Newborn with Birth Defect Denied Coverage

[shropshire 0]

Quote

Quote

I have ZERO problem with my tax £s helping kids like this - ZERO It would be completely heartless of anyone object.

I would pull back all of our troops from abroad and spend all that money on building our next generations rather than assisting in destroying someone elses.

You know, If we pull our troops from abroad, all those countries cited will have to increase their military spending considerably to make up for the holes left by us. All your free health care would have to disappear. Or something else would have to give. I think the U. S. should maybe stop "providing" free health care to the rest of the world and maybe start focusing on us.

Would it fuck

(.)Y(.)
Chivalry is not dead; it only sleeps for want of work to do. - Jerome K Jerome

[mnealtx 0]

Quote

Why is it, I wonder, O,.K by some Americans for their tax $s to be spent slaughtering innocent people but not making life easier for the less well off, at home

I'm sure Gawain and our other vets appreciate being referred to as having 'slaughtered innocents', Tone.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[TrophyHusband 0]

Quote

Quote

The blame belongs:
(a) On a micro level, on the parents for not following the rules of the system as it currently exists in the US;
(b) on a MACRO level, on the US for being the only First World country* in the world for whom this child's condition would not have been automatically guaranteed coverage from birth.

+1

I can't believe so many people are blaming the parents ... that's just plain weird to a European

because the parents are responsible for taking care of their children, not the government. this was not something out of their control, this child would be covered if the parents have been insured themselves.

"Your scrotum is quite nice" - Skymama
www.kjandmegan.com

[shropshire 0]

Sorry mate - bit harsh But innocents have been killed in that daft war

(.)Y(.)
Chivalry is not dead; it only sleeps for want of work to do. - Jerome K Jerome

[Andy9o8 0]

Quote

Why is it, I wonder, O,.K by some Americans for their tax $s to be spent slaughtering innocent people but not making life easier for the less well off, at home

Truthfully? Because, historically, The Powers That Be need to keep the common people in fear of a Great Boogeyman to hate and fight against, in order to justify a permanent national security state with which to compromise the US Constitution (latest installment: US Patriot Act), and a state of virtually endless war (hot, cold and tepid) in order to justify mass expenditures on the military-industrial complex. It was a strategy cooked up by Dean Acheson, and implemented by the signatures of Harry Truman, in 1947. Ever since then the US has been at war with Communism, until the Soviet Union finally collapsed.

Once that happened, the US needed a new Boogeyman. It quickly found one: Terrorism/Radical Islam. Now we're in a permanent War on Terrorism (and radical Islam). And it's hungry, and has to be fed. So fuck other priorities - they're for weaklings, like all those other Western countries that secretly wish they were us.

[shropshire 0]

Quote

because the parents are responsible for taking care of their children, not the government. this was not something out of their control, this child would be covered if the parents have been insured themselves.

In our system their Tax would pay for treatment (it's NOT Free) and it's a Not For Profit system so no fat cat insurance company benifit from others pain or suffering (how can an insurance based system be better?)


Also some of you seem to be O.K with your government taking the responsability for running wars that few would want ... that's O.K but not healthcare. Maybe you should all take out insurance to run the Military

(.)Y(.)
Chivalry is not dead; it only sleeps for want of work to do. - Jerome K Jerome

[kallend 1,679]

Quote

Apologies for going a bit off topic, but this is a very good example of how our entire system of priorities is fucked up. The cost flying the President or VP to give one speach to promote his agenda would be enough money to care for this child the rest of it's life.

The cost of one F35 would be enough to care for thousands.

...

The only sure way to survive a canopy collision is not to have one.

[idrankwhat 0]

Hey, you rabid "right to life"ers out there.
What's your take on the issue?
Just curious.

[mnealtx 0]

Quote

Hey, you rabid "right to life"ers out there.
What's your take on the issue?
Just curious.

The mother evidently didn't feel herself 'punished by a baby'.

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[pirana 0]

Quote

They do carry insurance on their other children -- they might have actually thought that constituted insuring their family. It's entirely possible they saved up their money to pay for the birth.

That said, had there been complications during the birth, they'd've had to have had a huge amount saved up to pay, and most likely they did not.

Wendy P.

Hogwash. They made a concious decision not to insure themselves, just the kids. They had to have applied with a health history to get coverage for just the kids, so I would not buy any story in which they claim they did not know that. They obviously saved a boatload of money with that strategy; but now that it has bit them in the ass, the insurance company is evil. What a crock.

This is a good arguement for guarantee issue, though mandatory coverage of some sort must be a part of guarantee issue - or you get anti-selection situations like this in which people opt out when they don't want ot or percieve they don't need it - then complain when that strategy backfires.

Glad the kid got the emergency care he needed (the cost of which will be passed on to others) and hope the parents can finance ongoing care.

Wonder how the parents feel about their strategy now?

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[idrankwhat 0]

Quote

Quote

Hey, you rabid "right to life"ers out there.
What's your take on the issue?
Just curious.

