A Market solution for pre-existing conditions?

[heyheybooboo]

Originally posted by: QuantumPion
~~~

That 2% only covers the lawsuits themselves.

~~~

Linkage, please.

Just as a quick Fun Fact # of the Day for you: $54,656,155,470.00

(That nearly $55 billion would be your '2%' for 2009)

 

[BoberFett]

As much of a free market supporter as I am, this is unfortunately one of the hardest questions for the free market to answer.

As others have pointed out and where I'm very much in agreement, is that part of the problem we have is that health insurance right now is like auto insurance that pays to change your oil and replace your wiper blades. That just adds a middle man where none is necessary and raises costs. Instead, auto insurance covers accidents. One time events. They fix your car and you go on your merry way. The problem is that if the mechanic told you that he could fix your car after the accident, but that due to the accident it would need a new engine every 1000 miles your insurance company would tell you take a hike. It's cheaper to total the car and buy a new one. Not really a viable answer to a patient.

The option I've supported for quite some time after a great deal of thought is Universal Catastrophic Coverage. Anything that required extraordinarily expensive or ongoing care would be covered. Everything else is up to you. Private companies can sell complete health care plans just like auto shops are selling comprehensive plans that cover all routine maintenance. Hell, I can buy that sort of coverage for my dog and for a couple hundred bucks per year it gets routine checkups. Why should something like breaking a bone cost thousands of dollars which is why it has to be covered by insurance? Setting a bone and putting on a cast should cost a couple hundred tops. I do believe in the free market enough to think that if we truly allowed it to operate freely that those kinds of basic procedures could come way down in price.

Edit: And those of you who disagree with the auto analogy are brain dead.

 

[fskimospy]

Originally posted by: QuantumPion

That 2% only covers the lawsuits themselves. It doesn't cover the enormous amount of excess tests, unnecessary procedures, doctor shopping, over-medication, and poor health care decisions doctors and insurance companies make to avoid being the target of frivolous lawsuits.

Now: the horrible car insurance analogy. Car insurance works that way because we as a society are willing to allow people to be struck with the consequences of not having their insurance, or not having enough money to fix their car. They simply don't have one then, and they take the bus to work. For health insurance, we as a society (because we are not animals) have decided that if someone is sick and we can help them, we will do so regardless of their ability to pay. That means that the fundamental structure of risk/reward is completely different for health insurance. Routine care is a long term money saver in many cases, not a driver of costs.

Until you're willing to sign legislation to allow sick and injured people to die when we could save them, the car analogy is worthless.

That is what Obama is proposing, in his own words on national television.

Oh, and just because your ideals say that society should pay for everyone's health care costs, does not change the reality of the nature of insurance. They are completely separate issues.

Since I guess you aren't reading other posts here I will cut and paste my response to DeLerium.

Originally posted by: eskimospy

No, in fact that was specifically addressed in my post. It is called 'defensive medicine'.

As I have linked in other threads, the CBO specifically researched this.

However, when CBO applied the methods used in the study of Medicare patients hospitalized for two types of heart disease to a broader set of ailments, it found no evidence that restrictions on tort liability reduce medical spending. Moreover, using a different set of data, CBO found no statistically significant difference in per capita health care spending between states with and without limits on malpractice torts.

So no, tort reform will most likely do almost nothing.

Furthermore, what Obama is proposing has almost nothing to do with what we are talking about here, and you know it. Examining end of life care and determining cost effective measures for health care implementation is not letting someone in an auto accident die because they don't have insurance. Shame on you.

 

[nobodyknows]

Originally posted by: BoberFett


Edit: And those of you who disagree with the auto analogy are brain dead.

Your money or your car!!

 

[fskimospy]

Originally posted by: BoberFett
As much of a free market supporter as I am, this is unfortunately one of the hardest questions for the free market to answer.

As others have pointed out and where I'm very much in agreement, is that part of the problem we have is that health insurance right now is like auto insurance that pays to change your oil and replace your wiper blades. That just adds a middle man where none is necessary and raises costs. Instead, auto insurance covers accidents. One time events. They fix your car and you go on your merry way. The problem is that if the mechanic told you that he could fix your car after the accident, but that due to the accident it would need a new engine every 1000 miles your insurance company would tell you take a hike. It's cheaper to total the car and buy a new one. Not really a viable answer to a patient.

