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Sandra Fluke Pushed For Sex Change Coverage

From the Media Research Center:

Sandra Fluke, Gender Reassignment, and Health Insurance

Stephen Gutowski
Monday, March 5, 2012

Here is an excerpt of Employment Discrimination Against LGBTQ Persons appearing in the Georgetown Journal of Gender and the Law’s Annual Review 2001 edited by Sandra Fluke and Karen Hu:

Employment Discrimination Against LGBTQ Persons

Edited by Sandra Fluke and Karen Hu

III. Employment Discrimination In Provision Of Employment Benefits

Many LGBTQ individuals face discrimination in the provision of employment benefits. Discrimination typically takes two forms: first, direct discrimination limiting access to benefits specifically needed by LGBTQ persons, and secondly, the unavailability of family-related benefits to LGBTQ families. A prime example of direct discrimination is denying insurance coverage for medical needs of transgender persons physically transitioning to the other gender. Denial of family-based employment benefits (including family health insurance, survivor benefits, and time off for family illnesses) is often predicated on a lack of recognition of civil unions, domestic partnerships or co-habitation. Only 33% of all organizations offering spousal benefits include benefits to same-sex partners, and LGBTQ employees in lower paying industries are less likely to be granted suck [sic] benefits.

A. Gender Reassignment Medical Services

Transgender persons wishing to undergo the gender reassignment process frequently face heterosexist employer health insurance policies that label the surgery as cosmetic or medically unnecessary and therefore uncovered. In Mario v. P & C Food Markets, Inc., an employee who was denied such coverage brought claims under the federal Employee Retirement Income Security (ERISA) and Title VII. The court rejected the ERISA claim, finding the plaintiff’s mastectomy and hormone therapy were not medically necessary. The court’s ruling was based upon controversy within the medical community regarding that treatment plan. Much of that controversy has been linked to ignorance and bias against transgender persons, and the American Medical Association has declared the lack of coverage to be discrimination. Mario’s rule that gender reassignment treatment is normally not medically necessary forces any individual claiming otherwise to show why his or her case is exceptional. This presumption is the reverse of the prevailing one for Medicaid and Medicare beneficiaries; those plans may not have a blanket denial, but can deny coverage on a case-by-case basis.

There is a relative lack of case law addressing coverage denials under private plans, as well as the difficulty of accessing FMLA leave for recovery from gender reassignment surgeries. By contrast, there are many cases adjudicating claims for Medicaid and Medicare denials of these services, as well as many cases relating to the government’s responsibility to provide prisoners with access to such services. The reason for this lack of cases is unclear. Private employee insurance plans do not more frequently cover this need, so it may be a sign that transgender employees do not see the courts as likely to provide any assistance against private employers…

Apparently, Ms. Fluke believes that it is discrimination deserving of legal action if "gender reassignment" surgeries are not covered by employer provided health insurance.

This article was posted by Steve Gilbert on Tuesday, March 6th, 2012. Comments are currently closed.

39 Responses to “Sandra Fluke Pushed For Sex Change Coverage”

  1. ezra

    Apparently, Steve Gilbert believes that it is not discrimination deserving of legal action if “gender reassignment” surgeries are not covered by employer provided health insurance.

    • fallingpianos

      What was your first clue, Ezra? And since when is discrimination such a bad thing? You obviously have no problem discriminating against those who provide health insurance.

    • ezra

      “since when is discrimination such a bad thing”

      The line of argument is so superficial, it’s embarrassing. Pursue it, and you just step in it deeper.

      We need to stop wasting our time polishing turds.

    • tranquil.night

      “You obviously have no problem discriminating against those who provide health insurance.”

      Any response to his main point ez, or is obfuscation the order of the day from Media Matters?

      What about if it’s an Islamic institution that doesn’t want to be mandated to cover these services because it’s an affront to Allah’s Law?

    • Rusty Shackleford

      “What about if it’s an Islamic institution that doesn’t want to be mandated to cover these services because it’s an affront to Allah’s Law?”

