Rape as a preexisting condition

According to this article in The Huffington Post, women are being refused health insurance as a consequence of being raped. The reason is that rape victims are given anti-AIDS drugs to prevent them from developing AIDS if they have been exposed- which leaves a record of having been treated for AIDS in their medical records. Afterwards, whenever they try to get health insurance, all the insurance underwriters see in the record is "AIDS patient", and they are rejected for this "preexisting condition".

Outraged? So was I- and I could feel a special sympathy because I, too, have a "haunting diagnosis" in my medical record. Not anything like that severe, nothing that would cause me to lose health insurance, but it has caused me to be later misdiagnosed by doctors who glanced at the chart and made the "obvious" diagnosis without further thought- and once it was a life-threatening condition that was missed, only caught by (lucky!) accident.

After I got over my initial rage at this story, I started thinking about causes. Why do insurance companies disallow preexisting conditions? "Because they're heartless, profit obsessed bastards" is the standard answer, but misunderstanding this is one of the reasons why we have the healthcare problems we do. Lets not single out AIDS; there are a lot of diseases that are both expensive and long term- call it "condition X". Suppose you're an insurance company, and one of your clients develops "condition X"- no biggee, one or two such patients divided by thousands of customers isn't so expensive, and anyway, every other insurance company will have the same percentage of "condition X" patients; you can stay competitive with the market.

So if it's no big deal, business wise, why then refuse them if it's a preexisting condition? Because if you're the first to allow the preexisting condition, everyone with "condition X" will flock to your company, costs will soar, and all your healthy customers will be outraged at your high rates and sign with your competitors instead- you'll be out of business in a year. So you must screen out any preexisting condition that might be expensive; a bankrupt insurance company doesn't help anyone.

This is why requiring all health insurance companies to accept all applicants regardless of preexisting conditions must pass, if nothing else does. Doing that will restore competitive balance; if nobody has to bear the burden of being first, then all insurance companies will have the same mix of customers on average, and so be able to cover any such "condition X" without fear- or outrageous rates.

If we passed the preexisting condition regulation and also licensed the insurance companies nationally, rather than state-by-state, so that we don't have the situation President Obama spoke of with entire states having only a couple of health insurance companies to choose from, half of our healthcare problems would be fixed.