Revived GOP health care talks could hurt those with pre-existing conditions

[Thorolfr]

I agree insurance is, or should be, risk pooling. But the government has turned health insurance partially into a healthcare finance system. Car insurance doesn’t pay for routine service. Homeowners insurance doesn’t pay for chimney cleaning.

Single payer health insurance doesn’t change the fact that people will still be denied healthcare. It just takes away individual choice and changes who makes that decision into a government bureaucrat. If government run insurance is so great why don’t we eliminate all private insurance and just have the government run it. They could provide auto and home insurance too.

The idea that as a society we aren’t wanting to make moral judgements about sickness runs into a wall when the issue is smoking. There are all sorts of mechanisms in place to punish smokers including higher insurance premiums. But you can’t charge a higher premium to gay men, even thought their lifestyle has high medical costs. I see plenty of moral judgments being made in terms of healthcare.

Alcoholism is a bigger problem in Ireland than in many other countries. It’s a cultural thing. For example

A REPORT FROM the World Health Organisation has revealed that Ireland has the second highest rate of binge drinking in the world.

The global status report on alcohol and health found that 39 per cent of all Irish people aged 15 and over had engaged in binge drinking, or “heavy episode drinking” in the last month.

So should people of Irish heritage be punished by being charged more for health insurance?

 

[sallybutler]

The European political system evolved totally differently from that of the United States.

In Europe they had monarchies and the king would deign to “give” benefits to the people.

In the United States, the benefits were provided by the people themselves.

And here I thought it was the Marshall Plan that was responsible for modern European’s attitudes towards what a government should provide.

 

[exnihilo]

Alcoholism is a bigger problem in Ireland than in many other countries. It’s a cultural thing. For example

So should people of Irish heritage be punished by being charged more for health insurance?

If a insurance company wants to charge more for the perceived risk then they should be free to do so. The thing about the free market is competition will eliminate unjustified premiums. As it is now insurance companies already charge higher premiums based on accidents of birth.

 

[Jeanne_S]

I agree insurance is, or should be, risk pooling. But the government has turned health insurance partially into a healthcare finance system. Car insurance doesn’t pay for routine service. Homeowners insurance doesn’t pay for chimney cleaning.

Single payer health insurance doesn’t change the fact that people will still be denied healthcare. It just takes away individual choice and changes who makes that decision into a government bureaucrat. If government run insurance is so great why don’t we eliminate all private insurance and just have the government run it. They could provide auto and home insurance too.

The idea that as a society we aren’t wanting to make moral judgements about sickness runs into a wall when the issue is smoking. There are all sorts of mechanisms in place to punish smokers including higher insurance premiums. But you can’t charge a higher premium to gay men, even thought their lifestyle has high medical costs. I see plenty of moral judgments being made in terms of healthcare.

Well said!

 

[liturgyluver]

And here I thought it was the Marshall Plan that was responsible for modern European’s attitudes towards what a government should provide.

Actually the commitment to universal care has absolutely nothing to do with systems of government and everything to do with a collective will of the people. That is why, in the UK’s case, the Atlee government in 1945 beat Churchill so decisively. The Marshall Plan was primarily about economic and industrial recovery.

 

[Questioner2]

One might add this.

In addition to other problems in creating a “pool” representative of all people, one would have to either abolish employer-provided insurance entirely or somehow require all insurers to include employed people in the same “pool” as all others.

The reason is the 'well worker effect". People who are able to work are, not surprisingly, less likely to utilize healthcare than those who are not. They’re healthier or they would not be working at all. So they’re a relatively “low risk pool” all their own, particularly industrial workers upon whom physical demands are greater than on white collar workers. That’s why premiums are lower, generally, for group plans for blue collar workers than for white collar workers.

Yes, let’s abolish employer provided insurance! Entirely! My employer pays huge sums for insurance on my behalf, and as a healthy person, I don’t use it. However, as soon as I get too sick to work, or am disabled in an accident, I lose my job and health insurance?

This system does not make sense and is cruel to boot. One of my relatives is trapped in his stressful job, because his sick wife’s medication would be too expensive to buy if he lost his insurance.

My understanding is that employer proved health insurance is a recent thing, developed after WWII to entice people into jobs during a labor shortage. Time for it to go!

edited to add: I have relatively good insurance, but over the years, it has grown more expensive and way worse. Insurance is in the business of denying claims. What a run around it is to find out what is covered, and by how much. Every year less is covered and more is charged. And adding dependants to your insurance in the form of spouses and children used to be low cost or free, now it will eat up a large part of your pay!! Grrrrr

I don’t know much, but I know our health care delivery system in this country is broken.

