Let’s have a little thought exercise into the hypothetical…you all know how I love to come up with a slightly plausible scenario and have everyone talk it out…

Let’s just say someone doesn’t get vaccinated.

We are not going to call these people names or anything like that, because then I will give you statistics as to who is and who is not vaccinated in NYC and I’ll ask you to explain your answer better, so we can be clear as to why we don’t stereotype or why we don’t blankly call anyone stupid

So unvaccinated…

Now say these anti vaxxers get one of these COVID strains that we are giving cute Greek names to…sort of like a special sorority…

So Anti Vaxxer gets COVID Delta…

And they need to go to the hospital…

Does insurance have the right to deny the claim?

If you get a virus that there is a vaccine for and you willingly chose to not vaccinate yourself, does that count as taking a risk?

Should premiums be higher for those who choose not to vaccinate?

Should unvaccinated people be required to waive their rights to health care coverage if they do indeed get sick from something that could be prevented?

Discuss:

109 thoughts on “Pre Existing

  1. Hummm, would that be any different than when someone makes other lifestyle choices that result in preventable medical costs (excess alcohol, obesity, excess sugar, etc. that I end up helping to pay for? (hip replacements, liver diease, etc. etc. The list is long) Raise the premium on the non-vaxer if they must, but make sure they treat everybody the same. Got to run. Have a great day LA!

    Liked by 7 people

    1. The insurance company my husbands company uses is trying to get people who smoke, drink, obese etc to go for counseling. My guess is any day now these things will be higher premiums. We know it’s a higher premium for these people with life insurance. I’m guessing as people lean towards socialized coverage, more rules regarding the group over the individual will exist. And I’m pretty sure smokers pay a higher premium for our health coverage…

      Liked by 1 person

      1. As health care costs rise, which they will post COVID, if I’m an insurance executive, and I’m giving free shots, I’m figuring out the legality right now.

        Liked by 2 people

  2. Haha a great one! I suppose that it does count as taking a risk but the wording on the policy would need to be tight enough to defeat claims that having the vaccine posed a risk or that no vaccine guarantees a 100% effectiveness. Also, who of new strains? It’s a virus and we can expect it to mutate for years. I wonder what is covered for those who catch flu and haven’t had the vaccine or typhoid? Hmmm

    Liked by 1 person

      1. If we did have universal healthcare, given the size of the population, the thinking would become group over individual…(ie why I think it’s Iceland that has no kids with Downs)

        Like

  3. Really made us think today, LA. 🙂 My mind instantly went to other lifestyle choices that lead to medical care, as DM already pointed out. If we consider anti-vaxxers aligning to a lifestyle choice, much like smoking, then I believe we’d have to first prove that they’ve been provided adequate information and warnings to fully understand the risks they are accepting, including not getting insurance coverage. Some people may believe that getting the vaccine puts them at higher risk than not getting it. I don’t know of anyone who believes that not smoking puts them at a higher risk of getting lung cancer (I’m sure someone knows that person though). We’ve educated people for years and implemented regulations to warn people of smoking dangers. Wouldn’t we need to do the same for opting out of a COVID vaccine to demonstrate that people understand the risks they are accepting?

    Liked by 2 people

    1. I just don’t know as far as medical insurance. My understanding is that at least one of the vaccines will be fully approved on September 1. Will non vaxxers need to sign a waiver stating they understand the risks involved? I haven’t actually read my insurance policy, but I know plenty of people who get denied coverage of routine things….how does this add to the mix? Figured I’d toss it out to the crowd to get ideas

      Liked by 1 person

      1. I don’t know either. But this would set an interesting precedent allowing insurance company to require all preventive actions to be taken for coverage. Didn’t get a cancer screening on time and get cancer, denied coverage. Didn’t used protection and get an STD, denied coverage. Didn’t wear your seat belt and got in a car accident, denied coverage. Didn’t wear eye protection while mountain biking and took a branch to the eye, denied coverage. It’ll require us all to take a proactive approach to our health…which in theory is great, but in practice, I just don’t know.