      When all this started, this was the elephant in the room to me. If he decided that Catholics will do it, then what of I-slam? They are violently against birth control in any form. Moreso than the Catholics. I posted many a blogosphere statement to this effect and all people wanted to yammer about was how it affected the Catholics. Of course, there was a fair amount of discussion about how it isn’t about religious freedom specifically but about freedom in general.

      No pundit, talking-head, journalist, other said a word about it. While the left was busy trying to skewer the truth of the matter, it escaped their pervue entirely. Yet, the day is coming when it will be an issue and the left will somehow, magically, and with complete lack of recollection of the past couple of weeks, be on the other side of the argument.

    • ezra

      This type of thing happens all the time. The law (thankfully) is not considering whether the parties involved are “not like us”.

      (These cases get complicated when the insurance is an employee benefit, because then you have a whole layer of employment law. But let’s stick with the discrimination against the insurance company.)

      1. We have broad federal and state laws prohibiting discrimination of protected classes. Is it discrimination to require any business to obey these laws?
      2. Insurance (of all types) is a regulated industry and additional legal terms may apply to their contract terms. (E.g., some states allow health insurers to exclude coverage of pre-existing conditions, while others do not.) Is it discrimination to require any insurance company to obey these regulations?
      3. Insurers routinely deny coverage to their customers — there is some excuse for almost any denial (e.g., that was “flood” damage, not “wind” damage!)
      4. Insurance customers routinely dispute these denials.
      5. Arbitration or legal suits follow. Winners win & losers lose. Less frequently, collateral damage may occur if existing contract terms, regulations or even laws are found to be “illegal” in and of themselves.

      It’s not all a bloody jihad, folks! How are we discriminating against insurance companies?

      So: What may not be acceptable around these parts is that you could have a legitimate case where an individual could be transgendered and a doctor could prescribe gender re-assignment treatments — including surgery — in order to preserve the health of that individual. If an insurance company contracted to cover medical treatments, they may very well be on the hook for those treatments and surgery. If they exclude these procedures in the contract language, the contract itself may be challenged under the law. They may win or they may lose. Any implied “morality” is embodied in the law and does not provide some constitutional “opt-out” clause whereby we get to ignore the laws.

    • fallingpianos

      And yet, Ezra, here you are, taking a turd and trying to polish it by putting forth the premise that insurance companies are wrong for not covering silly, medically unnecessary procedures.

      Real cute.

      If you can’t answer my question, then say so. But then, this isn’t really about discrimination, now is it? You’re perfectly fine with companies discriminating against Rush by pulling advertising when he offends the professional victim class. You on the left use love to use politically charged buzzwords as smokescreens in an attempt to distract from what you’re really trying to do: impose an alternative value system from the top down.

      The real question is: What authority instituted your value system and why should we accept it?

    • JohnMG

      Gender re-assignment? How cute. Since we’re into euphimisms, we’ll have to come up with a medical term to describe these operations. Perhaps I can help:

      The surgical removal of one’s appendix, when necessary, is termed an ‘appendectomy’.

      The surgical removal of some or all of a woman’s internal reproductive organs, when necessary, is termed a ‘hysterectomy’.

      So, in the case of Ms. Fluke, (can that possibly be her real name?) what else could we possibly call her gender re-assignment surgery but an ‘adadicktome’?

    • ezra

      “What authority instituted your value system and why should we accept it?”

      My value system and any related authorities (?) are irrelevant. These things play out in a court of law.

      Rush is free to sue the companies who have pulled their advertisers. If they have violated contracts, he will surely win and my cheers or jeers would just not matter.

      It is the making of the laws that matter, and to make laws you must get elected. Focusing on contraception coverage mandates, pay-for-sex, and gender reassignment would be considered a novel political strategy if it were to work!

      Who knows, plenty of time to see if it pays off!

    • tranquil.night

      “1. We have broad federal and state laws prohibiting discrimination of protected classes. Is it discrimination to require any business to obey these laws?”

