Mike the Mad Biologist

Keep in mind as you read this news item, this takes place in a country that spends thousands of dollars more per person for healthcare than other countries, including those that have a comparable per person GDP and median income. From Diabetes Health:

For most young adults, May is a month of looking forward. The month of May heralds summer vacation, and for those graduating from high school or college, it offers a diploma with a stamp of independence.

But Nicole Daley, a 23-year-old type 1 in New York City, warily eyes this impending milestone. She’ll be graduating from the Fashion Institute of Technology this month, and eight months later she will lose dependent status under her parent’s employer-sponsored plan–a deadline that has set her scrambling for health insurance. The clock is ticking: If she fails to secure coverage before her current plan expires, future carriers will view her diabetes as a pre-existing condition, and she’ll be forced to foot the bill for her diabetes care for at least a year, maybe indefinitely.

Most jobs available to recent graduates like Daley are low wage or temporary–the type that usually offer limited or no health benefits. She is working part time for a small marketing company, but the company can’t take her on full time. As a result, she is considering leaving her job to find something full time or leaving New York City altogether, where the cost of living, combined with her medical expenses–more than $1,000 a month, she estimates–is too much to bear.

Welcome to the real world, or, more precisely, the reality facing young adults with diabetes in America today.

If you read the article, it gets worse. Then there’s this little bit from Kaiser Health News about quality health care for federal workers (italics mine):

Toni knows she’s fortunate. This summer, she went to a summer camp for kids with diabetes. And she saw what kids do when they don’t have good health insurance. “At camp they provide you with supplies, but I’ve seen kids who have saved their needles and taken them with them,” she says. “Even though you weren’t like supposed to, they would kind of sneak them just to make sure they would have something when they got back home.”

Toni and Rhonda know that when people don’t have good insurance, they’re so desperate they will even reuse a needle. “It gets dull. And so it really hurts. But you have to have insulin, just like I said,” Rhonda says. “I mean, without insulin, Toni would die. So you, take the pain in order to live.”

The insurance companies’ treatment of juvenile diabetes illustrates how morally decrepit these companies are–which makes the Blue Dog Democrats’ defense of them all the more reprehensible. Why? Because juvenile diabetes is an autoimmune disease–a kid basically wakes up one day and her pancreas can’t produce insulin ever again. This has nothing to do with ‘bad behavior.’ Moreover, this disease practically defines the notion of social insurance: this is the healthcare equivalent of a thunderbolt from a clear blue sky. This is why we have health insurance. It’s as ridiculous as charging people more for getting old.

But, by all means, let private insurers essentially write healthcare legislation. I’m sure it will only be a problem for juvenile diabetics, right?

Comments

#1 The Ridger
September 29, 2009

Insurance companies are not in the business for moral reasons. They don’t care about your health. They are for-profit institutions who whose first – perhaps only – obligation is to their stockholders.

Simply put: every penny they pay on a a policy is a penny they don’t make in profit.

I don’t blame them; if they acted differently their shareholders would be defrauded.

I just can’t quite see why we let people whose jobs, whose whole reason for being, is not to pay out any money if they can help it be the ones deciding who gets paid and who doesn’t.
#2 Woody Tanaka
September 29, 2009

The fact is that we, as a country, permit these companies to act in this manner. We, as a society, could and should impose upon them a duty to their insureds that is higher than the duty they owe their stockholders. We could, very simply, pass a law which did not permit these companies to consider pre-existing conditions as a basis for limiting or denying coverage.

But we don’t. Because enough of us, most of whom pull the “R” at election time, simply care more for money than for people in need. They delude themselves that they’re not evil, by repeating lies about “the miracle of the markets” and other similar juvenile fantasies, as the solution to these problems, wholly ignoring that it was this same system that caused the problem to begin with.

Time to make all insurance non-profit or to introduce a true public option safety net, available to all, as true competition for the oligarchy of insurance corporations that we have now.
#3 JohnV
September 29, 2009

This is the sort of thing that makes me laugh/gives me ulcers when my reactionary acquaintances say things like “who wants some mindless government drone in charge of health care?”

Since these people, as Woody notes above, worship profits over all else, my response of “I certainly prefer that to someone who makes money be denying my claim” falls of deaf ears.
#4 Tony P
September 29, 2009

It isn’t just medical care. We’ve had a group of 30 to 70 homeless people camping out throughout Providence, RI, and now moving to Pawtucket, RI.

You would not believe the mean spirited comments on the news site. These people are probably one pay check from the streets themselves but they’ll say things like:

“They’ve got time to give interviews but not time to go interview for a job..”

As someone who has been job hunting for a while now I can tell you it isn’t that easy.

And no, not homeless but it’s a constant threat.
#5 eNeMeE
September 29, 2009

That’s just ugly.

