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Pre-Existing Condition Problem Is Greatly Exaggerated
IBD Editorials ^ | June 20, 2012 | JOHN MERLINE

Posted on 06/20/2012 5:53:22 PM PDT by Kaslin

If the Supreme Court rules this month that ObamaCare is unconstitutional, a big question will be how to ensure people with pre-existing conditions can get health care coverage.

Last year, the White House painted a grim portrait, saying that if ObamaCare is overturned, "129 million Americans with a pre-existing condition could be denied coverage."

Even conservative Republicans say they want to preserve this provision, whatever the health law's fate, since it's one of ObamaCare's more popular features.

"We've got to make sure no American gets turned back for pre-existing conditions," Rep. Allen West, R-Fla., said recently.

And presidential hopeful Mitt Romney says his reform plans will "prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage."

Not A Vast Problem

But the pre-existing condition problem affects fewer people than many politicians claim, and there are other ways to tackle it that could be more flexible and effective than banning insurers from considering applicants' medical history.

(Excerpt) Read more at news.investors.com ...


TOPICS: Culture/Society; Editorial; Government
KEYWORDS:

1 posted on 06/20/2012 5:53:35 PM PDT by Kaslin
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To: Kaslin

Tell me something about this pre condition BS. If it’s mandatory that the insurer cover your condition, is it mandatory that he charges you the same rates as a person without pre conditions?

Consider this: the insurer charges the pre condition client 100 times the rate of regular clients. Is that the intent?


2 posted on 06/20/2012 6:07:24 PM PDT by Rider on the Rain
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To: Kaslin

Tell me something about this pre condition BS. If it’s mandatory that the insurer cover your condition, is it mandatory that he charges you the same rates as a person without pre conditions?

Consider this: the insurer charges the pre condition client 100 times the rate of regular clients. Is that the intent?


3 posted on 06/20/2012 6:07:24 PM PDT by Rider on the Rain
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To: Kaslin

I might be wrong here but I seem to recall an ‘under the radar’ news story a little while back about the largest three (maybe 4?) health insurance providers having been successful in negotiating waivers or Grandfathered terms, or similar, that provided them an out for this requirement of Obamacare. If so, and if those insurers collectively insure upward of 60% of Americans (with coverage), then this debate is is a fruitless exercise.

OSI research for a substantiating link has not yielded anything worth posting.


4 posted on 06/20/2012 6:28:51 PM PDT by softengine (Betrayal and Hypocrisy play on both sides of the fence.......but no one will admit it.)
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To: Kaslin

Not all pre-existing are the same:
1. Genetic/nature
2. Nurture, lifestyle while a chld.
3. Nurture, lifestyle choices while an adult.
4. Results of negligence, crimiality of others
5. Results of true accidents
6. Results of heroism; sacrificed yourself to help others.
Insurance companies should be required to cover some with no surcharge.

But for adult lifestyle choices insurance companies and health providers should be allowed to charge as much as they can without restraint ... other than competition.

From drugs and alcohol to sexual promiscuity to gluttony and sky diving and football, most pre-existing cases and most medical costs are from life style choices.


5 posted on 06/20/2012 6:39:20 PM PDT by spintreebob
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To: Kaslin
"In 45 states across the country, insurance companies can discriminate against people based on their pre-existing conditions when they try to purchase health insurance directly from insurance companies in the individual insurance market."

The flip side of that statement is: In 5 states across the country, insurance companies can not discriminate against people based on their pre-existing conditions when they try to purchase health insurance directly from insurance companies in the individual insurance market.

In my state, "An individual applicant without prior coverage may have to wait for up to one year for coverage of a pre-existing condition." But after that, they are covered.

6 posted on 06/20/2012 6:40:55 PM PDT by Sooth2222 ("Suppose you were an idiot. And suppose you were a member of congress. But I repeat myself." M.Twain)
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To: Sooth2222

Just finished working for a company that was self insured they had a 1year wait on pre existing conditions. Didn’t matter on previous coverage. They didn’t say anything just denied payment. I had to quit because it was too expensive. Current employer no wait on pre existing.
You don’t know till the bills come in. There should be a disclosure.


7 posted on 06/20/2012 6:55:23 PM PDT by BeAllYouCanBe (Until Americans love their own children more than they love Nancy Pelosi this suicide will continue.)
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To: Sooth2222

Just finished working for a company that was self insured they had a 1year wait on pre existing conditions. Didn’t matter on previous coverage. They didn’t say anything just denied payment. I had to quit because it was too expensive. Current employer no wait on pre existing.
You don’t know till the bills come in. There should be a disclosure.


