The Politics of Pre-Existing Conditions

Throughout President Obama’s tenure in office, we’ve heard a lot of talk about pre-existing conditions.  The public has been inundated with studies and polls attempting to sway opinion in favor of eliminating these alleged hurdles to obtaining quality health insurance.  We’ve heard from politicians, statisticians, and pundits, but who can remember hearing from anyone personally affected?

I’ve been particularly interested in the passage of ObamaCare precisely because of its implications for pre-existing conditions.  Last Tuesday, a U.S. government study reported that as many as 129 million Americans under age 65 face rejection or higher premiums from insurance companies due to pre-existing medical conditions.  Arguments have ensued that this number is inflated and not reflective of reality.  Frankly, I’m not sure whom to believe.  That pre-existing conditions are a real problem affecting Americans cannot be denied, but what’s the real story?  Who is talking to those people whose lives have been drastically altered by their insurance company’s decision to deny benefits, or who have been unable to obtain credible coverage at all?

You see, I’m one of those unfortunate “statistics” who fell through the cracks of the health insurance industry as we know it.  When I was in college and covered by my father’s health care plan – a top-notch union negotiated plan, no less – a congenital condition with which I was born necessitated a series of reconstructive surgeries.  Because I obtained employment with a small business that did not provide health insurance, I continued coverage through my father’s insurance plan on a COBRA policy.  At the end of this 3-year period, I sought to purchase an individual plan. 

The obstacles my family and I faced along the way to obtaining individual coverage were virtually insurmountable.  We were met with a plethora of mis-information, discrimination, and rejection.  The companies that denied my applications informed me of my “rights” under HIPAA to purchase an adjustable-rate policy that would not contain riders, but the cost would vary month-to-month starting from $500 - $700.  This was neither realistic nor how the provisions regarding pre-existing conditions in HIPAA were meant to facilitate increased access to coverage.

Of the numerous health insurance companies to which I applied, only one was willing to insure me, and that policy contained riders for my congenital condition as well as other health issues for which I’d sought treatment in the past.  In other words, this company was willing to cover treatment for anything except the conditions for which I required care. 

To be fair, I didn’t entirely blame the insurance companies.  If I was on the other end of the stick, I’d have a few qualms about insuring a high-risk applicant too.  Yet, I had no lapse in coverage.  I had not acquired health problems through poor diet, lack or exercise, smoking, excessive alcohol consumption, or other behavioral risk factors.  I just had the simple misfortune of being born with a condition that required care, and as a result had been – for all intents and purposes – blackballed in the industry. 

This anti-big-government, pro-states rights conservative admittedly leapt out of her seat when she learned of ObamaCare’s provisions regarding pre-existing conditions.  Even as I unilaterally condemned this massive expansion of government, the affront to individual liberties through compulsory conscription into ObamaCare in the name of the “Commerce Clause,” and the potential probable bankrupting of small business (and our nation), I had to acknowledge ObamaCare would in some regards help me.

As conservatives in Congress have mounted an attack aimed at repealing ObamaCare and 26 states have filed lawsuits against the federal government, I couldn’t help but wonder if it was the federal government’s responsibility to overhaul the industry simply because some unknown percentage of the population undeniably needs intervention and regulation.  The Constitution-abiding conservative in me quickly answers no, but the private citizen who has been forced to pay hundreds of dollars out-of-pocket for x-rays knows reform is long overdue and absolutely necessary, especially for those employed by small businesses.

According to most polls, most Americans are generally content with their healthcare options; despite the riders on my policy, I, too, must admit I have access to the best healthcare in the world (an opinion reinforced by a recent trip to Europe).  Gallup polls show this country has not reached a consensus on ObamaCare – 46% of Americans support Republican led efforts to repeal the law, 40% are in favor of the law as it was written, and 14% are ambivalent.  It’s little wonder the nation is so divided.  None of us, including Mrs. Pelosi, knows precisely how the bill’s passage is going to affect our wallets or the health insurance marketplace, so we rely on imprecise statistics and economists’ predictions, hope for the best, and prepare for the worst.