The option I've supported for quite some time after a great deal of thought is Universal Catastrophic Coverage. Anything that required extraordinarily expensive or ongoing care would be covered. Everything else is up to you. Private companies can sell complete health care plans just like auto shops are selling comprehensive plans that cover all routine maintenance. Hell, I can buy that sort of coverage for my dog and for a couple hundred bucks per year it gets routine checkups. Why should something like breaking a bone cost thousands of dollars which is why it has to be covered by insurance? Setting a bone and putting on a cast should cost a couple hundred tops. I do believe in the free market enough to think that if we truly allowed it to operate freely that those kinds of basic procedures could come way down in price.

Edit: And those of you who disagree with the auto analogy are brain dead.

Your mention of a different form of universal catastrophic coverage to supplant your idea of health insurance shows exactly why it's different, and then you talk about how people who dispute the validity of your analogy are 'brain dead'.

You know I try not to be too mean to you, but you make it hard sometimes.

 

[Fern]

Originally posted by: BoberFett
-snip-
The option I've supported for quite some time after a great deal of thought is Universal Catastrophic Coverage. Anything that required extraordinarily expensive or ongoing care would be covered.

I strongly agree.

Back when the UHC (UHI) proponents were trying to sell it on the basis that catastrphic medical problems often result in banckruptcy, only to later learn that many who were bankrupted DID have HI so they dropped that line, it became obvious that major medical is our primary problem.

Fern

 

[BoberFett]

Originally posted by: eskimospy
Your mention of a different form of universal catastrophic coverage to supplant your idea of health insurance shows exactly why it's different, and then you talk about how people who dispute the validity of your analogy are 'brain dead'.

You know I try not to be too mean to you, but you make it hard sometimes.

You clearly have a mental disability. Don't worry, my plan would cover you.

 

[fskimospy]

Originally posted by: BoberFett

Originally posted by: eskimospy
Your mention of a different form of universal catastrophic coverage to supplant your idea of health insurance shows exactly why it's different, and then you talk about how people who dispute the validity of your analogy are 'brain dead'.

You know I try not to be too mean to you, but you make it hard sometimes.

You clearly have a mental disability. Don't worry, my plan would cover you.

Boberfett, I don't think I've ever seen someone call more people stupid, who is less qualified to make that determination than you.

 

[TheSkinsFan]

Originally posted by: eskimospy

Originally posted by: TheSkinsFan

Originally posted by: rudder
What if my religion forbids me from seeing a doctor? Will the government force me to buy insurance against my religious beliefs?

Given the nature of the current reform proposals, it's almost guaranteed that you'd at least be hit with a tax penalty, if not worse further down the road.

Some folks, like Hillary Clinton for example, want healthcare reform to eventually include some sort of "enforcement mechanism."

Remember her fun-filled ideas?

"We will have an enforcement mechanism, whether it?s [garnishing people's wages] or it?s some other mechanism through the tax system or automatic enrollments?

I sincerely doubt that she's the only one who wants to implement such things.

No you wouldn't be hit by a tax penalty. It's not 'almost guaranteed' in any way, shape, or form. In fact, it's the exact opposite. The government cannot tax you for exercising your religious beliefs.

Please go do some reading on the first amendment, particularly in reference to Jehova's Witnesses and you will see there is a long history of tax exemptions for religious liberty in this country.

There is absolutely nothing in the current proposal that I have seen that even HINTS at religious exceptions. If it passes, ALL U.S. taxpayers who do not elect coverage will incur a 2.5% tax penalty -- that is, if they make enough to be taxed in the first place.

I guess he could avoid that penalty by electing the "public option," and just never use it, but that wasn't his question -- he asked about being forced to have insurance, specifically.

IOW, the Government can't make him go to a doctor against his will or his religion -- yet -- but they can damn sure force him to elect coverage, of some kind, or penalize him.

 

[fskimospy]

Originally posted by: TheSkinsFan

There is absolutely nothing in the current proposal that I have seen that even HINTS at religious exceptions. If it passes, ALL U.S. taxpayers who do not elect coverage will incur a 2.5% tax penalty -- that is, if they make enough to be taxed in the first place.

I guess he could avoid that penalty by electing the "public option," and just never use it, but that wasn't his question -- he asked about being forced to have insurance, specifically.

IOW, the Government can't make him go to a doctor against his will or his religion -- yet -- but they can damn sure force him to elect coverage, of some kind, or penalize him.

