Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
"it is against the law, subject to fines and/or imprisonment, to reject a persons application for health insurance based on a pre-existing condition"
why not have ala-cart, for health insurance.......does a couple who are both 55 really need prenatal or pregnancy coverage??
oh and MANDATING that you have to BUY health insurance.....bad choice, I am sure these subject matter experts could have come up with a better plan
That's not how insurance works. You are oversimplifying the situation. Requiring coverage of pre-existing conditions does not come for free.. it comes with a hefty price. A price that insurance is designed to offset to a larger group comprised of both the sick and healthy as well as the young and old. The problem is you cannot make healthy young individuals participate out of the goodness of their heart without making it their responsibility through a mandate.
Don't want the mandate. Then the cost is offset by higher premiums.
As for the ala-cart pregnancy situation you mention. I would surmise that the 55 year old couple at one time in their life had a child/pregnancy when they were in their 20s-30s. The cost of that care would have been offset inpart by another 55 year old couple paying premiums as well as other subscribers in the group. That's how insurance works... spreads the cost over a larger group. In this case a young expecting couple to the older generation. When the older 55 couple needs services, the young couple that had help with their pregnancy in turn would absorb part of the cost of geriatric care.
I have my own health insurance. If I am paying my premiums and being responsible for the cost of my and my family's health care, why should my tax dollars contribute to a ACA (or similar) that has no mandate? You are not mandating that the irresponsible pay into the system. Yet you expect those of us that are responsible to fit the bill for those slackers? Good luck with that.
You cannot have all three
* lower premiums
* pre-existing conditions clause
* no mandate
You can only have two. You want it done without a mandate? Then you must either drop pre-existing conditions clause or we accept higher premiums.
In NJ, automotive insurance is very very expensive... highest in the country. A large portion of that comes from the extra fees attached to our policies to cover "uninsured motorists". So the responsible is again fitting the bill for the irresponsible. This system of offsetting the cost of uninsured motorists is the reason why we have high insurance rates and many insurance companies opt out of offering services in NJ (sound familiar?)
Health insurance rates will drop if there is higher participation from the healthy AND lower the cost of health care services itself.
There are many ways to provide and pay for more universal HC. A mandate is one, the current mandate has failed.
Another way in a very general fashion is from more central funding. We could conceivably leave all of HC as it is today, and have our central gov't create the funds necessary to make all the ends meet.
The main complaints today are from our lower middle/middle class, and that being too high HC insurance premiums and deductibles. We can do tax credits and/or central subsidies to provide the desired relief. Without asking for more taxes from that group, or more taxes from anyone for that matter.
That's not how insurance works. You are oversimplifying the situation. Requiring coverage of pre-existing conditions does not come for free.. it comes with a hefty price. A price that insurance is designed to offset to a larger group comprised of both the sick and healthy.
well then...how about we start with the fact that INSURANCE is not CARE
INSURANCE (risk management) is a way to have someone else (or some entity) PAY for your bill
your CARE on the other hand is provided by a Doctor, Nurse, Specialist, Hospital, and/or Clinic
INSURANCE has never been health CARE
do you call your auto insurance company every time you need tires, and engine overhaul, or even a simple oil change??? nope
do you call your homeowners insurance when you want to repaint your daughters room purple, or if you want new windows, or need a new hotwater heater???...nope
insurance has NEVER been about care... its about who is going to pay the bill, """"IF""" something CATASTROPHIC happens......not just if you are visiting the dr for the sniffles
that is why insurance is so expensive...fraud/ waste/ abuse from the users
well then...how about we start with the fact that INSURANCE is not CARE
INSURANCE (risk management) is a way to have someone else (or some entity) PAY for your bill
How about you read the topic? This is about insurance. I already posted that the true problem here is the cost of health services (in that respect we agree). But neither party has directly addressed it. Both parties are failing in that respect.
You post about the topic of insurance but don't quite grasp the concept of insurance. There is no one to be angry at but yourself for not understanding. Insurance is exactly that... You paying part of someone's bill and in turn someone paying a portion of your bill. If you don't like it, you can go without insurance and pay out of pocket.
There are many ways to provide and pay for more universal HC. A mandate is one, the current mandate has failed.
Another way in a very general fashion is from more central funding. We could conceivably leave all of HC as it is today, and have our central gov't create the funds necessary to make all the ends meet.
The main complaints today are from our lower middle/middle class, and that being too high HC insurance premiums and deductibles. We can do tax credits and/or central subsidies to provide the desired relief. Without asking for more taxes from that group, or more taxes from anyone for that matter.