 

[Sy_Noe]

Having other people pay for your health care is how health insurance works. The premiums paid by people who are healthy and do not need care pay for those who do. In fact that’s how all insurance works. People whose house does not burn down pay for the one that does burn down.

Now we do punish people for being careless drivers by raising their rates. But that is because we see it as a moral failing and do not want to reward the bad behavior. But there are medical preexisting conditions that arise randomly and could hit anyone regardless of their moral character. If people want to feel secure knowing they will have health care when they need it, they will have to decide** as a community** to support each other in that need. It is unreasonable for every person to have to amass the wealth necessary to deal with a lifelong condition on their own. That is why we need universal single-payer health insurance.

Yes, let’s abolish employer provided insurance! Entirely! My employer pays huge sums for insurance on my behalf, and as a healthy person, I don’t use it. However, as soon as I get too sick to work, or am disabled in an accident, I lose my job and health insurance?

This system does not make sense and is cruel to boot. One of my relatives is trapped in his stressful job, because his sick wife’s medication would be too expensive to buy if he lost his insurance.

My understanding is that employer proved health insurance is a recent thing, developed after WWII to entice people into jobs during a labor shortage. Time for it to go!

edited to add: I have relatively good insurance, but over the years, it has grown more expensive and way worse. Insurance is in the business of denying claims. What a run around it is to find out what is covered, and by how much. Every year less is covered and more is charged. And adding dependants to your insurance in the form of spouses and children used to be low cost or free, now it will eat up a large part of your pay!! Grrrrr

I don’t know much, but I know our health care delivery system in this country is broken.

 

[LeafByNiggle]

I agree insurance is, or should be, risk pooling. But the government has turned health insurance partially into a healthcare finance system.

What’s wrong with that?

Car insurance doesn’t pay for routine service. Homeowners insurance doesn’t pay for chimney cleaning.

When I said “Universal health care” I did not mean Universal Comprehensive health care. I think the government guaranteed health care should be limited to just a basic level of care for treatments that everyone agrees is health care. If someone wants to purchase private insurance to cover what the government plan does not cover, they can do that. I have no problem with a multi-tiered health care system, as long as the bottom tier is somewhat reasonable.

Single payer health insurance doesn’t change the fact that people will still be denied healthcare.

That depends on what you call health care. Yes, they may be denied coverage for cosmetic surgery. But there is no reason to deny anyone coverage for a needed hip replacement, provided the patient is reasonably expected to recover from the surgery.

It just takes away individual choice and changes who makes that decision into a government bureaucrat.

As opposed to private insurance where the decision is made by the insurance company. In neither case does the individual get to decide that his treatment should be covered.

If government run insurance is so great why don’t we eliminate all private insurance and just have the government run it.

Government run insurance is not so great. It just happens to be better able to solve the problems of universal coverage. If you know of a way to guarantee universal coverage using private insurance, please call your legislator. They would be glad to learn that so they could replace Obamacare.

The idea that as a society we aren’t wanting to make moral judgements about sickness runs into a wall when the issue is smoking. There are all sorts of mechanisms in place to punish smokers including higher insurance premiums. But you can’t charge a higher premium to gay men, even thought their lifestyle has high medical costs. I see plenty of moral judgments being made in terms of healthcare.

I agree. Making moral judgments and designing policy around those judgements is fair game. Financial penalties for smoking is entirely justified. I just don’t think that being born with a genetic defect ought to be one of those things one which we assign a moral judgement.

 

[mary_bobo]

And someone in the states who still doesn’t have healthcare coverage at all or avoids going to the dr because of out of pocket expenses or avoids paying for costly meds, may unnecessarily die in their sleep from a heart attack or stroke. Republican politicians have never cared about universal health care or a govt plan for those in need. And until those Christians who are more or less single issue voters stop electing them, Republicans may never change.

And people die in countries with single payer waiting for heart by-pass surgery. There has to be something in between to make health care delivery more affordable. Right now, with the government more involved than ever, that Medicare recipients, at least in my experience, are required to have a “wellness exam” every year for which the government pays. Many, many, like myself do not need this and I find it a waste of government money in my case, and I am sure in many others. IMO any time you get the government involved, things are mucked up. Oh, in case folks don’t know, your doctor gets penalized if you don’t go along with this extra exam.

