- My Forums
- Tiger Rant
- LSU Recruiting
- SEC Rant
- Saints Talk
- Pelicans Talk
- More Sports Board
- Fantasy Sports
- Golf Board
- Soccer Board
- O-T Lounge
- Tech Board
- Home/Garden Board
- Outdoor Board
- Health/Fitness Board
- Movie/TV Board
- Book Board
- Music Board
- Political Talk
- Money Talk
- Fark Board
- Gaming Board
- Travel Board
- Food/Drink Board
- Ticket Exchange
- TD Help Board
Customize My Forums- View All Forums
- Show Left Links
- Topic Sort Options
- Trending Topics
- Recent Topics
- Active Topics
Started By
Message
re: .
Posted on 11/2/18 at 2:41 pm to BugAC
Posted on 11/2/18 at 2:41 pm to BugAC
quote:
Personally, I think pre-existing coverage should be in it's own separate pool and everyone with PE pays a separate rate aside from their insurance rates. I am for providing assistance to help lower medical costs for those with PE, but i do not want that on my insurance bill.
PE is not insurance. PE is a known illness. Insurance, by definition, is covering the unknown.
This is exactly how every other type of insurance works: life, auto, homeowners, e&o, malpractice, liability, commercial, etc.
The more risk you present to a company (i.e., the more likely it is they will have to pay for a covered loss) the more they charge you in annualized premium. Insurance companies spread their risk by establishing large, homogeneous groups of people with similar risks and charge them similar rates.
Health insurance does not work like this. The companies cannot assess risk, so instead of grading people into rates of Preferred, Standard, or Qualified, everyone gets put into standard or qualified rates.
0
Posted on 11/2/18 at 2:48 pm to cahoots
quote:
Let's take a harder example. A person has tons of health problems growing up while on parents' insurance plan. Comes of age and has to get own coverage. Insurer says their coverage will be 5 times the average, making it impossible to afford.
Should there be a provision for that situation or is that person just SOL?
Honestly just curious.
Not a great example honestly. In the insurance world, companies have look back periods, and specifically to P&C insurance world, they have CLUE reports. It's basically an underwriter looking at claims that have been made over the past 2, 5, 10 or however many years. In the life world, they look at Rx history and information from the Medical Information Board for however many look back years they use. Health Insurers cannot do this.
Generally, insurance companies set rates based on the likelihood they will have to pay a covered loss. So yes, if someone has been to the ER 7 times in the past 5 years, he should pay more for health insurance than someone of the same age/gender who has not been.
The best way to prevent this person from having rates 5x the average is to let the Insurance Companies establish huge homogeneous groups of people like your example so they can collectively pay less rates together.
Obamacare prevents this.
Posted on 11/2/18 at 2:52 pm to ibldprplgld
quote:
The best way to prevent this person from having rates 5x the average is to let the Insurance Companies establish huge homogeneous groups of people like your example so they can
This is the literal definition of obamacare. You do know that right?
Insurance companies wrote the specs for obamacare so it benefits them.
Posted on 11/2/18 at 2:53 pm to cahoots
White suburban women think it's mean to "take away" such coverage, and republicans would rather eat shite than offend this swing demo. So here we are.
Posted on 11/2/18 at 2:57 pm to cahoots
quote:
Covering pre-existing conditions means that insurers can't turn unhealthy people away and/or raise premiums too high.
Which means it isn't insurance.
Posted on 11/2/18 at 2:59 pm to cahoots
Republicans have always said they liked that part of the bill from the very beginning. The media has not told the American people this. Never believe anything you hear or read about political news. Never.
Posted on 11/2/18 at 3:00 pm to mahdragonz
quote:
This is the literal definition of obamacare. You do know that right?
Insurance companies wrote the specs for obamacare so it benefits them.
No, it's different entirely.
Obamacare prevents health insurers from establishing homogeneous groups of similar risk profiles. Everyone gets put into the same group; your healthy people pay more and your unhealthy people pay less and the insurance company raises prices on everyone because it can't establish risk pools. Further complicating matters is the fact that to keep the rates from skyrocketing, this giant risk pool depends on healthy people buying in -- and they didn't, so rates increased even more.
Posted on 11/2/18 at 3:02 pm to bleedpg
quote:
Republicans have always said they liked that part of the bill from the very beginning.
