Coverage denied

Via C&L, the LA Times looked at the healthcare proposals of the leading GOP candidates and found, not surprisingly, that under each of their proposals the cancer-surviving candidates would themselves be denied coverage.

WASHINGTON — When Rudolph W. Giuliani was diagnosed with prostate cancer in the spring of 2000, one thing he did not have to worry about was a lack of medical insurance.

Today, the former New York mayor joins two other cancer survivors in seeking the Republican presidential nomination: Arizona Sen. John McCain has been treated for melanoma, the most serious type of skin malignancy, and former Tennessee Sen. Fred Thompson had lymphoma, a cancer of the immune system.

All three have offered proposals with the stated aim of helping the 47 million people in the U.S. who have no health insurance, including those with preexisting medical conditions.

But under the plans all three have put forward, cancer survivors such as themselves could not be sure of getting coverage -- especially if they were not already covered by a government or job-related plan and had to seek insurance as individuals.

"Unless it's in a state that has very strong consumer protections, they would likely be denied coverage," said economist Paul Fronstin of the Employee Benefit Research Institute, who has reviewed the candidates' proposals. "People with preexisting conditions would not be able to get coverage or would not be able to afford it."

If the arguments against the Democratic presidential candidates' healthcare plans include higher taxes and greater government involvement, then the Achilles' heel of the GOP plans is their dependence on the private market, which often rejects applicants with health problems.

Republicans want to expand the existing private insurance system, offering new tax breaks as a way of helping people buy insurance individually. But they also want to avoid federal regulation that would tell insurers whom they have to cover and how much they may charge.

That means the self-employed and others seeking individual coverage would be subject to a marketplace in which insurers generally pick the healthiest applicants and turn the rest away. Cancer survivors -- even if they have been free of disease for several years -- are routinely denied health insurance when they try to purchase it as individuals.

Even if coverage is offered, it often comes with restrictions or high premiums that many find unaffordable.

In the individual market, coverage rules "are really quite fussy," said Karen Pollitz, a Georgetown University research professor who specializes in the field. "Most companies won't touch you if you have a cancer history within five years, and with some companies . . . if you've ever had cancer, you can't get coverage."

Fortunately for Giuliani, Thompson, and McCain, they don't have to worry. As current or former government employees, they're covered under the "socialized medicine" of state and federal government healthcare plans.

Best line in the story: "Thompson's plan is a broad sketch at this point, and an advisor said specific options on coverage remained in development." Like the man himself.