by Bill Schanefelt

It  is stunning to watch Republicans being put on the defensive time and time again  by the “Pre-Existing Conditions” argument.

Every  word has meaning and power:

The  inherent power of (a) word is a phenomenon that has been both omnipresent and  essential throughout the long histories of literature, philosophy, religion and  politics.

Aside  from using the free ride to be given to the under-26 crowd, the most common club  used on our team is the nonsense that the existence of a pre-existing condition  must not restrict or deny a person’s “right” to health insurance.

The  very utterance of that notion conveys ignorance of the meanings of insurance  — namely, “[c]overage by a contract  binding a party to indemnify another against specified loss in return for  premiums paid[.]”

Then  there’s the meaning of insurance  contract:

…  includes, at a minimum, the following elements: identification of participating  parties (the insurer, the insured, the beneficiaries), the premium, the period  of coverage, the particular loss event covered, the amount of coverage (i.e.,  the amount to be paid to the insured or beneficiary in the event of a loss), and exclusions (events not  covered). An insured is thus said to be “indemnified”  against the loss covered in the policy.

And actuarial  risk:

Risk that a calculated model of an insurance  policy, which includes the frequency,  severity and correlation of losses, may be inaccurate  or subject to  unforeseen events. Also called insurance  risk.

And,  of course, Pre-Existing  Condition:

…  a risk with extant causes that is not readily compensated by standard,  affordable insurance  premiums. Pre-existing condition exclusions by the insurance industry  are meant to cope with adverse  selection by potential customers. Such exclusions have become a topic in the health  care reform debate in the United States in 2009 and 2010. Several surveys  over that period have shown a very strong opposition to the exclusions and  support for banning them.

Let’s  look at some situations wherein the word “pre-existing” is a  factor:

Take  the case of John, a typical person with coverage for his diabetes by his  employer’s insurer, who leaves his current employer, Jack, to go to work for  Jim.  Coverage for that pre-existing condition, diabetes, by Jim’s insurer  is a common situation for which there are many current and proposed remedies  that are less drastic than ObamaTax.  Similar remedies are also currently  available in the case of John’s leaving Jack for self-employment or no  employment.

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