      Actually, yes, the language of those laws is always being pushed by trial lawyer scum and activist judges towards a wider and wider umbrella of victimology. Sexual choices are not presented as choices, but as biological dispositions akin to race and gender. Those arguments are becoming law without settled science, because the legal process has been so politically corrupted. Judicial reform is a not a small component of our agenda. But the truth is the Liberals don’t even want to go through the courts. They just want to legislate that power to the bureaucracy so all the pesky legal arguments can be bypassed. Thus, ObamaCare and the Contraception/Abortifacient mandate.

      “Focusing on contraception coverage mandates, pay-for-sex, and gender reassignment would be considered a novel political strategy if it were to work!”

      Good, then this should be blowing up in the Democrat’s faces, right?

      They’re the ones making them public issues. Republicans and Conservatives are *gasp* providing a contrast to their arguments and holding them account to their deceptive political behavior. They don’t like that and neither do you!

    • ezra

      Yep. The Dems are running for the hills! Go get ‘em …

  2. BannedbytheTaliban

    Given all the problems facing the US right now why are we allowing the liberals to focus on this topic. Every time a GOP candidate or politician goes on TV or Radio and this comes up, he/she should immediately change the topic to one of these DNC cause disasters:
    JOBS
    DEBT
    BUDGET
    GAS PRICES
    CRONY CAPITALISM
    REPEALING OBAMACARE
    EXTRA JUDICIAL KILLING OF AN AMERICAN CITIZEN
    SPREAD OF FUNDEMENTAL ISLAM IN EGYPT, LIBYA, YEMEN, SOMALIA, ETC.

    • tranquil.night

      We’re focussed on this because it’s part of the regime caused disaster.

      In fact the contraception coverage mandate is the most direct affront to the Constitution and expansion of federal bureaucratic authority since the passage of That Which Must Be Repealed.

      It starts with this mandate, but someday soon, they will be pushing for what Fluke is advocating here. It never ends once the door is open. That’s what they understand, and that’s why the desperation to distract everyone from the logical, legal argument Republicans and Conservatives are making. It’s why this is the most important issue to both sides right now.

    • geronl

      It is the leftwing media that sets the topic. They don’t have to report anything they don’t want to report.

    • ezra

      TN, the contraception coverage mandate (aka this week’s defining moment of our generation) is a political loser:

      a) As long as the law exists, the jurisprudence is well-established and does not suggest constitutional issues
      b) Repealing or amending the law by focusing specifically on contraception is a public-relations nightmare and butts heads with the existing jurisprudence
      c) Repealing or amending the law in a broader fashion gets really messy: Blunt Amendment

    • tranquil.night

      Large majorities continue to tabor total repeal. Period.

      That’s the starting point.

      This episode underscores our argument.

      This is where your wing and ours differ tactically.

      Whereas the polls guide your political behavior, we believe the truth and the rule of law, properly articulated, passionately defended, can move polls. More importantly, it wins elections.

      I contend that the box in which you’d trap us is the surefire path to defeat. Thank you for continuing to be such an excellent representative of Moderatism, ez.

    • tranquil.night

      Ehh.. that’s clearly supposed to be “favor repeal”

    • ezra

      I’m doing my best, TN!

      Anyway, what does the contraception coverage mandate have to do with total repeal? Did it not exist in numerous guises (state regulations) prior to Obamacare? In these guises, was the underlying jurisprudence not well established?

      In my experience, everybody else (except the Tea Party and the Catholic bishops) has moved on. Treating the contraception coverage mandate as some Achilles heel of Obamacare (it is not) and continuing to hammer away on it does not enhance the chances for the eventual repeal of Obamacare.

    • tranquil.night

      “Anyway, what does the contraception coverage mandate have to do with total repeal? Did it not exist in numerous guises (state regulations) prior to Obamacare? In these guises, was the underlying jurisprudence not well established?”

      As I wrote, it underscores our central argument for total repeal, as you just did too. Nothing this ambitious has ever been attempted at the federal level, and once the precedent is established that the feds can force private citizens to engage in commerce on the basis of public health, then the role is forever changed in how government gets to define what must be provided in whatever political cause it deems a “public health” issue. This is the center of the ObamaCare legal challenge.