        Liked by 1 person

      2. And like you intimated…should we all be more responsible for our own health? Should the onus be back on the individual to take better care of themselves? While accidents happen, can some things be prevented or mitigated? It opens up all kinds of oaths to explore

        Liked by 2 people

      3. That could be a blog topic all on it’s own. Are we in too deep to shift the responsibility to the person? Do all people have the knowledge, means, support to take care of themselves? Is it ethical to align our health policy to Darwin’s Law?

        Liked by 1 person

  4. Here is a little parallel for you. A person buys a new car with a 3 year 36000 mile warranty. If said person doesn’t follow the manufacturers guidelines for service, they can void their warranty in certain situations. So maybe the anti vaxxer is voiding their warranty?

    Liked by 4 people

  5. Hmmm…. Well, as a retired teacher my views may be more aggressive than most. I’m used to there being rules and guidelines to follow regarding vaccines. Schools require all students to have vaccines before entering school. (Many of you already know I taught elementary school for 36 years so I’m sharing first hand experience). Schools look out for the health and well being of their students as well as their intellectual enlightenment. So I’d follow their guidelines. Schools have done a great job preventing disease from spreading.

    * Every year during flu season flu vaccines were brought into all the public schools in my district and teachers brought our students down to grade level vaccine rooms. Just so you know, That to do this the county also required parent permission slips. If a child had an allergy to the vaccine they would be sent to a holding room and the teacher would stay with her class.. Parents could bring in their younger children at the same time to get vaccinated with their older child.. It was a well coordinated event. Then vaccinated children sat in another room and waited for 15 min. While medical people or paramedics observed and watched for reactions. For decades the public schools in Broward county gave flu vaccines in schools in the same way the covid 19 vaccine was administered. It was a successful program.

    You see see flu season in the past was often a mess . If one child got sick, it would spread and almost the entire class got sick including the teachers and substitutes. Before this coordinated vaccination event (which happened for decades) there was always a teacher crisis during flu season. Teachers were out sick, students missed school , kids got reinfected etc. So the county and the school board provided free vaccines and brought it into to all the schools in my county. It improved the health of the entire district. No more crisis. It worked!

    Sooo… how is this any different? It’s not! The only difference I can see is this time people made vaccines political rather than worrying about the health of others. So YES, I have no problem with unvaccinated people (who aren’t allergic or unable to get the vaccine due to a health problem) having a penalty on their health coverage. I think that’s a great approach. Turn it back to a health issue period!

    However, I don’t think you can penalize young children for not getting vaccinated as that isn’t their fault. But anyone of legal age who refuses for anything other than a medical reason, should have a penalty. Enough with political nonsense we need to keep people safe. Health issues aren’t political it’s medical. I don’t know the political views of any of The doctors who treat me. I don’t care about the politics of the paramedics who come in an ambulance or the health care workers at the hospital. They risk their lives to help others. They can vote how they want.

    And yes, there are medical reasons people can’t get vaccinated. I got vaccinated after having gone through chemo. But during treatment I couldn’t even get a flu shot because my immune system was too weakened. I’m in treatment again now and if I needed to get a covid booster shot I’d have to wait until my treatment was done. So there would have to be specific guidelines and doctor signatures stating why a person couldn’t get vaccinated before health coverage could be denied. But I think that is an excellent way to encourage people to get vaccinated and take politics out of health care.

    Liked by 6 people

    1. I clearly see both sides of this issue and you present a very persuasive case for penalizing those who can be vaccinated not getting vaccinated. I’m interested in hearing what others think

      Like

      1. Yeah, if we require children to be vaccinated to enter school, then we should require adults to get vaccinated to get medical benefits (unless they are medically excused). I was turned down years ago for trying to add extra cancer insurance protection on my health care. The reason? I have a mitral valve prolapse. So the school board insurance said if I got cancer I might have a heart attack and they refused me the extra coverage. I was turned down for long term care insurance when I retired for the same reason. A heart murmur. Ironic because I now have cancer and my heart is just fine. Insurance companies have turned down people for a host of reasons. So it’s about time anti vaxers got a little of their own Medicine. Just sayin…
        BTW, have to pay out of pocket for the latest cancer medicine because insurance won’t cover it. It’s too new. And I have the best Medicare supplement insurance. I pay a fortune. This is a no brainer for insurance companies.

