three rivers fog » Domestic violence, C-sections considered pre-existing conditions

Domestic violence, C-sections considered pre-existing conditions

You’ve undoubtedly heard the news already. A history of domestic violence or C-section are considered, by private US health insurance companies, to be “pre-existing conditions,” which are used as a basis for denying coverage, rescinding coverage, charging higher rates, or other discriminatory practices.

Of course, this is outrageous. Why should a woman who has been beaten by some asshole be denied health care coverage? It isn’t fair.

But there’s something wrong here. And not just with this discriminatory practice — but with the people breathlessly reporting it.

Because, you see, it is being reported, not as:

Pre-Existing Condition Exclusions Are Morally Wrong, but as

How Dare They Treat DV Victims and Mothers the Same Way They Treat Women with Depression, Diabetes and Cancer!

It is being reported as different from “normal” pre-existing condition exclusions. It is being reported as being especially wrong. As being worse. A true moral violation, taking things to a new level.

But why?

Here’s the thing. Insurance companies refuse coverage to people with pre-existing conditions (anything from asthma to leukemia) because they know these people will be highly likely to incur greater costs than healthy patients. The entire rationale for excluding them is because they cost more money.

If you have had a C-section once, you are much more likely to end up having another one if you ever give birth again. If you have a history of domestic violence, you might end up with an abusive partner again, and end up needing care.

Yeah, it’s complete bullshit that these people would be refused health care. It’s downright immoral.

But why is it especially immoral to refuse health care to these women — but not to women with osteoporosis or an anxiety disorder or back pain? Or Ehler-Danlos Syndrome or food allergies or heart disease or lung cancer?

How is it any different?

Victims of domestic violence don’t deserve to suffer consequences for something that is not their fault. This is truth. It contributes to the very popular cultural myth that victims are somehow to blame for the abuse they suffer — that they must have done something to provoke it, or that they should have left, etc. All this stuff is highly damaging.

But that doesn’t make it different than telling a woman with lung cancer that she can’t have care because her disease is somehow her fault. Which contributes to the very popular cultural myth that people with medical conditions are somehow to blame for them — that they must have done something to earn them, that it’s their own fault they ended up that way, and therefore they lose rights to certain things because they are inflicting the costs of their mistakes on the rest of us.

Because if you haven’t done anything wrong, you won’t ever end up sick. If you do end up sick, there must be something you did wrong.

Maybe that woman smoked. And maybe that other woman slapped her boyfriend first. And that woman who was raped wore a short skirt and flirted with the man first. That does not make this violation her fault. This is basic feminist theory. “Blaming the victim.”

Health care is a human right. We all deserve basic health care that respects a person’s dignity and integrity and humanity.

So why are these things different? Especially outrageous?

I can’t identify any reason except one.

Because they apply to healthy women.

It’s understandable why health insurance companies would refuse care to women with arthritis. It makes sense that they would deny care to women with psychiatric disorders.

Because we, as a society, think it is OK to deny quality of life and societal access to people with medical conditions, disabilities and chronic illnesses. We have determined that it makes sense to discriminate against them. We get why these things are done. And they’re done to those people. Over there. Not to me and mine.

But C-sections? Why, one-third of mothers in the US will have a C-section instead of a vaginal birth! That affects me and mine. Therefore, it is especially outrageous — that we would be treated like we treat them.

Oh, but that’s not how you think?

Really?

What justification is there for acting as though these practices are any worse than the practice of denying coverage to women who have lupus?

There isn’t any that isn’t rooted in a deeply ableist bias.

How about we get outraged by the fact that there is any such thing as a pre-existing condition exclusion at all? I can get behind you on that one.

by amandaw on Friday, September 18, 2009 at 1:32 pm 16 Comments

Tags : chronic illness, color me unsurprised, disability, feminism, fuck that, healthcare, i thought you were supposed to be my ally, justice, politics, privilege, privilege-check, problematic attitudes, the media, treatment

16 responses

Sungold

| Friday, September 18, 2009 | 4:02 pm

This is the post I’ve been tempted to write over the past few days. I don’t think that your argument in any way diminishes the horrors of domestic violence. Instead, it throws into relief the callousness of insurers who would discriminate against both DV survivors and cancer patients. Thanks for saying what needed to be said!

lilacsigil

| Saturday, September 19, 2009 | 9:33 am

Spot on analysis. Oh, those fat women, those sick women, those useless disabled women and cancer victims who brought it all on themselves, somehow? Sure, charge them! I’m just waiting for someone to point out that fat, sick and disabled mothers are more likely to have caesareans (whether they need them or not) so why not charge them more? And disabled people are likely to suffer domestic violence, so really it’s just part of their overall condition, isn’t it.

