An illustration of how Health Care Reform will manage high-risk individuals who were denied coverage. The federal government has stepped in to increase the amount of funding for high-risk pools, but the type of coverage will vary by state.

The great news is that, come 2014, no one will be denied health insurance because of a preexisting condition.   The less-than-good-news, for people shopping for their own insurance who have diabetes, asthma, or even a pregnancy, is that 2014 is still more than three years away.

Under existing law in many states, insurance companies can turn down individuals for a wide variety of preexisting medical conditions.   Some will offer coverage with a preexisting condition exclusion or a waiting period; they won’t cover a medical expense associated with that condition for an extended period of time.

Why Insurance Companies Deny Coverage for Preexisting Conditions

Insurance companies have a very smart reason to take a hard look at preexisting conditions.   In a totally free market, people would have an incentive to buy insurance when they get sick to cover their bills, but not purchase it when they are healthy.  This works fine for the individual, but not for others covered by the same insurance, because the very concept of insurance relies on the company being able to spread risk among healthy (ier) and unhealthy patients.

Health Reform Offers Insurance for All – Regardless of Condition

In 2014, when the new health reform law goes into effect, denial of coverage will no longer be an issue, because the law requires everyone to have insurance.  “Everyone into the pool!”, including the young and healthy helps spread the risk, so that insurers can cover the 67-year-old diabetic without him bankrupting the system.

So what can individuals do from now until 2014 if they have a pre-existing condition and cannot get individual coverage?   Under health reform, many states have already begun to create or expand their ”high risk” pools – an option for people denied coverage.   In other parts of the country, individuals can enroll directly into the government’s new Preexisting Condition Insurance Plan, or they can request a quote for coverage here.

In many cases, coverage for those who are usually denied coverage is not cheap — not even close.  But it is coverage and a bridge to get us to 2014 when there will no longer be “pre-existing” conditions and insurance rates won’t vary based upon one’s health status.

Is there a difference between choosing a primary care provider (family physician) and a specialist to treat you?

Primary care is struggling. Doctors in this field aren’t getting paid from organizations like Medicare and other government-funded entities. And even though many people who have HMO coverage are required to have a primary care physicians, the same HMOs skimp on payouts to the same physicians in their network. No doubt, as a result, patient care is suffering. We can complain and moan all day about underfunding for primary care, but that won’t address the real issue here: Where is that money supposed to come from?

With our economy in the state it is currently in, we can rest assured that additional funds are going to appear out of thin air (or out of other countries’ pockets) to help us solve our health care issues, but wouldn’t it be nice if everything else could stay well funded (though thinking so is laughable), while enough money went to primary care?

One can dream. The Wall Street Journal Health Blog took an informal survey from readers, asking where they thought that extra money for primary care should come from. The most popular answer was this: Lowering reimbursements for care and procedures provided by specialists. Is this a feasible solution? What would Congress do? Are we all just going to have to keep hoping the health care system in this country is going to magically remedy itself? (more…)

Living and maintaining a healthy lifestyle is always something that should be a top priority. Your body is the only one you are going to get in this lifetime, and you should always be thinking about how to take the best care of it. Ladies, when you’re having to think about being healthy for two (and no we aren’t talking about fretting over your partner’s alarming disdain for vegetables), your health is more important than ever.

Your body is home to a tiny, dependent little being, and making sure you have the best of resources available to you should be your top priority. Your baby needs frequent and adequate checkups from the moment of conception, and this can quickly get expensive if you don’t have health insurance during pregnancy. But sometimes figuring out the best health insurance for you and your soon-to-be new addition isn’t simple and straightforward.

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Editor’s Note: This is the second part of a two-part series on the controversy surrounding health insurance for same-sex marriage partners.  You can find part 1 here.

Let’s assume that the Defense of Marriage Act (DMA) eventually gets repealed. States that don’t support gay marriage aren’t allowed to deny that other states do? Would this then open up the forum for the Federal Government to acknowledge same-sex marriages? It seems that for Obama to agree with what this appeals court in California is bringing up, the Defense of Marriage Act would have to be repealed. We’re talking about health benefits for federal employees and their partners — and it seems that same-sex partners of federal employees won’t be seeing health benefits any time soon unless the DMA is axed.

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Note from the Author: Before I even begin addressing this interesting piece of news, I would like to add a disclaimer. I greatly respect that there are a variety of opinions and beliefs in this world, and I am sure that our reader base is about as diverse as diverse can get. I mean, everyone cares about health insurance right? I also respect that not everyone is going to agree with my opinion. I realize that the sensitive and largely disputed topic of same-sex marriage usually involves disturbing some sort of beehive. If you choose not to agree with what is to follow, then I encourage you to post your thoughts in the comments section.

Even if you aren’t a resident of the Golden State, you probably heard all of the controversy and buzz around California’s Prop 8 back in November of 2008. The proposition passed by voters denies the rights of same-sex couples to legally get married. For those of us who believe that marriage should be a right for all people, regardless of their sexual preference, this proposition’s passage was incredibly disappointing. Interestingly enough, however, a federal appeals court in California seems like it is trying to redeem the state’s liberal reputation.

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Oh Boston…a stunning city rich with history, and understandably mad about their Red Sox. After all, they just so recently overcame the Curse of the Bambino to win a World Series, and it’s no surprise that the city and the baseball cans are rabid for the team’s good fortune to continue. One hospital that provides health care in Boston, Beth Israel Deaconess Medical Center, loves the team so much that they are not going to give up their partnership being the Sox’s “official hospital” while facing massive budget cuts. What is the hospital having to cut to keep ties with the team intact, and how might this effect hospital employees?

A Hospital’s Swing and a Miss

Imagine you are a hardworking, dedicated employee of your local hospital. You work hard, provide patients with the best care imaginable, and one day you come in to work to find that you won’t be getting matching contributions to your 401k as you were promised upon your initial hire. Why? “Oh, we want to keep out relationship with the Boston Red Sox strong. Sorry.”

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