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Started By
Message
re: Covering preexisting conditions...
Posted on 8/8/20 at 7:59 am to wackatimesthree
Posted on 8/8/20 at 7:59 am to wackatimesthree
quote:
1. Nationalize health care and have public clinics/hospitals alongside private clinics/hospitals. Can't afford private care? Go to a public clinic.
Nope !
If I have private insurance I shouldn't have to subsidize public insurance.
1
Posted on 8/8/20 at 8:04 am to NineLineBind
Insurance is insurance against catastrophic events. If you don’t want it, don't buy it, unless contractually required (in financing a house or car or driving on American streets) and, if you suddenly get an illness or have an accident, only get the medical care you can personally pay for.
Posted on 8/8/20 at 8:04 am to tigersbb
quote:
There are arguments on both sides of this issue. The best response would have been for Congress to create an assigned risk pool for those in your circumstances rather than the total disruption of health insurance which worked fine for the majority of us.
Another option: Have a condition-specific co-insurance for people who were uninsured. For each month someone was uninsured in the past three years, 3% of the insurance company's obligation drops to the patient.
A condition cannot be considered pre-existing if the patient was insured at the time of diagnosis or at the time the presenting symptoms were first documented.
That way, you don't have a situation where an insured person gets sick and becomes uninsurable. But people who try to game the system have to set up a Go Fund Me.
Posted on 8/8/20 at 8:43 am to themunch
quote:
If you get any illness once. The next time it is a pre existing condition. According to insurance.
Not sure what point you are trying to make but if you had insurance before you got sick you wouldn't have to worry about preexisting conditions. Making employer sponsored plans portable would help.
Posted on 8/8/20 at 8:47 am to wackatimesthree
quote:
Before Obamacare there were all kinds of insurance options available
There are still non qualified plans out there.
Posted on 8/8/20 at 12:23 pm to 93and99
quote:
If I have private insurance I shouldn't have to subsidize public insurance.
If you send your kids to private school you still have to pay for public schools.
Like I said, it's what we do for education.
This post was edited on 8/8/20 at 12:25 pm
Posted on 8/8/20 at 12:37 pm to deuceiswild
quote:
Wasn't this done a decade ago? What gives with this particular part of the EO?
Yes. Though the administration relaxed some of the essential benefits requirements for plans under certain circumstances, making it in some states legal for Payers to effectively exclude some pre-existing conditions through plan design. It's not clear to me that this new EO does much of anything other than message. But it's a good message, so I'm not mad at it.
This post was edited on 8/8/20 at 12:49 pm
Posted on 8/8/20 at 12:40 pm to Green Chili Tiger
quote:
You gotta admit, it's a pretty fricked up system that bills one price to people that have insurance and
a different price to people that don't.
By this answer, it seems like you are a single-payer advocate. I mean what exactly do you think Payers are selling? Your local retailer and Walmart pay different prices for the same goods too.
Posted on 8/8/20 at 12:43 pm to La Place Mike
quote:
Making employer sponsored plans portable would help.
How would you suggest going about doing this?
This post was edited on 8/8/20 at 12:59 pm
Posted on 8/8/20 at 1:29 pm to AUauditor
quote:
Insurance is insurance against catastrophic events. If you don’t want it, don't buy it, unless contractually required (in financing a house or car or driving on American streets) and, if you suddenly get an illness or have an accident, only get the medical care you can personally pay for.
You'd be surprised how little healthcare many people can actually afford without a payer supplement. For the majority of Americans that would mean no access to any advanced diagnostic imaging, inpatient care, cancer care of any type, and surgical services. I'm just not sure how what you're suggesting would work in practice. A good chunk of those folks will see that as something they'd want the government to intervene about.
Posted on 8/8/20 at 1:49 pm to longwayfromLA
quote:
You'd be surprised how little healthcare many people can actually afford without a payer supplement. For the majority of Americans that would mean no access to any advanced diagnostic imaging, inpatient care, cancer care of any type, and surgical services. I'm just not sure how what you're suggesting would work in practice. A good chunk of those folks will see that as something they'd want the government to intervene about.
But that's the point.
If we didn't have third party pay for non-catastrophic care and actual market pressure was applied for those services, costs would plummet.