We may very well, at some point, get single payer. I just want people to know what they are agreeing to and not blow a gasket when there is rationing and lack of the quality of care that the government is so good at promising but short on delivering.

 

[Ridgerunner]

Yes, let’s abolish employer provided insurance! Entirely! My employer pays huge sums for insurance on my behalf, and as a healthy person, I don’t use it. However, as soon as I get too sick to work, or am disabled in an accident, I lose my job and health insurance?

This system does not make sense and is cruel to boot. One of my relatives is trapped in his stressful job, because his sick wife’s medication would be too expensive to buy if he lost his insurance.

My understanding is that employer proved health insurance is a recent thing, developed after WWII to entice people into jobs during a labor shortage. Time for it to go!

edited to add: I have relatively good insurance, but over the years, it has grown more expensive and way worse. Insurance is in the business of denying claims. What a run around it is to find out what is covered, and by how much. Every year less is covered and more is charged. And adding dependants to your insurance in the form of spouses and children used to be low cost or free, now it will eat up a large part of your pay!! Grrrrr

I don’t know much, but I know our health care delivery system in this country is broken.

No matter what happens, it will be deemed “unfair” to someone. If it’s fully socialized medicine, it will be unfair to those who are paying higher taxes to pay for those who pay none or even get earned income credit besides. The only question then will be the level of pain to those on the paying end and whether they will put up with it politically.

 

[Questioner2]

No matter what happens, it will be deemed “unfair” to someone.

Yes, and…?

What’s the saying…don’t let the perfect be the enemy of the good.

We can do better than the status quo.

How? It’s complicated!

 

[ProVobis]

If a insurance company wants to charge more for the perceived risk then they should be free to do so. The thing about the free market is competition will eliminate unjustified premiums. As it is now insurance companies already charge higher premiums based on accidents of birth.

Free markets won’t put a cap on premiums and the insurance companies don’t have to insure. We get that. But have we as a society accepted that? I see no one complaining that he or she can only buy flood insurance through the government since no insurance company will do it?

 

[Sy_Noe]

And people die in countries with single payer waiting for heart by-pass surgery. There has to be something in between to make health care delivery more affordable. Right now, with the government more involved than ever, that Medicare recipients, at least in my experience, are required to have a “wellness exam” every year for which the government pays. Many, many, like myself do not need this and I find it a waste of government money in my case, and I am sure in many others. IMO any time you get the government involved, things are mucked up. Oh, in case folks don’t know, your doctor gets penalized if you don’t go along with this extra exam.

We may very well, at some point, get single payer. I just want people to know what they are agreeing to and not blow a gasket when there is rationing and lack of the quality of care that the government is so good at promising but short on delivering.

And I just want people who are well enough off and getting healthcare for themselves to understand there has always been plenty of rationing of healthcare in the US and lack of quality care even if they personally are not affected. And when it comes to healthcare, the free market and for profit insurance companies aren’t so good either.

 

[kozlosap]

This entire “pre-existing” condition issue scares me to death. My 32 year old had two cardiac ablations at age 25 and in January of this year had 60% of her stomach removed because a gigantic 7.5 cm ulcer had perforated into her pancreas. She, along with another attorney and a music specialist have started their own production company and she found coverage through the California Obama Care exchange system. The funniest part? She is now covered by OSCAR which was started by Jared Kushner’s brother. If pre-existing conditions are not covered, I guess she could move to Canada or London. What a mess. I pray that all humans receive the healthcare they need regardless of prior conditions.

 

[Sy_Noe]

This entire “pre-existing” condition issue scares me to death. My 32 year old had two cardiac ablations at age 25 and in January of this year had 60% of her stomach removed because a gigantic 7.5 cm ulcer had perforated into her pancreas. She, along with another attorney and a music specialist have started their own production company and she found coverage through the California Obama Care exchange system. The funniest part? She is now covered by OSCAR which was started by Jared Kushner’s brother. If pre-existing conditions are not covered, I guess she could move to Canada or London. What a mess. I pray that all humans receive the healthcare they need regardless of prior conditions.

Yes, I myself have preexisting conditions as does my niece. She just recently was able to obtain Obamacare for $129 mo and only a $250 deductible. She applied in January and her coverage began last mo. I just took her last wk to her first dr appt under her new coverage because she can hardly walk due to severe pain and needed me to drive instead of her trying to. There was no copay for her visit. As I sat there waiting and people watching, many were young families with children, and I was just wishing Trump and Ryan and others who don’t seem to get it, could see the many people whom have been helped by Obamacare and the many more who still need coverage. At one point my eyes teared up thinking about it and about how many it was reported would have lost coverage under the first Ryan-Trump Republican plan. May your daughter remain covered. Perhaps that she is in CA might be of benefit to her if it left to the states. But for those not so fortunate to live in such a state, I too am scared. And I join you in prayer.

