SIGforum.com Main Page The Lounge Ongoing issue in politics with healthcare and covering Pre-existing conditions
Main Page The Lounge Ongoing issue in politics with healthcare and covering Pre-existing conditionsPage 1 2
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| Member |
Maybe I’m naive, but why is this such a talking point in politics. I would understand the government stepping in and saying “hey Mr. insurance company, you’re not allowed to drop people for GETTING a condition” because that’s why you pay insurance. I’m just unsure why, let’s say you have cancer and no insurance, an insurance company would then be required to insure you. Isn’t that like saying I don’t carry car insurance but after I get in a wreck I call the insurance company to buy insurance and expect them to cover yesterday’s wreck? Again I know politics and stuff are against the forum rules so not trying to get in a huge debate about it I’m just trying to understand what I’m missing. I’m also not saying I’m for/against it I really just don’t understand why an insurance company would be required to cover someone that they KNOW already has whatever condition. The goal of insurance is to hope the good outweigh the bad and going in knowing it’s bad seems weird. | ||
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| Member |
Insurance companies were using preexisting conditions to deny insurance to practically everyone. It still exists if you swith Medicare supplement plans. It is not an issue of having no insurance for years getting cancer and then signing up. Insurance companies make plenty of money. The two provisions of covering preexisting conditions and allowing your child to be covered up until age 26 will continue. | |||
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| Member |
Gotcha. I appreciate it thank you | |||
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Unflappable Enginerd |
News to me!  __________________________________ NRA Benefactor I lost all my weapons in a boating, umm, accident. http://www.aufamily.com/forums/ | |||
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goodheart |
Much as I despise Obama and hate Obamacare, it did make it possible for our overweight son to get health insurance previously denied. I have no idea how the Republicans are going to keep their promise of “protecting people with pre-existing conditions” without destroying the health insurance market—for just the reason you mentioned. _________________________ “Remember, remember the fifth of November!" | |||
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Member |
How does this work? For example: if someone has a chronic condition that requires on-going treatment or expensive meds that are covered currently under an employer insurance plan. And then the employer lays off that person or the person wants to find a better job. The person is no longer insurable? That seems to suck and doesn't seem right. One should at least be able to continue the original employer insurance plan at whatever the cost is. Now, if one had no insurance and was seeking insurance, then perhaps that's a different situation. But if one has had insurance, one should be able to reasonably maintain insurance. At least on the face of it..... ETA: if pre-existing conditions gives one pause for pursuing different employment and/or makes one uninsurable through involuntary employment discharges, then it seems like something is wrong w/ the system. This does not seem largely beneficial to society. And somewhat makes one beholden to current employer. One could argue it's always a choice, but perhaps not pragmatically. "Wrong does not cease to be wrong because the majority share in it." L.Tolstoy "A government is just a body of people, usually, notably, ungoverned." Shepherd Book | |||
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| Member |
^^^^^^^^^^^^^ The insurance companies will simply raise their rates. The health insurance companies have been very successuful in their lobbying efforts. The companies knew this might be coming and they are prepared. I read the annual reports. UNH is hitting new highs. | |||
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| Member |
I'm sure some will flame me for this...but WHY should your employer pay YOUR health insurance? Does your employer pay your auto insurance or homeowner's insurance bill? The system needs to be blown up and true free market enterprise needs to be allowed. Let people buy what type of insurance they want, instead of some Obamacare mandated crap that includes coverages that many don't want or need. And open the market up across state lines so that insurance companies actually have to compete. Many "pre-existing conditions" are self inflicted. Yet most people won't make the changes to correct the issue so they can get coverage. But then bitch about the cost of coverage. I understand that some conditions can't be controlled, but if you're going to force an insurer to cover it, they should be allowed to price the policy accordingly. Just like auto insurance, if you have a shitty driving record, you pay more. And people need to pay their own way so that insurance is portable. There's a reason its called a "benefit" from employers. Once it stops being a benefit and is becomes a requirement now its just another cost of doing business and employers will look for the lowest, cheapest price. Health insurance needs to move away from the employer and back to the individual. Most people don't give two shits about the cost when someone else is paying the bill. If individuals bought and PAID for their own insurance, the costs would correct themselves PDQ. If doctors, hospitals and medical groups were held accountable for pricing BEFORE a procedure or surgery, the bullshit pricing issues would stop. Bottom line, INDIVIDUALS need to pay their own freight, and start questioning every cost of every line item, test and procedures that doctors want to perform. I bet most know what your auto insurance cost, how many know the TRUE cost of your health insurance? Not just your out of pocket, or your share of premium or your co-pay, but the FULL REAL amount that your employer shelling out. Health insurance also needs to go back to being insurance, not prepaid healthcare. Insurance should cover unforeseen events, not regular visits and such. Why do people think it should cover regular doctor's visits? Go back to an actual pay for service plan, costs will come down as a result. Our current system is like asking your auto insurance to buy you new tires when they wear out. You know they're going to wear out. Yes, some people purchase prepaid service plans for their vehicles, and they pay accordingly. The same should go for pre-paid health care. The question really should be do you want pre-paid healthcare or do you want health insurance? | |||
