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When Lying Is Good For Your Health
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by Tess Brown
TheSyndicatedNews columnist
Tess Brown is currently a VIP Blogger at www.today.com.
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When I was a poor college student and working class single mother living on minimum wage I didn't worry about healthcare. Let me repeat that. I did not worry about healthcare. I could get coverage for just about any ailment through my school health care center or through a no or low income state funded health care plan. Most states have them. When I got pregnant with my daughter eleven years ago I went on the Oregon Health Plan and didn't pay a cent for my prenatal visits or my delivery. In fact I delivered at Legacy Emanuel Children's hospital in Portland, Oregon. Legacy Emanuel’s Children Hospital has top of the line care with two state-of-the art neonatal intensive care units.
When I could finally afford health insurance I applied for an individual plan as my employer at the time did not offer medical benefits. I answered every pre-screened health question honestly. I was a very healthy thirty-one year old. I worked out regularly. My diet was healthy. I never had any major sickness or hospitalization. I was disease free. I did have an abnormal pap smear when I was nineteen and hadn’t had one since. I answered yes to this question and they denied me health insurance. It completely caught me off guard.
A year later I still didn’t have any health coverage. I wasn’t going to take any chances this time. I went online and filled out another application for individual health insurance. This time I lied about my abnormal pap smear. I also lied about my smoking habit. I had in fact grown my smoking habit from drinks with friends to cigarettes and coffee in the morning. I knew they would deny me if I said yes to smoking. I also knew if I ever developed a smoking related disease or ailment and they could prove I had lied on my initial application they could deny me coverage. I felt I had to take the chance. After all, I was trying to quit.
I did not feel good about lying. I didn’t want to lie. Even worse I felt I had to further lie to my doctor. I knew whatever we discussed could end up in my records. I have never felt my health so compromised as I did the day I couldn’t be honest with my own doctor about my health. I felt like my hands were tied.
I did acquire insurance that second time but canceled it in June of this year because I moved back to California. The company I was with only provided coverage for Oregon. I would have to find a new healthcare company once I got to Los Angeles. My previous healthcare company gave me a certificate when I terminated my coverage. The purpose of the certificate was to show evidence of my coverage and under federal law known as HIPPA (http://www.hhs.gov/ocr/hipaa/) this evidence reduced any pre-existing condition exclusion period. What is a pre-existing condition exclusion and why did I care? A pre-existing condition exclusion is when certain health plans restrict coverage for medical conditions present before an individual enrollment. I care because the day after I unpacked my Budget truck rental into my new Sherman Oaks apartment I discovered I was pregnant.
My initial reaction for trying to acquire healthcare now was honesty. We quickly confirmed no health care company was going to approve coverage for me because I was pregnant. I then resorted back to lying. I researched the cost of having a baby. A normal delivery with no complications could run us at least $8,000. A Caesarian delivery could cost more than $10,000 and thousands more for twins or complications. Twins run in my family. I am at a higher risk for twins because of my age and the fact this is my second pregnancy. Even if we decided to pay out of pocket for prenatal and delivery what if something went wrong?
I decided to take my chances. I went online and filled out an application for a major healthcare company in California. I lied about being pregnant and I lied about when my last period was. How could they prove I knew I was pregnant? I hadn’t been to the doctor yet. How could they prove when my last period was? I could lie and say I had one last month even though I didn’t. Some women experience implantation bleeding and can have a period after they get pregnant. I went back to my certificate and read something that almost made me tear up with joy. It said, “A pre-existing condition exclusion cannot apply to pregnancy.” There it was hidden all the way at the bottom. So even if they determined I knew I was pregnant when I enrolled I was protected under the HIPPA. Right? Wrong.
My husband found the nasty little word GROUP on that certificate. The HIPPA rights were only applicable to group coverage, meaning insurance through employment. It did not apply to individual coverage.
He reviewed the plan I had applied for. It was $188 a month. The deductible was $2,400. In order to get a reasonable monthly payment and maternity coverage I was forced to go with a high deductible plan. Furthermore, the deductible was based on a calendar year so once we paid the $2,400 through the end of this year we would get to pay it all over again once the baby was born next year.
I wasn’t convinced we shouldn’t at least try and get covered by lying and saying we didn’t know I was pregnant. My husband argued that they would base it on my doctor’s conclusion as to conception and would therefore consider my pregnancy a pre-existing condition and deny me benefits. I was desperate. I wanted to at least try.
He called another healthcare provider and found a nice woman to chat with about our situation. She was sympathetic and assured us they would go by how far along I was. She told us not to lie on the application because if I did and they denied me later they would put a mark on my record. That scared me. I went back to the computer and canceled my application. I was back at square one.
I am a married, thirty four year old woman with a Master’s degree who happens to be in between jobs and pregnant. Now I am worried about health care. Let me repeat that. I am very worried about healthcare. Due to the current housing crisis my husband and I recently lost money on a house we built and sold on his family's land in Alabama. He left our small construction company for the time being to find work in Los Angeles that would pay our ever rising gas and food bills. He was hired part time as an adjunct instructor at a technical college. It pays just enough to keep us from qualifying for Medical, California’s version of the Oregon Health Plan but not enough to pay for all my prenatal visits and delivery.
We feel lost in a middle vortex in working class America and I really want someone I can yell at. How is it that we are hard working people willing and able to pay for healthcare yet we can’t even get approved for it in the first place? Something is really, really wrong here. Don’t misunderstand me. I appreciated every cent of health coverage I received when I had my daughter eleven years ago. It alleviated the financial stress when I was already dealing with the emotional stress of being young, single and pregnant. So why do I feel punished now for working hard and making money and paying taxes?
The good news is I quit smoking. The bad news is there is no healthcare company left to tell the truth to.
Published: Aug 8,2008 19:24
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Andy Cowan
Andy Cowan, an award-winning writer, whose credits include Cheers and Seinfeld, regularly contributes humor pieces to the Los Angeles Times and the CBS Jack FM Radio Network.
Paul M. J. Suchecki
Paul M. J. Suchecki has more than 30 years of experience as an award winning writer, producer, and cameraman. He's written numerous newspaper and magazine articles. Currently he writes, produces and shoots for LA CityView Channel 35 and his more than 250 articles for Ehow.com are approaching half a million readers.
Coby Kindles
Coby Kindles is a freelance journalist, screenplay writer and essayist. She has been a staff writer at Knight Ridder and a regular contributor to The Associated Press.
Debbie Milam
Debbie Milam is a syndicated columnist for United Press International, an occupational therapist, family success consultant, and motivational speaker with more than 20 years experience. Her work on stress management, spirituality, parenting, and special-needs children has been featured in over 300 media outlets including First for Women, The Miami Herald, Elle, Ladies Home Journal, The Hallmark Channel, PBS and WebMD.
Dan Rafter
Dan Rafter has covered the residential real estate industry for more than 15 years. He has contributed real estate stories to the Washington Post, Chicago Tribune, Business 2.0 Magazine, Home Magazine, Smart HomeOwner Magazine and many others.
Jack Nargundkar
Jack Nargundkar has been repeatedly published in Business Week, The Wall Street Journal, The Washington Post, and The New York Times. He is also an author of "The Bush Diaries" published in July 2005.
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