Should "Pre-Existing" conditions be covered under regular health insurance? (unemployment, wages)

[natalie469]

Originally Posted by KUchief25

How did humans survive all those years without health insurance? One would think we'd be extinct now the way some think.

I wish we could go back to the days where docs made house calls because they cared and people paid them what they could. Things are so complicated now

And yes, pre existing should definitely be covered.

[northstar22]

Originally Posted by t206

So lets be blunt. What is more important:

1. A sick person getting lifesaving care, paid for by others, "at no out-of-pocket cost" to them.

or

2. Me as an individual being able to retire and live the rest of my life without fear of being destitute by using my own hard earned and smartly saved/invested money instead of being forced to pay for multiple other peoples health care?

One, by far.

[Nomander]

Originally Posted by gvsteve

Health insurance is fundamentally different than auto or homeowners insurance.

For starters, you don't have the option of 'totaling' a human life (if the damage is too bad) and buying a new one like you do with a car or a home.

Happens all the time, in fact... the government is the leader in such claim denials.

Originally Posted by gvsteve

You also have the problem of chronic diseases that require lifetime care. This is not a problem with cars or homes.

Public liability car insurance, for those who cause others pain and suffering in their neglect, resulting in situations that require lifetime care. Why isn't this government paid for?

Originally Posted by gvsteve

Thirdly, humans have morality and compassion for one another, which means we dislike watching a person die from an easily treatable ailment. With cars or homes, if someone's car is damaged, nobody is suffering, and we don't feel strongly obliged to help them as we do when someone is dying of leukemia.

So it is moral to steal, but not moral to expect people to be responsible for themselves? Interesting.

Originally Posted by gvsteve

There are many other reasons why the health of a human being is fundamentally different than a car or a home and why insuring them is therefore fundamentally different.

The issue is not really if a person has a "right" to healthcare. They have every right and nobody is denying them such.

What the real issue you are arguing is if people have the "right" to demand others pay for their healthcare. That is the real issue here... and the answer is... NO.

[Nomander]

Originally Posted by northstar22

One, by far.

What would you prefer?

1. Having every necessity provided for you "food, shelter, healthcare, etc..", yet at the cost of your freedom.


2. The risk and responsibility of seeking such for yourself, but the freedom to choose as you wish.

[Glitch]

Originally Posted by JetJockey

So you would tell a young person in their mid twenties that their life isn't worth saving and that they should just suck it up and die with dignity so you can save that couple bucks a year it would take to treat them and allow them to live a long, relatively normal life.

With the disorder I have it would take me years to die. Of course, I'd spend a good solid 30 or so of those years wheelchair bound and in extreme pain... But hey, as long as you get to buy that new tv all is good!

I do believe that taking care of our infirmed and helping them to live as productive and normal a life as possible is extremely important, regardless of costs. I do t believe in greed that causes death.

Now I know you are completely disingenuous. First, you are claiming $200,000 per year for the rest of their lives, now its a "couple bucks a year."

Remember this post?

Originally Posted by JetJockey

So, if you can't afford it, you should die? How in the world is someone supposed to pay $200,000 or more per year for the rest of their lives?

[Mircea]

Originally Posted by t206

The question:
Should a pre-existing condition be covered as part of regular health insurance plans?

First of all, there's no such thing as "health insurance."

Secondly, if there was such an animal as "health insurance" it would be akin to home-owner's insurance.

Something happens to your home, it's covered. But, there are riders for special circumstances. People who live in a flood zone have to pay extra for flood insurance, as do those who live in hurricane zones, earthquake zones, tornado zones, volcano zones or whatever. And if you want to use you home for special purposes, you need to get extra coverage for that.

If you live in a flood zone, and you don't have flood insurance, and you're home gets flooded, you're home-owner's insurance won't cover it, and shouldn't cover it.

Real health insurance would work the same way. Everyone would get basic coverage and then for the extras, you'll have to pay extra.

Originally Posted by t206

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.

But there is no such thing as "health insurance."

Originally Posted by t206

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.

That's true in part. The laws are changing or have changed over the last few years so some people are covered, while others aren't (since "health insurance" is government by the States each State has their own regulations and some States require this or that while others don't --- which is why health care does not fall under the Interstate Commerce Clause and Congress has no right to regulate it or interfere in it).

Originally Posted by t206

Water is a basic human necessity too, but for the most part we are all required to provide this on our own, no?

So is food. And clothing. And shelter. Some would argue electricity and gasoline.

What about "thingy?"

That's a basic necessity too.