I'm not aware of anything in the legislation for a religious exception either, but it doesn't matter. This is the reason why I directed you to go read about the first amendment, with Jehovah's Witnesses in particular. The USSC has already ruled in the past that you cannot be penalized through taxes for exercising your religious beliefs, and the same would just about certainly hold true here.

So no, it can't.

 

[BoberFett]

Originally posted by: eskimospy

Originally posted by: BoberFett

Originally posted by: eskimospy
Your mention of a different form of universal catastrophic coverage to supplant your idea of health insurance shows exactly why it's different, and then you talk about how people who dispute the validity of your analogy are 'brain dead'.

You know I try not to be too mean to you, but you make it hard sometimes.

You clearly have a mental disability. Don't worry, my plan would cover you.

Boberfett, I don't think I've ever seen someone call more people stupid, who is less qualified to make that determination than you.

Coming from the likes of you I'll take that as glowing praise.

 

[stateofbeasley]

Originally posted by: BoberFett

Originally posted by: eskimospy

Originally posted by: BoberFett

Originally posted by: eskimospy
Your mention of a different form of universal catastrophic coverage to supplant your idea of health insurance shows exactly why it's different, and then you talk about how people who dispute the validity of your analogy are 'brain dead'.

You know I try not to be too mean to you, but you make it hard sometimes.

You clearly have a mental disability. Don't worry, my plan would cover you.

Boberfett, I don't think I've ever seen someone call more people stupid, who is less qualified to make that determination than you.

Coming from the likes of you I'll take that as glowing praise.

Frak you! :disgust: Frak you all! :disgust:

I agree that some sort of tort reform is necessary. Scumbag lawyers and desperate indebted graduates of private Third Tier Toilet law schools are running physicians out of Pennsylvania.

Shut down these diploma mill law schools and put some reasonable limits on tort claims.

 

[Athena]

Originally posted by: Genx87
What % of people out there are hit with pre-existing conditions?

According to an HHS survey, an estimated 36% of those who tried to purchase individual coverage were discriminated against due to pre-existing conditions. In nine states, domestic violence can be a disqualifying "pre-existing condition".

And even when the applicant is successful in obtaining insurance, they policy may not cover conditions deemed to be "related" to the pre-exiting one -- as in, hay fever suffers may find that any respiratory problem will not be covered.

 

[blackangst1]

Originally posted by: Athena

Originally posted by: Genx87
What % of people out there are hit with pre-existing conditions?

According to an HHS survey, an estimated 36% of those who tried to purchase individual coverage were discriminated against due to pre-existing conditions. In nine states, domestic violence can be a disqualifying "pre-existing condition".
And even when the applicant is successful in obtaining insurance, they policy may not cover conditions deemed to be "related" to the pre-exiting one -- as in, hay fever suffers may find that any respiratory problem will not be covered.

LOL I didnt know that LOL

 

[glenn1]

Originally posted by: her209

Originally posted by: JS80
Yes, the solution is you pay more. Go make more money if you want a leech doctor to treat you.

You are paying more anyways since the sick people will just go to the hospital and skip out on the bill.

The only way the proposal to force the insurance companies to write a policy for someone with pre-existing conditions, is to allow them to price it at a point sufficient to cover the costs that will be associated with the inevitable treatment that will be required.

Where the problem comes in, is that most who demand that insurance companies cover pre-existing conditions also believe it's "unfair" to charge higher rates for those same clients. Instead, they get all misty-eyed upon hearing the sob story that "my insurance would cost $ eleventy billlion/year" and want the insurance company to write the policy at the same rates as a healthy person. Well, t As someone without pre-existing conditions, I should get lower rates than you if you have _____ (insert disease name here).

 

[fskimospy]

Originally posted by: glenn1

Originally posted by: her209

Originally posted by: JS80
Yes, the solution is you pay more. Go make more money if you want a leech doctor to treat you.

You are paying more anyways since the sick people will just go to the hospital and skip out on the bill.

The only way the proposal to force the insurance companies to write a policy for someone with pre-existing conditions, is to allow them to price it at a point sufficient to cover the costs that will be associated with the inevitable treatment that will be required.

Where the problem comes in, is that most who demand that insurance companies cover pre-existing conditions also believe it's "unfair" to charge higher rates for those same clients. Instead, they get all misty-eyed upon hearing the sob story that "my insurance would cost $ eleventy billlion/year" and want the insurance company to write the policy at the same rates as a healthy person. Well, t As someone without pre-existing conditions, I should get lower rates than you if you have _____ (insert disease name here).

