The Next March To Freedom

America has a new group among the marginalized. I'm not talking about people of any particular race, creed, sexual orientation, or gender. I'm speaking of the victims of corporate intolerance, the primacy of profit, and the corrupt politics of health care; Americans with pre-existing conditions. From victims heart disease to eczema, genetic disorders, to even minor ear infections, we're here, we're not profit-friendly, and thanks to governmental gridlock, we're screwed. It looks like it's going to be a long march to freedom.

In the bullet points of his healthcare proposal, President Obama wrote that one of his plan's priorities is to "end the discrimination against Americans with pre-existing conditions." The language, which seems more appropriate to a discussion of the civil rights movement than healthcare, was no mistake. Across America sick people have been finding it exceptionally difficult to find affordable health insurance. State policies intending to address concern about this have largely been a failure, leading to gaping holes in coverage or much higher premiums.

People with pre-existing conditions have the distinction of being the only marginalized group that is defined entirely by corporate interests and profit incentives. With Obama's proposal, our government is finally admitting that all Americans are not being treated equally, but, while we all theoretically have the final say in our government as voters, we are not represented in the boardrooms of WellPoint, GHI, and Aetna. In the past, activists have been successful at shaming our government into accepting its faults, at least some of the time, but Americans cannot even seem to shame WellPoint enough to get an adequate explanation of why premiums in California need to rise 39% this year.

Pre-existing conditions are a dangerous way to divide ourselves in a system of pooled risk because nobody is safe from them. News abounds of newborns being denied coverage for various "pre-existing conditions." In one extreme case in Colorado, a 17lb. baby was denied coverage when his insurance declared his "obesity" a pre-existing condition. Another newborn, mentioned by Sen. Harry Reid during his opening comments at President Obama's health summit, was recently denied coverage on a necessary cleft palate operation under the same rational. So when do pre-existing conditions begin? Conception? Birth? Apparently there is a grey area between pre-natal care and birth during which babies are not covered by insurance but are considered fully functioning human being. Pre-existing conditions for adults, meanwhile, can amount to just about anything that might allow HMOs to deny coverage, including old injuries, long-past illnesses, chronic but controlled diseases like asthma, and apparently even past abuse by others. (Domestic violence has been cited as a pre-existing condition.)

Maybe it's time to make a change. Like the major HMOs, taxpayers provide insurance for one of the largest pools in the country. We buy health coverage for millions of federal, state, and local workers, amongst them the very politicians who are financially invested in maintaining our exclusion from the system. If arbitrary criteria concerning our past health can be used against us in the name of corporate profits, why can't we use the same criteria against our customers, members of Congress and the Senate? From now on, we should only elect healthy people to public office. Politicians, after all, often remind us, how important saving taxpayer dollars is, even if it means excluding some people from necessary services.

If we had been as judicious as private insurance companies are, maybe we could have even rejected results of the 2000 presidential election. Vice President Cheney was and still is costing taxpayers thousands of dollars in treatment for his ailing heart. And once we're talking about conditions that make people a liability, perhaps we could have impeached Bush after the whole pretzel-choking incident for being dim-witted enough to be a danger to himself and the rest of us.

People with pre-existing conditions may become a financial liability to their families, their spouses, and their communities as it becomes more difficult for them to obtain insurance, but we cannot let them become scapegoats. They are not the reason a single-payer system is too expensive, health insurance premiums are always on the rise, or that healthy people can't afford insurance. HMOs have turned them, a vaguely defined and group that can include anybody they feel is too expensive to cover, into a straw man argument that purports to explain why insurance is so expensive. Pooling risk, as insurance does, is supposed to protect us from extremes. If under this system we can't take care of sick people or people who may become sick at some ambiguous future date, insurance not doing its job.

Perhaps one day Americans with pre-existing conditions will be able to stand with other Americans as equal members of peaceful, healthy society. And hopefully in that society, nobody will have to go bankrupt paying for healthcare.