      Not that it matters a whim to you.

      “In my experience, everybody else (except the Tea Party and the Catholic bishops) has moved on.”

      In my experience, you’re wrong. A lot.

      “Treating the contraception coverage mandate as some Achilles heel of Obamacare (it is not) and continuing to hammer away on it does not enhance the chances for the eventual repeal of Obamacare.”

      We’re treating it as an imposition of the Left’s social values onto the whole country by bureaucratic diktat which shreds the first ammendment. We’re treating it as what is – exactly what the Left always projects social conservatives as wanting to do, moral authoritatrianism. On the one hand, it’s exactly what you say chases off all the moderates and independents, and yet when the Left actually does it – yawn.

      Clearly the prospect of authoritarianism isn’t bothers you social liberals. It’s the right’s morals. In fact, authoritarianism in the name of suppressing the right’s expression and practice of their morals is virtuous, is that what I’m to understand you say Americans now are okay with, ez? It sure seems like you’re alright with that.

    • ezra

      Speaking only for myself, but probably as a fair example of “moderate” “social liberal” thinking, I am “comfortable” with the stingy manner with which conscientious objectors are treated by the government.

      By “comfortable”, I mean that I respect (whether I like it or not) the evolving jurisprudence and totally support legislative efforts that enhance individual liberties within the context of the constitution — such as repeal of Obamacare. (As you know, I am still concerned that the math is going to bite us … I am skeptical that health care is provisioned efficiently in a free market.)

      But instead of a well-orchestrated political & legislative campaign against Obamacare (preferably with an attractive alternative presented), we get “defining moment” losing court battles and crazy tangents like the Blunt Amendment: “we don’t need to obey your stinkin’ law because we don’t believe in it”. This behavior is unbecoming of my country club friends!

    • tranquil.night

      The Blunt Ammendment was largely a stunt, I agree with you there. But the Republicans don’t have many other tools by which to attempt to bring political pressure to bare than these maneuvers. I don’t think the symbolic parliamentary procedures are effective at all but more a ‘cover your ass’ cop out. I wish they would be more active in explaining their case to the public and helping us challenge the regime’s false meme’s daily.

  3. Anonymoose

    Two things get me. One is now we’ve gone to “LGBTQ,” I guess for “Queer,” although how they’re not covered by the other four letters is beyond me.

    The other is my insurance barely even covers new glasses, and even major medical has a huge co-pay. It’s more like a discount than insurance.

    I can’t get a hair transplant or an artificial tan or capped teeth covered under insurance, all of which would enhance my esteem and self worth, but not required for me to do my job.

    A sex change with the full regime of therapy, hormones, and surgery is very expensive–and how many employees would actually be needing it? Why should we collectively pay for something only 1-2 employees in an organization of thousands of people would need it? Oh that’s right, the needs of the few are more important than people with cancer, arthritis, or any other medical disease. There’s only so much money and so much to go around, that’s why everything isn’t a free ride in the first place.

    This makes as much sense as offering contraceptives for gay men, and I wouldn’t be surprised to see that happen at some point either.

  4. canary

    My opinion is now Sandra Fluke is a nymphomaniac sex addicted pervert & predator.

    Can you imagine how Sandra Fluke’s non-stop public sexual fantasies leads to hundreds approaching her and offering and requesting sex with her after each little request and demand she makes for the government to pay for sex.

    She preys on people as sexual objects and wants the government to pay for it. Fluke’s obsession with such perverted deviant out of the norm sex has led to law enforcement having to deal with growing violent sex offenders and murderers. Fluke is a danger to society and no telling how many cat and dog fights are fought to gain her affection. She is a menace to society and civility.

  5. canary

    Ezra, Employment health insurance companies are for the sick and to prevent sickness. I doubt a man’s or women’s genitals will fall off if they don’t get a sex change and plastic surgery.

