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zer0netgain
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03 Dec 2013, 2:37 pm

Kraichgauer wrote:
So what are we supposed to do with people with preexisting conditions? Just let them die, or become bankrupt?


Please PAY ATTENTION when reading posts.

The point of a "pre-existing condition" clause is to protect the insurance carrier from someone who comes in, having chosen to not carry insurance, and wants to buy a policy for coverage they don't have because now then KNOW they need it.

It's the same as buying life insurance then going out to kill yourself. All life insurance has a 2-year moratorium on suicide. If you buy or upgrade your life insurance then kill yourself (or your death is ruled a suicide), they policy won't pay (or at least won't pay the additional amount of coverage you bought). After two years, a suicide is deemed to be the act of mental illness, not a premeditated intention to defraud the insurance carrier out of money.

It's the same way property insurance won't pay in the case of arson or other loss where the beneficiary had a hand in the act which creates the loss. You can't get paid for your wrecked car if you deliberately drive it off a cliff.

This is no different with health insurance. You buy the coverage BEFORE you know of any specific need. To choose not to buy it then run out once a doctor says you need expensive treatments or surgery means you are trying to defraud the insurance carrier into paying for care.

Remember, you are buying INSURANCE. You are not buying HEALTH CARE.

I acknowledge that insurance carriers have long abused the "pre-existing condition" practice to the point that some reform is needed, but it is an otherwise valid legal practice.



Kraichgauer
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03 Dec 2013, 3:22 pm

So people who haven't bought insurance beforehand are s**t out of luck if they get sick or hurt?


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zer0netgain
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04 Dec 2013, 11:22 am

Kraichgauer wrote:
So people who haven't bought insurance beforehand are sh** out of luck if they get sick or hurt?


The issue could be addressed in several ways.

1. Limit how long these exclusions last on NEW policies where the policyholder did not come from another policy with another insurance company (say no more than 24 months).

2. Waive the policy for people conditions just now entering the age of majority and able to buy a policy for themselves.

3. Limit what kinds of services are not covered in the exclusionary period (e.g., normal monthly expenses but not NEW injuries or complications).

The point of not covering a "pre-existing" condition is to protect the insurance company from people who CHOOSE to not carry insurance until they see the need for it and now want someone else to pay for their medical care rather than carry a policy during the time they didn't see the need knowing that someday they MIGHT need it.

I don't see how I can make it any simpler than that. Perhaps you need to understand what the crime of "insurance fraud" consists of to understand why "pre-existing" conditions are generally not covered by health insurance carriers.



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04 Dec 2013, 11:43 am

zer0netgain wrote:
Kraichgauer wrote:
So people who haven't bought insurance beforehand are sh** out of luck if they get sick or hurt?


The issue could be addressed in several ways.

1. Limit how long these exclusions last on NEW policies where the policyholder did not come from another policy with another insurance company (say no more than 24 months).

2. Waive the policy for people conditions just now entering the age of majority and able to buy a policy for themselves.

3. Limit what kinds of services are not covered in the exclusionary period (e.g., normal monthly expenses but not NEW injuries or complications).

The point of not covering a "pre-existing" condition is to protect the insurance company from people who CHOOSE to not carry insurance until they see the need for it and now want someone else to pay for their medical care rather than carry a policy during the time they didn't see the need knowing that someday they MIGHT need it.

I don't see how I can make it any simpler than that. Perhaps you need to understand what the crime of "insurance fraud" consists of to understand why "pre-existing" conditions are generally not covered by health insurance carriers.


Perhaps insurance fraud - while existing - is blown out of proportion, the same as voter fraud. :P


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sonofghandi
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04 Dec 2013, 12:39 pm

zer0netgain wrote:
Kraichgauer wrote:
So people who haven't bought insurance beforehand are sh** out of luck if they get sick or hurt?


The issue could be addressed in several ways.

1. Limit how long these exclusions last on NEW policies where the policyholder did not come from another policy with another insurance company (say no more than 24 months).

