claim was self-evidently absurd. After all, states are free to opt out of Medicaid if they choose; Medicaid’s “coercive” power comes only from the fact that the federal government provides aid to states that are willing to follow the program’s guidelines. If you offer to give me a lot of money, but only if I perform certain tasks, is that servitude?

    Yet several of the conservative justices seemed to defend the proposition that a federally funded expansion of a program in which states choose to participate because they receive federal aid represents an abuse of power, merely because states have become dependent on that aid. Justice Sonia Sotomayor seemed boggled by this claim: “We’re going to say to the federal government, the bigger the problem, the less your powers are. Because once you give that much money, you can’t structure the program the way you want.” And she was right: It’s a claim that makes no sense — not unless your goal is to kill health reform using any argument at hand.

    As I said, we don’t know how this will go. But it’s hard not to feel a sense of foreboding — and to worry that the nation’s already badly damaged faith in the Supreme Court’s ability to stand above politics is about to take another severe hit.

    A version of this op-ed appeared in print on March 30, 2012, on page A27 of the New York edition with the headline: Broccoli And Bad Faith.

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