Posts Tagged ‘American Dream’

Pre-Existing Medical Conditions Impact As Many As Half of All Americans

Wednesday, February 9th, 2011

A Department of Health and Human Services (HHS) study reveals that as many as half of all Americans under the age of 65 have pre-existing medical conditions, which could mean rejection by insurance companies or having to pay more for coverage.  According to HHS Secretary Kathleen Sebelius, that totals approximately 169 million people.  The report says that, of those Americans who are uninsured, 17 to 46 percent have pre-existing medical conditions, depending on the definition used. Such health problems are particularly common among adults aged 55 to 64 – a group long recognized as a problem spot in the healthcare system, because people of that age tend to have higher medical expenses but are too young to qualify for Medicare.

A Democratic analysis, released last fall by Representative Henry A. Waxman (D-CA), then the chairman of the House Energy and Commerce Committee, said that between 2007 and 2009, the nation’s four largest private health insurers denied coverage to about 650,000 people based on their medical history.

“Not surprisingly, as people age, their likelihood of having – or having had – a health condition increases,” according to Sebelius.  “Looking only at pre-existing conditions used in determining eligibility for high-risk pools, the percentage of Americans with these health conditions ranges from five percent of children to 48 percent of people ages 55 to 64.  Adding in common conditions that major insurers generally use in medical underwriting raises the risk to 24 percent for children, increasing to 86 percent for people ages 55 to 64.”

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans (AHIP), the industry’s lobbying group, offers a different opinion, noting that “We’ve long supported reforming the individual insurance market so that everybody can have access to health-care coverage, regardless of their preexisting medical conditions.  But this report exaggerates the number of people who are impacted.”

Rick Ungar, who writes for Forbes, offers another perspective and asks if pre-existing conditions are an indication that the American Dream is dead.  According to Ungar — who is an attorney in Southern California, and a frequent writer, speaker and consultant on healthcare policy and politics – his initial reaction to the government report was “Yeah…it made me suspicious too.  Go figure that this extraordinary government revelation would surface on the very day the House is taking up debate on the repeal of healthcare reform.”

Ungar’s suspicion eased when he read this additional quote from Zirkelbach.  “Most of the Americans included in the figures currently have insurance. They would be at risk,” he said, “only if they needed to change coverage and buy it on their own.  People who get insurance through their jobs are guaranteed coverage.” Alter+Care Inspire notes that an additional reason might be people losing their jobs – something to consider at a time when the private sector has been so sluggish.

“And there it was,” according to Ungar.  “This spokesman for the nation’s pre-eminent health insurance lobby was not only acknowledging that there are millions upon millions of people with pre-existing conditions who could be denied healthcare coverage, he was actually telling us that we need not worry about them because – so long as they continue to get their insurance through their job – it’s all good.  But what if they want to leave their job to engage in some good, old-fashioned American entrepreneurialism?  Did Mr. Zirkelbach inadvertently direct our attention to the depressing reality that up to one-half of all Americans may not be free to pursue their futures and fortunes as they see fit because they are trapped in their jobs by their healthcare benefits?  You bet he did.”