    Actually, any time someone goes under the knife their health and life is great risk and I’m sure no employer or health insurance company wants that greater risk financially or ethically.

    Now if the laws determine and discriminate that people who want sex changes are medically ill each person claiming this medical illness they feel they were born in the wrong body would have to be treated on an individual basis with tests and exploratory surgeries unless it is very obvious of defects.

    People with sex identity problems have no problem finding partners and can compensate with toys and role playing and there seems to be a lot of growing support.

    And life isn’t perfect and everyone has problems and we just can’t have it all. Shouldn’t the person that wants fake breasts have the compassion to see women with breast cancer get priority.

    Shouldn’t the women wants a thingy realize that a man with prostate cancer should come first.

    Can’t have it all.

    • ezra

      Valid points. I agree.

      I appreciate that you do not simply belittle or make light of sex identity issues. It is clearly a big problem for a few people.

      What you’re going to find is that there are cases where physician-recommended sex change treatments are denied by plans that do reimburse physician-recommended erectile dysfunction treatments, acne treatments, etc. Then you come down to a situation, in fact quite common and probably justified, where insurance companies and courts second-guess the recommendations of physicians. Because this is all a big fat gray area, you then queue the mating dance of the lobbyists: http://www.lambdalegal.org/sit.....alth_1.pdf

      In the end, you just don’t want to hang your political hat here in my opinion.

  6. canary

    AP Exclusive: Obama’s transgender ex-nanny outcast

    By Niniek Karmini Mar 5, 2012

    JAKARTA, Indonesia (AP) — Once, long ago, Evie looked after “Barry” Obama, the kid who would grow up to become the world’s most powerful man. Now, his transgender[sic] former nanny has given up her tight, flowery dresses, her brocade vest and her bras, and is living in fear on Indonesia’s streets.

    “I knew in my heart I was a woman, but I didn’t want to die like that,” says Evie, now 66, her lips trembling slightly as the memories flood back. “So I decided to just accept it. … I’ve been living like this, a man, ever since.”

    Nobody knows how many of them live in the sprawling archipelagic nation of 240 million, but activists estimate 7 million. Because Indonesia is home to more Muslims than any other country in the world, the pervasiveness of men who live as women and vice versa often catches newcomers by surprise.

    Many transgenders turn to prostitution because jobs are hard to find and because they want to live according to what they believe is their true gender. In doing so, they put themselves at risk of contracting AIDS and other sexually transmitted diseases.

    The threat of violence is very real: Indonesia’s National Commission for Human Rights receives about 1,000 reports of abuses per year, ranging from murder and rape to the disruption to group activities.

    Evie says she chose her current name because she thought it sounded sweet. But she adds, as she pulls out her national identification card, her official name is Turdi and gender male.

    As a child, Evie was often beaten by a father who couldn’t stand having such a “sissy” for a son.

    “He wanted me to act like a boy, even though I didn’t feel it in my soul,” she says.

    As it turned out, she was pretty good at it, making her way into the kitchens of several high-ranking officials by the time she was a teenager, she recalls with a smile and a wink. And so it was, at a cocktail party in 1969, that she met Ann Dunham, Barack Obama’s mother, who had arrived in the country two years earlier after marrying her second husband, Indonesian Lolo Soetoro.

    Dunham was so impressed by Evie’s beef steak and fried rice that she offered her a job in the family home. It didn’t take long before Evie also was 8-year-old Barry’s caretaker, playing with him and bringing him to and from school.

    “He was so young,” says Evie. “And I never let him see me wearing women’s clothes. But he did see me trying on his mother’s lipstick, sometimes. That used to really crack him up.”

    When the family left in the early 1970s, things started going downhill. She moved in with a boyfriend. That relationship ended three years later, and she became a sex worker.

    “She was a nice person and was always patient and caring in keeping young Barry.”

