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Advocacy / Opinion

Harmonious Thought on Preexisting Conditions – in a Discordant Time

health-care-preexisting-conditions-obamacareRemarkable is one word for it. Ironic is another. The wordless sigh may be best. The longer you live, the more often you see history repeat itself, fold over on itself, contradict itself. Seniors in particular, have seen it all – or much of what life delivers, including irony.

In these midterms, and run-up to them on national television shows, Democrats walked around Obamacare, pretending its often onerous terms and taxes did not exist – but then harped irrepressibly on how Republicans would prevent insurance for those with preconditions.

Actually, nothing could be further from the truth – or from the historic defense of both a safety net and coverage of preconditions, by Republicans. I will not dwell on attention to this issue in present legislation (although there are competing, Republican-sponsored bills that expressly provide for preconditions) and will not dwell on attention to the issue by AMAC, the Association of Mature American Citizens.

Instead let me walk you through a bit of history. In 1992 and prior, I worked in the Bush 41 White House. Earlier, I had worked in the Reagan White House. While Reagan often noted that bloated government could not obscure the need for a safety net, George Herbert Walker Bush was more direct.

On health care, he was attentive, relentless and sought buy-in from resistant Democrats. Where they tended toward pie-in-the-sky single payer notions, he was practical, principled and a former businessman. He knew how economics, micro and macro, worked.

The elder Bush proposed, rather than single payer or leaving people uncovered, a different combination of ideas. It included attention to issues like preexisting conditions, but honored the quality and cost-saving tied to private sector insurance.

His composite was:  Offer vouchers to poorest Americans, allowing them to purchase private health insurance, provide a combination of tax credits and deductions for families up to $80,000 (which today would top $100,000), create all manner of “pools” for businesses, nonprofits, individuals and networks to negotiate – using economies of scale – with private (high quality, low premium) insurers. And be attentive to preexisting conditions. Simple, almost elegant.

Well, that was then – and as they say, this is now. Today, only individuals and organizations like AMAC that recall history, honor it, draw knowledge and inspiration from it, seem to remember that people like George Herbert Walker Bush were prescient. The former President, a man of honor and foresight, was adroit at balancing business incentives – based on his business experience, with public health and welfare – based on decades in public service.

The point is simple. We have too many demagogues today, ill-equipped, ill-educated or perhaps just disinterested in history, including the history of those – many of whom were thoughtful Republicans – who wanted to, worked to, and were clipped in their attempts to – fix health care. Preexisting conditions were one of the few bipartisan – not Democrat or Republican – concerns. Perhaps, as emotions settle and tempers are tamed, we could revisit these ideas.

George Herbert Walker Bush had many good ideas, as did his former boss, Ronald Reagan. We might do well to review the historical record – and think again about where history could be adopted with mutual benefit, not swept under the rug, misinterpreted for political gain, repeated, folded over or contradicted. Just a thought, a single harmonious note, in this discordant time.

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I have always felt that Pre-Existing Conditions should be part of insurance coverage for all. However, even though Medicare allows Pre-Existing Conditions … They do want to know if you are in End Stage Renal Failure. Since I am not in renal failure, I really don’t understand why this is on all Medicare Advantage Plans? No questions about Cancer or Lung Disorders like Emphysema/COPD or HIV or AIDS … Just End Stage Renal Failure. I do realize that End Stage Renal Failure is basically a “death warrant” without a kidney transplant … But, it still doesn’t make sense to me, that this one health issue is questioned. The question may simply have to do with how Medicare will handle this disease, like giving the person Medicaid to help offset expenses … Bottom line, I just don’t know why.

Glenn Rolloff

Let’s be clear, when Richard Nixon and Edgar Kaiser formed an unholy alliance, FOR-PROFIT healthcare was formed. Since then, it has grown to 21% of GDP and created many wealthy people who have no medical concerns except greed. ACA tried to control this but it’s too late unless AMAC and all real advocates join together and stop FOR-PROFIT Healthcare. It is NOT prolonging life or health.