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October 23, 1991

Insurance Loss Threatens Medical Gain

JAMA. 1991;266(16):2185. doi:10.1001/jama.1991.03470160013003

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YESTERDAY'S medical miracles are running headlong into today's health insurance morass.

Advances in repair and treatment of congenital heart defects over the last few decades are allowing hundreds of thousands of those who would have died as children to thrive now as young adults. New, long-term follow-up data show that their morbidity and mortality rates are often little or no different from those of the general population.

Yet these healthy and productive people are increasingly unable to get what health care they do need due to the metastasis of severe medical underwriting practices by health insurance companies. Those with congenital heart defects logged in their medical records are either excluded from coverage altogether, or from coverage for any cardiac-related care, regardless of their current health needs or prognosis.

Part of Daily Practice  Norman S. Talner, MD, professor of pediatrics and diagnostic imaging at Yale University School of Medicine, New Haven,