Pre-existing Language Condition

Pre-existing condition.

Lifetime cap.

Jargon. Jargon that gets in the way of understanding.

The President yesterday used these terms again when explaining the benefits of the Affordable Care Act that was upheld by the Supreme court.

Most Americans, barraged by conservative advertising, don’t like the law. But when asked about the law’s features, they like those. Democrats, particularly the president, have done a terrible job explaining in plain English what the law does.

How many Americans can explain “pre-existing condition” accurately?

“So you’re sick. You have diabetes,” the president should say. “You want health insurance to help pay for the huge costs of treatment and medicine. The insurance company says they won’t pay for any of the costs of treating your diabetes — can’t cover you for the very thing you need help with. So you can’t afford to get well. The Republicans think that’s okay. I don’t.

“So you have insurance, and then you get sick with diabetes. The insurance company says they won’t cover you anymore because you’re sick. The very thing you have insurance for causes the insurance company to dump you. And now you can’t afford to get well. The Republicans think that’s okay. I don’t.

“So you’ve been sick for awhile. Diabetes, skin cancer, now some broken bones. The insurance company says you’ve reached the lifetime limit of how much they’ll spend to help you, and now they won’t cover the cost of treatment. And now you can’t afford to get well. The Republicans think that’s okay. I don’t.

“Do you?”

The Institute of Medicine found almost 10 years ago that “nearly half of American adults face higher health risks because of trouble understanding medical terms and directions….Comprehending medicine’s arcane jargon is difficult for even the most educated person but is almost impossible for the millions who can’t read well, aren’t fluent in English or have vision or cognitive problems caused by aging.”

Speak more clearly, Mr. President. No jargon.

We have a friend here, my age, who pays huge monthly health insurance premiums. She doesn’t make very much money, she’s raising several young family members — grandkids, nieces — and can’t afford to pay her share of the drugs she needs. Hasn’t taken needed medication for over a year.

It’s not right. We need the reform Obama is leading. And we need him to help us understand that reform, and understand who’s standing in the way.

— Bruce Benidt

17 thoughts on “Pre-existing Language Condition

  1. Erik says:

    Conservatives have been pretty helpful here actually, what with their introduction of the term “death panel” in place of the ambiguously named “IPAB”.

    1. Erik: You appear to be a bright guy. Do you really, truly believe that the administration plans to put into place “death panels”?

  2. Erik says:

    Clarifying jargon isn’t any more helpful to Obama than it is the Republicans. This obfuscation around “pre-existing conditions’ is a perfect example.

    There isn’t an actuarial model that can be devised where it’s possible to offer say a $500 monthly premium to a person who is guaranteed to consume $2000 worth of services. To the extent that service can be offered, it ain’t insurance… It’s something else. Basically welfare. Which is fine by me, but there’s a lot of political baggage there.

    People understand this when it’s explained explicitly. Which is why it’s never explained explicitly.

  3. Jeremy Powers says:

    I agree there is jargon, but you would have to live in a cave – intellectually – to not have a general idea of a pre-existing condition. (OK, granted, that is a large group of Americans.)

    Wall Street jargon is much worse. It’s like a club. Sports jargon IS a club. (Although I spent most of my young life in Minnesota, I went to high school in California and have to run screaming from any room where people are discussing hockey. There is not even a crib.) And political jargon is essentially repeated in the press verbatim and rarely challenged. I saw the expression “anchor baby” used in the recent decision regarding immigration as if it was as clear to everyone as “car tire.”

    Actually, to me, what should be explained here is the advantage of early diagnosis. Type 2 diabetes is a perfect example. Caught early and with a willing patient, it is quite manageable. However, if you let it go, that’s where the real trouble and costs come in. This is what is NOT happening under America’s misnamed “greatest health care system in the world.” Several of the people I saw interviewed about not wanting or needing health care in the last day had a pack of cigarettes in their pocket and were overweight. Let that continue for 20 more years and when that person DOES need health care, it’s going to be for a heart bypass operation and a foot amputation.

  4. Newt says:

    Re: Death panels. What compelling interest does the federal government have in offering “end-of-life consultation,” other than to expedite end of life and end-of-life expenditures? I would say death panels are aptly named.

  5. Jeremy Powers says:

    End of life consultations, to me, mean talking about death. But there are laws that prohibit doctors from talking about anything but “natural” (read painful) death because the so-called pro-lifers want people to go to heaven. Complete and utter nonsense.