Sounds fine... but the key question is
How will central gov't create funds?
tax credits don't help much to those on the lower income scale.
central subsidies means government funding towards the industry to help lower the cost. Where does the money come from?
I can be on board with this plan if we remove employer provided insurance and we all go into a central/universal health care. This will establish high participation numbers that are required to make it solvent. Unfortunately, that's been tried and gets defeated because it is too "socialist" for the American taste. What you are proposing is very similar to other countries....
End of life care remains a big nut to crack. We have living wills and hospice. And those along with a primary care doc weed out most of the really stupid spending. Most elderly do not want all stops pulled if they are going to be veggies the last few days of their lives. When the primary doc is not involved at the terminal stage of patients care, much more gets spent medically, and many times not in coherence with the living will.
In my limited experience, it's the family who often advocate for the so called, beyond reasonable, end of life care for relatives nearing the end stage. They typically are not paying for that care which likely contributes to emotional reactions.
I agree it's often the Primary Care doc who is the voice of reason, especially when the doc and patient have a history.
In my limited experience, it's the family who often advocate for the so called, beyond reasonable, end of life care for relatives nearing the end stage. They typically are not paying for that care which likely contributes to emotional reactions.
I agree it's often the Primary Care doc who is the voice of reason, especially when the doc and patient have a history.
I agree with this. I personally support provisions for assisted end of life is a reasonable option. It would solve a few problems associated with the high cost to both the system and family of terminal ill situations.
I also would like the option to choose how /when I die in such situations.
I have my own health insurance. If I am paying my premiums and being responsible for the cost of my and my family's health care, why should my tax dollars contribute to a ACA (or similar) that has no mandate? You are not mandating that the irresponsible pay into the system. Yet you expect those of us that are responsible to fit the bill for those slackers? Good luck with that.
You cannot have all three
* lower premiums
* pre-existing conditions clause
* no mandate
You can only have two. You want it done without a mandate? Then you must either drop pre-existing conditions clause or we accept higher premiums.
In NJ, automotive insurance is very very expensive... highest in the country. A large portion of that comes from the extra fees attached to our policies to cover "uninsured motorists". So the responsible is again fitting the bill for the irresponsible. This system of offsetting the cost of uninsured motorists is the reason why we have high insurance rates and many insurance companies opt out of offering services in NJ (sound familiar?)
Health insurance rates will drop if there is higher participation from the healthy AND lower the cost of health care services itself.
The ACA is "guaranteed issue". It ended discrimination against those with preexisting conditions as previously defined by some states but more often delegated to the insurers.
The ACA also mandated a " community rating" meaning those with preexisting conditions could not be charged a higher premium than someone with no preexisting conditions in the same geo rating area of any state.
At the same time, the ACA eliminated annual/ lifetime caps on claims and capped annual out of pocket expenses which included the deductible.
The mandate was intended to offset the benefits.
A different approach could continue to be "guaranteed issue" while eliminating the community rating and / or allowing insurers to impose annual/ lifetime caps and/ or allowing issuers to eliminate caps on out of pocket expenses. The outcome would be that insurance would be unaffordable for most with preexisting conditions.
None of this addresses the root causes of premiums, the cost of healthcare in the US, the way healthcare is delivered in the US and that 75% of us are overweight- obese and therefore more vulnerable to diseases.
An aggressive administration and Congress could, with a stroke of a pen, do more to reduce the cost of healthcare by regulating the wholesale and retail price of prescription meds. That Congress chose not to do so twice during the Bush 2 Admin, be damned.
Should you be able to go get car insurance with a broken car and then turn around and have them pay for it? Do you know what insurance is?
Most states , if any, do not require a physical inspection of the auto as a condition of insurance.
Auto insurance does not cover the risk of routine maintenance, repair and replacement of worn out parts.
Appropriate liability, comprehensive and collision insurance will however, cover an accident, auto and property damage caused by a lack of routine maintenance, repair and when necessary replacement of worn out parts.
The payout on a totaled claim is the same if the care was properly or poorly maintained.
Please register to post and access all features of our very popular forum. It is free and quick. Over $68,000 in prizes has already been given out to active posters on our forum. Additional giveaways are planned.
Detailed information about all U.S. cities, counties, and zip codes on our site: City-data.com.
Please register to participate in our discussions with 2 million other members - it's free and quick! Some forums can only be seen by registered members. After you create your account, you'll be able to customize options and access all our 15,000 new posts/day with fewer ads.