As I said elsewhere, I truly wish I could wake up tomorrow and the US would have universal healthcare. In Australia, even private insurers (who exists alongside the public system) can’t refuse you for pre-existing conditions – they can only impose a waiting period. Thanks, government!

Femmostroppo Reader – September 20, 2009 — Hoyden About Town

| Sunday, September 20, 2009 | 9:14 am

[...] three rivers fog » Domestic violence, C-sections considered pre-existing conditions [...]

flora poste

| Tuesday, September 22, 2009 | 6:34 am

“…the very popular cultural myth that people with medical conditions are somehow to blame for them” is something I only came across when I started following the discussions about health-care reform in the US.
Not being from the US, I found that pretty shocking. So much of what happens in the US seems to be taken up with enthusiasm in other parts a few years later, so I’m worried.

Zailyn

| Wednesday, September 23, 2009 | 3:59 pm

I’m also not from the US – European here – and I don’t think I can agree with that. Not quite a medical condition, but I do have a speech disorder and the (remarkably similar) stereotypes about its cause have all boiled down to “it’s only because they’re shy/have low self-esteem/are cowardly/talk too fast/etc. etc. etc.” – so because we’re doing something *wrong*, not because our brain happens to be wired slightly differently or anything like that – no matter where I’ve lived. And, you know, the prejudice against people with medical conditions and other disabilities suffer tends to be quite similar. Dig down enough, and you very often find the undercurrent of “this can’t possibly happen to ME because it only happens if you do X and I’m too smart to do X!”

I think the reason it’s more obvious in the US is because the US has a strong individualist bent – “you can achieve anything if you try hard enough!” which has the nasty dark side of “if you don’t achieve something, it’s because you didn’t try, so you certainly don’t deserve any help” and often gets used against welfare initiatives – this attitude is much less strong in Europe, I think. Saying all these attitudes don’t *exist* outside the US, however, just goes too close to whitewashing what happens in the rest of the world for my comfort.

Thursday Blogwhoring « random babble…

| Wednesday, September 23, 2009 | 9:41 pm

[...] amandaw: Domestic violence, C-sections considered pre-existing conditions. [...]

Chally

| Thursday, September 24, 2009 | 11:51 pm

I just wanted to tell you I thought you’ve done a smashing job on this post and I’m including it in the next Feminists’ Carnival. :)

Jesse the K

| Monday, September 28, 2009 | 7:23 pm

outstanding! Thank you.

The Fifth Carnival of Feminists « Zero at the Bone

| Tuesday, September 29, 2009 | 10:42 pm

[...] hits it out of the ballpark with Domestic violence, C-sections considered pre-existing conditions at three rivers fog. It’s about ableism, healthcare, ableism, misogyny and [...]

OuyangDan

| Wednesday, September 30, 2009 | 12:26 am

Wow. I gotta say, as outraged as I was at that news, and as much as the cherry picking that goes on w/ pre-existing conditions, and the rage I reserve for companies who practice rescission, I didn’t think about this angle.

Thanks. It’s a brilliant perspective.

PSA: 5th Carnival of Feminists has arrived! « Raising My Boychick

| Wednesday, September 30, 2009 | 1:43 am

[...] hits it out of the ballpark with Domestic violence, C-sections considered pre-existing conditions at three rivers fog. It’s about ableism, healthcare, ableism, misogyny and [...]

Arwyn

| Wednesday, September 30, 2009 | 1:49 am

I think you’re absolutely right on about the ableism, but I do also think these two “conditions” are a little different in that they are things that are done to women — which is “better” than excluding conditions inherent in a person (like my bipolar disorder or my partner’s clotting disorder) not at all, of course, but I do wonder if the done to/inherent in difference is a part of the difference in reaction.