Health Insurers Consider A Caesarean-Section Pregnancy A Pre-Existing Condition

Discussion in 'Healthcare/Insurance/Govt Healthcare' started by Modbert, Sep 18, 2009.

  1. Modbert
    Offline

    Modbert Daydream Believer Supporting Member

    Joined:
    Sep 2, 2008
    Messages:
    33,178
    Thanks Received:
    2,957
    Trophy Points:
    48
    Ratings:
    +2,962
    Think Progress » Health Insurers Consider A Caesarean-Section Pregnancy A Pre-Existing Condition

    Adding to the list that in seven states that being a victim of Domestic Abuse is a pre-existing, now is having a Caesarean-Section Pregnancy.

    So to go over the list of what is considered a "pre-existing condition"

    1.) Pregnancy
    2.) Survivor of Domestic Abuse
    3.) Caesarean-Section Pregnancy
    4.) Cancer
    5.) Diabetes
    6.) HIV/AIDS
    7.) Depression
    8.) Mild Asthma

    Feel free to add more that you know of.

    Also, on the topic of abused women who are survivors of domestic abuse:

    So, for all those of you against ALL types of Health Care Reform, and others. Thoughts? Opinions?
     
  2. Political Junky
    Offline

    Political Junky Gold Member

    Joined:
    May 27, 2009
    Messages:
    19,542
    Thanks Received:
    2,948
    Trophy Points:
    260
    Ratings:
    +5,534
    California's Real Death Panels: Insurers Deny 21% of Claims


    For Immediate Release
    September 2, 2009
    Print Text Only
    Tell-a-Friend


    California's Real Death Panels: Insurers Deny 21% of Claims

    PacifiCare's Denials 40%, Cigna’s 33% in First Half of 2009

    More than one of every five requests for medical claims for insured patients, even when recommended by a patient's physician, are rejected by California's largest private insurers, amounting to very real death panels in practice daily in the nation's biggest state, according to data released Wednesday by the California Nurses Association/National Nurses Organizing Committee.

    CNA/NNOC researchers analyzed data reported by the insurers to the California Department of Managed Care. From 2002 through June 30, 2009, six of the largest insurers operating in California rejected 47.7 million claims for care -- 22 percent of all claims.
     
    • Thank You! Thank You! x 1
  3. Modbert
    Offline

    Modbert Daydream Believer Supporting Member

    Joined:
    Sep 2, 2008
    Messages:
    33,178
    Thanks Received:
    2,957
    Trophy Points:
    48
    Ratings:
    +2,962
    Health Care Rationing does exist as I just mentioned in another thread. It's amazing how these companies think they can charge so much more and yet cover less. The arrogance on their part.

    However, when you have your profits up 428% from 2000 to 2007, it's no wonder why they're doing it.
     
  4. American Horse
    Offline

    American Horse AKA "Mustang"

    Joined:
    Jan 23, 2009
    Messages:
    5,741
    Thanks Received:
    892
    Trophy Points:
    153
    Location:
    The Hoosier Heartland
    Ratings:
    +938
    Not quite the same as what the OP implies.
    An insurer may - but some won't - make the determination, no doubt statistically, that a female who has had one caesarian section will more than likely fall into that same category during a subsequent pregnancy.

    A female purchaser of a health insurance policy will have a harder time finding a policy which will take her on, but by no means is she precouded from finding one, even though she has a recent history. Insurance companies already know that a female of child bearing age will probably have a child, and take those policies on by actuarily calculating the risk; from your post quoted above (bolded) indicates that she still "might have qualified," and that the Golden Rule company takes positive information into account.

    Insurance companies aren't providers of health care. But for a monthly premium they take on the obligation to pay for a large percentage of the cost of our healthcare to alleviate the burden of risk of high medical costs. The woman in this case could opt for sterilization, which would eliminate any risk of the need for a caesarian section. That would also probably earn her a lower rate for insurance since she would never again run the risk of becoming pregnant.

