Lack of Insurance Coverage for Many Cancer Survivors Not Named Giuliani, Thompson, or McCain

The Los Angeles Times examines a major flaw in the health care proposals of Rudy Giuliani and other Republicans–the market has failed to make health care available for many who have serious medical problems. When decisions are made purely based upon maximizing profits, the wisest course is to avoid selling insurance to those with costly claims. Three of the Republican candidates are cancer survivors:

All three have offered proposals with the stated aim of helping the 47 million people in the U.S. who have no health insurance, including those with preexisting medical conditions.

But under the plans all three have put forward, cancer survivors such as themselves could not be sure of getting coverage — especially if they were not already covered by a government or job-related plan and had to seek insurance as individuals.

“Unless it’s in a state that has very strong consumer protections, they would likely be denied coverage,” said economist Paul Fronstin of the Employee Benefit Research Institute, who has reviewed the candidates’ proposals. “People with preexisting conditions would not be able to get coverage or would not be able to afford it.”

If the arguments against the Democratic presidential candidates’ healthcare plans include higher taxes and greater government involvement, then the Achilles’ heel of the GOP plans is their dependence on the private market, which often rejects applicants with health problems.

Republicans want to expand the existing private insurance system, offering new tax breaks as a way of helping people buy insurance individually. But they also want to avoid federal regulation that would tell insurers whom they have to cover and how much they may charge.

That means the self-employed and others seeking individual coverage would be subject to a marketplace in which insurers generally pick the healthiest applicants and turn the rest away. Cancer survivors — even if they have been free of disease for several years — are routinely denied health insurance when they try to purchase it as individuals.

Even if coverage is offered, it often comes with restrictions or high premiums that many find unaffordable.

Tax breaks won’t help if coverage is not offered at a reasonable price, or if insurance companies can drop subscribers as soon as they find they are too expensive to keep. I fear that the present problems will be much worse as our ability to predict future medical problems becomes greater and insurance companies know which problems applicants are genetically prone to. As long as Republicans fail to address these problems their plans are of little value.

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