    I know the Tea Party people believe any form government is evil, But if that were the case, Medicare would be out there killing people to save a buck.

    Calling end of life consultation “death panels” is like referring to our prisons as gulags, our military as organized murderers, our police as butchers and our teachers as indoctrinators.

    1. Newt says:

      Again, what compelling interest does the FEDERAL GOVERNMENT have in offering end-of-life consultation?

      1. Bruce Benidt says:

        Newt, 60 Minutes reported that in 2008 the cost for docs and hospitals to take care of Medicaid patients in the last two months of their lives was $55 billion. We all pay for that. Most of that care is ineffective at best. Talking with patients and family ahead of time to determine how much heroic care they want can help bring that cost down. If someone wants all heroic measures, they say so and receive them. If they don’t, they say so ahead of time in a living will and they can die in relative peace. Counseling families about all this is humane, and cost-effective.

        It’s not just about money.

        Both of my parents died with their family there and no medical interruptions, because, when my dad was diagnosed with a fatal disease, I sat down with both my parents and talked through what they wanted and wrote living wills.

        A dear friend of mine’s father was dying, and they had written a living will together — no heroic measures. At the end, a nurse rushed in and called for a doctor and all kinds of medical procedures to try to prevent the death. My dear friend looked at the nurse and said, “We have a living will, my father wants no heroic measures and wants to die in peace with his family around him, and if you touch him I will throw you through the window.”

        Thinking and planning for death is in everyone’s interest.

    2. Rob Levine says:

      Well, if you follow the news, many of our prisons ARE like gulags. And what else is our military except organized murderers? The president even individually is selecting who gets to die next.

  6. Expatriate says:

    Brother Benidt —

    You visit this theme with some frequency within this forum. I quote:

    2009: “Speak straight with us, President Obama. Please.”

    2010: “How hard is it, for a speaker of Obama’s caliber, to just look at the cameras and talk?”

    2011: “Talk like a human, Mr. President….Come on, you know this. What’s happened?”

    2012: “Speak more clearly, Mr. President. No jargon.”

    [Let the commenter chorus begin: “It’s strategic!” “Bad advisors!” “Too cautious!” “The left bought into an illusion in 2008!”]

    Be all that as it may.

    But Benidt, this has vexed you for three and a half years. Are you about ready to throw in your Strunk and White Commemorative Towel on this one? Or will you continue this cri de coeur at intervals in the hopes that the communicator you envision will one day emerge and beat his teleprompter stands into East Room topiary supports?

    1. Bruce Benidt says:

      Brother Hornseth, old age is a wonderful thing. I can repeat things over and over and not know I have. I can repeat things over and over…oh.
      I may let it go for a year now.
      I was amazed that several commentators said Obama had done such a good job, after the court ruling, explaining the reforms. Apparently this drives me crazy. Crazier.

  7. Wiki says: Jargon is terminology which is especially defined in relationship to a specific activity, profession, group, or event. I agree – that’s what the word has always meant. There’s nothing inherently bad about jargon as long as you use it in the appropriate context. (Know thy audience.) “Lifetime cap” might qualify as jargon, but it’s not at all ambiguous as far as I am concerned. I’d call it “plain English”….”Pre-existing condition” – don’t see that as jargon and I can’t imagine anyone having difficulty understanding what it means. I take it Mr. Benidt had a slow news day on his hands.

    1. Bruce Benidt says:

      Burgess, this is a particular hot button for me. I make my living helping people bust jargon, so I’m a bit touched in the head about this.

      But try this on — from the Good Neighbor Insurance website, in the “understanding insurance” section, defining pre-existing condition:

      “Any injury or sickness, or any complications there from which is present or manifest itself, or for which medical care, treatment, advice or consultation was rendered to a Covered Person with the 12 months period prior to the Effective Date of Coverage. Any injury or sickness shall be considered to be present or manifest if the condition or symptoms exist prior to the Effective Date of coverage, even though no diagnosis, care or treatment were sought or received.”

      Clears it right up for me.

      I still think it’s jargon, in the sense that jargon is institutional, bureaucratic language. Jargon denatures, dehumanizes any issue. It robs us of understanding, understanding of the brain, and understanding of the heart.

      I sent you a msg on facebook — not sure it got through. I think we are old South Minneapolis neighbors.

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