And re-using syringes sucks giant donkey balls (which I’ve only done when I’ve run out with no access to a pharmacy). Nothing quite like the experience of waiting a half second as your skin dimples since the needle isn’t sharp enough to pierce the skin and it takes a whole lot of pressure to force it through…
#6 Colin
September 29, 2009

My girlfriend has Type I Diabetes but luckily we’re in Germany. Last week she got a call from her health insurance to remind her to go for her doctors appointment (as far as I understand, insurance companies in America rarely encourage their clients to use their services).

At the moment she has to pay a small amount for every prescription (€5 every time), but once she finishes university and loses her family plan she won’t have to pay anything (only people who make enough money are changed a prescription fee).
#7 David
September 29, 2009

Any chronic disease with high incidence in the teenage years creates the same problem. In mental health, it’s bipolar disease and schizophrenia. In those cases, the illness can prevent the patients from obtaining stable employment, and so they become uninsured.
#8 natural cynic
September 29, 2009

they’re so desperate they will even reuse a needle.

If you knew very many diabetics, you would be less surprised than Capt. Reynaud. Shocking!! Actually not, most diabetes educators that I have encountered will say “Don’t do it” with a wink and a nod or “Well, you can do it, but you didn’t hear it from me”. And a dulled 31 gauge needle is still better than a new, sharp 28 gauge disposable that was used 2-3 decades ago and it is ridiculously better than boiling glass syringes with sharpenable needles from 50-60 years ago.

or leaving New York City altogether, where the cost of living, combined with her medical expenses–more than $1,000 a month, she estimates–is too much to bear.

?? Ambiguous. Is her COL+meds in NYC $1k/month, in which case it is shockingly low, or her meds are $1k/month, which is shockingly high. See Toni in the second quote needing a more reasonable $200/month with pump supplies. [unless Nicole has severe complications and needs monthly MD visits].

But, yeah, being a diabetic without single-payer universal insurance sucks!
#9 Paul Murray
September 30, 2009

“Insurance companies are not in the business for moral reasons. … They are for-profit institutions who whose first – perhaps only – obligation is to their stockholders.”

Insurance companies are fictional persons – homonculii, if you like – created (incorporated) by the state. The state is free to define their purpose, and to require that they not act contrary to the public interest.

This notion that stockholder profit is their only obligation is not at all a given, and a generation or so ago it was understood that all corporations were obliged to be a good “corporate citizen”.

The rightful monitor and guardian of the public interest is a democratically elected government, and it is long past time that that government began revoking charters.
#10 ABM
September 30, 2009

You would not believe the mean spirited comments on the news site. These people are probably one pay check from the streets themselves but they’ll say things like:

“They’ve got time to give interviews but not time to go interview for a job..”

This sort of thing is the middle class whistling through the financial graveyard. It’s another woman looking down on a girl who gets raped at a party in college. In other words, we want to believe that victims of misfortune are inherently different from us, because that means we won’t ever have to worry about ending up like them.
#11 william e emba
September 30, 2009

Insurance companies are not in the business for moral reasons. … They are for-profit institutions who whose first – perhaps only – obligation is to their stockholders.

Insurance companies are fictional persons – homunculi, if you like – created (incorporated) by the state. The state is free to define their purpose, and to require that they not act contrary to the public interest.

We already do this with banks. Banks are pretty much pwned by the Fed, which for the most part tries to not intervene, but boy, can they move fast.
In contrast, the whole point of a public option was, in effect, to simply drop one highly regulated insurance company into the mix. Said company is to intentionally act in the public interest.

Right now we have to wait forever for Congress to notice that insurance industry dirty tricks have gone too far and should be regulated upon, and then of course another round of dirty tricks will get invented and again the public will get fleeced. But if one large company can set a high standard, the others will have to play nice just to stay in business.

Of course, they won’t be able to make ridiculous profits by breaking contracts willynilly anymore, but you can’t have everything.
#12 NoAstronomer
October 1, 2009

‘This notion that stockholder profit is their only obligation is not at all a given, and a generation or so ago it was understood that all corporations were obliged to be a good “corporate citizen”.’

Ah the good old days. Stockholder profit may not be the only obligation, but it is the number one obligation. Remember the existence of any company is solely dependent on it’s investors. If they don’t think they are getting a good return they pull their capital and the company eventually ceases to exist one way or another.

I certainly agree that penny-pinching on needles is foolish and almost certainly counter-productive. I’m sure that the money saved on needles is out-weighed several times by the few extra ER visits required across the population.
#13 Damitall
October 4, 2009

How can any society call itself civilised when it withholds help from a young person, sick through no fault of their own, who could become and remain a useful and productive citizen, in employment and paying taxes? It’s stupid, unjust and barbaric; the more so when it happens in the wealthiest nation on earth
#14 sailor
October 4, 2009

Insurance, as it is conceived at this point, is about taking out a policy against the “chance” of something happening. When you have an illness, there is no chance – it is a certainty, so no insurance company would reasonably take on such a case.
This is why private insurance companies are a poor way to go.