Society & Social Justice

I Have a Pre-Existing Condition

I have a pre-existing condition – does that mean I'm SOL for health insurance?

As a Canadian, the fact that I have a pre-existing health condition doesn’t affect my ability to access basic healthcare. Our health care system certainly isn’t perfect, but our publicly funded system costs a heck of a lot less than the privatized system in the United States. Unfortunately, things look like they could get a whole lot pricier in the U.S., and if I was an American, I would be getting awfully worried right about now.

The Affordable Care Act (aka Obamacare) prevents insurers from discriminating against or denying coverage to people with pre-existing health conditions, i.e. conditions that the person already had at the time their health benefits took effect. Wikipedia cites a Kaiser Family Foundation figure from 2016 that one quarter of Americans under age 65 had a pre-existing condition. That’s a lot of people.

The great pumpkin and the Republic party want to do away with Obamacare. The chorus of “repeal and replace” seems to have faded away and been replaced with a focus solely on giving Obamacare the heave ho. There are videos of the great pumpkin making pre-election promises not to leave people with pre-existing conditions high and dry, but that ship appears to have sunk.

A couple of months ago, CNN reported that the Trump administration supports a Texas district court judge’s ruling that the Affordable Care Act is invalid, and plans to support that ruling on appeal. Bring on the insanity.

So who is up shit creek if this goes down? A whole lotta people, including people who have mental illness. The most vulnerable people, and the people who are already getting the short end of the stick financially because illness, or the associated stigma and discrimination, gets in the way of working. These are people who are faced with enormous drug costs because their government is too busy blowing sunshine up Big Pharma’s ass to take action on outrageous drug prices in the U.S., which has some of the highest drug prices in the world.

The argument that insurance companies use, while of course not admitting that all they really care about is show me the money, is that by excluding people who would have high health care costs, they’re making insurance more affordable for people using fewer health services. Heck, while they’re at it, they should refuse to offer car insurance to people who actually drive their cars, or refuse to provide house insurance for people who don’t have 24/7 security guards.

It’s not just health insurance that trots out the pre-existing condition pony. The one time I bought travel cancellation insurance, I tried to make a claim, and they denied it for a supposed pre-existing condition, even though at the time I bought the insurance I hadn’t yet been diagnosed with depression. I have never bought trip cancellation insurance again and I never will, because my personal bias is that the whole thing is one big scam.

So here I stand, as a proud Canadian with a pre-existing condition whose government isn’t usually trying to kick me to the curb, and hoping that sanity will somehow prevail and health care systems everywhere won’t discriminate against those who of us who happen to be sick.

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35 thoughts on “I Have a Pre-Existing Condition”

  1. Not sure why wordpress said I wasn’t following your blog (how else did I get the email) but YES this is one of the biggest issues with what Trump’s administration is doing to healthcare. Like, ADHD is something I’ve had from birth, it’s hard to get more pre-existing than that. People often don’t talk about how much ADHD effects emotional regulation and my meds help me with that SO much that I haven’t been in acute hospitalization in like two years. Well that and antidepressants. Still though. For me these meds are a matter of staying alive. I don’t know what I’ll do if they’re not covered. Move to Canada maybe? It’s a ridiculous thing to have to think about leaving your home country just to get healthcare.

    1. WordPress has been doing some random unfollow lately for some reason.
      Covering people’s meds is not only better for the people who need them, but it also saves a whole bunch of money in hospital costs.

      1. Hospital costs, as well as costs for government funded healthcare, especially since preventative care often pays for itself. I feel bad for the doctors out there who are good but just caught up in the system.

  2. My concern isn’t about a mental health care situation, but a pre-existing medical condition that is life-threatening, I can’t get life insurance because insurance companies view my PKD as terminal. It isn’t always!!! I just don’t think the direction of healthcare is the right way these days, and I don’t think it’s Trump’s fault either. This stuff has been happening for a long time gradually.

  3. My comment got so wordy that I’m going to reblog your post and comment on my own about this. I worked in ‘insurance’ health care at the end of my career and I know the point where things went to hell. It was a republican politician who opened Pandora’s box, and things have been shitty in that regard ever since. Because insurance of any kind has no responsibility any more, answers to no one. They can do whatever the heck they like and get away with it. I was horrified when that first action happened, and my ‘paranoia’ about the consequences has been realized ten times over. What we need down here in the states is a complete revamp of our government and big corporations which include insurance companies and pharmacies. That’s not going to happen and the little guy will continue to pay for it. It’s demoralizing.