Right, they like the part that increases premiums for everyone (pre-existing conditions provisions) but they also say that Obamacare is a disaster because it increases premiums for everyone. It's hard to explain/understand your position when it is inherently contradictory.
Posted on 11/2/18 at 3:06 pm to ibldprplgld
quote:
Obamacare prevents health insurers from establishing homogeneous groups of similar risk profiles. Everyone gets put into the same group; your healthy people pay more and your unhealthy people pay less and the insurance company raises prices on everyone because it can't establish risk pools. Further complicating matters is the fact that to keep the rates from skyrocketing, this giant risk pool depends on healthy people buying in -- and they didn't, so rates increased even more.
But if you segregate the unhealthy people with pre-existing conditions, they are going to pay even more than they curerntly do. In your prior post, you suggested that such a group could somehow wind up paying less. That likely would not happen if you segregated the groups. That's how it was before obamacare and a lot of those people couldn't afford coverage.
This post was edited on 11/2/18 at 3:07 pm
Posted on 11/2/18 at 3:07 pm to cahoots
That’s a very elementary understanding of the issues with Obamacare. However, I think most people took issue with being compelled to buy insurance. I, personally, dislike that Obamacare disallowed catastrophic plans. Limiting my ability to contract is not helpful.
Anyways...back to your elementary understanding and trite posting. Wouldn’t want to get in the way of such a subtle sky scream.
Anyways...back to your elementary understanding and trite posting. Wouldn’t want to get in the way of such a subtle sky scream.
Posted on 11/2/18 at 3:08 pm to cahoots
If someone has a pre-existing condition then they should be on Medicaid or Medicare. No insurance should be required to cover them unless their premium is allowed to reflect the risk.
I would go back to the pre-Obamacare world of insurance but let pre-existing conditions be covered by Medicare/Medicaid.
I would go back to the pre-Obamacare world of insurance but let pre-existing conditions be covered by Medicare/Medicaid.
Posted on 11/2/18 at 3:13 pm to cahoots
This is like trying to insure a wrecked car.
I mean if the insurance companies want to cover them and the insured wants to pay for the extra coverage, I'm cool with it.
But don't make healthy people pay the same amount as unhealthy
I mean if the insurance companies want to cover them and the insured wants to pay for the extra coverage, I'm cool with it.
But don't make healthy people pay the same amount as unhealthy
Posted on 11/2/18 at 3:15 pm to volod
quote:
Then what was the point of fighting the ACA.
Team Oriented Politics
Posted on 11/2/18 at 3:16 pm to cahoots
quote:
But if you segregate the unhealthy people with pre-existing conditions, they are going to pay even more than they curerntly do.
As they should; health insurers are paying out more claims for unhealthy people, are they not?
quote:
n your prior post, you suggested that such a group could somehow pay less.
Unhealthy people should pay more than healthy people for health coverage. A better way to explain it is if an insurance company is able to establish a group risk pool of 4,000 stage two cancer patients, those 4,000 people are going to pay more for their coverage than if that same insurance company is allowed to establish a similar risk pool of 4,000,000 people with stage two cancer. Law of large numbers. Those cancer patients should always have to pay more premium than a non-cancer patient because their carriers are paying more for their treatment.
Insurance companies know how to most effectively spread risk and establish these groups so that premiums are lowest they can be for a risk pool. This is why carriers employ thousands and thousands of actuaries. Obamacare prevented them from doing conducting a major facet of their industry. Couple that with healthy or low-risk people not buying in, and it was the perfect storm for rates to increase considerably more than they would have.
quote:
That's how it was before obamacare and a lot of those people couldn't afford coverage.
Health coverage is not a perfect industry, and yes, for some the coverage will be very expensive. But turning the industry on its head and screwing with the coverage of millions is not the answer.
Posted on 11/2/18 at 3:25 pm to BBONDS25
quote:
That’s a very elementary understanding of the issues with Obamacare. However, I think most people took issue with being compelled to buy insurance. I, personally, dislike that Obamacare disallowed catastrophic plans. Limiting my ability to contract is not helpful.
Anyways...back to your elementary understanding and trite posting. Wouldn’t want to get in the way of such a subtle sky scream.