Following the passage of ObamaCare, many large companies announced that the costs of providing health care to their employees would necessarily skyrocket: AT&T, $1 billion; Verizon, $970 million; Deere & Co., $150 million; Boeing, $150 million; Caterpillar, $100 million; Prudential Financial Inc., $100 million; and Lockheed Martin, $96 million.  Moreover, there have been numerous conflicting studies concerning how much the implementation of ObamaCare will increase the federal deficit, but nearly all agree that it will increase.  

Though my struggles with insurance have been great, I have been blessed in several regards – the riders on my policy were not for life-threatening conditions, and I have family who would give their last dime to ensure I received necessary medical treatment.  Others with similar obstacles haven’t been so fortunate.  There are many in this country whose stories are not unlike my own, and whether they number in the hundreds or millions, their stories matter.  Those who denounce recent statistics as “liberal propaganda” need to remember there are faces and names behind numbers.

While I applaud this administration for bringing pre-existing conditions and other deficiencies in the healthcare system to light, I do not believe ObamaCare, as the law is currently written, is the panacea liberals hyped.  Even as I wrestle with the question if health care is a basic human right or a privilege, I know the answer to my own dilemma is not to impose a mandate on someone else or bankrupt the country for the sake of “fairness.”  That’s precisely the lack of personal responsibility that’s wrong with this nation – from Wall Street charlatans down to those able-bodied persons who pilfer social security disability benefits.  

I don’t begin to have the prescription for what ails the insurance industry, but ObamaCare surely isn’t it.  Real reform can be achieved without removing the American citizen from the decision-making process regarding his / her health care, and it can certainly be done so while adhering to the Constitution and free-market principles – by allowing individuals to purchase health care coverage across state lines – to name one.  For those facing pre-existing conditions, centralized control of health care in the hands of Washington bureaucrats and the HHS is simply more of the same lack of choice and competition that allowed insurance companies to implement these restrictions and will surely result in lesser personal freedoms than we currently enjoy.  Don’t give Washington the very power insurance companies banded together to divest from us.

 

"Let's Move!" Away from Party Lines to Combat Obesity

"If people let government decide which foods they eat and medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny." 

 Thomas Jefferson 

Everywhere we turn, someone is telling us what, how, and when to eat.  From Marie Osmand touting Nutrisystem success to newly svelte singer and actress Jennifer Hudson boasting of her Weight Watchers victory over the battle of the bulge, the diet industry has become big name and big business.  Each new fad promises a seemingly more effective and exercise-free way to become healthy and stay slim than the last.

In the 1990s, we were told that fat makes us fat, and yet as we filled up on pasta, bagels, and non-fat yogurt, we filled out.  This decade, we have learned that the Dr. Adkins’ theories of low-carbohydrate diets may be more effective at producing weight loss and effecting positive metabolic changes than previously believed.  Even as we stopped vilifying meats and cheeses and the Doctor was seemingly vindicated, his theories haven’t solved the complex problem of obesity.  We’ve been told to monitor our weight according to the mathematical formula of body mass index, but this measurement fails take into account age, gender, or muscle mass or to distinguish between lean body mass and fat mass.  According to this index, a bodybuilder would be considered overweight.  With the constant bombardment of competing and conflicting information about nutrition, it is hardly baffling that obesity and morbid obesity are on the rise, especially in our nation’s youth.  

Television shows such as The Biggest Loser highlight the growing national interest in addressing obesity, which the CDC now recognizes as a “national health threat,” and its “behavioral risk factors.”  More recently, the federal government has confronted childhood obesity.  President Obama created the Task Force on Childhood Obesity to “conduct a review of every single program and policy relating to child nutrition and physical activity and develop a national action plan.”  In conjunction, Michelle Obama’s "Let’s Move!" campaign has brought the need to address nutrition and physical activity to the forefront of national consciousness.  Mrs. Obama admitted she would employ whatever means necessary to effect real change: “No one gets off the hook on this one from governments to schools, corporations to non-profits all the way down to families sitting around their dinner table."  In December, the U.S. House of Representatives passed “The Healthy, Hunger-Free Kids Act,” which contained key measures that will help improve the nutritional content for school lunches and combat childhood obesity.  

