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Interesting discussion, but no mention of the main issue. Guaranteeing coverage inherently means you can buy coverage only if, when and for as long as you need it. It's like if your house burns down, you could buy homeowners insurance, get the house replaced, then drop the insurance until you need it again.
My thoughts:
Personally I don't think they should be covered as part of a regular insurance plan because I think that may be part of what causes insurance to be so expensive overall.
If this is the case, it would seem that those countries utilizing the Bismark model of UHC should have more expensive health care.
In practice, the countries using the insurance-based model such as Germany, the Netherlands, Switzerland etc all provide health care to everyone, regardless of pre-existing conditions, at far lower costs per person than America.
I don't think there should be major changes to health care plans except to take the decision making process out of the hands of actuaries and number crunchers. There are already 3 health care models, and please understand I am not an expert but this is how I understand it.. Wellness/preventive care for yearly phyiscals, shots. Minor medical for ER visits, broken bones and illness that normally lasts 6 months or less. Major medical for illness lasting 6 months or more, certain chronic conditions, surguries, and anything requiring extended or repeated hospital stays.
If you were to take those with catastrophic illness and put them in their own insurance pool it would never be affordable. Those with expensive conditions need a healthier population to dilute the insurance pool in order to recieve affordable care.
The thing that gets my goat is that if a Doctor says you need a bone marrow transplant and you pay your premiums every month then you should have a bone marrow transplant..that decision should never be circumvented by someone sitting at a dest 1500 miles away reading a chart. That person also should not have the ability to say "We will pay for this treatment but not the treatment you requested" or "We as the insurance company do not feel this treatment is necessary"
The insurance companies are actually employed by the people paying the premiums and as such should just pay the bills incurred by the insured. If I hired a roofer to reshingle my roof and I told him I wanted brown shingles and he decided black shingles were more cost effective and shingled my roof with black shingles I would demand my money back and if he balked I would see him in court. I don't know when or how Big Insurance became so powerful but they really need to get their nose out of the decision making process and just pay the bills. It really is that simple..if a Doctor prescribes a treatment then that is what needs to be done.
OMG I forgot why I even started this!! YES pre-existing conditions should be covered...if there has to be a waiting period, and I don't think there should be, then it shouldn't be longer then 3 months.
Insurance is run as a profitable business using actuary tables to gamble against the health of people. The problem with health care isn't Obama's plan, the doctors, or hospitals, but the input of insurance in the mix. They alone are why the heathcare costs have climbed.
Remember they want profits, nothing more. Don't think they want to resolve your health challenge, they don't. They would assume you die fast and save them money.
The problem with the new health care law is that insurance is still involved. They are the problem.
If as an uninsured person I go to a doctor and I tell them I want this test. they give it to me and it isn't wrapped up with the tests for BP , temperature weighing me and all the other acts I'm not there for, but will get charged to an insurance company. Doctors cover charge insurance so they can make out ok in the end.
Patients get too many activities done because we don't treat only what is needed.
I went to a Chiropractor once and asked for an adjustment .. they informed me that they had to get this huge background on me, that they needed a physical. they wanted to charge me $250.... I went down the road to another who gave me what I asked for price $40 and he sees me regularly when I need an adjustment. I use 10 minutes of his time, get what I want, at a price I can afford. that's medicine that makes sense.
Want to fix health care.... eliminate insurance, their goals are not the same as those of the patient.
I'm sure this will be quite controversial, so all the more fun to strike up a conversation about it. I don't have a 100% answer, but I have some thoughts.
The question:
Should a pre-existing condition be covered as part of regular health insurance plans?
The facts:
The concept of insurance is that it is a way to financially hedge yourself against an unexpected occurrence such as breaking a leg or getting struck by lightning. For things like home owners and car insurance, you couldn't get insurance to pay for physical damage that already exists...aka, a "pre-existing" condition.
Part of the problem with "pre-existing" conditions is that the concept only exists because we are forced to change insurance providers if/when we change jobs.
My thoughts:
Personally I don't think they should be covered as part of a regular insurance plan because I think that may be part of what causes insurance to be so expensive overall. I wonder if the market place could come up with some insurance product that is targeted at those with pre-existing conditions, or that you somehow pay into separately from regular insurance that can only be used once certain ailments are diagnosed like cancer, diabetes, or other commonly identified "pre-existing" conditions?
I also think that shifting insurance from being something that most employers provide, to something that individuals shop for and purchase on their own would go a LONG way in changing this situation.
I'm sure others have different thoughts and ideas, or would just like to chime in and call me evil or crazy.....
Yes. This is from a physician who is uninsureable outside of a larger group practice due to pre-existing conditions. For me, it is not a big deal, as I can work through a larger organization. For others who cannot, it is an extreme hardship as result of an illness that they incurred through no fault of their own.
