I have good insurance. I like my insurance plan. Even so, I nearly became a statistic yesterday, when my doctor called and said that a procedure, which had been scheduled for weeks, was requiring pre-authorization. I'm scheduled to undergo this procedure today, and in fact, have probably already done so by the time you have read this. I was able to get this little paperwork snafu resolved because I know people at the insurance company, and so I was able to call someone who was able to walk through my pre-auth. Had I not known someone, I would have been up a creek. I'd have been trying to figure out exactly what requirement I hadn't met to have this rather unpleasant test done.

    Now, I bring this up because it points to a what-if scenario. What if we had had single payer insurance already? Then there would have been a more byzantine process to get this test authorized, but it would have been the same for everyone, and the poor doctor wouldn't nave had to guess whether I qualify for the test, so I wouldn't be in the middle of prepping for the test when I found out that in fact I was going to have to pay for it myself if I wanted to have it done. And if the doctor were sure I needed the test, he would be more able to be sure I could get it, instead of guessing what the insurance company wanted to hear in order to approve it.

    Let's say this test reveals that I have a Really Expensive Condition. Let's further say that my wife, who provides the insurance in our home (what, you thought that blogging had a great insurance plan?) gets a great job offer next week. Without a strong public option, at least, or single payer at best, we are trapped by the preexisting condition clause of current insurances, and these clauses aren't scheduled to be outlawed in the next two weeks. If Senator Baucus gets his way, they won't be outlawed at all. This could mean, hypothetically, that my wife would be stuck in a job she hated (except she loves her job, of course) because the doctor found out I was sick right before she got a fabulous job offer instead of right after.

    And while that isn't going to happen to me, it (or something like it) probably did happen to someone this month, and last month, and the month before. I don't know how often it happens, but I'm willing to guess at least monthly, that someone finds themselves screwed on a good job because it would mean changing insurance and thus having a pre-existing condition.

    And that doesn't even count the thousands of people every month who find themselves without insurance because of job loss, who are facing a long search for work. How many of them will get seriously ill while between jobs?

    No, if I, with good insurance, can almost get screwed by my company over a stupid bureaucratic mistake, then it's time to stop pretending that we're preserving the good in the system for anything. If congress isn't willing to condemn every insurance company outright, and make them all fight for their survival in court, then set a bar that they must reach, that includes no denials for pre-existing conditions and no prior authorizations for procedures that doctors deem necessary. Any company that doesn't reach the bar would be subject to condemnation.