Mrs. Obama’s campaign has come under attack by many conservatives, who decry government intervention at any level and argue it will lead to an Orwellian Nanny State for food.  Rush Limbaugh told one of his callers that she would be reported to Mrs. Obama for “being part of the obesity problem.”  On his Fox News show, Sean Hannity sardonically questioned, “Does every American family need a dietitian appointed by the government to tell them that this food is going to make you fat and this food is not?”  Glenn Beck linked government takeover in the health care industry to the need to police food intake.  His libertarian sentiments were captured when he not so eloquently declared, “If I want to be a fat fat fatty and shovel French Fries all day long, that is my choice.”  More recently, Sarah Palin impugned Mrs. Obama’s obesity initiative:

“Take her anti-obesity thing that she is on. She is on this kick, right. What she is telling us is she cannot trust parents to make decisions for their own children, for their own families in what we should eat. And I know I’m going to be again criticized for bringing this up, but instead of a government thinking that they need to take over and make decisions for us according to some politician or politician’s wife priorities, just leave us alone, get off our back, and allow us as individuals to exercise our own God-given rights to make our own decisions and then our country gets back on the right track.”

Governor Mike Huckabee, who has been an outspoken advocate for exercise and healthy eating, defended “Let’s Move!” following Governor Palin’s comments: “With all due respect to my colleague and friend Sarah Palin," Huckabee said during an interview on the Curtis Sliwa Show, "I think she's misunderstood what Michelle Obama is trying to do."

As a conservative with libertarian leanings, I’m tempted to tow the party line with regard to President and Mrs. Obama’s initiatives.  Even as I recoil at the creation of task forces and know that the cure for government intervention is never more hair of the dog, as we observed with the healthcare, financial, and auto industries, conservatives cannot simply deny the obesity epidemic.  While I believe Obamacare is more about control and government expansion than it is creating equitable access to healthcare, I cannot deny the need for public awareness about obesity, and “Let’s Move!” is stimulating much needed conversation about weight loss, healthy living, and physical activity.  Admittedly, Mrs. Obama’s campaign has the potential to grow government, and its ties to SEIU are predictable.  Yet, I’m under no dis-illusion that Mrs. Obama or the fairy “food police” are suddenly going to begin jailing parents who serve Pepsi. 

As a fitness enthusiast, I find it appalling that so many prominent conservatives have turned a blind eye to the obesity epidemic in the name of individual liberty.  Historically, First Ladies have championed important social causes from anti-drug campaigns to literacy, and there are none more pressing than the health risks associated with obesity such as Type 2 diabetes, cardiovascular disease, and high blood pressure – to name a few.  These conservatives fail to realize that there is no freedom in the saga of yo-yo dieting and plethora of mis-information that exists about nutrition and fitness.  Ask anyone who’s ever purchased a can of Slim Fast or gone on the “cabbage soup diet.”

Though conservatives are correct that the Obama administration has no right to control the foods we eat as Jefferson once said, that is not the stated or implied goal of "Let's Move!"  The health of our nation is not a liberal or conservative issue – it is a moral one that should cross party lines.  It is a travesty that this topic has simply fueled the culture war between liberals and conservatives rather than stimulating honest discussion and plans of action.

Fad diets don’t work, because they are gimmicks designed to produce short-term weight loss rather than long-term lifestyle changes.  Mrs. Obama’s campaign promotes those changes by empowering parents with information, providing healthy food in schools, improving access to healthy, affordable foods, and increasing physical activity.  Each of these elements is integral to improving the health and quality of life for our nation's youth and our nation as a whole.  Of all the policies this President and his administration have implemented in this "fast-food nation," this is the first real change this conservative can believe in.

~ elf