Friday, October 30, 2009

More Important Things Than Rape: Health Insurance Edition

Yesterday, we saw how money is one of they many things that are More Important than rape. Today, let's continue that theme.

Via the Huffington Post, we have learned that health insurance companies are refusing to insure women (and presumably men, although none have come forward in this particular article) whom men have sexually assaulted. For some background, those who have been sexually assaulted will sometimes take HIV medications for a month in order to prevent HIV infection. Sometimes, they will seek counseling for post traumatic stress disorder as a result of sexual assault.

In an ideal world, we would have a health care system whose primary purpose was to keep people healthy. Of course, we do not live in that world. In the US, we have a health care system, but as many experience everyday, it is a system for doing something else. It is a system in which health insurance companies, seeking to minimize risk rather than maximize public health, have been denying coverage to those whose medical records show that they have used HIV medications and/or mental health treatment in the past, even if those people are not actually infected with HIV. While these companies may intend no discrimination targeted at sexual assault victims or, say, healthcare workers who have been pricked with needles, their policies certainly have a discriminatory impact on such people.

From the Huffington Post, we read one woman's account:

"Even after she explained the assault, the insurers would not sell her a policy because the HIV medication raised too many health questions. They told her they might reconsider in three or more years if she could prove that she was still AIDS-free....

Some women have contacted the Investigative Fund to say they were deemed ineligible for health insurance because they had a pre-existing condition as a result of a rape, such as post traumatic stress disorder or a sexually transmitted disease. Other patients and therapists wrote in with allegations that insurers are routinely denying long-term mental health care to women who have been sexually assaulted."

Now, I understand that health insurance companies are running a business and, as such, they seek to minimize risk. Yet, in addition to the basic unfairness of denying coverage to someone who obtained a "pre-existing condition" via rape, the chances of someone contracting HIV after sexual assault has been estimated to be about 0.46%. The chances are even lower if a person takes HIV antiretroviral medication (called "Post-Exposure Prophylaxis") within 36 hours of the assault.

I further understand that, if people are denied coverage, they are "free" to purchase their own medical care. Yet, I also understand that that's not a realistic option for many (most?) people.

Acknowledging these realities, I was genuinely infuriated reading through some of the others accounts in the article juxtaposed with statements from insurance representatives who smugly declared that discrimination wasn't going on and that that people denied coverage could just buy the care they needed on their own. That sort of out-of-touch covering of a company's ass, makes one imagine, in vivid detail, that special place in Tartarus reserved for health insurance bureaucrats.

For those of us who are lucky enough to have insurance, isn't it strange to know that our insurers are happiest and most successful when we aren't utilizing services and when they can deny our claims? I wonder, in a society where money is More Important than helping people deal with trauma and preventing HIV, is anyone truly surprised that some rape victims must weight the benefits of taking HIV medications against the cost of possibly becoming "too risky" to insure?

When will we decide that the health of human beings is a More Important Thing than the health of insurance companies?

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