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Posted by David T. Ashley on August 27, 2008, 11:29 pm
> About 15-20 years ago my neighbor (and friend) was shot in the stomach by
> his cousin (a .22 and an accident).
>
> So anyway the sight of the wound has started to herniate (sp?). The
> surgery requires a 6 week recovery. Insurance will cover the surgery, but
> he can't collect on his disability insurance because it is a
> "pre-existing" condition.
>
> I don't get it, he will be unable to work for 6 weeks, I call that a
> disability. Is this how we treat our workers in America? (He is a hard
> working union electrician, a stout republican, NRA member)
>
> What is the point of disability insurance? Union membership? Maybe he
> should sue the doctor for the shoddy surgery perform 20 years ago.
>
> There has got to be a better way than the current direction this country
> (America) is going.
>
> Why do I care? Because I had shoulder surgery 20 years ago from a skiing
> accident. If I fall off my bike and hurt my shoulder, will they (the
> insurance company bastids) call it a "pre-existing" condition. And then
> there was the broken back in a mountain bike race 15 years ago, if I
> suffer back problems later in life, will that be called a "pre-exisiting"
> condition.
Hi Bryan,
I would recommend you see the Michael Moore movie "Sicko" (available on DVD
anywhere). In one part of the movie, there is one M.D. who testified before
legislators that essentially she was given bonuses for finding reasons to
deny care.
In the end, an insurance company is out to maximize premiums in and minimize
payments out.
I disagree that this is a pre-existing condition, unless it has herniated
before. It is the aftermath of an old injury. For example, if you break
your foot and it heals but then you break it again 20 years later, would an
insurer cite the old injury and say that the bone was more brittle or weak?
I don't think this is a pre-existing condition in the way that most people
think of a pre-existing condition.
> Why do I care? Because I had shoulder surgery 20 years ago from a skiing
> accident. If I fall off my bike and hurt my shoulder, will they (the
> insurance company bastids) call it a "pre-existing" condition. And then
> there was the broken back in a mountain bike race 15 years ago, if I
> suffer back problems later in life, will that be called a "pre-exisiting"
> condition.
Oops, in reading your post again, it seems you had gone through the same
thought processes.
> I don't get it, he will be unable to work for 6 weeks, I call that a
> disability. Is this how we treat our workers in America? (He is a hard
> working union electrician, a stout republican, NRA member)
The insurance company doesn't care about anything but the payments out.
> There has got to be a better way than the current direction this country
> (America) is going.
"Sicko" mentions some of this. As a national policy, just like social
security, we need to decide what we're trying to achieve and how we pay for
it.
I agree with you.
Dave.
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