Originally Posted by JetJockey

And how would you determine how much more one should pay?

It's called "actuarial science."

It is a science based on statistical data.

Originally Posted by JetJockey

Should it be based on the disorder?

Yes, because statistically, some disorders cost more than others.

Originally Posted by JetJockey

Should a person who is in cancer remission pay far more because they might relapse?

Of course they should. You pay more to drive a red car than a white car, and more for an 8-cylinder than a 6-cylinder or 4-cylinder and you pay more for 2 doors and less for 3-doors, and even less for 4-doors and still less with 5-doors.

Originally Posted by JetJockey

There's a lot that goes on with pre existing conditions that I don't think many people understand. Or rather, they think they understand but in actuality have no idea.

I understand.

Originally Posted by northstar22

No, preexisting conditions should not be covered under "regular" health insurance . . . . because there should be no "regular health insurance." I support 100% federally run, single-payer free health insurance for ALL Americans -- including those with preexisting health issues. Healthcare is one aspect of life in which the "free market" should have no say.

Then I take it you have your cardboard box all comfy and ready to live in, right? Because if your economy doesn't start cranking at 12.5% per quarter every quarter for the next 456 months not only will you not be able to pay for Social Security and Medicare, you won't be able to pay for your health care either.

Originally Posted by MadeInAmerica

Market pricing. To subsidize one group of people, means that somewhere you discriminate against others and another disease.

That is absolutely right. For years, single people have been subsidizing the health care of married people and married people with children by paying unjustly higher premiums.

Married people have been subsidizing married people with children.

Men subsidize child-birth.

Originally Posted by Chanygirl

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.

They aren't involved.

Originally Posted by Chanygirl

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.

Yes it should, and legally it can, because you don't have health insurance.

If you had real bona fide health insurance, then it wouldn't be a problem (unless you committed fraud or made false statements).

Originally Posted by Chanygirl

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"

B-b-b-b-but that's how it works in Europe. Don't you want a single-payer program like European countries?

In Europe, the reason they can afford health care, is because you do Treatment Plan "A" and if it works, then that's great, and if it doesn't, then you go to to Treatment Plan "B" and if that works great, but if it doesn't then that is just too bad.

There ain't no let's go to Treatment Plan "C" then back to Treatment Plan "A" then to Treatment Plan "B" then back to Treatment Plan "A."

Originally Posted by Chanygirl

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.

Yes, I know. That's because you don't have "health insurance."

What you are doing is paying money into a pool of money and you get the opportunity to use that all of the money in the pool of money sometimes, but not all the time.

Why? Because you don't have "health insurance."

I've been posting on this forum for years and no one ever asked why I always put "health insurance" in quotes. I explained it once a long time ago. It is not insurance.

Originally Posted by Chanygirl

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.

Since they existed. This might come as a shock, but HMOs and similar types have always existed. And there has always been a cut-off point too, although I think Carter changed that. Or maybe it was Nixon.

That's right. If you cost too much money, the health care providers would just say, "Sorry, you cost too much and you're being cut off and we aren't spending another dime on you. Ever."

That happened a lot back in the 1950s and 1960s.

Originally Posted by Chanygirl

It really is that simple..if a Doctor prescribes a treatment then that is what needs to be done.

What if it doesn't work? That's a lot of money to spend on a huge gamble.

Originally Posted by JetJockey

It costs that much because there is only one manufacturer. There is only one manufacturer because it's a lengthy and expensive process to make the drug and most companies simply don't want to deal with it. not enough profit to be made. My drug is manufactured here and finished in Ireland and since it's for a rare and life threatening disorder there was almost no red tape to go through.

Yes, that's quite typical.

Originally Posted by JetJockey

As for your last little snippet, what do you think people in my situation should do?

Write to the manufacturer. That's what my sister did. Less than 1 Million people on Earth have her condition. She wrote to the pharmaceutical company in Sweden, explained her situation, and about 3 months later someone showed up at her home and talked to her, and then a few weeks after that she got a letter saying they had discounted her drug for her.

Originally Posted by JetJockey

I have no alternative for the medicine, no other companies are interested in making it

Well, it's just not cost effective. Companies hold the patents, so that limits generics for a while, but even then, who is going to spend money to make a drug for 3 people?

It's just not worth it.

Originally Posted by JetJockey

Should I simply accept my fate?

10 years ago, 20 years ago and so on, and you wouldn't have had a choice.

Originally Posted by JetJockey

What would you do of one of your children (real or hypothetical) were to get diagnosed with something similar?

