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It negates the entire concept of risk mitigation and insurance. If an insurer must insure you regardless of preexisting condition and must also do so at an artificially low rate mandated by the government, adverse selection and the death spiral of the insurer is guaranteed.
Why buy insurance ahead of time if you know for a fact that an insurer must insure you no matter what? Wait until you get sick, buy insurance when you know medical expenses are coming, take the insurance provided discount, get better, dump insurance, wait for next medical issue, lather, rinse, repeat.
And this is EXACTLY what happened after the ObamaCare change occurred. Young and/or healthy people blew off buying insurance, correctly calculating how much cheaper the tax penalty was, and old and/or sick people were the only ones signing up. Adverse selection, prices started shooting up and insurers began dropping out of the marketplace. It was guaranteed to happen and did.
Private insurers cannot survive on their own with the combo of preexisting mandate and mandatory community based rates. Either by themselves violates virtually every rule of actuarial math, and together are simply an ironclad guarantee of insolvency.
Only government can "insure" under those rules because they have exactly zero revenue, cost or profitability concerns. Whatever they want to do, they can simply do by force. Nobody else has this luxury. So the preexisting mandate can only work if they are the provider. Nobody else can mathematically sustain that nonsense.
Essentially, if the preexisting thing is mandatory, having anything other than government as single, sole, solitary provider of health care/insurance makes no sense and simply delays the inevitable.
I'm glad you are finally arriving at some useful conclusions.
I think ALL HC insurance companies should cover prosthetics. I just don't know if I'll need one tomorrow, next week or year.
My wife had no idea up to the morning of 1/1/17.
Then ask when negotiating the policy. Why does government have to force the coverage? What if other members of the risk pool don't want, need or care about it?
Sorry to hear about your wife, but her misfortune does not create a need for a new level of tyrannies and government intrusion.
It negates the entire concept of risk mitigation and insurance. If an insurer must insure you regardless of preexisting condition and must also do so at an artificially low rate mandated by the government, adverse selection and the death spiral of the insurer is guaranteed.
Why buy insurance ahead of time if you know for a fact that an insurer must insure you no matter what? Wait until you get sick, buy insurance when you know medical expenses are coming, take the insurance provided discount, get better, dump insurance, wait for next medical issue, lather, rinse, repeat.
And this is EXACTLY what happened after the ObamaCare change occurred. Young and/or healthy people blew off buying insurance, correctly calculating how much cheaper the tax penalty was, and old and/or sick people were the only ones signing up. Adverse selection, prices started shooting up and insurers began dropping out of the marketplace. It was guaranteed to happen and did.
Private insurers cannot survive on their own with the combo of preexisting mandate and mandatory community based rates. Either by themselves violates virtually every rule of actuarial math, and together are simply an ironclad guarantee of insolvency.
Only government can "insure" under those rules because they have exactly zero revenue, cost or profitability concerns. Whatever they want to do, they can simply do by force. Nobody else has this luxury. So the preexisting mandate can only work if they are the provider. Nobody else can mathematically sustain that nonsense.
Essentially, if the preexisting thing is mandatory, having anything other than government as single, sole, solitary provider of health care/insurance makes no sense and simply delays the inevitable.
I understand what you mean about the insurance industry having a cost vs risk model, but we're not talking about car insurance or flood insurance here. We are talking about life vs death. If someone cannot get car insurance because they have DUIs, they can take cabs or the bus. If someone cannot get health insurance because they are sick, I guess they'll just have to win the lottery or die?
I don't even know why it's called health "insurance". Insurance is supposed to be for unexpected events that can potentially bankrupt someone. Going to the doctor for a checkup or going to the dentist for a cleaning is anything but unexpected.
Here's what I'd say: Prohibit insurance companies from denying coverage for pre-existing conditions, but allow them to charge the actual rate. Seems pretty fair.
I'm glad you are finally arriving at some useful conclusions.
1) In a public discussion forum, my conclusions are not required to be useful. Take your above quoted bit of condescension...nothing useful about it really, yet still the forum allowed it to be posted. Remarkable thing, that.