They'd still be high for cancer treatment or serious trauma care or heart bypass surgery or anything like those things, but being in the hospital for acute pancreatitis and having fluids or diabetes management or a broken arm set or being in the hospital "for observation," or getting an anti-biotic prescribed for a sinus infection...in other words, about 80% of what medical services are actually consumed, the cost of those things would drop through the floor if they were paid for directly by the patient.
The insurance would cover things that actually make sense for insurance to cover...things that are unexpected and rare.
Posted on 8/8/20 at 2:19 pm to DavidTheGnome
quote:Not if it covers pre-existing conditions.
But insurance is still insurance
Posted on 8/8/20 at 2:25 pm to longwayfromLA
quote:The parallels to student loans are striking. Out-of-pocket costs are relatively steady. Prices going up almost in unison with the subsidy amount. Who woulda thunk?
You'd be surprised how little healthcare many people can actually afford without a payer supplement. For the majority of Americans that would mean no access to any advanced diagnostic imaging, inpatient care, cancer care of any type, and surgical services. I'm just not sure how what you're suggesting would work in practice. A good chunk of those folks will see that as something they'd want the government to intervene about.
Posted on 8/8/20 at 3:29 pm to wackatimesthree
quote:
If we didn't have third party pay for non-catastrophic care and actual market pressure was applied for those services, costs would plummet.
I think they would come down quite a bit, but down the level where an average American could afford it? Keep in mind in your system a good chunk of the country would continue to be willing to pay for insurance with all the EBs and the heaviest users of healthcare, old people, would continue to get and use Medicare. With all that going on, you'd still need to take treatments that now costs tens of thousands of dollars and get them down to hundreds of dollars. That's just not feasible.
Take something like putting in stents, which costs Payers $15-20K. That procedure adds years to lives and often saves money in the long run by avoiding more invasive surgeries later. Do you think you'd be able to get Hospitals and highly trained physicians to cut their reimbursement for that incredibly common procedure by 90% when most of the patients who need that procedure have financing available to pay the current rate? Have you ever met an interventional cardiologist?
This post was edited on 8/8/20 at 3:36 pm
Posted on 8/8/20 at 3:34 pm to Taxing Authority
quote:
The parallels to student loans are striking. Out-of-pocket costs are relatively steady. Prices going up almost in unison with the subsidy amount. Who woulda thunk?
I don't actually disagree with this has been the effect for both. In both cases, the tradeoff was inflated costs for access to a product that had previously been unattainable by large portions of the population, even at the lower costs. I suppose it's an ideological question whether it was worth it. For Healthcare at least, I am firmly in the yes camp.
Incidentally, education cost inflation is a significant driver of healthcare costs too. Docs carry a really heavy debt load and they put in a lot of arguably inefficient classroom time into getting those degrees. They're going to want a return.
Posted on 8/8/20 at 5:11 pm to longwayfromLA
I proposed two plans, one in which insurance was only utilized for catastrophic care and was tied to an HSA, and the other in which we had public clinics and hospitals which would be "free" to any citizen who walked in the door.
In the latter case anyone who wanted care would be able to get it at taxpayer expense.
The former case is the one in which costs would come down because we would re-introduce market forces that do not operate right now. So I'm not sure what you mean.
In the latter case anyone who wanted care would be able to get it at taxpayer expense.
The former case is the one in which costs would come down because we would re-introduce market forces that do not operate right now. So I'm not sure what you mean.
Posted on 8/8/20 at 5:14 pm to mahdragonz
quote:Because sometimes, stupid people stumble on something correct.
Why do stupid people use this example?
Posted on 8/8/20 at 5:16 pm to longwayfromLA
quote:
I don't actually disagree with this has been the effect for both. In both cases, the tradeoff was inflated costs for access to a product that had previously been unattainable by large portions of the population, even at the lower costs. I suppose it's an ideological question whether it was worth it. For Healthcare at least, I am firmly in the yes camp.
We have the worst health outcomes in just about anywhere in the first world, and we pay more for those results than anyone else by a huge margin.
That's worth it to you?
Posted on 8/8/20 at 5:18 pm to NineLineBind
quote:
Insurance IS a scam
Until you need it. Then it's a great investment.
Posted on 8/9/20 at 3:31 pm to wackatimesthree
quote:
We have the worst health outcomes in just about anywhere in the first world, and we pay more for those results than anyone else by a huge margin.
That's worth it to you?
Single-Payer advocates make the same point all the time, is that position you're suggesting?
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