Opinion L.A.

Observations and provocations
from The Times' Opinion staff

« Previous Post | Opinion L.A. Home | Next Post »

The insurance companies' preexisting condition: heartlessness

HealthWe've all seen the images that testify to the increasing heatedness of the healthcare debate: pictures of   people bringing their heaters, 9 mms and AR-15s to town hall meetings. Toting your assault rifle in public seems a little over the top, but as long as the 2nd Amendment exists and the gun owners are complying with local law, it is their right to pack heat -- and I have the right to call them overcompensating wackos.

The extreme pressure from the right has even led President Obama to backpedal from his insistence on a public option. "The public option, whether we have it or we don't have it, is not the entirety of healthcare reform," Obama said at a town hall meeting in Colorado last Saturday.

For many of the low-income voters who made their $5 contribution to Obama's campaign and strolled out to the polls last November to elect their champion for reform, the president's retreat can't be good news. But how much can you fight back when a handful of your rivals are showing up to the debate with guns?

While the tug-of-war over what role a public option should take will not come to a head any time soon, both sides can agree that some degree of reform is necessary because the status quo is unacceptable.

One of the most egregious practices in the current system is insurance companies denying coverage because of a preexisting condition. The insurance companies say rescinding coverage, even for those who are gravely ill and in most need of medical treatment, keeps costs lower, deters fraud and gets more people the treatment they need more quickly. The practice of occasional rescission allows insurers to only have to do "random" background checks as opposed to poring over all medical records. So they say.

Yet too often the patients being retroactively denied healthcare are those in most need. Insurance companies quote the infinitesimally small one-half of 1% of people who face rescission each year to prove their point. But when you cover hundreds of millions of people, less than 1% is still a lot of individuals. And denying a cancer-stricken woman coverage just days before her surgery (watch the first video below) smacks of cold, hard cost-cutting, not the due diligence insurers say they are doing to save everyone else money. Insurers often claim rescission befalls patients who acted fraudulently. That may be the case for some people -- but the insurer of that poor woman said the same thing in denying her coverage because a doctor she had seen previously scrawled a note on her chart about (wait for it) acne.

Below are the testimonies of three individuals whose insurers denied them desperately needed coverage. They testified in front of a House subcommittee in June. The insurance companies' spokesmen responded despondently to the testimonies with a promise to do not much else than look into the situation. No one should have expected much more; after all, the insurance companies came in with a preexisting condition: heartlessness.

--Kevin Patra


Comments () | Archives (15)

The comments to this entry are closed.

Alan Shore

The public healthcare system here in New Zealand is amazing. We read these stories and it's hard to equate the lack of medical coverage with America being the richest nation. Rich? Maybe there is a lot of money, but the healthcare system is certainly broken in the US. Health is our only REAL wealth.

jimmy kraktov

The fact that the average family in the U.S. has to come up with the price of a small car EVERY year for their 'healthcare plans' should have every one of you livid.
When someone has a serious health problem such as a heart attack or is involved in a car accident and needs to be hospitalized for weeks, and the resulting bills he recieves puts him and his entire family into bankrupcy because his 'plan' doesn't cover him for all his expenses, or the insurance company cancels his policy because it will cost them too much , after he's paid tens of thousands of dollars in premiums, you cannot call that the 'finest health care system in the world.'
When I hear some of your Republican politicians speak of the horrors of 'socialized medicine', which, by the way, you people have had for decades in the form of Medicare, (yes, that IS socialized health care, wake up!) it makes me want to go right through my TV screen and throttle them.

You folks are being lied to, plain and simple. You have the resources, ie: the internet, so please, do your homework and stop being fooled, and foolish. An insurance plan that can be cancelled when you most need it is NOT insurance, it's a SCAM!!!

As I get older, I'm 59, I have really come to appreciate the fact that if I need healthcare, and I will, I will get it and it won't take a dime out of my hard earned retirement account.
Just sign me,
A Happy Canadian.

David Shedlock

Might I suggest an addition to the current proposals for insurance reform? I believe that we should forbid life insurance companies from rejecting applications from people who are already dead. Granted, my cousin Eddie didn't have life insurance, but of no fault of his own - He spent all his money at the liquor store. The evil greedy insurance should have to pay our family the $300, 000.00 policy that he would have bought last month had he known he was going to die while driving while intoxicated. Consider his death a pre-existing condition.