People die. That's what happens, and humans are incredibly good at dying. I've seen people die all sorts of different ways. I was really naive until I had my first call to an auto-erotic "death by misadventure."

Death is a sad thing to be sure, but apparently some people would bankrupt the US to save a few million people or extend their lives.

Originally Posted by northstar22

Life-saving medical treatment is not a "service," it's a human right, and it needs to be available to all people at no cost.

Edit: yes, I know we ultimately pay the cost through taxes, and that's fine. I mean "at no out-of-pocket cost to the individual."

You're dreaming.

I had to take my troops an hour to get to Landstuhl Army Medical Center and then they had to wait hours while all of the dependents got treated. Yes, military personnel are supposed to get priority over dependents, but the hospital administrators didn't see it that way.

Then came something wonderful.

Want to know what it was?

It was a $10 co-pay assessed to dependents.

Lo and Behold! We could go to Landstuhl and get seen straight away by a doctor because that little $10 co-pay cleared out the waiting room of all the abusers of the system.

Originally Posted by C.C

Isn't food a human right? Why isn't it available to everyone at no cost?

Apparently not.

Originally Posted by JetJockey

So, if you can't afford it, you should die? How in the world is someone supposed to pay $200,000 or more per year for the rest of their lives?

What do you think cancer patients did before the advent of chemotherapy?

Originally Posted by Glitch

Fine, when you completely abolish abortion then you can talk about life being an inherent right. Until that time you are nothing more than a hypocrite.

Oooops!

Originally Posted by Glitch

Life is indeed something you are born with, and by definition that makes life an "inherent right." However, you do NOT have the right to impose your life on others by demanding that they provide you with a service for free. If you want healthcare services, be prepared to pay for them, treat yourself, or go without. Those are your only choices.

Effectively you're subsidizing other people's life-styles. It's bad enough now that people who have "health insurance" are forced to subsidize the life-styles of others, but it'll be worse under some kind of government abomination.

Originally Posted by gvsteve

Everyone has a risk of getting hurt/sick to the point they can't afford to pay for it. And so everyone should share the risk of paying for those that unfortunately get sent to the hospital.

So some guy goes with a prostitute and I'm supposed to buy his penicillin?

Why?

So drug user gets HIV/AIDS and I'm suppose to suffer and cough up money to pay for his treatment?

Why? Why I should I subsidize their life-styles?

Originally Posted by gvsteve

It's the entire theory behind insurance, and the more people you spread the risk over, the better things work for everyone.

But you don't have insurance and you are not spreading the risk.

Insurance is based on actuarial science, not pooling people of different genders, ages, ethnic groups and life-styles together and charging them a flat rate.

As a male, I can't get pregnant, so why should I subsidize pregnancy/child-birth for some other man's wife or some single wench who's out bed-hopping?

Originally Posted by KUchief25

They could have simply "fixed" health insurance by providing some sort of pre existing pool for these folks instead of trying to revamp the entire thing.

That might be a good idea.

Have real insurance based on risk. Everyone gets a certain base level of coverage, and then riders for those who smoke, drink, stuff their face full of McDonald's, participate in X-treme sports, use drugs, hang with prostitutes, those who have a high risk of cancer or heart problems and such.

For people with extremely rare conditions, you could create a separate pool for that. I would imagine that there would be a lot of charity involved there. You know, corporations and businesses giving money, groups giving money, philanthropic trusts making grants and things like that.

Originally Posted by workingclasshero

not with out extra charges

if you have lots of tickets/accidents your auto insurance (IF YOU CAN GET IT) will cost more


INSURANCE is based on RISK

insurance is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss

also brings about the word Insurability

That's right, but "health insurance" is not real insurance and I don't think the vast majority of people understand that.

Originally Posted by gvsteve

Health insurance is fundamentally different than auto or homeowners insurance.

For starters, you don't have the option of 'totaling' a human life (if the damage is too bad) and buying a new one like you do with a car or a home.

Again, "health insurance" is not true insurance. You might want to look at the legal definitions and case law.

You can actually "total" a human life.

I have asked repeatedly on this forum how much money we should spend on one single person and not one of the freaking *******s has ever had enough courage to grow a spine and crawl out from under their rock in the cesspool/slime pit they live in and state how much money should be spent on one person.

You cannot afford to spend $1 Million on 1 Million people. That'll cost you $1 TRILLION and you ain't got it now, and you ain't gonna have it 50 years from now either. So you're going to have to put limits on what you can spend on people either per year or per life-time.

You can't even spend $1 Million per life-time on 300 Million people. That would be...