8 posted on 06/20/2012 6:55:42 PM PDT by BeAllYouCanBe (Until Americans love their own children more than they love Nancy Pelosi this suicide will continue.)
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To: Kaslin

As a Type I diabetic, I can buy a vial of R Insulin for $25 at Wal-mart - a months worth. The needles cost $16 and last 3 months.

It’s actually how I’m stock piling. For other diabetics, friouk.com is a good place to buy a cold pack that stays cold forever.


9 posted on 06/20/2012 6:58:05 PM PDT by struggle (http://killthegovernment.wordpress.com/)
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To: Kaslin

I’ve been trying to get my Auto Insurance carrier to cover my pre existing automobile accidents. I haven’t had any luck so far.


10 posted on 06/20/2012 6:58:13 PM PDT by Rides_A_Red_Horse
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To: Sooth2222

Looking at short term policies in Ohio. 12 month wait to cover pre-existing but its waived for children under 19. My insurance runs out next week so I am getting everything possible in for me and my family before that time. However, I can’t get my annual liver CT scan for tumors I have had for years. I am monitored for their growth as they are quite large but the procedure will be denied for that first year.


11 posted on 06/20/2012 7:04:17 PM PDT by nurees (Oh...there is a NEW Mexico (Homer Simpson))
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To: Sooth2222

I bet that 90% of all insurnaces have a year to two year wait period on pre-existing conditions.

The four different companies for whom I have worked (in different states) all had this requirement.

This the clear SUPER-MAJORITY.


12 posted on 06/20/2012 7:05:29 PM PDT by ExTxMarine (PRAYER: It's the only HOPE for real CHANGE in America!)
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To: struggle

I have TWO juvenile diabetics. Neither their Lantus insulin, Novolog insulin or glucose test strips are available at Walmart.


13 posted on 06/20/2012 7:16:21 PM PDT by Lizavetta (You get what you tolerate)
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To: Kaslin

definition: Insurance is a form of risk management primarily used to hedge against the risk of a contingent, uncertain loss...........key point uncertain

....With a known pre-existing condition, ie a known loss, being covered-—it cannot then be called Insurance.

It then fits the defintion of either welfare, or wealth redistribution


14 posted on 06/20/2012 7:29:11 PM PDT by sbark
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To: ExTxMarine
This the clear SUPER-MAJORITY.

This is NOT an issue to a clear SUPER-MAJORITY of Americans.
15 posted on 06/20/2012 7:34:44 PM PDT by ExTxMarine (PRAYER: It's the only HOPE for real CHANGE in America!)
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To: Kaslin
Imagine you didn't have car insurance but could under some government mandate get it anytime. You don't bother to buy car insurance but when the Weather Service issues a warning that a hurricane is headed to your location so on your way to a shelter you quick buy a car insurance policy to cover your inevitable losses. Hundred of people in your location do the same. How long do you think car insurance companies would last under that scenario?

Insurance is all about risk pooling and works only because more premiums are being collected than losses being paid. If you allow large numbers of people to get insurance who are such bad risks that they will almost immediately have expensive claims without having paid any premium, the result is that rest of the risk pool will have to pay more to cover the costs of those who are making claims without having paid much in premiums. Imagine a life insurance company being forced to write large policies on people who are terminally ill with only a short time to live. That would work either.

16 posted on 06/20/2012 7:34:54 PM PDT by The Great RJ
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To: spintreebob

And the award for most cogent, concise, and clear-thinking rational breakdown of the problem goes to....

drumroll....

spintreebob!!!!! Yeah!

Nicely said.


17 posted on 06/20/2012 7:36:39 PM PDT by FateAmenableToChange
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To: Lizavetta
And you don't find that odd?

Diabetes is supposedly at horribly epidemic rates in the USA, and insulin should have been eligible for generic manufacturers to produce under FDA standards for many years.

Why is insulin not an “Over the Counter” product?

Could it be due (gasp/sarcasm) to Government, Pharmacy and Insurance Company's joint collusion and corruption?

I'm sorry you have two kids who suffer from diabetes.

I'm also sorry I have skin cancer, and even though I pay several thousands of dollars every year for “Health Care Insurance”, I can't afford to pay for any of the actual medical care “they” say I require this year.
I have a large deductible before any insurance benefits begin to kick in.