2. Waive the policy for people conditions just now entering the age of majority and able to buy a policy for themselves.

3. Limit what kinds of services are not covered in the exclusionary period (e.g., normal monthly expenses but not NEW injuries or complications).

The point of not covering a "pre-existing" condition is to protect the insurance company from people who CHOOSE to not carry insurance until they see the need for it and now want someone else to pay for their medical care rather than carry a policy during the time they didn't see the need knowing that someday they MIGHT need it.

I don't see how I can make it any simpler than that. Perhaps you need to understand what the crime of "insurance fraud" consists of to understand why "pre-existing" conditions are generally not covered by health insurance carriers.


Don't you realize that a large portion of the reasoning behind the individual madate was to limit the risk to insurers in regards to covering pre-existing conditions and to establish a larger customer base and revenue stream to offset possible financial consequences? People have to have insurance now, so they aren't just going to wait until they need it, so your arguments make little sense to me. I could see your concern if the individual mandate had been struck down by the SCOTUS.


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04 Dec 2013, 12:42 pm

ruveyn wrote:
Kraichgauer wrote:
So what are we supposed to do with people with preexisting conditions? Just let them die, or become bankrupt? .


Whatever became of Christian Charity?

ruveyn


Whatever became of public charity?


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04 Dec 2013, 1:08 pm

There has never been a coverage issue for healthcare in this country, the actual amount of people that were denied coverage for pre-existing conditions or lifetime caps or whatever is pretty miniscule. Congress would of been much better off crafting some law that specifically targeting these "uninsurables" and trying to bringing down the costs of healthcare in general which helps everybody and government getting the hell out would go a long way to doing that. Government interference and their total servitude to their corporatist financiers is the reason why we're in this mess.



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04 Dec 2013, 1:18 pm

Jacoby wrote:
There has never been a coverage issue for healthcare in this country, the actual amount of people that were denied coverage for pre-existing conditions or lifetime caps or whatever is pretty miniscule. Congress would of been much better off crafting some law that specifically targeting these "uninsurables" and trying to bringing down the costs of healthcare in general which helps everybody and government getting the hell out would go a long way to doing that. Government interference and their total servitude to their corporatist financiers is the reason why we're in this mess.


I don't quite follow your logic here. Corporations are making the government do things that will increase their profits, which is why the ACA is bad, but if the government stayed out of healthcare (which they have in regards to the ACA - it is insurance regulation and has almost nothing to do with actual health services) these same corporations would be somehow motivated to bring healthcare costs down? I must be missing something; could you please clarify?


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04 Dec 2013, 1:28 pm

Most young people are opposed to the law. Also, the 18- to 24-year old cohort is becoming increasingly conservative:

http://www.nytimes.com/news/affordable- ... bama/?_r=0


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04 Dec 2013, 2:07 pm

Young people think they are immortal.



ruveyn
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04 Dec 2013, 4:35 pm

AspE wrote:
Young people think they are immortal.


We should let them prove it. If they don't pay into the system they will get no medical services out of it.

ruveyn



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04 Dec 2013, 8:40 pm

sonofghandi wrote:
Jacoby wrote:
There has never been a coverage issue for healthcare in this country, the actual amount of people that were denied coverage for pre-existing conditions or lifetime caps or whatever is pretty miniscule. Congress would of been much better off crafting some law that specifically targeting these "uninsurables" and trying to bringing down the costs of healthcare in general which helps everybody and government getting the hell out would go a long way to doing that. Government interference and their total servitude to their corporatist financiers is the reason why we're in this mess.


I don't quite follow your logic here. Corporations are making the government do things that will increase their profits, which is why the ACA is bad, but if the government stayed out of healthcare (which they have in regards to the ACA - it is insurance regulation and has almost nothing to do with actual health services) these same corporations would be somehow motivated to bring healthcare costs down? I must be missing something; could you please clarify?


These corporate interests use government to raise barriers of entry to stifle competition while at the same to stimulating demand by so heavily subsidizing healthcare. Government getting out of the way would make these corporations accountable to the market economy which ups quality and lowers prices. We're not getting our money's worth for healthcare in this country, we spend more on healthcare than any other country in the world and something like a third or more goes to overhead and the bureaucracy.