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| Member |
I am self employed and paid the full cost of my family's health insurance since 1980. Doctors are not the problem. The days of profiteering are over with the exeption of those writing prescriptions for opiates. I think you need to study history to understand the origins of our current system which tied healthcare to your employer. Medicare did not begin until 1965. Take a look at the biggest lobbyists in D.C. What you propose is not going to happen in your lifetime. Medicaid, the health insurance for the poor and disabled is paid for by taxpayers. It has its problems. | |||
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| Thank you Very little  |
Actually not completely true, If you have a pre-X prior to obamacare, and you were insured covering that Pre-X, when you changed jobs the new carrier could not deny you on that condition. If you didn't had coverage and had a condition, prior to obtaining any insurance coverage, or, you lapsed your coverage then yes the carrier could deny Pre-X. Individual coverage did have Pre-X restrictions, but you could move group to group without restrictions. ZeroCare changed that, and it's why your premiums are $3000 a month for full family vs $1500 a month. Everyone wants Pre-X covered but ignores that putting that into place dumps millions of people into the claims pool immediately raising claims expenses. Insurance isn't Health Care, It's Insurance, I'd like to see it broken into two types of Health benefits. Care and INsurance. You want Health Care, you pay X You want Insurance, You pay Y Buy both is you'd like, people think that Health Insurance is pre-paid health care, PPO and HMO plans have done this and it's why many folks do want socialized health care. Insurance isn't care, you don't buy Car Insurance and expect Aetna to pay for your oil change, belt replacements, engine rebuild, etc. That's what's happened, we've morphed care into insurance. | |||
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| Yew got a spider on yo head  |
Why would I flame you? Do I look like a commie to you? *raises one eyebrow* | |||
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| Member |
^^^ OK I will grant you that. Insurance companies did go through considerable effort to FIND some preexisting condition to delay or get around claims payment. A note in your chart that your Doc prescribed Wellbutrin would preclude any mental health care. You could appeal and explain that it was for smoking cessation and then they might cover. Of course all that time the doctor was not paid or said he could not see you. I recall the onerous forms that needed to be completed. It was all a game to avoid payment. I would love to see a cash system except for hospital care. Concierge care is what it is called and I have friends that do it. | |||
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| Do No Harm, Do Know Harm |
Whose employer is paying 100% of their health insurance cost these days? Hell, many employers are just cutting their insurance plans entirely. For as much is I pay for my insurance plan these days, you’re damn right I expect it to cover more than catastrophic events. It’s absolute insanity. I actually believe that employers should go back to paying more, as part of a competitive salary package. If I was looking at two jobs, being close to the same, you can absolutely bet I’m gonna look at health insurance cost and details as part of that package. Because we know damn well they’re not gonna pay me enough to afford health insurance all by myself. We’re not talking about a couple hundred dollars a month for most people. Health insurance premiums are thousands of dollars a month. And it’s only getting worse. Knowing what one is talking about is widely admired but not strictly required here. Although sometimes distracting, there is often a certain entertainment value to this easy standard. -JALLEN "All I need is a WAR ON DRUGS reference and I got myself a police thread BINGO." -jljones | |||
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| Member |
Well, I disagree. There is no reason an employee couldn't take the cash wages and buy the insurance plan that meets their needs. | |||
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| A teetotaling beer aficionado  |
Years ago medical insurance was for going to the hospital, not for every ache, pain or sniffle. Got to see your family doctor, $25 (probably $150 in today's dollar) out of pocket was the norm and no one complained. Well that morphed into "I want every nickel covered" and of course that drove the cost out of sight. After the military, I didn't go to the doctor until I was about 35 and that was because of poison ivy. And even after that, regular doctor visits didn't start until I was late 50's. In the end insurance companies are businesses betting you will stay healthy and keep paying your premiums. Taking on someone with terminal cancer or end-stage renal disease will be very costly to them and that cost will be passed on or the company will go out of business. I don't have and answer and I do have compassion for those in the lower economic curve that struggle with medical costs these days. I just find it hard to grasp that the government can fix this very easily. Men fight for liberty and win it with hard knocks. Their children, brought up easy, let it slip away again, poor fools. And their grandchildren are once more slaves. -D.H. Lawrence | |||