        Liked by 1 person

  6. You just jumped right in there didn’t you!! So…healthcare and it’s associated systems are about making profits…large profits. Right now I am reaping the benefits of government actions that have lowered my insurance premiums to $1.17 per month thru this year. I have no doubt my insurance company and every other major medical insurance provider has teams working overtime on strategies to implement what you describe.

    Liked by 3 people

    1. Well, you know if there might be controversy I have to be in the front lines…that’s what I said to tater…if I ran an insurance company I’d be looking into all the loopholes right now. And as my guess is at least one vaccine will be approved in September, when it’s no longer emergency status the whole game changes

      Liked by 3 people

  7. I’d like to see anti vaccine folks be denied healthcare, but that’s a daydream, of course. I think it makes sense and can happen that their insurance costs rise. Good blog. You helped get my pulse going this morning. 🌅

    Liked by 3 people

  8. Hummmm… I think there should be health available to all people no matter if they choose not to get vaccinated. In fact, maybe if the US had healthcare for each and every citizen then this issue would not even need to be discussion as most people would learn from an early age the need to take care of their bodies. Maintain a healthy lifestyle, work reasonable hours (12 hr days are crazy and very unhealthy!!!). If everyone pays into a healthcare system and it takes care of everyone that gets sick then you wouldn’t see crazy insurance companies or hospitals making profit off the sick and dying.

    Liked by 1 person

  9. It’s hard to dispute the rise in cases and deaths which over 90% are due to unvaccinated individuals. If they choose to play Russian Roulette with their lives so be it. I have little sympathy at this stage of the game. The only ones I feel sorry for are children who aren’t at an acceptable age to be vaccinated or have parents who choose to not vaccinate them. I could hardly wait to get vaccinated because I no longer wanted to live in fear. I have two friends who chose not to get vaccinated and spent numerous weeks in the hospital and ventilated. They endangered their family, friends, caused doctors and nurses to be stressed to exhaustion, spent thousands of unnecessary dollars just because they didn’t get vaccinated.

    Liked by 1 person

    1. I’m with you Carolyn! Until covid is a thing of the past like smallpox, diphtheria and polio, then people who refuse to get the vaccine are perpetuating the spread of this disease. My mom lost her older brother to diphtheria before there was a vaccine. He was nine years old. She and my grandmother never got over it. The spread of that disease Traumatized the entire family. We have lived in a society filled with medical miracles. Did that make us lazy ? For people suddenly to ignore health and safety precautions seems like there needs to be consequences taken. People are prosecuted for not having a driver’s license, or following other legal protocols. This would just be one more requirement in society to help keep people safe.

      Liked by 2 people

      1. COVID isn’t going away though. It will not be eradicated. It’s a virus, not a disease. COVID/sars has been around and it’s not going anywhere.

        Liked by 2 people

  10. Good topic. I guess my thinking is why not penalize people for other ways they contribute to rising Healthcare costs? Obesity is a huge (no pun intended) contribution. Along with addictions (smokers, drugs). If non vaxxers feel forced to get a vaccine and they suffer side effects, will they be compensated? It’s all so very questionable. The bribes for getting a vaccine and then the thought of being penalized for not. In my opinion it’s a bit disturbing.

    Liked by 1 person

    1. Stephanie that’s an interesting point of view to think of it as a bribe. I think the difference perhaps is that as long as there is a National threat to health, citizens should follow cdc and their doctor’s advice. I’m highly allergic. I also had to wait until my chemotherapy was done. But my oncologist wanted me to get the vaccine. He told me to take 25 ml of liquid Benadryl about 45 mon. before I got the shot. I did that. Yes, I still had an allergic reaction and paramedics on site monitored my breathing by making me wait 45 min after the shot rather than 15 min. The Benadryl worked it’s magic. I had a difficult reaction to the first shot but that was expected. However, the reality was made very clear by my doctors. Without the vaccine the disease would kill me because of my weakened health issues. But, With the vaccine, I’d have a reaction but would survive. So, I trusted my doctor. With the vaccine I’d live and wouldn’t infect others. It was a no brainer.
      I think that’s the thing. At some point we need to trust medical people. My oncologist, besides being a brilliant surgeon, is also certified in the same areas as Dr, Fauci regarding communal diseases. So he is an expert in his field and is called on in community emergencies. I trust the science and the medical field. Plus, I think often about protecting my community from disease.