$300,000,000,000,000 or $300 TRILLION. You can't even come with the $108 TRILLION to fund Social Security and Medicare unless you economy takes off like a rocket and cranks out 12.5% every quarter for the next 456 straight quarters.

Where are you going to find $300 TRILLION?

Making other people pay for things sounds really cool, until you actually have to start paying for, and then it isn't so cool at all.

None of you really understands what you're asking for, and wanting the government to be involved, and especially with the 14th Amendment, it just ain't gonna happen.

Call it what you want, but you'll end up with "Death Panels" and they'll be cutting people off or limiting their treatment and then you'll all be sitting here whining and longing for the days when the government wasn't involved.

Originally Posted by gvsteve

You also have the problem of chronic diseases that require lifetime care. This is not a problem with cars or homes.

Doesn't matter. You can still assess risk for that based on statistical data and charge people a responsible amount, instead of sloughing it off on other people.

Originally Posted by gvsteve

Thirdly, humans have morality and compassion for one another, which means we dislike watching a person die from an easily treatable ailment. With cars or homes, if someone's car is damaged, nobody is suffering, and we don't feel strongly obliged to help them as we do when someone is dying of leukemia.

But that is not a reason to take my money. If I wish to voluntarily donate, and I have donated to such causes (on an individual basis) and many others do and so do corporations and businesses and civic groups and others, then that's something else.

Originally Posted by gvsteve

There are many other reasons why the health of a human being is fundamentally different than a car or a home and why insuring them is therefore fundamentally different.

But you can still assess risk.

If someone can't stop stuffing McDonald's into their fat mouth for 20 minutes to go walk 3 miles, then why should I pay for the illnesses that are associated with their stupidity?

Originally Posted by pvande55

I saw a top secret report showing that the US pays more per person than any other country. That "30 to 60k to each taxpayer" is way higher than what countries with single payer pay.

Other countries do not use your grotesquely inefficient and antiquated Hospital Model.

Other countries use the Clinic Model, which your very own American Hospital Association outlawed with Obamacare.

Other countries do not have Hospital Cartels that illegally collude to illegally fix prices illegally higher than what the market allows.

When do you intend to break up the Hospital Cartels in the US? Is that before or after you all die for lack of insurance or before or after your country is bankrupted?

There are many, many differences between the health care system in Europe (excluding the UK), and the health care system in the US.

If you want your health care system to be like Europe, then you need to make the changes necessary to make it like Europe, and that means closing lots and lots and lots of hospitals, about 60% of them.

I live in a Metropolitan Statistical Area with 3 Million people and 19 full-service hospitals. You will not find a city in Europe that has 3 Million people and more than 6 hospitals, and that is a rarity (most have one hospital per 1 Million people).

Here I can go to any hospital and have open-heart surgery. Not so in Europe. In a given country, you can only go to certain select facilities.

You might want to think about that.

[t206]

Originally Posted by northstar22

One, by far.

So someone else literally has more right to my own money than I do?

What happens when I'm retired and can't afford to care for myself because I had to give away my money?

[Rhenzanite]

Originally Posted by Glitch

Now I know you are completely disingenuous. First, you are claiming $200,000 per year for the rest of their lives, now its a "couple bucks a year."

Remember this post?


This amply demonstrates that you are not only a complete flake, but only interested in pushing your bogus myopic agenda.

ROLFMAO! Epic FAIL!

Yes, I remember, especially considering I'm the one with the disorder that costs that much.

I meant that spread across a lot of people it costs a couple bucks to save a lot of people. Of course, you'd rather let people die or suffer to save a few bucks.

So, epic comprehension fail on your part.

[emilybh]

Originally Posted by t206

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.....

HIPAA passed while Clinton was in office prevents any loss of coverage if you are forced to change jobs. A) when you leave company A, if they are big enough, they have to offer you COBRA (or the option of paying the entire cost of your group plan for 18 months. If the company has fewer than 20 employees they don't have to offer it in which case you would be eligible to get an individual plan in your state that would HAVE to cover any pre-existing conditions you might have. Pretty much as long as your coverage is continuous, you don't have to worry about the next insurer not covering pre-existing conditions..

You are right about insurance costing more when insurers are forced to cover pre-ex conditions, In many states you can get individual plans that will let you rider or temporarily or permanently exclude a pre-existing condition in exchange for lower rates. They would of course cover everything else.

[pvande55]

I believe that Europe has less unnecessary surgery. There was a secret, though available to subscribers of Consumer Reports, study revealing that heart scans often lead to superfluous angioplasty.