I can sympathize with the 14 million Americans who are unemployed as I have been unemployed for 16 months with little prospects for employment. Now I can identify and empathize with another group: the unemployed who also do not have health insurance. I’ve tried applying for public aid in Pennsylvania, and was put on a waiting list for their AdultBasic coverage. Recently, I applied for private health insurance through Aetna as an AARP member. I believed, going through AARP, that coverage could be expected, maybe not the cheapest but I could get coverage. I was quite wrong: Aetna denied me health insurance coverage.
The tragedy here is that Aetna denied coverage based on false perceptions, assumptions, and without objective medical facts. Their reasons were four: treatment for high cholesterol, a history of hypertension (high blood pressure), enlarged prostate, and a history of tobacco use. Let’s examine these claims from Aetna.
First, the things that are true, or kind of true. Yes, I’m being taking medication for high cholesterol. However, my last blood test was normal. No problem here. Regarding the hypertension (high blood pressure), over two years ago during a routine office visit my blood pressure was ‘slightly’ (my doctor’s word) elevated. He recommended no prescription, but rather that I quit smoking and get more exercise. I did both. Within six months (maybe even three), my blood pressure was been normal and, as far as I know, it has been to this day. This is a perfect example of how Aetna made assumptions based on limited factual information.
As for the tobacco use, I do not smoke and have not smoked in more than two years. Though their questionnaire asks for info within the last 5 years, it is more important that I did quit smoking and continue not to use tobacco. Denying coverage based on perceived ‘ history of tobacco use’ proves Aetna’s inflammatory bias towards a perceived preexisting condition.
For the enlarged prostate, my doctor never indicated with objective medical proof whether I have an enlarged prostate. Additionally a routine PSA test proved normal. It is quite possible that my prostate is enlarged or enlarging, but this is normal for any male approaching 50 years age. In other words, all men will have some enlargement of their prostate in their lifetime. It’s like death and taxes, it’s inevitable. This also proves Aetna’s bias once more, and but also ignorance of basic medical knowledge. This is pure foolishness.
Now, add this important fact: I exercise daily and maintain a healthy diet. Currently, I walk more than 4 miles a day, at a brisk pace, and sometimes one of those miles is running. Every other day I blend in light weightlifting and calisthenics. I also work a healthy low fat, sodium, and cholesterol diet consisting of high amounts fruit and vegetables, fish, and chicken and less red meats. Nevertheless like a typical American, now and then, I still enjoy a grilled steak, some rich food, and some beer or wine, but always in moderation!
Clearly, Aetna is mistaken and confused; they’re facts are wrong. Aetna Insurance is guilty of working on false and bias assumptions. They are both wrong and wrongheaded. This proves the worst of our health care system and our health insurance companies.
If this is future of health care reform, then we are in sad shape. Aetna, and I’m sure many other companies, are taking advantage the ability to deny coverage based on pre-existing conditions, while they still can (and preserve stockholder profits). The health care system is still broken, and the health insurance companies are still the main problem. Frankly, a company like Aetna is the enemy of all good citizens and the good of this country.
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