Obamacare, Healthcare, etc.

[archibaldcrane]

Now that Obamacare has passed, I believe there are no states without one.

Before that there definitely were, and many of them that existed were underfunded or too restrictive.

But thank you for answering the question, by saying "the government should intervene."

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[SwampdonkeyPLD]

Now that Obamacare has passed, I believe there are no states without one.

Before that there definitely were, and many of them that existed were underfunded or too restrictive.

But thank you for answering the question, by saying "the government should intervene."

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I've never said State governments couldn't/shouldn't intervene. It's always been that the federal govt. shouldn't.

And, that question doesn't even imply that I think it's okay for the government to intervene. It simply implies that there might already be an answer to the pre-existing condition problem.

[archibaldcrane]

The only reason high-risk pools exist is because of government intervention.

Do you have another answer to the pre-existing condition problem?

[Headspace]

The only reason high-risk pools exist is because of government intervention.

Do you have another answer to the pre-existing condition problem?

His answer is another question.

[Demosthenes11]

I've never said State governments couldn't/shouldn't intervene. It's always been that the federal govt. shouldn't.

so you want the government to spend more? Because it's going to cost the government more money if it's by state and not federal.

[SwampdonkeyPLD]

The only reason high-risk pools exist is because of government intervention.

Do you have another answer to the pre-existing condition problem?

Sure, apply the same rules in the employer provided market to the individual market, thus largely eliminating the problem.

You can't eliminate the pre existing condition rules entirely though, otherwise no one would get insurance until they were sick. That's what would bankrupt the insurance companies.

[Acturus]

Sure, apply the same rules in the employer provided market to the individual market, thus largely eliminating the problem.

You can't eliminate the pre existing condition rules entirely though, otherwise no one would get insurance until they were sick. That's what would bankrupt the insurance companies.

What, pray tell, are those "rules"?

[Byrthnoth]

Germany has really shown me just how terrible socialism can be with their ~75% government funded health services sector (~10% of their government's budget). People die left and right. The other day I had to step over three dead hobos on my way to work. And the people? Oh my, I don't even want to think about how depressed they are by the heavy tax burden their 24-42% income tax rate places on them. I'm surprised their job creators can even get out of bed in the morning.

I got sick here with American insurance (I pay now, they reimburse me when I get back to the US) and I'm not even going to file a claim. The uninsured payment for my doctors visit and medicine here were lower than my in-network co-pay in the US, let alone the $50 copay my insurance company wants to hit me with per out of network visit I make.

Why can't we have this?

[SwampdonkeyPLD]

What, pray tell, are those "rules"?

Pre existing condition exclusions don't apply to employer based health insurance plans.

[Dantrag]

Pre existing condition exclusions don't apply to employer based health insurance plans.

Not true. If you're adding someone that hasn't been on insurance for a certain amount of time they can get screwed by per-exisitng conditions.

[Acevalefor]

Pre existing condition exclusions don't apply to employer based health insurance plans.

I specifically remember an employee of mine getting excluded from the employer group plan because he had (has) a currently incurable medical condition. The letter from Blue Cross Blue Shield stated that he would be covered under no circumstances.

So, either you are mistaken and pre-existing condition rules do apply to employer based plans, or BCBS did something shady/illegal in denying him access to an employer health plan.

I am going to go out on a limb and say it is not BCBS that was doing anything wrong, but rather your assertion that is incorrect. I have talked to many people about this issue and nearly all of them have anecdotal evidence that exclusions happen. In fact, there are probably a few stories just in this thread.

[SwampdonkeyPLD]

I don't doubt there are certain exceptions.

[Acevalefor]

I don't doubt there are certain exceptions.

That's just it. I don't think those are exceptions. I think that is the rule and doing something like requiring personal health insurers to follow the same rules as are required for employer group policies would do nothing to fix the problem that is created by pre-existing condition clauses in the first place.

[BaneTheBrawler]

From what I remember, pre-existing condition clauses can (usually) only be activated if the person has been uninsured for more than a year. If you go from insurance company A directly to insurance company B, they can't deny you based on a pre-existing condition.

That being said, I went from being uninsured for ~3 years to being back on my dad's insurance and fully covered, so idk what the deal is. Maybe because I had already been on it before, or because he's got a family plan and I'm immediate family? Insurance is annoying. Until I get $20,000 bills in the mail and am responsible for $60 of it. Then it's fucking awesome.

Edit: In case everyone isn't aware, I have Crohn's an incurable, expensive, and thoroughly awful disease. Definitely qualifies as something insurance companies would want to claim is a pre-existing condition.

[Demosthenes11]

I'm so confused. The government doesn't need to intervene, they just need to intervene?

If the government isn't enforcing those "rules," who is?

[RKenshin]

Pre existing condition exclusions don't apply to employer based health insurance plans.

This is because employer plans are group coverage plans, which typically don't include much to any underwriting at all (bar some exceptions).

The same applies for life insurance. Group life insurance plans offered through employment usually don't (though some can) require any serious underwriting at all. Certainly not compared to private insurance.

The only reason this works though is because both healthy and unhealthy employees across the board are 'forced' to pay into it (typically with the employer also paying into it in varying amounts).

People that elect not to, if the option is available (not always is), are unable to join the group plan until either annual enrollment time or if there is a special election period. Sometimes not joining will remove the option permanently. So if someone suddenly gets seriously sick, and they're a year away from the next enrollment, they either die or hope their health lasts until they can enroll (since they won't be able to qualify for private insurance while sick).

Needless to say, the overwhelming majority do not take that risk.

So basically, what you're saying is that the federal government should 'require' or 'suggest' health insurance, or punish those that don't, are you not? Because that's essentially how group insurance plans work, and is just about the same as what the ACA (Obamacare) tries to do.

[SwampdonkeyPLD]

I think the federal govt. should quit distorting the market altogether, but that's just not realistic. I don't think there is anything hypocritical about attempting to work within the framework we have.

Ideally, health insurance should be allowed to be sold across state lines, states would eliminate the laws that force insurance providers to cover certain things, and either buying insurance with pre-tax dollars would be eliminated or extended to individuals. Then let's see what happens.

[Demosthenes11]

Ideally, health insurance should be allowed to be sold across state lines, states would eliminate the laws that force insurance providers to cover certain things, and either buying insurance with pre-tax dollars would be eliminated or extended to individuals. Then let's see what happens.

how would this give any incentive to cover those with pre-existing conditions?

[SwampdonkeyPLD]

how would this give any incentive to cover those with pre-existing conditions?

Preexisting conditions isn't the only problem that needs to be solved.

[Salodin]

Preexisting conditions isn't the only problem that needs to be solved.

So ignore the pre-existing coverage issue, because there are other things to "test out" first?

Don't know why we don't just fix the thing that is easily fixable, forbidding companies from denying people based on pre-existing health issues. Then again, I'm not republican an asshole.