Posted on 11/06/2009 7:20:04 AM PST by SeekAndFind
I have have a Canadian friend who keeps telling me that Canada's healthcare system is better because it caters to ANYONE regardless of pre-existing condition.
In other words, the Canadian system has a safety net for people ( who through no fault of their own ) were born unhealthy ( asthma, diabetes, etc. ).
In the USA, people who have these conditions cannot be insured because they are a drain on insurance companies and most of them are not poor enough to qualify for medicaid. The result is it drains the family's budget and makes the middle class actually poorer.
Since people with pre-existing condition are un-insurable, how are they going to cope ?
Let's say you were a conservative politician running for national office and were asked this question about how people with pre-existing conditions can best be helped, how would you respond ?
Since FR is a discussion thread, I'd like to hear your suggestions on how to solve this problem ( SERIOUS ANSWERS ONLY PLEASE, wisecracks and one liners not welcome ).
Thanks all
Yes. Have the insurance company (if any) that covered the individual fully or partially responsible.
Since the illness occurred during that time but was not treated until later then the first should cover the cost.
Self-ping for later. I, too, am interested in what Freepers have to say on this. I’d like to know how to answer my liberal nephew who wants Obamacare because of people with preexisting conditions. I myself am taking medication for something and wonder what would happen if I switched jobs. Will my new employer’s insurance refuse me because of “preexisting condition”?
That should Read _ The company that had coverage earlier.....
I would like to see something like that; primarily because it would remove one of the underpinnings for the wholesale overhaul now being considered. I would even consent to a token $10 or so monthly fee taken out of everyone else’s insurance to pay for a “national disabled fund” *except* for the single notion that placing such a fund in governments’ hands would invite summary theft of same.
Pre-existing conditions is a straw-man argument because current law forbids insurance companies from denying coverage after one year of the condition treatment.
Increased competition will help fill in the gaps. Just like auto insurance, there are policies for high risk drivers. Yes, they may have to pay more, but whenever there is a service gap, someone will fill it.
This is a very good question, SeekAndFind!
I’d really like to see some ideas, too. Sadly, I’m too ig’nert of the system to have any clue.
(Bookmarking this for later)
This is the ONE issue I have with the conservative stance on healthcare. Especially with people losing their jobs left and right.
My mom had insurance through her employer. She was diagnosed with cancer, stage IV. In order to get her disability insurance, she had to quit her job, not just be out on leave. However by quitting her job, she had to move to COBRA which was nearly triple the cost.
Now I know that is not someone else’s problem, but when I see my own family torn up in this case, I know how it must feel with jobs being lost everyday.
So, I’m interested in a conservative plan as well. I do think there are some good ideas in a risk pool type plan like they have for auto insurance and property insurance. But those plans are extremely expensive due to the high risk, and you are right back where you were before.
There does seem to be a need, overhauling the healthcare isn’t the answer. But with unemployment as it is, interstate health insurance sales isn’t going to do very much right now.
We have the best health care in the world. If you are penniless you can go into great emergency rooms around the country AND NOT BE DENIED CARE.
Depending on your financial circumstance you will then either be considered indigent and have it waived, or get on some payment plan to cover it.
A pre-existing condition cannot be "insured" because it has already happened and trying to do something like that will bankrupt the system and drive it to a government solution...which will be far worse in terms of quality of care and ultimately (due to rationing) in terms of extent of care.
Sorry...in life people get sick and die. We are not going to stop that. A free market solution means the most people will get the best care. Just like it has meant that the most people will rise in their economic standing and create the envy of th world when it comes to standard of living and individual wealth.
That is really what this debate is about. The socialists and marxists wanting to foist control on the economy and destroy the free market.
If you’ve been on the medication for more than a year, it is against the law for them to deny you coverage. Sure, you may have to pay more, but you will be able to get insurance.
But in all seriousness, the best way to deal with pre-existing conditions is to allow for insurance companies to sell cheaply priced catastrophic insurance coverage. Throw in some other adjustments to make the premiums as cheap as possible. This will entice more people to buy this type of insurance and it will help to prevent the pre-existing condition problem.
Also keep in mind that HIPAA regulations effectively solve this problem for people who switch jobs and insurance plans. So for most people in the USA who work regular jobs with benefits included, this is not an issue.
Don't forget that the reason insurers do not want to cover pre-existing conditions is because if they were required to do so, no one would buy insurance. They would wait until they got sick to buy it. It'd be like buying liability car insurance after you caused a crash.
I’m not sure about diabetes, but my son and daughter both have asthma and they are insured under my wife’s policy from where she works. The insurance company pays for their inhalers, and any medication they need. The company is Aetna.
I’m sure there are web sites that you can search which give you a full overview.
It is my understanding that group policies through an employer do not exclude pre-existing conditions, and individual policies only exclude pre-existing conditions for a set period of time.
I was diagnosed with a curable cancer in 2008 and am presently receiving follow-up care and scans. If I lose my job, I have COBRA coverage available and any future job with a group health insurance plan will cover my medical care. It appears that the one difficult thing would be starting my own one-man company or small business. Other than that, I should be able to have care if I or my wife have a job with a company that offers a health plan.
