I have a dirty secret: for most of last year, I couldn’t get health insurance because of a pre-existing condition. Lucky for me, an insurance agent tipped me off to a little-known program called the Pre-existing Condition Insurance Plan (PCIP, pronounced, unfortunately, “pee-sip”). PCIP is one of the first phases of the Affordable Care Act, aka Obamacare.
Today, PCIP transitioned to the insurance exchange program you’ve been hearing so much about. Alas, some blowhards in the House, many who enjoy taxpayer-funded health insurance, want to take my insurance away.
Before I shake my tiny fists at the ironies, injustices, and idiocies of the insurance industry in general, and anti-Obamacare factions in particular, let me tell you a little bit about my situation. I am a vegetarian triathlete with a body mass index of 20.4 (that means I’m normal sized), a resting heart rate of 60, blood pressure of 110/70, no surgeries, and no chronic conditions. I completed a postdoctoral certificate in health psychology at UCSF, mentor doctors in the Stanford School of Medicine, and collaborate with a healthcare company to design Web interfaces that inspire healthy behavior changes. At the risk of sounding arrogant, I daresay I am more physically robust, motivated, and knowledgeable about health and healthcare than your average American.
And so when I resigned from my job to write a book and launch a business, I thought I would have no trouble purchasing an individual plan. But I was wrong: the insurance/healthcare company (they were one in the same) that had covered me for seven years through my employer rejected my application to become an individual purchaser.
As veterans of the uninsured life know, after one insurance company denies you, all insurance companies deny you.
So, what was my crime against the insurance establishment? The answer is ridiculously mundane: Two abnormal Pap smears (a test for precancerous cells of the cervix), taken in 2010 and 2011.
You may be thinking, Aha! You had cervical precancer! Of course you couldn’t get insurance, you wenchly drain on our healthcare system!
But let me point out that 25 percent of women have an abnormal Pap smear in their lifetime. Only a handful of these cases would progress to cancer if left untreated, and that would take 10-20 years, on average. But when detected early, cervical cancer is 100 percent curable.
You would think my insurance/healthcare provider would want to keep an eye on my precancerous cervix because doing so would be in everyone’s financial best interest. After all, preventing cancer is a hell of a lot cheaper than treating it. Aside from the business case for insuring me, you might suppose the Hippocratic Oath and other ethical edicts would induce the organization that diagnosed my precancer to want to track and, if needed, treat it–not for free, mind you, but using the premiums and co-pays I regularly fed into their coffers for the better part of a decade.
But that is not what happened. I appealed my insurance/healthcare company’s decision, and lost.
My former insurer suggested I opt for COBRA. But at $850/month, COBRA was impossibly expensive for a social entrepreneur attempting to get her book and business off the ground.
So I signed up for PCIP, which requires its applicants to forgo health insurance for six months. After half a year of driving in the slow lane, not riding my bike (to the detriment of my mental and physical health), and worrying that maybe I was indeed incubating tumors in my reproductive apparatus, I received my PCIP acceptance letter. The premium of $275/month was not cheap, but when you think you might have cancer, expensive insurance beats the heck out of no insurance.
Later that week, I visited my new OB/GYN for a Pap smear and a test for all high-risk strains of human papillomavirus (HPV), the germ that causes 99 percent of cervical cancers. The results of both tests were normal, and have remained normal over the past year. As is the case for the vast majority of women, my immune system has repaired my cells, and my cervix has returned to its usual healthy and happy state.
I’m not in the habit of writing about my lady bits, and I’m not terribly comfortable with disclosing this chapter in my health history. When your insurance/healthcare company rejects you, it’s hard not to feel dirty and diseased. I would have just as soon kept this shame to myself.
Yet I feel compelled to visit the Land of TMI because I don’t think opponents of Obamacare understand whose lives they’re screwing with. My sense is that, to them, the uninsured masses are the unwashed masses–obese, lazy, dumb, poor, and probably brown or black.* I’m here to tell you, though, that Dr. Middle-Class White Triathlete was also among the uninsured and, until recently, uninsurable. If politicians want to keep their citizens healthy and innovative, they need to stop blocking affordable healthcare.
*I also happen to think it is our shared responsibility to take good care of all members of our society, regardless of their race, socioeconomic status, intelligence, size, or even motivation. But I realize this idea seems loony-pants to many of our “leaders.”