Done properly, removal of pre-existing conditions limitations can work. There are people who get into situations where they simply cannot afford insurance. Should they fall ill during that time, then by all rights they should be responsible for the costs of their care, although I don’t think someone should go to debtors’ prison because they had a heart attack while they were out of work and couldn’t afford insurance. Likewise, I think it is tragic that someone in that scenario would then be denied most likely from ever purchasing health insurance again in the individual market. This is a huge problem. So, what to do about it? Implement a form of guaranteed issue that would be optional. If someone wanted to sign up for standard policies that require underwriting, they get the best rates, but if someone has a health condition and can’t qualify for medically-underwritten policies, they would pay a higher monthly premium, say, 25% more than the medically underwritten policy. In addition, they’d face a 2 year delay before the policy would cover any treatments related to the pre-existing illness. That will weed out those who only want to buy insurance when they get sick. Insurance companies can deal with that kind of coverage. They’ve been doing it for years here in Florida in the group market, which was defined to include businesses as small as one insured.
Another option that I think would be awesome is to make all health insurance polices a form of health savings account. Put the financial incentives into the hands of the insured people, so that they see that by reducing their health care expenditures, they come out ahead financially.
A very simple solution to the problem of uninsured and pre-existing conditions is a return to the public health system. Public health system hospitals would treat medicaid patients and medicare patients who don’t have supplemental policies, as well as military families and the uninsured, or anyone else who chooses to go the public health clinic or hospital.
Doctors killed the public health system because of the low pay. They could make so much more in private practice. That just isn’t the case anymore and will be even less so if Obamacare is put into force. A system could be put into place to pay off medical school debt in return for service in addition to the pay.
I have a friend who lived in Norway for 8 years. She told me that doctors in Norway make the same pay as a bus driver. That’s what Obama would like to see here. A public health system could avoid that.