Healthcare: Do we have a Conservative Solution to Helping People with Pre-existing Conditions ?

11/6/2009 | Vanity

[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

[freemama]

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.

[Uncle Miltie]

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.

[Rockingham]

That does not work as many illnesses are congenital or are long standing without a clear inception date.

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.

[E. Pluribus Unum]

The entire idea of insurance is that you can assess the risk of an event in a pool of people who are paying premiums.

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.

[DennisR]

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.

[crymeariver]

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.

[SeekAndFind]

Have the insurance company (if any) that covered the individual fully or partially responsible.

I'm trying to understand this. That sounds like COERCION by government to me. You are in effect TELLING a business to COVER an individual who will be a continuing expense to you. Is that a conservative solution ?

[sodpoodle]

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.

[Marie]

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.

[aSeattleConservative]

“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.

[massgopguy]

COBRA, the only governmnet program with a truthful name.

[autumnraine]

“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.

[autumnraine]

“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.

[sodpoodle]

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.

[autumnraine]

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.

[Brilliant]

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.

[fso301]

There are two categories. Those presently dealing with pre-existing conditions and those whose conditions have yet to be diagnosed.

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.

[mnehring]

What law?

Health Insurance Portability and Accountability Act of 1996 (HIPAA)

[Marie]

“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.

[Vigilanteman]

Laws on coverage of people with pre-existing conditions vary from state to state but generally do not allow an insurance company to opt out of coverage if the pre-existing condition has been under successful treatment for a given amount of time (usually one year) prior to writing the policy.

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:

1. Mandates. Here in Pennsylvania, employers are required to cover substance abuse even for companies such as ours where drug testing is a condition to getting and keeping your job. Over in Delaware, the gay mafia has mandated full coverage for behavioral diseases such as AIDS even for people who can control their schlong. A few of these mandates may be worthwhile, but most are just a way to force a large pool of people to cover the politically connected, largely behavioral based ailments which people who avoid the behaviors will never use. My daughter, on the other hand, buys a $30 per month policy from Utah because she attends college in Idaho which has an insurance reciprocity agreement in place, for a fraction the cost because the state doesn't lard up their mandates with this type of useless coverage.

2. Overregulation-- in addition to the above, insurance companies are not free to sell policies across state lines. They deal with 50 different regulatory agencies, so 50 different markets. For example, the Utah company which my daughter uses will not even sell into the Pennsylvania or Delaware market because they do not wish to deal with behavioral based illnesses. It does, however, begin phasing in coverage of pre-existing conditions after one year, a benefit far more worthwhile for my daughter than coverage of substance abuse or AIDS.

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.