  4. Jeees, there’s still a lot I probably don’t know about the ins and outs of insurance in the US and Canada but I still get so infuriated on behalf of you all over there when struggling with it. With the travel insurance thing, you definitely shouldn’t have been denied if your pre-existing condition hadn’t even been diagnosed at the time of the cover! Absolute shamsters. x

    1. Canada’s pretty good about the basics of healthcare, as most things are publicly funded, but as soon as you start getting insurance companies and providers in it for profit then there are serious problems.

  5. You have no idea how angry I get over the healthcare/insurance topic. When I was “Finally Approved” for Medicare, I had to search for insurance. That was the most difficult and tedious thing I ever had to do. They still had Obamacare vs. the “Trump” plan running neck in neck. Neither one was affordable! Not a damn one. I spent nearly five months trying to find the lowest insurance, but one that would cover what I needed. Even now, I still can’t afford to see more than one doctor/therapist in the same month, plus the expense of my medications.
    You are so dead on with your comment, “It is demoralization. Big corporations have way too much influence over our government policies.” It’s disgusting!
    There are so many people suffering from medical conditions and these same people have to actually decide which is more important, “Eat or medication” – Not Right!
    I sure as hell never hear our government officials and the rich suffering in this way. As the ole’ saying goes… “The rich keep getting richer and the poor keep getting poorer.”
    A damn good topic, Ashley. It’s just one of many in this country that is really pissing me the hell off.

  6. I think it’s totally wrong to discriminate against a pre-existing condition, which probably everyone has (in one form or another). I feel blessed to have governmental disability, because it pays for any hospital stay (unless I’m only treated in the ER, in which case the hospital often waives the fee due to my low income), it covers drug costs (minus a very modest copay); and all I have to pay is doctor visits to see Dr. Phlegm, or if I go to the little clinic with a mild illness/injury. For years, I didn’t have insurance (pre-disability status), and Dr. Phlegm would provide me with Geodon samples by the bagful from his pharmaceutical providers. I’d also order it generic from Canada before it became generically available here in the US. But I no longer have to worry about the pre-existing stuff, which I think is horrid–talk about an easy way to deny someone coverage! Every health condition everyone currently has is already extant! My take as a Republican regarding Obamacare is that he messed up our healthcare massively by taking away the ability to keep your doctor; and that Trump’s trying to fix it by making it more accessible and streamlined. But I’m not very sharp politically; that’s just what I’ve picked up on.

    1. Whatever problems Obamacare may have, it’s hard to make healthcare more accessible if people can’t get or can’t afford insurance. I get that a conservative position would be against government regulation, but giving priority to money-making insurance companies over actual people is something that makes no sense to me.

      1. Good point, and you totally went over my head there! I’m not kidding about how poorly I understand politics! πŸ˜€

      1. Well, if I were to pay $150 a month, I could have doctor coverage. It’s just that I don’t pay that much to doctors each month, so it seems more prudent to reject the part-B coverage! πŸ™‚

  7. This is another topic that, like women’s right to choose, pisses me off. But it scares me, too, because I have a pre-existing condition. If my husband ever loses his job I’d be up shit’s creek. I hate to think what would happen.

  8. I agree with everyone who has said how infuriating and scary this is. Those who have access seem to forget what it must be like to be without what they need. Life with mental illness can be difficult enough without having to give an arm and a leg to get the necessary support.

  9. know more about my country than I do. I guess I refrain from watching all that stuff. I worry about other crap…which I probably should not worry about. The great pumpkin? I like that. I’m assuming that’s the name for our president. I really appreciate your article. It has taught me a lot. Ugh…. I certainly do have a pre-existing condition and I pay for private insurance through my work. It has been going okay…however, what I run in to is providers that don’t take insurance (therapists and psychiatrists). The insurance that I have will not pay for out of network providers …because I chose one (insurance plan) that seemed it would be more appropriate. Now I pay over $1000 a month sometimes out of pocket to see therapists and I won’t get any of it back. If I go with another plan, I will have to pay copays when I go to the doctor and also it won’t only pay 90% of the cost…so I was afraid of what my portion would be. I may have to consider it though. It sucks that all our country is worried about is making money…and could care less about the people. Thanks for this eye opener.

      1. Yes, it is. A credit card pays for all of that. And it’s maxed…like I’m talking $14K maxed. Then I stress about that.
        It is expensive.

            1. I think that’s why it’s so hard for me to wrap my head around the U.S. system, because Canadian “socialist” medicine is all I’ve known.

  10. My son has SVT, a pre-existing condition. He was born with it and we had no idea until he was in the fourth grade. He’s on Medicaid so he’s covered. Otherwise we would go bankrupt trying to pay his hospital bills, which is horrible to think about.
    Btw, the great pumpkin is a great nickname lol.

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