Healthcare

One of the issues with which Obama, and to be fair, Clinton, have been dealing is healthcare and the need for reform in that area. Frankly, I couldn't agree more. The US is the ONLY first world country that does NOT provide universal healthcare for its citizens. Instead, we're stuck with either health insurance from one's place of employment, which works fine for many people. But it can also get expensive. On a personal level, for instance, my wife's health insurance from her company (I'm self-employed and don't make all that much money, so no insurance from my end) cover the two of us, but not our two children, as that would nearly TRIPLE the cost, and we just can't afford it. So we pay for the children as we go and pray they stay healthy. This is really NOT a good way to live, but at this point, we have no choice, so I'm all for healthcare reform, not just because it greatly affects me, but also because it's a huge issue in US living.

In the meantime, though, the only other option is private insurance. Ok, so for those of you out there who know me personally, you know I'm overweight. Very overweight. A few years ago, I worked diligently at losing weight and lost ninety-four pounds, a large percentage of which I've since gained back. I know, it sucks. But, I'm trying to work on it.

So, let's say I wanted to get private insurance. Here's how the conversation/exam would go:

Insurance agent: "Do you smoke?"
Me: "No."
IA: "Drink?"
Me: "No."
IA: "Do drugs?" (Ok, they wouldn't ask in those words, but that IS what they ask...
Me:"No." Or, if I'm in a feisty mood: "You're kidding, right? And if I did, do you think I would admit it?!"
IA: "How much do you weight?"
Me: "three-hundred plus pounds."
IA: "I'm sorry sir, but we can't insure you. You have a pre-existing condition."
Me: "But aside from the weight, I'm in perfect health!"
IA: "I'm really sorry, but you have a pre-existing condition which prohibits us from insuring you. Have a nice day."

End of conversation.

Except here's scenario number two:

We have insurance through a place of employment (in this case, my wife's). I'm really serious about losing weight again, but as we all know, like other addictions, it's nearly impossible without some kind of support, especially medical so a doctor can monitor progress, blood pressure, cholesterol, blood-work, and whatever else. Make phone call to insurance company. Here's how that conversation goes:

Me: "Hi! I'm calling to find out about weight loss coverage. I'm very over-weight and have a doctor who has a program to help me lose all the weight. Is that covered?"
IA: "No. We don't cover weight loss."
Me: "Why not?"
IA: "We don't really consider it a medical condition."
Me: "Why not?"
IA: "We just don't. You gained the weight, you can lose it. Like smoking. You started, you can stop."
Me (aside): "Yeah, like that really works"
Me (to IA): "Now let me get this straight. If I were to call you to apply for insurance, you would deny me because I'm grossly overweight, right?"
IA: "Correct." Ok, they wouldn't really come out and say that, probably because they're not allowed to, but when you get through all the fluff, that is what they end up saying. Need proof? See the first scenario, above. It actually happened to me.
Me: "And you would deny me insurance because it's a pre-existing condition, right?"
IA: "Right."
Me: "And yet, here I am, calling you about my 'condition' and asking you to cover my medically monitored weight loss, a 'condition' you are implying is medical because you would deny me coverage if I was applying for private health insurance, and you're telling me it's NOT a medical condition. So, um, which is it, because you really can't have it both ways."
IA: "Well, sir (a whole bunch of gobbledegook about how it is but isn't, depending on which side of the insurance you, whether you have it or not)."
Me: "Aha. So you're basically saying if I don't have insurance, I can't get it because I have a pre-existing medical condition, but if I do have insurance, the insurance won't cover the weight loss because this is not a medical matter and because I can just lose the weight on my own. Have I got that straight?"
IA: "Yes, sir."
Me: "Do you have ANY idea how incredibly ridiculous you sound?"
IA: "No, sir. I'm sorry, sir, but that's policy. Sir."
Me: "OK, now let me ask you this. Do you cover gastric bypass surgery?" (For those who don't know, click here. It's a complicated surgery that does help with weight loss, but can be dangerous and can lead to all sorts of other problems, both psychological and physical.)
IA: "Yes. Yes, we do."
Me: "Uh-huh. So, then, you cover gastric bypass surgery, a costly medical procedure SPECIFICALLY geared toward allowing a person to lose weight, a condition you just told me was non-medical and therefore not covered. But you won't cover MUCH less expensive (downright inexpensive, comparatively) medically monitored weight loss. Explain that, please."
IA: "Um. Ah. I'm... Um. Well, sir, I'm not sure I can, but that is company policy. Sir."
Me: "So, just to get this straight, so I have it for my records: You will not cover medically monitored weight-loss because you don't consider obesity to be a medical condition, and you wouldn't cover me if I was applying for private insurance because it's a pre-existing condition. Correct?"
IA: "Yes, sir. That is correct."
Me: "So which one is it?"
IA: "I'm sorry sir, but that is company policy."
Me: "Alright, then. You have a great day!"
IA: "You too, sir, and thank you for choosing Hypocrisy Medical."

Oh, and just for the record, even though I knew how the conversation would go, I still called my insurance company and had the conversation anyway, just to prove myself right. And I did. And when I asked her the question about obesity as a medical condition when applying for insurance but not when you already have it, she agreed that it made no sense. Then she said some nonsense to me about if they covered medical, non-surgical weight loss, they'd have to cover other things, like going to a health spa. That one really took me by surprise! Imaging if the insurance companies covered health spas! "Hi, my doctor said I need to go to Club Med for three weeks, and since my doctor prescribed Club Med, you guys get to cover my excursion! Thanks!!" How stupid is THAT?!

All joking aside, though, this is a VERY serious issue, at least for me and for the MILLIONS of overweight Americans. The medical community across the country has for YEARS been stating obesity is not only a serious medical condition, but a SERIOUS medical condition that afflicts MILLIONS of people. And yet, the all-powerful insurance companies choose to ignore this. Worse, they use it as an excuse to NOT offer coverage to people, further causing even more people to be forced to live without insurance.