By the way, could you also make some car insurance company pay us enough to replace his Mercedes? I know he didn't have full-coverage for the vehicle, but he would have, if he knew, well, you know.

Pro America

Do away with "Pre existing condition" clauses, end rescission, offer Guaranteed Coverage mandates to all state health insurers via the "assigned risk" rules of auto and other liability insurance companies. Allow everyone who wants health insurance the ability of buying it. Make Health Insurance an "Above the Line" Form 1040 deduction so everyone can claim the expenses against their AGI and allow a Tax Credit up to 50% of the Premiums Paid for lower income families.
No socialized medicine, no Government Options are necessary. Fix what is broken, leave the rest alone.


The only outcome from the insurance legislation will be more money for the medical industry profits and less coverage. There is no way anything else can happen, too much money is a stake. Some people might think that even though you don't smoke, exercise regularly, drink in moderation, you could get reasonably price health insurance, even if you had a medical problem in the past or have a genetic problem that may make you susceptible to medical problems, dream on.

If you are rich and healthy, the insurance companies want you. Poor and sickly, pull the the side of the road and let nature take its course. The initial purpose of insurance was to spread risk. Under the guise of 'lowering' insurance costs (and also increasing executive bonuses), insurance companies will discard any client who threatens their profits (bonuses). Basically cherry-pick who they will cover to reduce the risk. You can get very good average care, but no catastrophic insurance. With the public-option now gone, any 'reform' from Washington will result in additional money for insurance companies to cover non-preexisting conditions and non-catastrophic conditions, only from a larger pool of people and with the approval of the government to gouge those with pre-existing condition (mandatory enrollment). So stay rich and healthy, and if you do have a pre-existing condition or an accident, well it is probably your fault anyway and if you were a 'real-American' you would either live with it or deplete your assess to cover the medial costs.

One additional comment to those who believe that government-sponsored insurance is bad. I can't believe that a government bureaucrat making decisions by following set guidelines will be less inclined to approve a procedure than a private insurer whose bonus depends on increasing profits (limiting expenses). Social Security had been operating for many decades and I never heard my mother complain that her check was later or the amount incorrect. Evil government bureaucrats.

John Bottari

Healthcare for all 

Before you go on reading I would like to emphasize the fact tha I am a canadian citizen. Therfore I have no interest either in the democratic or republican parties. My only goal is to let you know that canadians are lucky to have a universal healthcare system without any discrimination against rich or poor, healthy or sick. Canadians are insured from coast to coast and not one child lacks proper healthcare.

The Canadian healthcare plan is not as bad as some people would like you to think. In my humble opinion the lobby against the Obama-Biden plan is only a question of big bucks. Over 45 million of you do not have acces to any kind of health insurance. 8 million of your children cannot receive quality healthcare. Is that what you really want? D'ont you want the best for ALL americans, regardless of income? Do you think it is fair that a powerful and rich insurance company can refuse insuring you because you have a pre existing condition? I don't!

Insurance companies here in Québec and the rest of Canada, still have their share of this lucrative market. Nothing will stop american companies from profiting on healthcare. The only difference, if the proposed plan is adopted,is that there profits will not be earned on your backs. it is only normal that some people are against this plan. Change is rareley welcome when billions of dollars are concerned.

The major differences between my governmental healthcare plan and yours are the costs and accesibilty. Furthermore in my case healthcare is a right. In the US it is a privilege not available to everyone. Your constitution guarntees you the right to carry a weapon but omits you the right to having your life saved! Do you honestly think that is right? Nothing is perfect and neither is our plan. But would you rather have to wait a while for your child to receive care and medication that could save his life or for him not to be accepted because you can't afford it?

Think about it!

From a canadian in solidarity with the amercian people.

Jonh Bottari


Québec, Canada


Do you lefties really not understand that the insurance industry has been for profit and against loss of personal property for centuries? From the time that ships sailed & risked complete loss of all? Two suggestions: buy insurance, if only the catastrophic type; invest in insurance companies if you think their profits are so wonderful. This country better wake up & get off the anti-profit & anti-business kick before socialism brings us all "trickle up poverty" like Cuba!


