Just because "coverage" is guaranteed doesn't mean claims will be paid

One thing I am not hearing anything about in the so-called "health care reform" debate is the actual payment of claims. We are hearing a lot about "coverage" but nothing about claims. As anyone who has ever fought with an insurance company knows, you can be covered for any number of things, but getting the claim actually paid is another story. Somehow I think that when all is said and done, what we will end up with is a mandate to buy insurance that professes to "cover" pre-existing conditions, but that still won't pay related claims. And in case you think that pre-existing conditions only cover major illnesses like heart disease and cancer, guess again.

We've already seen that being a victim of domestic violence or wanting to have a child constitute pre-existing conditions. (So much for "family values", eh?) But as Consumer Watchdog points out, there are any number of ailments small and large that the insurance industry deems to be pre-existing conditions, including:

• being an air traffic controller, professional athlete, police officer, or war correspondent


• taking prescription allergy medications


• having ever had a toenail fungus


• having ever had acne


• being an expectant FATHER


• having ever sought therapy or counseling


• any symptoms for which you did not consult a doctor


• taking Lipitor or similar statins for high cholesterol

In other words, simply not being dead constitutes an uninsurable pre-existing condition.

Remember, "coverage" is not an agreement to actually pay claims. So when politicians, even Barack Obama, talk about "coverage", don't be fooled. Until you start hearing a requirement to actually pay out, it's all a big wet kiss on the buttocks of insurers.

(via ThinkProgress and Cookie Jill, who notes that "the insurance companies are creating 15 - 9/11's each year in the number of american deaths due to lack of coverage, under coverage and denial of coverage.")