      Over weight people don’t kill others just by being large. But Second hand smoke can endanger others.. So guidelines on insurance have to be very specific. If someone’s addiction or political views endanger the health of others than perhaps there should be a penalty. People shouldn’t be penalized for a disease they cannot help or get treatment for. But I would leave that to the medical professionals to determine criteria rather than the insurance companies. I think this would not be an issue had this whole thing not gotten political.

      Liked by 2 people

  11. This is one of those where I’m torn. My gut says, in the current climate with the number of deaths and the potential to create an even deadlier variant, then absolutely, the insurance companies should put additional pressure on by holding that as a threat. This is because it not only opens the door to that one person ending up with much more expensive medical care and treatments that the insurance has to cover, but that they could cause other insurance customers to need the same. The main reason why I hesitate is that this kind of action could open the door to the insurance companies using similar leverage over issues that aren’t as critical and end up as more discriminatory. Once you open that door, it is nearly impossible to close it.

    Liked by 2 people

  12. Good thought provoking questions. So many reasons people give for not being vaccinated. Believe me, I have heard many. I see some incentives working to get people to vaccinate but I wonder if financial scare tactics would work. We recently started giving out State Fair Admission Tickets when people get their vaccine. Oddly enough, we have had more than you would think get the vaccine because they want free State Fair tickets. I’m finding it fascinating that facts and statistics did not encourage people yet a small incentive has. Great post for food for thought today!!! So many directions this can go!!

    Liked by 3 people

  13. At first glance that might seem reasonable, but down the line that type of thinking doesn’t work. What about smokers, people who don’t lose weight, those who don’t exercise, people who don’t take their meds on a regular basis…could they all be turned down by their insurance companies? This wouldn’t work. In my opinion, insurance companies collect SO MUCH MONEY from people who barely have any claims that they should be able to afford treating those who do!

    Liked by 2 people

    1. Becky, I think it’s simpler than that. If a person endangers others than they get penalized. It’s about protecting our community and keeping people safe. I’m now a senior citizen. My medication costs doubled the minute I turned 65. So The most vulnerable part of our population is penalized due to age.sadly discrimination happens daily in healthcare.. Medicare is expensive and doesn’t cover as much as everyone thinks. . Cancer treatment is outrageously expensive. My co payment for my last treatment of a new form of chemotherapy was almost three grand. My doctor found me a grant to help pay for the medication. He doesn’t charge me for anything. But the latest life saving drugs are off the charts expensive. (Sadly Only rich people seem to get great health care in America). So quite honestly, I’m not that worried any more about those who are too selfish to care about their fellow citizens’ health and safety. All during the pandemic I was fighting daily to survive cancer. And yet, in South Fl a lot of people spread disease by not wearing masks or getting vaccinated. So, I finally decided that I don’t have a problem with giving higher costs to people who don’t care about others. (This does not include those that have a medical reason for not getting a vaccine.)
      Someone who won’t exercise or take their medication isn’t harming society. People who refuse to vaccinate are. That’s my opinion. Take it or leave it.

      Liked by 3 people

      1. I’m also a senior citizen on Medicare. I live alone and have been mainly isolated for these past months and still wear a mask if I’m in public, indoors. I feel very lucky that I wasn’t battling cancer besides! I would go along with penalizing people who choose not to get the vaccine, I’m just not sure it would work or be feasible to to do that through the insurance companies. Many young people barely depend on their insurance, and this might not be a strong incentive for them. Maybe some kind of a tax would work?

        Liked by 2 people

  14. I think you just like to see a lot of activity on your blog! We have an adult daughter who refuses to get vaccinated because she is worried about the unknown side effects that could potentially affect child birth. Makes for very difficult encounters sometimes since the rest of us are all vaccinated. CA is giving lottery type $$ to vaccinated people and she still won’t get it. “My health is more important than $” which to me is kind of an odd way to look at it since the possibility of getting covid is also a risk she’s taking to her health. It is interesting to think about and I can see something like that coming but what a hullabaloo it will be! I can just hear her rant about “the government forcing” people to do things.