Well, half of your post is grindingly unsubtle ad hominem. Which I believe qualifies as a more personal, condescending form of sky screaming. So here we are.
Posted on 11/2/18 at 3:34 pm to ibldprplgld
quote:
As they should; health insurers are paying out more claims for unhealthy people, are they not?
Okay, that's your opinion, but that's not what you initially suggested.
quote:
Health coverage is not a perfect industry, and yes, for some the coverage will be very expensive. But turning the industry on its head and screwing with the coverage of millions is not the answer.
It's not just a matter of expense though. People with "pre-existing" conditions (I'm using that term loosely) were/are being outright denied coverage for certain things by their own insurers. And there was/is no way to get supplemental coverage either.
People tend to bring up examples of those who were gaming the system - going without coverage and then getting it when they get sick. That happens, but it's only one scenario. The other scenario is that people are paying a LOT for coverage and still getting denied claims. And have no other option but to fork over huge bills.
This post was edited on 11/2/18 at 3:36 pm
Posted on 11/2/18 at 3:49 pm to cahoots
Here’s the problem with pre-existing conditions as it stands now, and as it is happening.
John doesn’t have health insurance. He has never paid into anything. John develops medical condition and needs surgery/treatment. John waits until open enrollment or has a qualifying event. John picks up insurance. He goes and has surgery/treatment. John is a month out of surgery/treatment and needs no more medical care. He quits paying premiums. He does his for the rest of his life. John pays lifetime premiums of $5000 and uses $2 mil in healthcare costs.
This is happening every day. How does the system survive that?
John doesn’t have health insurance. He has never paid into anything. John develops medical condition and needs surgery/treatment. John waits until open enrollment or has a qualifying event. John picks up insurance. He goes and has surgery/treatment. John is a month out of surgery/treatment and needs no more medical care. He quits paying premiums. He does his for the rest of his life. John pays lifetime premiums of $5000 and uses $2 mil in healthcare costs.
This is happening every day. How does the system survive that?
Posted on 11/2/18 at 3:51 pm to ShortyRob
quote:
Exactly.
Forcing an insurance company to cover them and then price the POOL accordingly is nothing but basically using the insurance system to cover for the fact that the govt just passed a welfare program and got us to fund it indirectly.
I get that distinction, but the question is where do Republicans stand? Where does Trump stand?
That's the point. They aren't getting specific and you know it.
Posted on 11/2/18 at 3:53 pm to cahoots
quote:
Okay, that's your opinion, but that's not what you initially suggested.
That's not opinion; that's fact. Health insurance companies pay more for people who are unhealthy. My stance has not changed, you do, however, seem to have a fundamental misunderstanding of insurance and how it works, and what I have said.
quote:
It's not just a matter of expense though. People with "pre-existing" conditions (I'm using that term loosely) were/are being outright denied coverage for certain things by their own insurers. And there was/is no way to get supplemental coverage either.
People tend to bring up examples of those who were gaming the system - going without coverage and then getting it when they get sick. That happens, but it's only one scenario. The other scenario is that people are paying a LOT for coverage and still getting denied claims. And have no other option but to fork over huge bills.
Again, you simply don't understand how insurance works and what it is and what it is not supposed to cover. Ideally there should be another market and product availability for unhealthy people at the next renewal period that is not "health insurance."
And don't kid yourself, it is 100% about expense and Obamacare, whether you want to acknowledge it or not, drove it up for the majority of Americans. Insurance companies are not charities; they are able to cover losses because they are for profit.
Posted on 11/2/18 at 3:54 pm to Fratigerguy
quote:
Here’s the problem with pre-existing conditions as it stands now, and as it is happening.
John doesn’t have health insurance. He has never paid into anything. John develops medical condition and needs surgery/treatment. John waits until open enrollment or has a qualifying event. John picks up insurance. He goes and has surgery/treatment. John is a month out of surgery/treatment and needs no more medical care. He quits paying premiums. He does his for the rest of his life. John pays lifetime premiums of $5000 and uses $2 mil in healthcare costs.
This is happening every day. How does the system survive that?
As it stands, it doesn't. That's why the individual mandate was invented. I realize that people disagree with that part of obamacare in principle, but that was the backstop that incentivized people to remain insured while they're healthy.
Page 4 of 6
Popular
Back to top
Follow TigerDroppings for LSU Football News