Oh to be an an average foreign illegal alien or welfare recipient!
Then all my medical bills would be freeeeeeeeeeee!

18 posted on 06/20/2012 7:57:23 PM PDT by sarasmom ( http://www.youtube.com/watch?feature=player_embedded&v=xZsFe6dM3EY)
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To: Lizavetta

For $25 you can buy one N(long lasting) or R (quick) vials of insulin. I’d suggest you’d buy a crapload and go to friouk.com and buy two large water packs immediately.

I don’t want to die, simply because I have a family to defend. If you can purchase at least 10 vials like I have, you should be ok. When the economic crash hits I don’t think anyone will get fatter. You might wanna get some ammo with that too, IN CASH.


19 posted on 06/20/2012 8:19:19 PM PDT by struggle (http://killthegovernment.wordpress.com/)
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To: Kaslin

For about the last 20 years, anybody who had employer insurance, COBRAed it, and used up all the COBRA has had to be offered insurance without a pre-existing condition exclusion, it’s federal law. There’s some timing hoops to jump through, and you pay for it, but you can get it. I took advantage of it in ‘97. So, the solution’s already there, it’s just little advertised because the politicians are getting more mileage out of touting a false “crisis”.


20 posted on 06/20/2012 8:22:22 PM PDT by ArmstedFragg (hoaxy dopey changey)
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To: spintreebob

Many insurance companies deny individual coverage for people with metabolic syndrome, insulin resistance and/or Type II diabetes even if the person seeks a very high deductible like $5,000 or $10,000. It is still up for debate whether these diseases are caused by lifestyle or genetics. It is in every generation of my family all the way back to my great grandmother who was born in the 1870s!

The scary thing is that people age 50 and up are the group who have been hit very hard by unemployment and are having difficulty finding a job. These are the same people who tend to have or be developing the above mentioned conditions.

And yes, the number of people denied coverage because of pre-existing conditions may be small. But they tend to be the ones who have paid into the insurance system their entire life and suddenly find themselves without health coverage and unable to qualify for state plans because of savings or whatever. All it takes is one catastrophic health event and they are suddenly in a huge amount of debt.

This is something I wish we could figure out how to fix. I understand the business of insurance and actuarial tables and why they deny coverage, but there has to be a clever company out there somewhere who could figure out how to cover them.


21 posted on 06/20/2012 8:26:21 PM PDT by OrangeDaisy
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To: Sooth2222
In my state, "An individual applicant without prior coverage may have to wait for up to one year for coverage of a pre-existing condition." But after that, they are covered.

That has been the federal law (I believe) since Clinton was in office.

22 posted on 06/20/2012 8:33:39 PM PDT by Straight Vermonter (Posting from deep behind the Maple Curtain)
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To: nurees

This is a State of California site, but the information applies nationwide, might be of interest.

http://www.dmhc.ca.gov/dmhc_consumer/hp/hp_hipaacp.aspx


23 posted on 06/20/2012 8:39:46 PM PDT by ArmstedFragg (hoaxy dopey changey)
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To: Kaslin
"We've got to make sure no American gets turned back for pre-existing conditions," Rep. Allen West, R-Fla., said recently.

GGGrrrrrrrrrrrrrr.
Another dishonest republican I would never vote for.
He can do anything he wants, but at least be honest. Stop calling it insurance.

Promote and sell (more) welfare on its merits.
How many parasites can the working citizens support?

24 posted on 06/20/2012 9:14:36 PM PDT by publius911 (Formerly Publius 6961, formerly jennsdad)
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To: Kaslin

bfl


25 posted on 06/20/2012 10:06:20 PM PDT by llandres (Forget the "New America" - restore the original one!!!)
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To: OrangeDaisy

Don’t bother trying to educate the fools around here who do not understand the actual problem. The “it’s like trying to buy car insurance after an accident” platitudes have worn rather thin.

You are correct that the people typically shoved out the door are those who have responsibly paid into the system for their entire lives. The lowlifes just show up at the emergency room for treatment, having NEVER bought insurance.

Case in point: My Mother. She and my Father were paying close to $20,000 per year in premiums (being self employed) because they had reached the “golden age” where insurance companies rape and pillage their clients. That would be over age 60, but before they qualified for Medicare. Both were generally healthy, Mom took a low dose of meds for high blood pressure.

Anyway, when they were 62, Dad was diagnosed with an aggressive cancer...he died three months later...there really was no “treatment” available.

