'Yes, I'm ringing for a quote for some travel insurance. I need to declare a pre-existing medical complaint.'
'No problem at all. Can I just check that none of you have a terminal illness, or are awaiting surgery?'
'I'm awaiting surgery. But it will be done well before the trip.'
'What's it for?'
'A trapped nerve. But as I said, it will be done well before the trip.'
'Unfortunately we will not be able to cover you for the trapped nerve.'
'Well, that's OK, it won't be trapped by then.'
'No, but if you need to cancel because of the trapped nerve, you won't be covered.'
'Do you have any other pre-existing illnesses?'
'Yes. I have systemic lupus.'
'Oh, right, OK. I just need to ask the following questions. How many medications do you take for the lupus?'
'Is it 0-2, 3-4, 5-6 or more?'
'It's still one.' There is a pause. '0-2.' The pause this time seems to have taken on a slightly disbelieving quality. 'Well, I do take a further two medications but these are to protect me from the effects of the one.'
'So you take 3-4.'
'No. I take one drug for the lupus, prednisolone. I take another drug so that the prednisolone doesn't irritate my gut, and another so it doesn't weaken my bones.'
'Oh, OK. So you take 0-2 medications for your lupus.'
'And you take one for your gastric reflux.'
'Yes!....no, wait. I don't have gastric reflux.'
'Is the drug one that ends in "...azole"?'
'Yes...omeprazole....' (feeling that I am walking into a trap)
'Then you have gastric reflux.'
'Ah, no, you're misunderstanding. You see, I don't have gastric reflux, never have had, because I am on omeprazole. Not the other way around. It's preventative, you see. Trust me, I'm a nurse. Next thing you'll be telling me that I have osteoporosis, because I'm on bone-protecting medication.'
'And you also have osteomalacia, for which you take 0-2 medications. That's not so bad, it's just softening of the bones.'
'I definitely don't. I've had scans. My bones are stronger than yours, I'll bet.'
'I'm sorry, Madam. You are on this medication. Therefore you are classed as having these conditions. Therefore we must charge you extra.'
'So I'm stuffed for being cautious and sensible'.
(brightly) If you come off any of these medications before your holiday, you can let us know, and we may be able to reduce your premium.'
'So I'd be rewarded for putting myself in a position where I'd be more likely to develop a medical problem whilst on holiday.'
'Now, is there anything else? No heart problems? Is anyone on blood pressure medication?'
(Thinks: actually, my blood pressure has been a bit high of late, years of taking the prednisolone are catching up. But playing safe by seeing the GP to start medication is clearly going to cost me.'
'No, nothing that way at all. Fit as a fiddle.'
So...the moral of the story is: if you want to stay healthy, keep taking the tablets. But if you want to keep the insurance premium down, stop. Which of course makes it far more likely that more people, having a strong disincentive to start / continue on preventative medicine, develop problems that in the long run put up the premiums for us all.
Bit of a wobbly system, isn't it?