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04 Dec 2013, 10:21 pm

ruveyn wrote:
AspE wrote:
Young people think they are immortal.


We should let them prove it. If they don't pay into the system they will get no medical services out of it.

ruveyn

How is that supposed to work?



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04 Dec 2013, 10:52 pm

Kraichgauer wrote:
zer0netgain wrote:
The point is that INSURANCE does not protect you from a known risk that WILL happen.

Car insurance won't cover you if you are racing, doing demolition derby, etc.

Life insurance won't cover you if you are over a certain age (whole life policies don't count).

Health insurance isn't there to pay your medical bills when you KNOW you are sick and need medical care. You buy it BEFORE you know of the need. Buying it knowing of a need is similar to setting your house on fire to collect the insurance money.


So what are we supposed to do with people with preexisting conditions? Just let them die, or become bankrupt? And what if the person in question isn't an adult who has lived a hard and fast life, but a child born with a medical condition? Are we to turn a blind eye to that child?
Claiming to be a Christian nation goes beyond sticking your nose into people's bed rooms, or telling other people what they should and shouldn't watch on TV or movies, but rather should be about caring for the most vulnerable.


I agree with Zer0 and have invoked the fire insurance analogy frequently. The question of "what are we supposed to do with people with preexisting questions" is an important question but it has nothing to do with what the nature of insurance is. "Insurance" that is forced to cover people with expensive preexisting conditions for the same price as a healthy person is not insurance at all. That's the problem and I think that that was the point Zer0 was making.



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04 Dec 2013, 11:19 pm

American wrote:
Kraichgauer wrote:
zer0netgain wrote:
The point is that INSURANCE does not protect you from a known risk that WILL happen.

Car insurance won't cover you if you are racing, doing demolition derby, etc.

Life insurance won't cover you if you are over a certain age (whole life policies don't count).

Health insurance isn't there to pay your medical bills when you KNOW you are sick and need medical care. You buy it BEFORE you know of the need. Buying it knowing of a need is similar to setting your house on fire to collect the insurance money.


So what are we supposed to do with people with preexisting conditions? Just let them die, or become bankrupt? And what if the person in question isn't an adult who has lived a hard and fast life, but a child born with a medical condition? Are we to turn a blind eye to that child?
Claiming to be a Christian nation goes beyond sticking your nose into people's bed rooms, or telling other people what they should and shouldn't watch on TV or movies, but rather should be about caring for the most vulnerable.


I agree with Zer0 and have invoked the fire insurance analogy frequently. The question of "what are we supposed to do with people with preexisting questions" is an important question but it has nothing to do with what the nature of insurance is. "Insurance" that is forced to cover people with expensive preexisting conditions for the same price as a healthy person is not insurance at all. That's the problem and I think that that was the point Zer0 was making.


The question remains - what becomes of people with preexisting conditions but are without insurance? There is a matter of simple mercy involved here.


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04 Dec 2013, 11:35 pm

Kraichgauer wrote:
American wrote:

I agree with Zer0 and have invoked the fire insurance analogy frequently. The question of "what are we supposed to do with people with preexisting questions" is an important question but it has nothing to do with what the nature of insurance is. "Insurance" that is forced to cover people with expensive preexisting conditions for the same price as a healthy person is not insurance at all. That's the problem and I think that that was the point Zer0 was making.


The question remains - what becomes of people with preexisting conditions but are without insurance? There is a matter of simple mercy involved here.


I acknowledged the importance of that question to our society. However, that is completely irrelevant to this particular discussion because of what insurance is and is not. And insurance is a business of statistics. It should never be the the case that, from the outset based on known facts, it is practically certain that an insured person will cost the insurance company more money than the insured person pays in premiums. I refer you back to the fire insurance analogy. If fire insurance companies had to cover the "preexisting condition" of one's home having burned down without charging that person more than they would charge someone whose home had not already burned down, it would cease to be insurance. It would be ridiculous is what it would be. The same is true for this new type of health "insurance" that Obamacare creates.