Insurance is supposed to be a pooled, shared risk. There will be "winners" and "losers" in that system, but the system survives paying for the higher cost patients by insuring lower cost patients as well.
I don't think there should be major changes to health care plans except to take the decision making process out of the hands of actuaries and number crunchers. There are already 3 health care models, and please understand I am not an expert but this is how I understand it.. Wellness/preventive care for yearly phyiscals, shots. Minor medical for ER visits, broken bones and illness that normally lasts 6 months or less. Major medical for illness lasting 6 months or more, certain chronic conditions, surguries, and anything requiring extended or repeated hospital stays.
If you were to take those with catastrophic illness and put them in their own insurance pool it would never be affordable. Those with expensive conditions need a healthier population to dilute the insurance pool in order to recieve affordable care.
The thing that gets my goat is that if a Doctor says you need a bone marrow transplant and you pay your premiums every month then you should have a bone marrow transplant..that decision should never be circumvented by someone sitting at a dest 1500 miles away reading a chart. That person also should not have the ability to say "We will pay for this treatment but not the treatment you requested" or "We as the insurance company do not feel this treatment is necessary"
The insurance companies are actually employed by the people paying the premiums and as such should just pay the bills incurred by the insured. If I hired a roofer to reshingle my roof and I told him I wanted brown shingles and he decided black shingles were more cost effective and shingled my roof with black shingles I would demand my money back and if he balked I would see him in court. I don't know when or how Big Insurance became so powerful but they really need to get their nose out of the decision making process and just pay the bills. It really is that simple..if a Doctor prescribes a treatment then that is what needs to be done.
OMG I forgot why I even started this!! YES pre-existing conditions should be covered...if there has to be a waiting period, and I don't think there should be, then it shouldn't be longer then 3 months.
You can take cost controls away from the insurance companies, but then insurance costs go way up. If you leave it up to doctors, they'll order every test and every procedure in the book to protect themselves from lawsuits. And providers will be free to charge whatever they want. Take a look at your EOBs - providers submit a $1000 charge, but it only ends up costing $200. (That's one of the great things about high-deductible policies - everything is out-of-pocket but those out-of-pocket costs are far lower than they would be without insurance).
I'm in favor of overhauling the entire system and making it a single-payer system which WOULD cover any pre-existing condition.
Somebody remarked that humans have survived a long time without health care. I would answer yes, but many died young from causes not of their own fault which can now be cured or at least treated. If you look at old moral theology texts, you will see that doctors and lawyers are morally obligated under pain of mortal sin to provide services pro bono to the poor; I think the best structure (medically) to do that would be a single-payer system.
I'm sure this will be quite controversial, so all the more fun to strike up a conversation about it. I don't have a 100% answer, but I have some thoughts.
The question:
Should a pre-existing condition be covered as part of regular health insurance plans?
The facts:
The concept of insurance is that it is a way to financially hedge yourself against an unexpected occurrence such as breaking a leg or getting struck by lightning. For things like home owners and car insurance, you couldn't get insurance to pay for physical damage that already exists...aka, a "pre-existing" condition.
Part of the problem with "pre-existing" conditions is that the concept only exists because we are forced to change insurance providers if/when we change jobs.
My thoughts:
Personally I don't think they should be covered as part of a regular insurance plan because I think that may be part of what causes insurance to be so expensive overall. I wonder if the market place could come up with some insurance product that is targeted at those with pre-existing conditions, or that you somehow pay into separately from regular insurance that can only be used once certain ailments are diagnosed like cancer, diabetes, or other commonly identified "pre-existing" conditions?
I also think that shifting insurance from being something that most employers provide, to something that individuals shop for and purchase on their own would go a LONG way in changing this situation.
I'm sure others have different thoughts and ideas, or would just like to chime in and call me evil or crazy.....
Why should an insurance company be forced to give insurance to someone? That's no different than telling a bank they have to give someone a mortgage--regardless of credit history.
I think insurance companies should offer the option of such coverage plans in a special pool with the fees to reflect the higher costs that accompany such risk. If a person does not want the higher fee they could opt out of pre-existing condition coverage.
Choice and competition will bring down insurance costs. Getting government out of healthcare delivery and payment business will bring down the cost of healthcare.
I'm in favor of overhauling the entire system and making it a single-payer system which WOULD cover any pre-existing condition.
Somebody remarked that humans have survived a long time without health care. I would answer yes, but many died young from causes not of their own fault which can now be cured or at least treated. If you look at old moral theology texts, you will see that doctors and lawyers are morally obligated under pain of mortal sin to provide services pro bono to the poor; I think the best structure (medically) to do that would be a single-payer system.
How is it the responsibility of government to cover health care?
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I don't have a 100% answer, but I have some thoughts.