 

[exnihilo]

When I said “Universal health care” I did not mean Universal Comprehensive health care. I think the government guaranteed health care should be limited to just a basic level of care for treatments that everyone agrees is health care. If someone wants to purchase private insurance to cover what the government plan does not cover, they can do that. I have no problem with a multi-tiered health care system, as long as the bottom tier is somewhat reasonable.

Americans can’t agree on anything. How would we all agree on what is a basic level of healthcare? We wouldn’t. A majority or even just a plurality will impose a definition on everyone else.

That depends on what you call health care. Yes, they may be denied coverage for cosmetic surgery. But there is no reason to deny anyone coverage for a needed hip replacement, provided the patient is reasonably expected to recover from the surgery.

Needed as determined by who? Even today you can find doctors who disagree as to the best treatment for any particular case.

As opposed to private insurance where the decision is made by the insurance company. In neither case does the individual get to decide that his treatment should be covered.

Private insurance companies can deny coverage, but they have a contract they should be abiding by. If a customer disagrees with the determination they are free to pursue legal action. This would be difficult, but trying to do the same against the government is even more daunting.

I agree. Making moral judgments and designing policy around those judgements is fair game. Financial penalties for smoking is entirely justified. I just don’t think that being born with a genetic defect ought to be one of those things one which we assign a moral judgement.

Who is to say smokers don’t have a genetic defect that inclines them to smoke? Who is to say someone’s problems are not caused by a genetic defect in addition to lifestyle choices?

 

[exnihilo]

Free markets won’t put a cap on premiums and the insurance companies don’t have to insure. We get that. But have we as a society accepted that? I see no one complaining that he or she can only buy flood insurance through the government since no insurance company will do it?

No one insured is complaining about flood insurance because he is getting a steal. His risk is being covered by tax payers. Federal flood insurance has led to a ridiculous building in flood prone areas.

To be clear our insurance markets are anything but free. They are highly regulated. When they fail it isn’t a free market failure it is a regulated market failure.

 

[Sy_Noe]

Most European countries are not as large and the USA and they have not experienced the quality care that we have here. They have come to accept the care and rationing of that care that would not be well accepted here. They also do not have the population numbers that we have nor the number of illegals that do receive medical care here one way or the other.

The care that “we” have here is based in large part on what someone can afford. Catholics are free to disagree with me but I don’t believe that is what Jesus meant when he talked about caring for the sick. Nor do I believe he meant wait til you are so sick that you run to the ER and if you need costly treatment by that point, pray you are not billed and have to go bankrupt and homeless or that individual charity alone can cover medical costs in the 21st century. And just because you may not have experienced it personally, doesn’t mean that the quality is all that great here. Most of those countries don’t have the wealth that we find in the US either or the larger population to pay taxes. For many any additional taxes might even be less that the premiums and deductibles and co-pays and out of pocket expenses that they pay under the US healthcare system where private for profit insurance companies are involved.

 

[mikekle]

The care that “we” have here is based in large part on what someone can afford. Catholics are free to disagree with me but I don’t believe that is what Jesus meant when he talked about caring for the sick. Nor do I believe he meant wait til you are so sick that you run to the ER and if you need costly treatment by that point, pray you are not billed and have to go bankrupt and homeless or that individual charity alone can cover medical costs in the 21st century. And just because you may not have experienced it personally, doesn’t mean that the quality is all that great here. Most of those countries don’t have the wealth that we find in the US either or the larger population to pay taxes. For many any additional taxes might even be less that the premiums and deductibles and co-pays and out of pocket expenses that they pay under the US healthcare system where private for profit insurance companies are involved.

‘For profit’ is the key word there.

Its funny how insurance companies seem to be so profitable year after year…gee I wonder why?

 

[stinkcat_14]

‘For profit’ is the key word there.

Its funny how insurance companies seem to be so profitable year after year…gee I wonder why?

The real question is: how much are insurance companies profiting and will having the government take over improve things? If government runs health insurance then profit will be eliminated. But government agencies are by design less efficient. So it is very possible that the reduced efficiency would outweigh the effects of the eliminated profits.