One of my employee's husband has diabetes with a non healing wound. He has had numerous hyperbarric treatments. There is no threat of dropping his coverage.
Separate insurance from employment so individuals and families make the decision directly for their needs. That way, they do not make changes to their insurance the way you have to today when you leave a job or get fired/laid off, or if employers do not provide health care.
Encouraging lifetime policies would help bring the overall cost down and keep people insured.
Your parents buy you a policy at birth that you simply keep as long as premiums are paid. This is one that is owned instead of being a leased one from your employer.
This would be an affordable solution if the government would reverse some of the ridiculous requirements that they have on insurance companies today.
Well said.
US care is expensive due to extremely high medical insurance, and because it’s being given to people who have no right to it.
If we care about the poorest in our society we owe it to them to get rid of the parasitic forces that weigh down the medical system.
I believe the best answer is to find a way to qualify for small group guaranteed issue health insurance, even if you must start your own business to do so.
Many states have high risk pools but they can be very costly.
This is a very important issue. We all have pre-existing conditions whether we know about them or not.
I worry about how my wife, a stroke survivor will fare if something were to happen to me. Here in Colorado, there is a state program for folks like her, but I don’t know if she would have to first spend everything I leave her first.
Health insurance needs to be moved away from being employer based and pools set up large enough to make it affordable, and denial due to pre-existing conditions needs to be done with.
Here’s a link to the Patient’s Choice Act, which is a Republican alternative to the current Democrat bill.
http://www.house.gov/ryan/PCA/PCA.QA.htm#7
Check out the answer to question #7.
I, too, have a pre-existing condition (cancer) that will make getting insurance very difficult if my husband loses his job. I hope whatever the people at the capitol do, they can provide for people who have this problem.
Yes.
First, we’re in this mess because people are effectively not allowed to buy insurance individually when they are young and healthy, and retain it for their whole lives. If that were possible, virtually everyone would be covered starting the day they leave their parent’s policy. So the main solution is to level the playing field so that individuals can buy insurance with pre-tax dollars, just like employers can.
That leaves us with the problem of transitioning to that logical system from the BS we have today. We would have to pool people with pre-existing conditions and subsidize their pool. Once. After those people have passed away, the subsidy will go to zero, and we’ll have a fully private system that works.
The best approach is: (1) permit insurers to operate across state lines; (2) permit group health insurance to be established easily outside of employment; (3) expand health savings accounts and managed care programs for those with preexisting conditions; (4) grant more favorable tax treatment for individual health insurance policies; and (5) set up a federally subsidized risk pool for those with preexisting conditions who cannot otherwise obtain insurance.
As soon as you say that somebody gets to wait until AFTER they have an event to join the pool, you are no longer talking about something rational.
Irrationality is the sole province of government.
There should be a savings account - not at the federal level, but at the state level - that would be used for people who fall into this category. A set percentage would be placed into that account and used until the money is gone. Once gone, that’s it. Kind of like the way most of us have to live every day.
North Carolina has a high risk pool for people who are denied insurance because of pre-existing conditions. For example, I am a Type 1 diabetic, if I lose my job, I can still have COBRA for 18 months but it would be triple what I pay now. When COBRA ends I can pursue private insurance but it will be very expensive because of my Type 1 diabetes and automatic high risk designation. The cost would sink me financially. The State of NC has an option for me that can cut my costs significantly through a high risk pool insurance. Some conservatives have eyed this option of offering a high risk pool insurance policy, similar to a group insurance policy. I think the idea is good.
Thank you for sensibly comparing waiting to buy health insurance until you are diagnosed with a serious medical condition - to buying car insurance AFTER A WRECK.
This illustrates why we are even contemplating *mandatory* health insurance for folks who are either eternal optimists or gamblers.
We have one body - but we can replace a damaged vehicle.
The idea of a life-term catastrophic health policy is a good one - for intelligent, thinking people. That is why we now have government mandated and regulated Medicare - because SOME people failed to consider the possibility that they would ever NEED EXPENSIVE, LIFE SAVING MEDICAL CARE.
I have the same concerns. My son was diagnosed with Type 1 (autoimmune) diabetes when he turned 10. At 15 he was diagnosed with Selective IGA Deficiency and as immunocompromised due to chronic infections.
In Texas, for a 25 year old male with these conditions to be covered it cost $3,000 a MONTH. (I called for the quote.)
At the moment, he’s only 16 and he’s covered until he’s 21 by our insurance if he stays in college. But I’m scared to death about his future.
In a year, I’m going to start working with his dr and a lawyer to have him declared disabled and get him on SS and medicaid. He can’t go 30 days without an infection and he’s hospitalized about once a year with this crap, so I’m having trouble seeing him maintaining a job. (Heck, we’re fighting to get him through high school.)
Prayer is great, but G-d helps he who helps himself. Conservatives need to find a solution.
One easy fix would be to loosen the definition of “disability” to allow more people coverage under SS and Medicaid. Or to make it illegal to discriminate against people with pre-existing conditions.
There. I suppose those are my Conservative suggestions to fix this issue.