If you force insurance companies to take all pre-existing conditions, then it's not insurance anymore it's a social program.
Let's be honest.

We don't force home insurance companies to cover a tin shack on the edge of a cliff or force auto insurance companies to cover Ferrari drivers with a history of drunk driving.

Jon Healey

@TK -- I don't wish you ill, but if you ever come down with skin cancer, thyroid malfunction or a variety of other chronic or expensive ailments that can afflict *anybody*, regardless of behavior -- and render them uninsurable in the current system -- perhaps you'll recognize how cruel your comment was. Health insurance isn't like car insurance in the sense of guarding against the completely unforeseen. It's partly that, but also partly a way to share the cost of the expected.

George Fulmore

My wife had breast cancer, found by her GYN, then confirmed by a mamography. She had a radical massectomy and chemo. She is now in remission. She has no chance of being accepted by an insurance company via an individual application at their "standard" rates. Her applications will be denied. How heartless is that? No one in the world can tell you how women get breast cancer. Sure, there are theories, but some are that it starts generations before and is no fault at all of the one who later gets the disease. Denying health care insurance to those who might need it most is heartless and wrong. We need health care reform in our country, and we need it now!


This healthcare bill may have a secret hidden agenda some may not have considered. The Dems and their supporters are pusing this healthcare bill because this may be another backdoor attempt to have the tax payers cover expensive treatments to persons exposed to HIV and AIDES, and future exposure due to risky behavior.

Jerry Lynn Dunaway


First of all, it's not AIDES, it's AIDS.

Secondly, you really think that this whole healthcare reform proposal is all about covering such "risky behavior?" So, the people who got HIV/AIDS from transfusions were participating in risky behavior? And even without that aspect, this is about allowing people who have no way to afford health insurance to get the treatment they need/deserve. No hidden agenda.

Just stay off here and keep reading the facebook page from the "quitta from Wasilla"

k lukac

Scenario: 24-year-old son gets Grade VI brain cancer. Medical student. Now on leave of absence. Insurance dependent on full-time student status, still on parents' plan. Still get coverage? No longer full-time student. Highly unlikely. Ever getting health insurance again? Not on your life.

Same scenario: Luckily, put student on own individual policy 1 year before diagnosis. Covered? Thankfully, yes. Pre-existing condition? Hard to prove. Isn't every cancer "pre-existing"? Could they rescind? Could have, but didn't. Thank the Lord. Ever get insurance again? Not in this lifetime, in this country.

BTW, parents pay a grand/month with a $5k deductible for the "privilege" of health insurance because they're self-employed. 6 more years to evil government-run program known as Medicare. Can't wait.

Shouldn't something be done? How can we call ourselves a civilized society?

Jarom Bowman

The publis option is a joke. Clearly the democrats have no idea about the serious repercussions this government plan would have on the economy, plus it's just one step closer to communism. The government has no right meddling in the affairs of the public, it’s unconstitutional. Not only that, everything they get involved with seems to fall apart. Sounds to me like Americans have forgotten that we have the best health care system in the world, primarily because it has no affiliation with the government. Look at every other health care system around the world that is government operated and see how it compares to ours, oh that’s right it doesn’t.

Captive Insurance

Yes, they're heartless. But, think about it from their perspective for a moment. They're a business. They have to make money to be around. If they're not, they wouldn't be around for all the others they insure. It sucks, but there it is.




In Case You Missed It...



Recent Posts
Reading Supreme Court tea leaves on 'Obamacare' |  March 27, 2012, 5:47 pm »
Candidates go PG-13 on the press |  March 27, 2012, 5:45 am »
Santorum's faulty premise on healthcare reform |  March 26, 2012, 5:20 pm »


About the Bloggers
The Opinion L.A. blog is the work of Los Angeles Times Editorial Board membersNicholas Goldberg, Robert Greene, Carla Hall, Jon Healey, Sandra Hernandez, Karin Klein, Michael McGough, Jim Newton and Dan Turner. Columnists Patt Morrison and Doyle McManus also write for the blog, as do Letters editor Paul Thornton, copy chief Paul Whitefield and senior web producer Alexandra Le Tellier.

In Case You Missed It...