The basic problem is that many preexisting conditions would put the cost so high that it might as well be impossible to get anyway. Since we're going to eventually treat them anyway when they end up in the emergency room, this is not a good solution.

 

[glenn1]

Originally posted by: eskimospy

Originally posted by: glenn1

Originally posted by: her209

Originally posted by: JS80
Yes, the solution is you pay more. Go make more money if you want a leech doctor to treat you.

You are paying more anyways since the sick people will just go to the hospital and skip out on the bill.

The only way the proposal to force the insurance companies to write a policy for someone with pre-existing conditions, is to allow them to price it at a point sufficient to cover the costs that will be associated with the inevitable treatment that will be required.

Where the problem comes in, is that most who demand that insurance companies cover pre-existing conditions also believe it's "unfair" to charge higher rates for those same clients. Instead, they get all misty-eyed upon hearing the sob story that "my insurance would cost $ eleventy billlion/year" and want the insurance company to write the policy at the same rates as a healthy person. Well, t As someone without pre-existing conditions, I should get lower rates than you if you have _____ (insert disease name here).

The basic problem is that many preexisting conditions would put the cost so high that it might as well be impossible to get anyway. Since we're going to eventually treat them anyway when they end up in the emergency room, this is not a good solution.

So your solution is to force the healthy to subsidize them, making insurance unaffordable for more of them as well. So instead of a a handful of folks facing a bad situation, you've turned this into a tradegy of the commons scenario.

 

[fskimospy]

Originally posted by: glenn1

So your solution is to force the healthy to subsidize them, making insurance unaffordable for more of them as well. So instead of a a handful of folks facing a bad situation, you've turned this into a tradegy of the commons scenario.

The healthy already subsidize them, and they always will. Unless you are no longer willing to treat people who are dying in emergency rooms regardless of their ability to pay, the healthy will always subsidize them.

Since that's a stance our society is extremely unlikely to ever support, I feel like we should move past it and figure out how the healthy can most cost effectively subsidize the sick.

 

[SammyJr]

Originally posted by: glenn1
So your solution is to force the healthy to subsidize them, making insurance unaffordable for more of them as well. So instead of a a handful of folks facing a bad situation, you've turned this into a tradegy of the commons scenario.

Is someone who is healthy always going to be healthy? I'm 30 and very healthy. In another 30 years, am I going to be this healthy? Probably not. 60 years from now, definitely not.

 

[JSt0rm]

Originally posted by: SammyJr

Originally posted by: glenn1
So your solution is to force the healthy to subsidize them, making insurance unaffordable for more of them as well. So instead of a a handful of folks facing a bad situation, you've turned this into a tradegy of the commons scenario.

Is someone who is healthy always going to be healthy? I'm 30 and very healthy. In another 30 years, am I going to be this healthy? Probably not. 60 years from now, definitely not.

I think the suggestion is to make Logan's Run a reality.

 

[WhipperSnapper]

Insurance, as a business model, is supposed to only protect people from unknown future ailments and not known current ailments. Why would any business agree to pay for someone's half-a-million dollar cancer treatment? Thus, if someone is not already covered, and, as a result of a contract, cannot be dropped, they won't be able to obtain insurance.

The issue is whether we as a society want to care for sick people. One of the reasons why it's selfish to support health care for sick people is, very simply, you are potentially one of them--one day you could be the sick person.

What's really amazing is that when you cut out all of the profit and economic waste that results from our current system and from having a huge percentage of the people involved with health care not actually providing any health care, it's possible to cover everyone for a smaller percentage of our nation's GDP than what we're doing now.

 

[glenn1]

Originally posted by: WhipperSnapper

Insurance, as a business model, is supposed to only protect people from unknown future ailments and not known current ailments. Why would any business agree to pay for someone's half-a-million dollar cancer treatment? Thus, if someone is not already covered, and, as a result of a contract, cannot be dropped, they won't be able to obtain insurance.

The issue is whether we as a society want to care for sick people. One of the reasons why it's selfish to support health care for sick people is, very simply, you are potentially one of them--one day you could be the sick person.

What's really amazing is that when you cut out all of the profit and economic waste that results from our current system and from having a huge percentage of the people involved with health care not actually providing any health care, it's possible to cover everyone for a smaller percentage of our nation's GDP than what we're doing now.