The mother evidently didn't feel herself 'punished by a baby'.

Just trying to figure it out when the "right to life" ends. Seems like it's birth.

[SkyDekker 1,151]

The original story posted implies the parents were insured. Why is everybody saying they were not insured?

Quote

his parents, Doug and Kim, applied to have his corrective surgery covered under their insurance, they were denied

[Shotgun 1]

Quote

The Tracy's are both small business owners and do not carry health insurance for themselves. They do carry insurance on their two other children and tried to get insurance for Houston, but they found out Wednesday his coverage was denied.

[Belgian_Draft 0]

Quote

Quote

Apologies for going a bit off topic, but this is a very good example of how our entire system of priorities is fucked up. The cost flying the President or VP to give one speach to promote his agenda would be enough money to care for this child the rest of it's life.

It's really not off-topic. It's the age-old debate on how best to allocate the expenditure of tax revenues.

Re: trips to promote agenda - surely you don't think that's done by one party more than the other, do you? And yes, I'm calling you Shirley.

One party is as guilty as the next.

HAMMER:
Originally employed as a weapon of war, the hammer nowadays is used as a
kind of divining rod to locate the most expensive parts adjacent the
object we are trying to hit.

[Andy9o8 0]

Quote

The original story posted implies the parents were insured. Why is everybody saying they were not insured?

Quote

his parents, Doug and Kim, applied to have his corrective surgery covered under their insurance, they were denied

Basically, Mr. and Mrs. Tracy bought health insurance from Blue Cross/Blue Shield for their two existing children only. Each being small business owners, and thus needing to pay for health insurance entirely out of their own pockets, Mr. and Mrs. Tracy decided not to pay the extra cost of insurance for themselves. That was obviously a financial decision, albeit a risky one in the US, on their part. So the existing children were insured, but the parents were uninsured.

Had Mrs. Tracy had insurance coverage for herself, the baby's condition would have been covered from birth. Instead, once the baby was born, the Tracys tried to add the baby on to their children's existing policy within the "31 days from birth" window provided for under the terms of that BC/BS policy. (The policy did not allow the baby to be added to the policy while still in utero.) However, because BC/BS considered the baby's medical condition to have existed from the moment of its birth - at which moment the baby had not yet been added to the policy - the baby's condition was considered by BC/BS to be a "pre-existing condition", and thus coverage under the policy was denied.

--------------

Part of the irony of this is that the US holds itself out as a land where individual entrepreneurs - small business owners - can start their own businesses and, if run properly, can eventually grow them into very successful enterprises. And that is correct. The ironic part is that one of the biggest down-sides to being self-employed is the fact that you have to pay full freight for your and your family's health insurance; and for any decent kind of family policy that actually covers anything worth a damn, it's expensive as hell - a daunting prospect for self-employed people living on a tight and sporadic budget. So people gamble. And sometimes, like the Tracys, they lose.

[SkyDekker 1,151]

Quote

Quote

The Tracy's are both small business owners and do not carry health insurance for themselves. They do carry insurance on their two other children and tried to get insurance for Houston, but they found out Wednesday his coverage was denied.

I'm happy I live in a country where this doesn't happen.

I'm happy I live in a country where the majority of personal bankruptcy is not due to medical bills.

I'm happy I live in a country where 45,000 did not die because they didn't have health insurance.

I'm happy I live in a country where debate has not completely deteriorated and a somewhat normal debate can still take place.

[kelpdiver 2]

Quote

Quote

But in those other countries, the parents would be paying for this all along.

In those other countries, the taxes paid by everyone, including those parents, would pay not just for the roads and police, and fire protection and public schools and military, but also for national health service.

Yes, that's what I said. But in this case, the American parents did not pay into health care. They were taking advantage of the system, gladly pocketing money not spent if all went well, and finding someone else (the rest of us) to cover when they lost that bet.

Quote

Quote

Having a child without insurance seems risky, both financially and for the health of the upcoming child.

Careful. Taken to its logical extreme, such a standard would prohibit pregnancy - or mandate the termination of a pregnancy - of the uninsured.

Our solution in this HC reform is to mandate that everyone obtain insurance. So that should make this concern moot in the near future. So will the elimination of the preexisting conditions issues that lead many to stop carrying a policy.

But to put it simply - I think the parents were grossly irresponsible, bordering on child abuse. People should not choose to have children that they cannot provide adequate care for. And from what we've seen thus far, it wasn't a matter of being unable to afford it, rather than a choice not to.

[christelsabine 1]

Quote

Quote

I have ZERO problem with my tax £s helping kids like this - ZERO It would be completely heartless of anyone object.

I would pull back all of our troops from abroad and spend all that money on building our next generations rather than assisting in destroying someone elses.

You know, If we pull our troops from abroad, all those countries cited will have to increase their military spending considerably to make up for the holes left by us. All your free health care would have to disappear. Or something else would have to give. I think the U. S. should maybe stop "providing" free health care to the rest of the world and maybe start focusing on us.

