The Grammarphobia Blog

Preexisting conditions

Q: You can settle a dispute I’m having with my doctor. I say all conditions are pre-existing; otherwise, she wouldn’t be able to diagnose them. No? Nu?

A: Well, from your standpoint, all the medical conditions you have when you walk into the doctor’s office are preexisting.

But they’re not necessarily preexisting from your doctor’s standpoint. And especially not from your insurance company’s.

The issue is not whether the condition preexists when you arrive at the examining room. It’s whether the condition preexists when you take out an insurance policy (or, rather, whether it existed “pre” the policy). 

The Oxford English Dictionary’s entry for “pre-existing condition” defines the noun phrase as an insurance term for “a disease or disorder from which a person taking out an insurance policy is known to be suffering, the effect or treatment of which is thus often not covered under that policy (or is only covered after a certain amount of time).”

The usage is relatively new. The first published reference in the OED is from a 1947 issue of the Reno (Nevada) Evening Gazette:

“Many people with disabilities that formerly were not insurable can now secure this new health service and have these chronic pre-existing conditions removed or repaired.”

The latest citation in the OED is from a 2003 issue of New York Magazine: “My new health insurance doesn’t start until March 1, and I wasn’t sure if dirty-bomb radiation would be considered a pre-existing condition.”

Although the OED uses a hyphen in “preexisting,” as do all the examples cited for this sense of the term, we’ll follow the hyphenless spelling in The American Heritage Dictionary of the English Language (5th ed.) and Merriam-Webster’s Collegiate Dictionary (11th ed.).

Interestingly, the adjective “preexisting” is surprisingly old, showing up in English (minus the hyphen) in the late 1500s.

The earliest citation in the OED is from The Silkewormes and Their Flies, a 1599 book written in verse by the farmer, physician, and naturalist Thomas Moffett:

“Now what are seedes and egges of wormes or foule / But recrements of preexisting things.”

In this sense, the OED defines “preexisting” simply as existing beforehand. A similar adjective, “preexistent,” showed up two years earlier. And the verb “preexist” appeared earlier still.

We’ll end with the OED’s first citation for the verb, from The Difference Betwene the Auncient Phisicke, First Taught by the Godly Forefathers (1585), by Robert Bostocke:

“God, which of nothing, that is hauing no matter, preexisting, or goying before, hast created al the world.”

We’ll assume that “goying” here means going, not hanging out with goys. Nu?

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