You're incorrect in thinking that the health insurance companies are the (or even *a*) main cost driver. For the most part they're offering a comodity product offering very slender margins (many years 2-3%, some good years 7%). This fellow summarizes it fairly accurately, if crudely.

 

[WhipperSnapper]

Originally posted by: glenn1You're incorrect in thinking that the health insurance companies are the (or even *a*) main cost driver. For the most part they're offering a comodity product offering very slender margins (many years 2-3%, some good years 7%). This fellow summarizes it fairly accurately, if crudely.

What about all of the money spent on health insurance administrative costs, billing, insurance brokers, and benefits plan managers at private companies? I wouldn't be at all surprised if more than 50% of all medical costs is administration-related red tape and if most people involved with health care have nothing to do with the actual provision of health care.

At any rate, it's already been demonstrated that other systems are much better and less expensive than ours. You might find the PBS Frontline documentary about other first world nations' health systems enlightening.

 

[BarneyFife]

Originally posted by: QuantumPion

Originally posted by: Modelworks
Insurance came into existence to pay for unexpected expenses that someone could not normally afford. If you look at the history of medicine, before insurance, people actually paid cash for services. It was no different than paying someone to paint your house.

Somewhere along the way someone realized they could make a bundle and prices increased to the point that insurance was no longer about unexpected expenses but everyday expenses. Imagine if car repair and maintenance increased to the point that an oil change was $500. That is what happened to health care.

They really should just change it from insurance companies to medical brokers, because that is all they are. They act as a go between from the patient to the doctor negotiating for the best price for what the patient can pay. It isn't insurance anymore. The old insurance model cannot work with pre-existing conditions, it just isn't possible. You can't insure a house that is sitting halfway over a river for flood insurance and expect to make a profit. The insurance model only works when you have less claims than you have money being paid in premiums and pre-existing conditions nullify that.

Exactly. The purpose of insurance is to cover your medical expenses if you are in an auto accident or get appendicitis. In an ideal system, if you have a heart condition or cancer or diabetes (e.g. something that is a known condition and requires long-term expenses), you should pay for it yourself using an HSA or loan.

The problem is that the government has interfered with the health care industry so destructively that the cost of treatments has increased to ridiculous levels that no one can afford, unless they have an insurance plan which pays for it. Thus everyone demands to be covered by insurance for everything. Which causes the prices to become even more astronomical.

There are other major problems with our health care, but these can be easily fixed if the Democrats were interested in actually fixing health care, rather then socialize it for their own power. These two are: health care for poor/old people. Replace medicare/medicaid with government-provided HSA's (or even better, contribution-matched). That way, people will be responsible for the price they pay for care. Second: tort reform. This is self-explanatory but will never happen as long as the lawyers dump billions in contributions to congress to keep themselves in business.

First of all, you have no clue on how much medical care costs. To think that a poor person or anyone for that matter has thousands laying around for HSA or getting a loan for a procedure may be one of the most retarded things I ever heard.

Tort reform does nothing. The total cost of lawsuits to insurance companies is one tenth of one percent. Peanuts. I'm sure you're one of those people that thinks it was ok to spend all those billions in Iraq instead of the USA.

 

[CADsortaGUY]

Originally posted by: Modelworks
Insurance came into existence to pay for unexpected expenses that someone could not normally afford. If you look at the history of medicine, before insurance, people actually paid cash for services. It was no different than paying someone to paint your house.

Somewhere along the way someone realized they could make a bundle and prices increased to the point that insurance was no longer about unexpected expenses but everyday expenses. Imagine if car repair and maintenance increased to the point that an oil change was $500. That is what happened to health care.

They really should just change it from insurance companies to medical brokers, because that is all they are. They act as a go between from the patient to the doctor negotiating for the best price for what the patient can pay. It isn't insurance anymore. The old insurance model cannot work with pre-existing conditions, it just isn't possible. You can't insure a house that is sitting halfway over a river for flood insurance and expect to make a profit. The insurance model only works when you have less claims than you have money being paid in premiums and pre-existing conditions nullify that.

You started out correct and then ended up completely wrong. The old model would work with pre-existing. It's like buying a house in a flood plain. You can still get flood insurance - but it'll just cost you more due to RISK. RISK mitigation is what INSURANCE(old model) is for. It's not intended to pay for every little thing related to what is being insured.