    Liked by 1 person

  15. I read the post LA and the comments. Hot Topic! I’m not going to enter the fray since it seems that emotions are running high here. But I wanted you to know that I read your post today and thought it was definitively thought provoking…

    Liked by 1 person

    1. Janie, That’s half the fun when emotions run high. LOL
      Actually, I think everyone is being civil and just expressing their opinions. Everyone has that right. Great post LA. I was very vocal today because this issue affects me. But, also because I live in a state that is divided when it comes to the vaccination issue. I may be a person who normally is a free thinker and dances to the beat of a different drummer. But, not when it comes to public health and safety. Then I’m a rule follower. Yeah, I totally believe in science.

      Liked by 2 people

  16. I think there is something wrong when people are entered in a lottery to entice them to take the vaccine. Either you take it or not. As for those who don’t take it, they may be on medications for prolonging their life and they are worried about the results of taking the shot. How ill it effect a shot that keeps them alive? Many military veterans have elected to have the shot, and for many their health care benefits are not needed as they use the VA hospital, doctors, etc. and have excellent care, sometimes ground breaking. Forcing people to do things is never a good idea or singling one group out sounds like targeting a group. Like saying “All white people do this…or “All people speaking Hebrew go this line….thanks for listening.

    Liked by 3 people

  17. One of my daughter’s friends mom had a heart transplant. She had the COVID shot. But due to the meds she takes for her body to not reject the heart, she got sick with COVID. So there are valid reasons not to get the vaccine. Would insurance not be a one-size fits all and allow for exceptiions?On our insurance, we can earn “wellness dollars” for completing items on their list. Getting an annual physical, exercising, etc.

    Liked by 1 person

      1. This reminds me of one of my best friends. She is very healthy, a vegan and cycles 50 to 100 miles several times a week. She had a stroke two summers ago. Passed out at the gym. The insurance denied coverage — and it was five days in intensive care. Their reason was she didn’t fill an Rx a doctor gave her high cholesterol. She thought she could control it with exercise and diet.

        Liked by 2 people

  18. My gut reaction is ‘yes’—an insurance company should be able to deny coverage for treatment of COVID to someone who refuses to be vaccinated.

    BUT, I know there are mitigating circumstances in some cases, such as a friend’s daughter who is unable to enjoy the benefit of any type of vaccine due to a wonky immune system.

    And, then, I’m a strong proponent for women’s reproductive rights. My body; my choice. How can I then tell others, vis a vis, a penalty for refusing to be vaccinated, that it’s NOT their choice to decide what’s best for their body in this instance. I may want with all my heart for them to protect themselves and society at large by getting the vaccine, but does that give me (and by extension) insurance companies and hospitals the right to penalize them?

    Liked by 3 people

      1. I’ve been so frustrated with the anti-vax movement for so long. Way before COVID. And COVID. has turned some former pro-vaxxers into politically motivated anti-vaxxers. It’s enough to make me crazy. I may already be crazy.

        Liked by 1 person

  19. I am not sure if we can deny health care coverage to someone just because you refuse the vaccine.
    However many health care related employers where I live are moving towards mandating the vaccines for employees–so curious how this will play out in the long run.
    We have a teaching hospital where I live that employees a big percentage of people locally–could become more interesting down the road.

    Liked by 2 people

    1. I agree, this WILL get very interesting. I’m not going to say where, obviously, but I am aware of a fairly large hospital where as of recently, 43% of the employees have refused to get the vaccine.

      Liked by 1 person

  20. Anti vaxxers make me angry, science gifts you a vaccine that may well save your life or if you do have to go to hospital, may well save you from health disabling ‘long covid’…………….refusing is an act of selfishness and just another trait of the ‘me me me’ generation!

    Liked by 2 people

  21. OH you do like to stir the pot, don’t you! LOL! You raise an interesting question and I am thinking …. If insurance wouldn’t cover it, I could see that opening a can of worms. Not that it wouldn’t necessarily be wrong to not cover it, since they did have the option to get the vaccine, but … what about alcoholics that need medical treatment or druggies or people who smoke and get lung cancer, and the list goes on. We do bring a lot of illnesses on ourselves.
    If they would decide not to cover anti-vaxers, what about the ones who aren’t anti-vax but couldn’t get the vaccine because of an allergy or auto immune disorder,etc?