Anyway, after he died Mom decided to see about having Dad dropped from the policy since he was...you know...DEAD. They had carried a Blue Cross/Blue Shield policy for 30 years at that point. They would not lower her premiums, or do anything else for her....OTHER than to offer to write a new policy that excluded her high blood pressure. To add insult to injury, they also wanted to exclude “mental health issues.” You see, she had been given a prescription for several days worth of Xanax by the Mayo Clinic on the Friday afternoon that my Dad was diagnosed with terminal cancer before they sent them home for the weekend so Dad could “get his affairs in order.”

So, she continued to pay that ridiculous premium for several years. Her story would be far more typical than some lowlife loser who had never purchased insurance attempting to purchase it “after the fact.”

Also, in my business, I often deal with clients who have been forced to stop working because of health issues (advanced MS, for example)...guess what? They have no way to afford Cobra, and often are involved in the arduous process of qualifying for disability. We meet them because they have filed bankruptcy, or are selling off their belongings to pay for medical bills.

The worthless, useless, illegal, and judgment-proof, continue to get treatment and never pay. This is an untenable situation, and if people do not want single-payer care, there had better be some solution offered that addresses these and other issues.


26 posted on 06/20/2012 10:13:24 PM PDT by garandgal
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To: spintreebob

If we decide some people shouldn’t have to pay for what would be the high cost of their insurance, why should we dictate that certain private companies have to bear that cost instead?

If all pre-existing conditions are covered, it’s really not insurance any more, is it? It is healthcare coverage, but not insurance.


27 posted on 06/20/2012 10:13:39 PM PDT by 9YearLurker
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To: Kaslin

I have always had insurance thru work. BCBS. There has never been an issue with preexisting conditions, no waiting with a group policy here in PA.
May be different for individual but I’d venture to guess that the overwhelming majority of folks have group coverage thru work.


28 posted on 06/20/2012 10:33:54 PM PDT by Eagles6
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To: 9YearLurker
If all pre-existing conditions are covered, it’s really not insurance any more, is it? It is healthcare coverage, but not insurance.

Similarly shouldn't an insurance company have the option of not renewing your coverage if you develop an expensive to treat disease?

Similar to an auto insurance company dropping you for too many claims.

29 posted on 06/20/2012 10:43:19 PM PDT by Doe Eyes
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To: Doe Eyes

I could see that as an option to be battled in the marketplace, but the original idea was for insurance only to cover expensive treatments.


30 posted on 06/20/2012 10:47:15 PM PDT by 9YearLurker
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To: Doe Eyes

Maybe the comparison would be if you were obese and smoked they wouldn’t cover diabetes or lung cancer.


31 posted on 06/20/2012 10:49:05 PM PDT by 9YearLurker
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To: OrangeDaisy

re: “I wish we could figure out how to fix”
A few possibilities for discussion:
- Let people die. Yes, cold hearted on the surface.
- Government subsidize the insurance premiums of privileged groups. If that happens, watch politics, not science, determine who gets on that list.
- Private not-for-profits subsidize insurance premiums...or healthcare directly.

Isnt’ the latter what we had for hundreds of years? Catholics, Luterans, Jews, Methodists, Baptists, etc opened hospitals that they subsidized. Those who could pay did. Those who could not pay still got treatment. Not just through church, but through Lions, Kiwanis, CoC and dozens of poorly organized groups with no names would raise money for their neighbor. In the 60s and 70s I repeatedly gave amounts of money for the direct care of casual acquaintances, as did many of my neighbors.


32 posted on 06/24/2012 6:27:51 PM PDT by spintreebob
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To: Doe Eyes
Similarly shouldn't an insurance company have the option of not renewing your coverage if you develop an expensive to treat disease?

If someone gets in a car wreck, the insurance company may decline to renew one's coverage, but doing so would not excuse the company from paying for future costs associated with the wreak. If "medical insurance" were actually insurance, the same principle would apply to major illnesses. For example, if someone had a cancer policy and developed cancer while the policy was clearly in effect, the policy would cover all lifetime costs associated with the cancer treatments indicated in the policy. Declining to renew the policy for someone who developed cancer wouldn't help the insurer, since it would still be on the hook for treating the person (note that if the policy is only required to treat people with the methods indicated therein, it should be possible to reasonably predict the expected lifetime cost per patient who develops cancer; of course, the vast majority of policy holders wouldn't develop cancer, so the costs of paying for those who do would be divided among the much larger pool of those who don't.

33 posted on 06/29/2012 9:49:59 PM PDT by supercat (Renounce Covetousness.)
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