The only thing to disappear would be your (last remaining) troops, my dear. On this, f. e., our lovely Mrs. Chancelor is working very hard ....

Our health care system does exist since a long time and is working fine. Where is the coherence with your troops on that?

Which *holes* are your troops leaving behind? Black Holes, perhaps?

Oh, and thanks so much for the *free health care*, the US is providing .....seems, it also is disappeared into a Black Hole .....

dudeist skydiver # 3105

[nanook 1]

Quote

The only thing to disappear would be your (last remaining) troops, my dear. On this, f. e., our lovely Mrs. Chancelor is working very hard ..

You are thinking too locally. The U. S. Army is not the only U.S. force out there. You have to think beyond the "occupying" part and think more strategic and globally. If we pull out of your country troopwise, you are still under the protection of NATO and other treaties. The protection will still be there. Your costs will not increase and you have your health care. Your military will not have to increase more just because we move out. We will just not be able to bunny hop into the next crisis.

Quote

Which *holes* are your troops leaving behind? Black Holes, perhaps?

Sealane policing. Defensive programmes your country cannot support by itself. The ability to hop-skip-jump over to a country that may have a major effect on your country's (and then ours because this is a very small highly dynamic global community extrememly sensitive to changes) economy and safety.

Quote

Oh, and thanks so much for the *free health care*, the US is providing .....seems, it also is disappeared into a Black Hole .....

You're welcome. Feel free to step in and pull more weight. How about some assistance in the Malacca straits, Panama and Suez canal, the Atlantic and Pacific routes, strategic defense, ect. ect.

_____________________________

"The trouble with quotes on the internet is that you can never know if they are genuine" - Abraham Lincoln

[pirana 0]

Quote

(The policy did not allow the baby to be added to the policy while still in utero.) However, because BC/BS considered the baby's medical condition to have existed from the moment of its birth - at which moment the baby had not yet been added to the policy - the baby's condition was considered by BC/BS to be a "pre-existing condition", and thus coverage under the policy was denied.

No insurer adds kid in utero. That would be silly. Everywhere that I know of kids are only added after they are born, and to do so w/o health history review requires that they are being added as a dependent to their parent's/guardian's existing contract.

The idea is that providing continuous coverage to entire families reduces anti-selection, broadens the pool, and spreads costs. Newborns are high risk, and these parents were doing exactly what insurer try to avoid; selecting out low risk individuals and selecting in for high risk.

This is basically another call for guarantee issue/mandatory coverage. One w/o the other simply does not work; or you get all kinds of anti-selection issues/fraud.

As far as pre-x; that is an irrelevant term until you have coverage. What this child did not pass was a health history review to obtain coverage to begin with.

The rules can be confusing, though it only takes a small amount of reading to gain the necessary understanding; and they are quite logical once you think thru the issues of risk, loss, and selection. An expanded government program is going to be no less confusing than the commercial market.

ACTUARIAL JOKE: 2 actuaries go out deer hunting. They spot a buck across a clearing. The first one takes a shot and misses 5 feet to the left. "Rats!" The second one takes a shot and misses 5 feet to the right, and exclaims "We got him!"

" . . . the lust for power can be just as completely satisfied by suggesting people into loving their servitude as by flogging them and kicking them into obedience." -- Aldous Huxley

[idrankwhat 0]

Quote

The rules can be confusing, though it only takes a small amount of reading to gain the necessary understanding; and they are quite logical once you think thru the issues of risk, loss, and selection.

I agree. However it also illustrates that the HC industry has lost sight of the purpose of health care.

[RonD1120 58]

Question:

I was thinking about this HC thing yesterday and it occurred to me that tort reform is not addressed.

Am I correct?

If so, doesn't Obamacare open a picture widow of opportunity for financial gain to attorneys?

It seems to me that this unprecedented change is going to produce such a quagmire in the grab for governmental control and the fixing of malpractice responsibilities that lawsuits will fly like snow flurries.

Look for the shiny things of God revealed by the Holy Spirit. They only last for an instant but it is a Holy Instant. Let your soul absorb them.

[DrewEckhardt 0]

Quote

The rules can be confusing, though it only takes a small amount of reading to gain the necessary understanding; and they are quite logical once you think thru the issues of risk, loss, and selection.

I agree. However it also illustrates that the HC industry has lost sight of the purpose of health care.

[Andy9o8 0]

Quote

Question: I was thinking about this HC thing yesterday and it occurred to me that tort reform is not addressed. Am I correct?

I think you are.

Quote

If so, doesn't Obamacare open a picture widow of opportunity for financial gain to attorneys? It seems to me that this unprecedented change is going to produce such a quagmire in the grab for governmental control and the fixing of malpractice responsibilities that lawsuits will fly like snow flurries.

Hadn't thought about it that way. How so?

[Nightingale 0]

Quote

I agree. However it also illustrates that the HC industry has lost sight of the purpose of health care.

No, the kid got his surgery. The parents just couldn't convince an outside third party to pay for it.