    And as for your last comment. About everyone, Democrat or Republican, believes our health care system needs reforming. Most of the solutions that have been real solutions have come from the R side, with the Ds holding back any ideas from that side so as to completely re-shape the whole health/medical sector. They have been rabid about it, for instance setting limits on the number of MSAs and HSAs because they will work, find satisfied customers, and add competition - siince people would be spending their own tax credit money to buy it - but also those instruments will undermine their opportunity to do a government take-over of the whole medical field.

    Some of what you say, like woman who have a history of being with men who abuse them are going to be risky to insure, either for health and yes even for life insurance, and that suggests the type of help they need.
     
    Last edited: Sep 18, 2009
  5. JW Frogen
    Offline

    JW Frogen Gold Member

    Joined:
    May 10, 2009
    Messages:
    6,165
    Thanks Received:
    1,167
    Trophy Points:
    153
    Ratings:
    +1,206
    We are only just down from the trees so it comes as no surprise people will kill for money.

    The men in ties behind dull desks have no immunity to this compulsion.

    In fact it is easier to kill with a stamp that says "denied" than looking a real enemy in the eye.
     
  6. Modbert
    Offline

    Modbert Daydream Believer Supporting Member

    Joined:
    Sep 2, 2008
    Messages:
    33,178
    Thanks Received:
    2,957
    Trophy Points:
    48
    Ratings:
    +2,962
    Ain't that the truth.
     
  7. auditor0007
    Offline

    auditor0007 Gold Member

    Joined:
    Oct 19, 2008
    Messages:
    12,566
    Thanks Received:
    2,255
    Trophy Points:
    255
    Location:
    Toledo, OH
    Ratings:
    +3,218
    They won't consider it a pre-existing condition if she's already had a hyterectomy though. You see, if a woman needs a C-section for one pregnancy, odds are extremely high that any later pregnancies will also require a C-section, and those cost money, so the insurance companies can't possibly take on the risk that she might become pregnant again. Remember something very important; insurance companies aren't here to do us a service; they are here to make money for their stockholders.

    Bottom line? Insurance companies and healthcare are a bad mix.
     
    • Thank You! Thank You! x 1
  8. auditor0007
    Offline

    auditor0007 Gold Member

    Joined:
    Oct 19, 2008
    Messages:
    12,566
    Thanks Received:
    2,255
    Trophy Points:
    255
    Location:
    Toledo, OH
    Ratings:
    +3,218
    This is the only thing I don't have a problem with when it comes to insurance companies and healthcare. They really are not making huge profits. Based on sales, their profits are only three to six percent. Unfortunately, insurance companies have created a bigger bureaucracy than the federal government could ever imagine, and this is driving up costs on both sides, from the insurance companies and the providers.
     
  9. Emma
    Offline

    Emma Evil Liberal Leftist™

    Joined:
    Mar 10, 2009
    Messages:
    5,377
    Thanks Received:
    757
    Trophy Points:
    48
    Location:
    On the street, acting all loud and tumultuous and
    Ratings:
    +757
    You don't even have to HAVE the 'condition' for it to be considered a pre-existing condition. I was denied private health insurance because of the supposed-pre-existing condition of 'biliary tract / gallbladder disease'. Since I most certainly did not have this, I contacted them to find out how they'd come to that conclusion. Seems they looked at some old hospital records where I was admitted for abdominal pain to rule out gallbladder disease and ran with it. Even though it WAS ruled out, they insisted I did indeed have that pre-existing (NON existent) condition and the denial stood.
     
  10. code1211
    Offline

    code1211 Senior Member

    Joined:
    Apr 8, 2009
    Messages:
    5,999
    Thanks Received:
    845
    Trophy Points:
    48
    Ratings:
    +845

    For the sake of comparison, a listing of the top 52 industries by profit. "Health Care: Insurance and Managed Care" ranks at 28th. "Wholesalers: Health Care" ranks at 47th. The one at 28 has more recognizable names in it.

    "Network and other communications equipment" is first and "Homebuilders" is last with a big negative.

    "Food Services" is 16th, so, the next time you get a Big Mac, be sure to spit at the counter person when they take your money.

    http://money.cnn.com/magazines/fortune/fortune500/2008/performers/industries/profits/
     
    Last edited: Sep 19, 2009

Share This Page