    Liked by 3 people

  22. I say denying them healthcare doesn’t go far enough. I say round them up and send them to work camps making solar panels and iPhones. As a matter of fact, not just the anti-vaxxers, but everyone who thinks differently than me. It’s for the greater good, really.

    Liked by 2 people

  23. I think this would set an unfortunate precedent for insurance to become more aggressive at denying claims. Eating sugar is a major health risk, smoking, drinking alcohol, not exercising, not following a diet prescribed by a doctor-an endless list of choices people make that affect their health.

    Liked by 2 people

  24. COVID might be a special case…but is it? Would hospitals be able to deny service to those who are admitted with the flu if they didn’t get a flu shot? How about the shingles or pneumonia vaccine if one is older? Would insurance companies be able to hike rates for those who choose not to get these vaccines? Would there come a day when insurance companies (or government free health care) get to monitor what we buy at the grocery store to make sure we’re making healthy choices? Should people receiving food stamps be subject to a review of their choices? Should the government get to weigh in on our personal choices? It’s a slippery slope and while the current pandemic raises these questions, the long-term ramifications of this extend far beyond COVID because once you give these institution the power to approve or deny services based on personal choices, the sky is the limit. I believe many of the COVID un-vaxxed do so because the vaccine didn’t go through normal channels for testing and they would prefer to wait to see what the long-term side effects will be. Yes, you did stir the pot! Be careful it doesn’t boil over!!

    Liked by 1 person

    1. My ego would love to think that I’m the first person to think of this, but as Deb pointed out…this is what every insurance person is thinking right now. And if we use Houston as an example….we are at 200 degrees Fahrenheit….as soon as the first vaccine gets full approval, (which I’ve heard is Sept 1) the game changes

      Liked by 1 person

  25. I’m fortunate in being an observer on this one due to the UK’s health service being free. While private healthcare is available, it’s a matter of choice (and availability of funds). How long that will continue is a big question, as our government is keen to follow the US system and currently pushing through laws to facilitate this. Sadly, the majority of the population either doesn’t know or doesn’t care. My generation will probably be fine, but that of my daughter or my grandchildren will find themselves needing to have this face this type of consideration.

    Liked by 1 person

  26. I swear you and my husband are like twin thinkers or something. He wholeheartedly believes no one should pay for your sickness if you’ve denied specific things, like a vaccine.

    I don’t know where I am with this. The compassionate part of me is like nooooo…., but the other half is thinking meh.

    Liked by 1 person

    1. Well, to be fair, I’m not saying I think this should happen. More like it could happen so what do we think about it…as others have mentioned…there’s a bunch of insurance people combing through fine print of policies. And other than health insurance, what about life insurance?

      Liked by 1 person

      1. The funny part is that people think I’m advocating for this….I’m just presenting an idea that I’m sure someone will try to do. Someone said their friend had a stroke and insurance denied the claim because she didn’t fill her cholesterol prescription….

        Liked by 1 person

      2. 😳 that’s crazy!

        And I understand the misinterpretation. I misunderstood for a sec and I’ve been misunderstood more frequently on my own blog.

        Like

  27. A couple of points, and I understand if you want to delete my comment:
    1. Nothing is free. People are paying for those vaccines through taxes and insurance payments.
    2. The vaccines were approved on a temporary basis because the trials have not actually been completed.
    3. People fully vaccinated with their 2 shots are coming down with Delta variant.
    4. Survival rate from Covid is 99.97% for adults and 99.99% for children.
    5. There are effective therapeutics, but it has not been allowable in some states to prescribe them.
    6. It is not disputed that there are major side effects and deaths from the vaccine, but it is hard to get data on that.
    7. What should be a medical issue has become a political issue.

    Liked by 1 person

    1. Would never delete your comments. You make valid points. I’m not advocating that they should do this. However, we have to consider that this is a real possibility for a variety of reasons. I know what my ER visit cost. Based on that, I’m guessing the cost of the average patient in nyc to get treated in a hospital for COVID, assuming a hospital stay of 10 days, would be a million dollars a person. It would be short sighted to think that on or about September 1, which is supposedly the day that at least one vaccine gets full approval, the game doesn’t change. As someone stated, their friend didn’t take prescribed cholesterol medicine and insurance didn’t pick up cost after stroke. This is a very real scenario that people should at least consider

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s