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| Do No Harm, Do Know Harm |
You are absolutely right. But if I’m looking at two jobs, and one of them is going to save me $2,000 a month, which one do you think I’m gonna go to? And add in the complication that in many cases the person can’t access plans as good as an employer may be able to access. Companies have that exact option right now. Like I said, many places are no longer paying for health insurance. But if you’re not gonna pay for my health insurance, give me my two grand so I can go buy my own. Otherwise, highest bidder wins. Healthcare is a massive consideration to me when I look at employer. It is one of the main reasons I work where I work now. And at the trajectory we’re looking at, it’s only going to get worse. I firmly agree that Health insurance should not cover every piddly visit to a doctor. But the prices I am paying right now are stupid. And the coverage I have is nowhere near as good as it was 15 years ago. The system is broken. But I’m gonna get the best I can out of it for myself and my family. My employer only pays a fixed amount across-the-board. Anything else is covered by the employee. So if you get the cheapest high deductible plan, or the most expensive PPO plan, my employer pays a flat rate, and you are responsible for the difference. And the difference is crazy. I cannot afford the best PPO they offer. They pay nothing on vision and nothing on dental. You just have the option of a negotiated plan price. The single greatest thing about my employer’s health system is that they have their own primary doctor/sick care locations. They realized that doing that save them money in the long run. Knowing what one is talking about is widely admired but not strictly required here. Although sometimes distracting, there is often a certain entertainment value to this easy standard. -JALLEN "All I need is a WAR ON DRUGS reference and I got myself a police thread BINGO." -jljones | |||
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Sigforum K9 handler |
Insurance seems to be an area that even conservatives want for free, or they at least want someone else to pay for it. There are so many falsehoods about the topic. NO ONE in the US is “denied” health care. And they never have been. This idea of healthcare being a “right” is one of the dumbest talking points known to man. You can go to any doctor, any hospital and they can’t refuse you. It comes down to who pays, and that’s the heart of the issue. That’s pretty simple. If you introduce a large number of high risk into the system, someone has to pay the tab. Insurance is no longer affordable because now all the “preexisting conditions” have to be paid for. That is part of the problem. The other part of the problem is hospitals and providers have gotten ridiculous on what the can and do charge. My son had his tonsils out. Total billed amount- $29,000. Surgery lasted 8 minutes. I fully understand that pre-op and post op takes time and money. The hospital charged nearly $11,000 for rent of the OR and “supplies”. Ridiculous. | |||
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| Member |
Medical insurance is ridiculous. I’m all for distribution of risk so the average price is affordable just like all insurance. It’s a sharing of risk, and yes some conditions are behavior related (just like a driving record), but there are many that are not. If you took out the insurers profits and overhead costs, required transparency and fairness in billing, coverage costs would be less. It’s not abnormal for a doctor to lose 10-15% of gross to medical billing services (that literally just interpret and code the costs to insurers). There are also many instances, where the doctors must bill PHI significantly more than Medicaid/Medicare to cover their costs. It wouldn’t surprise me if insurance and billing costs are 35% of our healthcare costs. Not covering pre existing conditions is a problem to me. I had an ex MIL. She Got brain cancer, and lost her job. When she lost her job, she lost her health insurance. Now, she’s no longer covered or coverable for anything related to her cancer. Several friends have T1D, not behavior related. Before the ACA, if they left our employer they could be denied coverage for any care related if they had a lapse in coverage. I don’t like a system that can bankrupt a contributing member of society when the coverage is not extraordinary. Where you draw the line is not an easy decision to me, but one that I feel warrants discussion. There are many services we have in this country that cover everyone with some basic level of service. Think education, fire, police, and countless government services. Are there better private options? Always. Is our government ever the most efficient at providing these services? Never. I personally feel there are improvements we could make to our current system though. | |||
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| Member |
I would just expand Medicare (or is it Medicaid) and then tax everyone $2-5 a month to pay for it......and leave everyone else's health insurance alone. | |||
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| Member |
^^^^ Medicaid is for poor people, unwed mothers below the poverty line and the disabled who meet income guidelines. Medicare is for those over 65 and the disabled who have worked a sufficient amount of time. We already pay a payroll tax for Medicare and Seniors pay several hundred or more per month in most plans. I wish I could pay two bucks a month. | |||
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SIGforum.com Main Page The Lounge Ongoing issue in politics with healthcare and covering Pre-existing conditions
Main Page The Lounge Ongoing issue in politics with healthcare and covering Pre-existing conditions© SIGforum 2024