    Evie hopes her former charge will use his power to fight for people like her. Obama named Amanda Simpson, the first openly transgender appointee, as a senior technical adviser in the Commerce Department in 2010.
    ____

    Associated Press writer Robin McDowell contributed from Jakarta.
    http://news.yahoo.com/ap-exclu.....07242.html

    Evie aka Turdi (vice versa) who cared for Barry aka Barack Sotoetro aka Obama (vice versa) “does not” have a transgender problem.
    Going public with camera crew shows his/her sexual addiction is a “Sexual Exhibitionist”.
    Such as severe exposure disorder, fear does not stop he/she from letting the entire world know.

    1000 reports of abuse out of 400 million people. With their main job being prostitutes that is pretty low.

    • Rusty Shackleford

      “Many transgenders turn to prostitution because jobs are hard to find and because they want to live according to what they believe is their true gender. In doing so, they put themselves at risk of contracting AIDS and other sexually transmitted diseases.

      This is the old, “There were no jobs so I became a murderer”, “I’m a victim” schtick. If you are unhappy with who you are, it is no excuse to “turn to prostitution”. My god, the illogic of that line of thinking is morose. “I’d rather have AIDS as a hooker than just wear dresses and accept myself as I am.”

      This whole thing has me thinking that if you’re that confused as to what gender you are/want to/ should be and you become a prostitute “because of it” then there’s something else misfiring in your head. Not much different than calling 911 because McDonald’s was out of french fries. Lots of confused people out there who seem to think they need validation from outside of themselves. Not just the cross-dressers but Captain Skidmark too. Pelosi, Holder…the whole enchilada. Dysfunctional, irrational people thinking that in order to be of value to themselves, they seek the acceptance of others.

      At the base of national socialism, this is key. Belonging trumps independent thought and character.

  7. tranquil.night

    Prof. Jacobson on Discrimination in Hollywood.

    Including a blockquote from this great piece by writer Daniel Knauff: http://blackbxx.blogspot.com/2.....ndrew.html which Insty linked to yesterday.

  8. The Redneck

    So, in the case of Ms. Fluke, (can that possibly be her real name?) what else could we possibly call her gender re-assignment surgery but an ‘adadicktome’?

    There’s a more accurate name–Female Genital Mutilation.

    If I told a doctor that I’ve seen sin, and that in accordance with the Biblical command that “If thy right eye offend them, pluck it out and throw it away,” I want them to remove my eye and dispose of it, no doctor would do it. If I told a doctor that I wanted to do the same with my right hand, none of them would consider it. But if I tell a doctor that I have so little belief in myself as a man that I want him to feed me hormones and mutilate my genitals–apparently that’s a different matter.

  9. Busted and Exposed: Why the apology Rush? Did you know this?

    http://patdollard.com/2012/03/.....ith-video/

    http://www.teapartynation.com/.....my-apology

    The President takes time out his “busy schedule” and calls Sandra Fluke to apologize but why didn’t he make the same call to Sarah Palin? http://www.westernjournalism.c.....rah-palin/

    We, the taxpayers do not want to pay for your “lifes experiences”:
    http://therealrevo.com/blog/?p=68386

    • canary

      I can’t believe such a big deal being made over Rush’s joke. Republicans have been called murderers and told to burn in hell by politicians and received no apology.

  10. canary

    EZRA, I can not find AMA document in this page put together by some lobbyists.

    Sure the AMA see it as a $ win $.

    As far as the American Psychological Association who are not Medical Doctors and able to perform any medical procedures or prescribe any medicine, I can see it an easy $ win $ situation.

    Oh dear EZRA , ” the mating dance of the lobbyists”

    What surgeries are needed for lobbyists to be able to mate by dancing.

    EZRA I don’t know what you are telling me I don’t want to do or what it means to hang my political hat on that proposal.

    “In the end, you just don’t want to hang your political hat here in my opinion.”

    As I said, we can not have it all at the expense of government laws. Especially, the Obama care which mandates every citizen to carry insurance or be fined. I don’t see “getting it all” for the proposed $500 dollars.