2) I made all these points before ObamaCare ever got passed. Actuarial science and mathematics are what they are. Same as all of the theories/laws of the universe, they exist independently of how human beings feel about them. From that immutable basis, the preexisting + community based rates creating an adverse selection death spiral is as predictable as the Sun coming up in the east. Nothing too prescient there, same as predicting the sum of 2 + 2.
I have always maintained that only government can do these things because only government can conjure revenue out of thin air or take it by force. Only government can pick and choose winners and losers in an industry and back the choice with force of law and threat of violence. So only government can "solve" the preexisting problem, by bludgeoning the entire nation over the head with their various revenue generation methods and by forcing actors in various roles to perform on their command, or else. No other possible way to make it work really.
Back to your unfortunate wife. In a private market run by normal actuarial rules, her misfortune would indeed be a huge dilemma for you both. I do not deny that for a second. Totally accept that as a true statement. Her misfortunes would be greatly alleviated, to the maximum extent they can be anyway, if instead of a private market, we simply jam a freaking gun in the face of every taxpaying American and demand they contribute t the cause of alleviating her suffering. Point being, if we can alleviate her suffering, we must, whether we care to or not. Okie doke, we all just took the Hippocratic Oath at gunpoint.
At this point, I don't much care. I am actually for nationalized healthcare if it will shut everyone up about how we need to be more like other countries and can't we all just have a heart. Plus, listening to every shrieking hysteric, apparently nationalized healthcare means we're all going to live forever, since access to healthcare is the ticket to immortality...and heck yes, I'm down with living forever.
Then ask when negotiating the policy. Why does government have to force the coverage? What if other members of the risk pool don't want, need or care about it?
Sorry to hear about your wife, but her misfortune does not create a need for a new level of tyrannies and government intrusion.
That's it. It should not be a 'new level.'
Any patient should not have to worry if a medical standard of care is not covered by their HC insurance.
Here's what I'd say: Prohibit insurance companies from denying coverage for pre-existing conditions, but allow them to charge the actual rate. Seems pretty fair.
Then only the rich get this coverage without central supports.
It negates the entire concept of risk mitigation and insurance. If an insurer must insure you regardless of preexisting condition and must also do so at an artificially low rate mandated by the government, adverse selection and the death spiral of the insurer is guaranteed.
Why buy insurance ahead of time if you know for a fact that an insurer must insure you no matter what? Wait until you get sick, buy insurance when you know medical expenses are coming, take the insurance provided discount, get better, dump insurance, wait for next medical issue, lather, rinse, repeat.
And this is EXACTLY what happened after the ObamaCare change occurred. Young and/or healthy people blew off buying insurance, correctly calculating how much cheaper the tax penalty was, and old and/or sick people were the only ones signing up. Adverse selection, prices started shooting up and insurers began dropping out of the marketplace. It was guaranteed to happen and did.
Private insurers cannot survive on their own with the combo of preexisting mandate and mandatory community based rates. Either by themselves violates virtually every rule of actuarial math, and together are simply an ironclad guarantee of insolvency.
Only government can "insure" under those rules because they have exactly zero revenue, cost or profitability concerns. Whatever they want to do, they can simply do by force. Nobody else has this luxury. So the preexisting mandate can only work if they are the provider. Nobody else can mathematically sustain that nonsense.
Essentially, if the preexisting thing is mandatory, having anything other than government as single, sole, solitary provider of health care/insurance makes no sense and simply delays the inevitable.
There is no question that Guaranteed Issue and the Elimination of annual/ lifetime caps on claims are major contributers to the cost of premiums, in a post ACA enviornment.
The American Healthcare Act of 2017 ( Trump Care) narrowly passed the House but failed in the Senate. It specifically sought to restore state rights to determine preexisting/ ongoing conditions and permit insurers to charge higher premiums to people with a history of and/ or current condition. This included, but was not limited to Diabetes 1 and 2 and Heart Disease. Diabetes 2 and Heart Disease can be prevented 80% of the time through lifestyle management. It also included all Cancers, Stroke MD, MS, Parkinson's, Kidney Disease, Mental Health and more, lots more.