“A pre-existing condition cannot be “insured” because it has already happened and trying to do something like that will bankrupt the system and drive it to a government solution...which will be far worse in terms of quality of care and ultimately (due to rationing) in terms of extent of care.”
Well said Jeff. Total out your car and then go to a car insurance company and ask for full coverage on your wrecked vehicle and see what they say.
Find out that you have a terminal disease and go to a life insurance company and ask for a million dollar policy.
I know it sounds evil, but private enterprise is in business to make money (those damn capitalists).
Get the government out of the healthcare business and let the free market work it’s magic; it will help make healthcare affordable for all, even those with pre-existing conditions.
COBRA, the only governmnet program with a truthful name.
“Pre-existing conditions is a straw-man argument because current law forbids insurance companies from denying coverage after one year of the condition treatment.”
What law? Insurance laws are regulated by state, is this the same in all states? Furthermore, one year is a long time when diagnosed with diabetes or cancer.
“We have the best health care in the world. If you are penniless you can go into great emergency rooms around the country AND NOT BE DENIED CARE. “
I didn’t realize they gave people chemo in the ER.
Marie, your personal story illustrates the high cost of cure and maintenance for chronic medical conditions.
IIRC Most group policies (employer/employee) have *conversion* options - or possibly COBRA extensions for age ineligible dependents or divorcing spouses.
I apologize if you have already investigated the policies you currently have - but if not - you may find your son is eligible to convert his coverage to an individual policy without pre-existing penalties or excessive premiums.
That’s because it’s a group policy. There is a difference in pre-existing condition laws under group plans as opposed to individual and family plans.
With unemployment going up, group plans are getting scarcer and so the pre-existing conditions issue will be felt moreso.
Most employer sponsored healthcare plans already cover pre-existing conditions. My wife has had ms for years and its been covered on every plan we’ve had.
By requiring all to have at least have a high deductible catastrophic overage policy. Future pre-existing conditions will be covered at some non-ruinous level.
As for current pre-existing cases, create two lists; one of all licensed insurers and one of all having pre-existing conditions who are not qualified for public coverage. On a one time basis, take the uninsured and enroll them with an insurer on a round-robin basis. The round-robin helps spread the burden equally amongst insurers.
Health Insurance Portability and Accountability Act of 1996 (HIPAA)
“Pre-existing conditions is a straw-man argument because current law forbids insurance companies from denying coverage after one year of the condition treatment.”
Oh, they’ll cover you, alright. But you will pay. I called the Texas COBRA office a year ago to ask about a 25 year old male with my son’s conditions. They gave me a quote of $3,000 a MONTH.
What average American can afford *that*??
Will employers hesitate to hire him because he’s going to be so expensive??
I’m terrified for this kid’s future and I have no idea how to help or advise him.
Most employer provided plans do not even have the time requirement because the pool is big enough that they can spread their risk. However, government screwing around in the insurance market has raised costs for two key reasons, neither dealing with pre-existing conditions:
Of course, the standard libtard rebuttal to the above is to equate diabetes, obesity or any of the other common ailments to AIDS or substance abuse by claiming they are behaviorally based as well.
“Don’t forget that the reason insurers do not want to cover pre-existing conditions is because if they were required to do so, no one would buy insurance. They would wait until they got sick to buy it. It’d be like buying liability car insurance after you caused a crash. “
So what’s the excuse for them when CHANGING plans? The new carrier on an individual policy could refuse treatment that the old plan covered because they were diagnosed say, last year.
Don’t worry, big brother will take care of him.
My advice, buy a catastrophic plan on his own, then save an invest every single extra dime he has. If he needs it for medical coverage, he's got it. If he doesn't need it for medical coverage, it is still his money, he can use it for something else.
Yes, pre-existing condition laws are different for group plans than individual. But say your company went belly up, I think the issue is what is that couple supposed to do then if they can’t find a job with group health insurance?
I am not for government run healthcare, but conservatives DO have to recognize it is an issue that effects a lot of people. Especially in this tricky economy.
If we can find one, we should also apply it to Homeowners, Auto and Life insurance. My Grandfather died a few years ago without life insurance. And now, because of his "pre-existing condition", life insurance companies will not write a new policy for him.
If you have had coverage all along you will get a certificate of insurance from your old insurance company and usually not refused.
Pre-existing exclusions that are invoked are usually 6 to 12 months.
My brother died of cancer, and though he had insurance, it did not cover all that he needed through his treatment. But he got the care anyway. We were blessed as a family to be in a position to pay the bills after they came.
So please, take your attempts to discredit the system we do have and peddle them elsewhere. The fact remains, we have the best system in the world (realizing that no system is perfect), people can get care if they need it and not be denied, and a government take over is not an answer to improving health care in the least. It is a political solution to more control.
What kind of smart alec post is that? This is her son!
*****My Grandfather died a few years ago without life insurance. And now, because of his “pre-existing condition”, life insurance companies will not write a new policy for him.****
You are the maestro;)
LOL!!!!
It is triple the cost because her employer paid the other two thirds.
There was something in the stimulus bill that gave credits to her former employer for the the COBRA payments for a period of time.
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