Monday, March 29, 2010

Blue Cross Blamed in Baby Death

The facts be damned, no reason to let a good story stand in the way of the truth, especially if it supports your cause.

The Star-Telegram posted a story about a newborn that was denied health insurance coverage due to a pre-existing condition. The story is tragic. No one will argue that. But just as sad is when someone leaves out relevant facts in order to advance their cause.

Baby Houston Tracy was born with a serious heart defect. Something called d-transposition of the great arteries of the heart. The paper reports the following.

Surgery would correct it, but within days of Houston's birth March 15, Tracy learned that his application for health insurance to cover his son had been denied. The reason: a pre-existing condition.

To those who want to advance a cause, in this case, health insurance reform, these few bits of truth are enough to fan the flames of revolt against the big, bad health insurance company.

But to those who know how insurance really works, something is missing.

But first, consider this.

Can a dead person apply for life insurance and be issued a policy? Is it possible to have an auto accident and then apply for auto insurance a few days later and expect the insurance company to pay for damages incurred in that wreck?

The answer is no.

But some would want you to believe it is possible to buy insurance AFTER you get sick and expect the health insurance company to pay for it.

Unfortunately for all of us, this is exactly what will happen once we get to 2014.

But for now we have a different set of rules.

In this particular case there are facts missing from the story. Nowhere does it mention if the parents, either of them, had health insurance at the time the baby was born. Nor does it mention if the mother was covered by Medicaid.

If either parent had health insurance prior to the birth, there would be no need to make application for health insurance. The baby would automatically be covered, including any pre-existing condition, as long as the carrier was notified of the birth within 31 days of the birth.

If the mother had Medicaid, not only would the cost of pre-natal care and delivery be paid for by the taxpayers, the child would be eligible for SCHIP from birth until at least their first birthday if not beyond.

Therefore it is logical to conclude that the parents were totally irresponsible and did not purchase health insurance in advance of the pregnancy, nor did the mother apply for Medicaid.

But who wants to read a story where the headline reads, "Parents Fail to Purchase Health Insurance, Baby Dies".

No, a much better headline is "Blue Cross Kills Newborn".
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