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To: Texan5

The flip side of this addiction treatment being covered by private insurance policies is that it increases the rates non-addicted insurance payers have to shell out. It’s always the case that those who follow the rules and keep their noses clean have to pay for those who don’t give a care and expect others to pay for their bad habits.


11 posted on 10/30/2019 4:16:51 PM PDT by taxpayerfatigue (Taxpayer Fatigue)
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To: taxpayerfatigue

When you-or your employer-buys insurance, you become part of a risk pool.

In the case of workers comp, the employer has an experience rate based on the injuries/payouts of similar businesses. The more dangerous jobs, the more work-related injuries and payouts-but at least your retail store or small construction company isn’t in the same risk pool as an offshore drilling company or one that provides guards to minimum-to-medium security prisons, etc-similar companies, similar risks make the rates more fair-high for the prison guard provider, lower for the retail or small construction business, etc.

In the case of your health insurance, you are in the same risk pool as everyone with that insurer-from preachers to criminals, you are in the same pool with them-and that is how your rates are figured-on the average of illness/injury of every person with that insurer. I’m a naturalist who eats organic and unprocessed, don’t take drugs/meds-occasionally has wine or beer and 1-2 cigarettes, works and works out, never been overweight, no chronic illness and I don’t go to a doc unless I’m injured badly enough to need one-but I’m still in the same risk pool with the 400 lb. heifer who is a couch potato with clinical depression, early onset arthritis, Type II diabetes, takes several K$$$ worth of meds every month and is insisting on bariatric surgery to lose weight-she will get it-on the dime of all of us in the risk pool.

It is totally unfair-you are right-I’m all for people with chronic major problems being in separate risk pools from those of us who are ordinary and don’t spend everyone’s insurance money just because we pay our premiums unless it is a real need-also, reward those of us who don’t run to a doc whether we need one or not-I’m sure being a case manager makes me see things this way- I guess that makes me mean and intolerant-and I don’t care...


12 posted on 10/30/2019 5:34:56 PM PDT by Texan5 ("You've got to saddle up your boys-you've got to draw a hard line"...)
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