Pre-existing conditions

Pre-existing condition. That is a phrase that strikes fear into many LGBT Americans, especially if you are living with HIV or AIDS.

Let me give you an example. It’s an old story, but it’s worth retelling.

In the early days of the AIDS epidemic, I had many friends who fell to the disease. Their demise was often quick, and rarely the stuff of made-for-TV movies about heroic battles against illness.

Cal and Fred had been a couple for many years. They owned their own business and had bought a house in the suburbs. That was before they become ill. Fred was diagnosed first after a bout with a rare pneumonia that just wouldn’t go away. He died before any viable treatments were available and though his medical expenses were high, the insurance they had covered most of them.

The problem was his death made their business too small to qualify for group insurance, so Cal had to find an option. About that time he was diagnosed with AIDS as well. From that point on, getting insurance was no longer an option. An individual with full blown AIDS had no choice but to seek services from local non-profits and the county health system. The Nelson-Tibedo clinic had been established and he managed to survive with their help and treatment but for Cal that treatment didn’t work.

Before long he was being hospitalized every few weeks. The medical bills piled up and his business failed. I saw Cal one last time in the hospital. His robust personality strained inside his fragile body. He told me he had filed for bankruptcy but didn’t expect to live long enough to see the process through. He was right.

Today, people living with HIV have many more treatment options, if they have the money or insurance coverage to pay for the expensive treatments. Yes, there are still wonderful services like the Nelson-Tibedo Clinic, but their resources are strained. If a person with HIV looses his or her insurance, getting another policy is almost impossible unless you work for a large employer with guaranteed coverage as part of their benefits.

Loose your job, and you loose your insurance and expensive HIV treatments might just go away as well.

It’s not just people with HIV or AIDS that face this kind of reckoning. Almost any pre-existing condition makes getting health coverage impossible or impossibly expensive. Have Hepatitis? Forget it. Diabetes…sorry pre-existing condition. Asthma, adios! Lupus, so sorry. Breast cancer, even if you are a survivor….no dice.

Do you see a pattern here? Of course. Sick people are not profitable for insurance companies whether they are gay, lesbian transgendered or bisexual, if they are sick or fall into a group that is prone to specific diseases, they become loss leaders. That kind of “profit and loss” medical care is killing thousands of straight and LGBT Americans.

Meanwhile the media is abuzz with frightening warnings about the horrors of “single-payer” systems and socialized medicine. Harry and Lewis are worried that some bureaucrat will be making their health care decisions instead of their trusted doctor.

Well guess what? Some call-center number-cruncher is already making those decisions, and your doctor has little choice. He or she is busy trying to keep up with the mountain of paperwork needed to stay in business. Drug companies constantly lobby your Doctor to prescribe their latest profit leader rather than an older less expensive drug that might work just as well. Your medical treatment is already in the hands of bureaucrats, except they have no concern except the bottom line for their stockholders.

So why is this an LGBT issue? It’s not just an LGBT issue. It’s an American issue and unless we do something to fix the broken system it will get worse. The LGBT community, and specifically the portion of our community affected by HIV already know how bad it is. They really understand how broken the system is and how we cannot afford to allow it to continue in its “pre-existing” condition.