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
“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.
“Pre-existing conditions is a straw-man argument because current law forbids insurance companies from denying coverage after one year of the condition treatment.”
Really? We changed insurance companies almost two years ago and they put a rider in that they would not cover my ankle which I had broken 3 years prior. I didn’t have a problem with that but I did ask them a couple of questions about this exclusion. What if I was in an accident and something happened to this ankle? I still would not be covered! We had to change because our other Health insurance had jacked our premiums up so much that we couldn’t afford it anymore. AND we have very high deductible HSA policy. Even they are expensive now! I still don’t want Obama care though!!!
If you felt the need, you could fight it with the HIPAA law. You have the right to dispute the rider. I bet if you read it, the rider said something along the lines of “for this policy, it excludes X”, however, if you made an issue, they would have to offer you a policy that did cover it. You obviously would probably have to pay more, but they can’t deny you.
If somebody has a condition since birth, they would be covered by their insurance they had when they were born, presumably. If they switch insurance after that point, they would be placing an inordinate burden on the next insurance company, which would have to be compensated.
One way to have coverage of pre-existing conditions with portability would be to have the insurance company that is losing the customer with the condition pay a certain premium to the insurance company that is taking that customer on. Since the customer changing insurance is a real benefit to the first company, this benefit would provide the money for the premium.
The amounts of the premiums could be determined by an industry group that would be able to predict the future pay-outs likely for specified conditions. Insurance companies are really good at that sort of thing. Since the first insurance company is going to have to pay a premium for any patient who drops them in favor of a new company, they will no longer have an incentive to dump sick patients.
Or, if you want a brute-force approach, the government could set up a fund to compensate insurers for taking on pre-existing conditions. This approach does not have the benefit of recovering costs from the first insurer, however, and gives the first insurer an incentive to dump patients. But at least it does not completely supplant the existing insurance industry and can be accomplished for a small fraction of the costs we are bandying about with Obamacare.
Not, not triple the cost because of the employer paying the other 2/3, the actual premium increases. Yes, the employee has to pay the employer portion as well, but the premium itself goes up as well.
“I never said that...I said they would get care. If they have advanced stages of cancer, they will be diagnosed, treated there to help, and then sent to get the care they need. “
Treated and sent to get care they need. Where?
I am not saying we do not have the best healthcare in the world, but don’t act like people have the care they need as it is when they have a serious medical condition.
The thing was...we couldn’t afford to pay more. That’s why we were changing insurance companies. We rarely used our health insurance when we were employed by someone else but since then (my husband is self-employed)...I’ve broken my ankle and then this year I had to have my gall bladder out! Can’t wait to see how much our policy goes up after that! I am just praying that nothing happens in the next couple of years.
The thinking is.. if these conditions are being treated regularly, the regular treatment outweighs the risk of a catastrophic medical event occurring from these conditions. It makes sense to not cover the conditions if they have not been treated for a truly significant amount of time (i.e. >1 year) because it is probably statistically significant that a major claim will be made to the company for the condition that has not been treated satisfactorily. However, upon reading the fine print of my policy, pre-existing conditions are only not covered for a period of 6 months, after 6 months they are covered.
Actually, although I was (and I REMAIN!) opposed to the Medicare part D drug plan, it does have an interesting feature that might provide an answer.
Each year, we have the option of signing up for a “qualified” drug coverage plan. If we do so, we also “earn” the privilege of doing it again the following year at the standard price. But if we do not, we still can sign up for such a plan during the annual open enrollment period every year. However, for each year that we are eligible but do NOT participate, the price of future enrollment increases significantly. Also, while anyone generally eligible should be able to enroll during the open period, they should be subject to “rating” based on their medical condition for a period of five years.
I think this might be an appropriate model, because it does reward anticipating and providing for future need.
The combination of “Community Rating” and “Guaranteed Issue” does just the opposite, and should NEVER be adopted.
However, the best way to offer medical insurance is and remains the combination of a Medical Savings Account and high-deductible or catastrophic coverage insurance.
The system is not perfect...insurance companies should be allowed to compete across state lines, tort reform is a real need, etc....but the care is there and not denied by the doctors.
Boards on insurance companies come up with guidelines for the insured and that is understandable because in a free market they can establish their plans as they will...as can others who will take advantage of any lapses and draw market share to themselves if another company does not offer good services.
Having the government do this, particularly as it establsihses itself as the sole provider...which is the goal...will have the opposite effect. The free market will not be involved so government officials will mandate care and guidelines regardless of their need to attract customers and true rationing and lessening of care will occur.
Agaian, the debate is really about whether we allow socialists in government, under the guise of "helping" health care, destroy the free market or not. That's what this is about with the dems and the left.
Approach it from a different direction. Look for a smaller policy versus full coverage. Get a catastrophic-only policy and then invest and save the difference plus every extra dime you have. Then, you have the money in the bank if you need it for day to day medical treatment, you have a catastrophic policy for major events, and if you don’t need the money for medical, it is still your money earning interest for you.
People often look at this entire issue incorrectly. Health Insurance isn’t Health Care. View it from this approach, you can see there are a lot more options to you.
Now don’t get me wrong, I think there are a lot of things that need fixing, but I believe they can be achieved by getting big brother out of the mix, not having him regulate more. Allow policies to be sold across State lines (one of the few things I think the commerce clause of the Constitution would legitimately cover). Insurance companies should be free to create customized, ala carte type plans, like you add widgets to your phone to customize how you use it. There could even be tax incentives for companies who take riskier policies (not subsidies, but maybe lower rates). Freedom is the answer, not regulation.
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