If this bill had passed, no one knows how states would react. Instead of one common requlation, there would be 50. Taking it to an extreme, some states would likely choose to continue to require insurers to charge the same premiums no matter what, while other states would choose to let it rip. At the point of diagnosis, one would be faced with substantial increases in premiums or becoming uninsured. Guess if you can't afford it, you die due to a lack of medical care that otherwise could sVe your life.
No sweat off legislators' backs. They would continue to be covered by special plans providing consistent benefits, regardless of state and the Federal Government would pick up 75% of the cost of premiums.
Pre ACA most states did not have high risk pools. Those that did, designed them to exclude more people than insured and did so by excluding conditions, capping annual claims, imposing premiums that only the wealthy could afford, and capping the number of people. The rest were put on Waiting Lists - waiting for someone else to die.
While this bill was in play, Trump persisted with the goofy rhetoric of enabling insurers to sell insurance across state lines despite there is no Federal Law prohibiting doing so. The issue has always been the huge differences in state regulations and lack of instate networks.
Universal Healthcare is the right to healthcare. No two countries do it the same way. Some choose a Single Payer model. Some choose only private insurance. Most are a mixed bag. Some expect employers to kick in and some do not. All have an insurance mandate and subsidize public or private premiums for low/ no income.
Essentially, if the preexisting thing is mandatory, having anything other than government as single, sole, solitary provider of health care/insurance makes no sense and simply delays the inevitable.
I understand what you mean about the insurance industry having a cost vs risk model, but we're not talking about car insurance or flood insurance here. We are talking about life vs death. If someone cannot get car insurance because they have DUIs, they can take cabs or the bus. If someone cannot get health insurance because they are sick, I guess they'll just have to win the lottery or die?
I don't even know why it's called health "insurance". Insurance is supposed to be for unexpected events that can potentially bankrupt someone. Going to the doctor for a checkup or going to the dentist for a cleaning is anything but unexpected.
Here's what I'd say: Prohibit insurance companies from denying coverage for pre-existing conditions, but allow them to charge the actual rate. Seems pretty fair.
If you charged the proper actuarial rate based on measured data and calculated risk, the premiums for someone with preexisting conditions would take the expected costs over the life of the policy, plus the cost of doing business for the insurer, plus the profit margin. Take the claims made by Hoonose and his unfortunate wife. Her costs are somewhere north of $2 million over the last year, iirc. If an insurer knows or can estimates such costs, let's say they craft a ten year policy based on them. Your boy Hoonose is now staring down the barrel of the ~$18-20k monthly premium over ten years. If we follow proper actuarial math that is.
That's why the community rating price mandate got implemented right along with the preexisting mandate. Politically, one cannot exist without the other, and the reason the bailout fund, even in the Rubio limited version, was added as well. Every insurer and person associated with figuring out ObamaCare knew that preexisting conditions plus community rate pricing would wreck any profit model, so that model had to be backed by the bailout fund and the individual/corporate mandates.
And I agree about going to the doctor for a checkup and teeth cleaning. These are not unexpected events, and they shouldn't be covered by insurance. It would be like having your car insurance make all fillups at the gas station only cost a $1 copay NO MATTER WHAT the actual cost of gasoline is. Figure out what would happen to the price of gas if we set up car insurance that way and the government mandated it and backed the mandate with the same force they do health coverage?
That was another issue in the ObamaCare laws...mandated coverages. Men paying for OB/GYN visits, old people paying for fertility, young people paying for equipment used by the elderly, etc. Same as government telling State Farm and Geico that no american should ever pay more than $1 for a tank fo gas, or $2 for an oil change, or $3 for a new set of tires, etc. And if you're Johnny the Gas Station Owner, and a new set of laws says no matter what you charge people for gas and automotive service, the consumer will never see and the government will make damn sure you get paid guaranteed, you tell me what you're prices will do.
No point in discussing anything else in your post based on just this one sentence.
Healthcare is a combination of goods and services provided by others, i.e. the labor of other individuals. To have a right to another individual's labor, that individual is your slave by any and all definitions of the word.
Chances of someone like me, who abhors the concept of humans enslaving other human because a majority of those humans think it's a swell idea, agreeing or finding common ground with someone casually claiming health care to be a right....yeah, that would be approximately 0.00%.
Universal healthcare would not make health care a right. It would simply enslave every American to the health care spending desires of every other American.
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