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Get cancer? Get fired, become homeless and lose your health insurance!


Here’s to the new road to ruin in America. Got cancer? Now you can get fired, become homeless and lose your health insurance, and therefore all your money too! Statistically, it’s unlikely to happen. But it’s perfectly legal if your employer has very few scruples.

Being a member of one of America’s most despised minorities – atheists (or secular humanists as we’re now calling ourselves) – and being none too impressed with the New York Times in recent years with both its reporting of Iraq and its continued insistence on writing rubbish about how we get the health care system we want, I have been doubly gratified by a current Times series on the unfair privileges which religious institutions receive in the U.S. It illustrates, in passing, an important point about the relationship between health insurance and employment – for the worse, I’m afraid.

The most egregious case highlights the typical issue of a small business having an employee get sick and firing them. This is nothing new, and employers do this all the time. Why? Because they can. Back in the late 1980s H&H Music changed its insurance policy retroactively to make sure that it didn’t have to pay for the care of an employee who contracted AIDS. It used the simple trick of exempting AIDS from the maximum lifetime insurance of $1 million and changing it to $5,000. Essentially the Supreme Court ruled that under the Employe Retirement Income Security Act (ERISA) self-insured companies (which by the way means virtually all employers with more than 200 employees) can basically make up their insurance plans as they go along.

But it would be a particularly brutal and uncaring employer who upon finding that you had cancer would not only cut you off from insurance, but also kick you out of your house and your job at the same time. And it is. They’re called the Sisters of the Visitation of Holy Mary — an order of nuns in in Toledo, Ohio which kicked out a novice called Ms Rosati. Apparently the sisters have been borrowing from the Torquemada school of Catholicism.

But for [the nun's lawyer] Mr. Heck, the question of whether these workplace exemptions are fair to religious employees was crystallized by the case of Ms. Rosati, the novice nun in Toledo. He said the doctor involved in her case had been prepared to testify under oath on Ms. Rosati’s behalf. The doctor “had quite a vivid memory about these events.” In fact, Mr. Heck said, the doctor had cautioned the nuns who accompanied Ms. Rosati that it would be virtually impossible for the ailing novice to get affordable insurance anywhere else if she were dropped from the diocesan health. Lawyers for the diocese disputed Ms. Rosati’s account of that visit and denied that health reasons were the causes of her rejection by the order, the Sisters of the Visitation of Holy Mary, which is covered by the diocesan health plan.

To paraphrase Mandy Rice-Davies, “well they would say that, wouldn’t they?”

Meanwhile the Times also mentions another case where a rabbi was forced to retire early die to illness, even though he wanted to keep on working and his wife desperately needed access to the temple’s health insurance.

It is though very unclear to me as to whether there’s actually anything legally wrong with cutting someone off from their job to get them off the health insurance docket. You’ll notice that in the case of the nun with cancer, her lawyer is suing for employment discrimination under the Americans with Disability Act, and it’s that act which is being avoided by the order. There is no act enforcing health insurance provision, and there basically is no legal way to compel employers to keep insuring their employees. And of course many don’t, and most new jobs with small businesses no longer come with health insurance, and fewer than 60% of small businesses offer insurance at all.

Of course what’s really going on here is that these employers themselves are struggling with how to afford health insurance for all their employees and are seeing their costs increase. And although really huge employers statistically know that they’ll have a few cancer patients or other sickies in their midst, in the medium and small group insurance market, (let alone the individual market) the consequence of having a sick employee can be pretty dire for the company’s finances, and its prospect of getting a decent insurance deal next time around. Frankly on a purely economic basis, the Sisters are better off sending novice Rosati out into the street.

And that kids is why we need one, big social insurance pool for health care, in which the connection between employment and health care is broken. So these decisions can be taken out of the hands of employers. Because if we can’t trust the religious maniacs to do the right thing, what hope do we have if the country is over-run by atheists?

Share  Posted by Matt Holt at 8:01 AM | Permalink

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