    It should be up to Insurance Companies what they can afford to offer.
    These trangender people get enough understanding from each other at their parties. If one is upset that he lost his girl or boy friend that would follow under regular Psychological care. If Psychologists feel a calling to specialize in this area they can take more classes or maybe read some books, or get better with experience.

    Only the very wealthy get the best health care and that’s their reward. I am not jealous of this, but think how lucky they are.

    And the solution is for George Soros and Warren Buffet to start an affordable health insurance company with no subsidy from the government that is just for transgenders.
    Like a dental plan,…. except a sex-part plan. And if they probably would not pay for gold sexual parts, but they may offer it out of pocket.

    • canary

      Chaz aka Chas is in a love partnership. The partner loved her the way she was. That wasn’t good enough for Chaz. She was lucky to have a rich famous mother to diss in a book to pay her top part change. And she went on dancing with the stars to pay for her future plans for the bottom part of surgery.
      I was so dumb I thought she really meant her bottom, but she meant her bottom “front”.
      Now was this necessary. And will she need therapy when it may destroy her love partnership as she/he is a different person than the girlfriend she fell in love with. And if her girlfriend is bi-sexual (which I do not believe in) what if her bi-sexual girlfriend decides she’s a lesbian. Should insurance pay to change Chaz back. Chaz must be really mad at her rich mom for not paying for all this and really exploited her mother like a spoiled brat. She even went on loser weight before the surgery and failed at that, but got some kind of prize I guess.

      The media just wants ratings. They exploit people.

    • canary

      and worse is these men aka women like Chaz keeping both sex parts so they can have baby’s to raise and confuse for life. This “oh, I quit my hormones for 6 months before I got pregnant”. Then men will want to uterus’s.

      We’re fighting a war. People need to quit being selfish and buy arms and legs and body parts for them.

      Transgenders need to be put on way back on the back burner and have compassion for others.

    • tranquil.night

      “And the solution is for George Soros and Warren Buffet to start an affordable health insurance company with no subsidy from the government that is just for transgenders.”

      Exactly. Nothing is stopping the Left from using market forces in conjunction with their social values. They do it on a wide array of matters.

  11. ezra

    Canary, I continue to agree with your sentiments but just want to point out one thing you’ve missed.

    When you say “It should be up to Insurance Companies what they can afford to offer,” nobody is disputing this.

    However, the way the health insurance market has evolved historically is that policies have few exclusions for specific conditions. Why? The industry tried to go this route 20 years ago and the doctors rebelled. Intuitively, the doctors’ case makes sense, but yes they also have skin in the game and are not unbiased actors. Anyway, once the doctors refuse to accept your insurance (which more or less occurred in the case of the HMO’s back in the 90’s), you are out of business. Instead, the contract terms for health insurance typically define processes that the insured follows in order to be covered, with the primary physician being the lynch pin in the process and almost acting as a contract-employee of the insurance company. This is the whole game with the “primary physician”, “referrals” and the contract “definitions” for “pre-existing conditions”, “emergency care”, etc. All of this developed primarily in the marketplace (nothing to do with the government), although there have been parallel processes that are well known in the medicare / medicaid worlds.

    So again, the insurance companies, not the government, writes the contract. If they cannot afford to honor the terms of the contract, then they inevitably lose their license to write insurance. We do not say, “gee, you are not honoring your contract, but that’s OK because you can’t afford to.”

    And again, if an insurance company wanted to write a policy that excludes specific conditions, they are free to do that, but the market for the policies would be severely constrained not only by state regulations, but also by the market itself.

    • tranquil.night

      But none of what you chronicle leads me to the conclusion that the best solution is for the government to force citizens into a contract over which it has total authority to dictate what must be covered. That’s only predictably collapsing the insurance industry.

      Those looking for different levels and types of health coverage should’ve joined us in supporting market based solutions like cross-state competition, clarifying/simplifying the regulatory code.

      As it is by the time ObamaCare gets repealed, private health insurance might have to be completely rebuilt.

    • canary

      Ezra “So again, the insurance companies, not the government, writes the contract.”

      It’s the government writing the insurance companies contracts now.




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