the latest absurdity in health insurance

Bryan · 11-08-2009, 11:41 PM

Your baby has a pre-existing condition: obesity!

Alex Lange | Obese Baby Denied Health Insurance

I mean really, what the hell? Insurance companies are gay.

Ax · 11-09-2009, 12:21 AM

You're about 2 months late on this one.

jthomas1600 · 11-09-2009, 04:27 AM

OK, here's the thing about "pre-existing" conditions...of course there are crazy examples of insurance companies abusing this practice but in general it is a necessary mechanism to protect the rest of us from people who want to reap the benefits of the system but not pay into it. The people I'm talking about are the ones who choose not to have insurance through their 20s and 30s because they're healthy and then go to to the Dr. and find out they might have cancer or some such ailment so they want to rush out and buy health insurance. It doesn't work that way with any other insurance. What do you think my agent would say if I called while my house was on fire to get quotes on additional fire insurance for my home.

**Epaphras** · 11-09-2009, 06:33 AM

Quote:

Originally Posted by jthomas1600

What do you think my agent would say if I called while my house was on fire to get quotes on additional fire insurance for my home.

While you are correct, it also happens that people buy homeowner's insurance, have a fire, make a claim, and are denied because the conditions for the fire to start were "pre-existing" -- some part of the bureaucracy found something to pin it on.. They thought they were covered and they weren't.

jthomas1600 · 11-09-2009, 06:55 AM

Quote:

Originally Posted by Epaphras

While you are correct, it also happens that people buy homeowner's insurance, have a fire, make a claim, and are denied because the conditions for the fire to start were "pre-existing" -- some part of the bureaucracy found something to pin it on.. They thought they were covered and they weren't.

And while this practice also gets abused there is nothing wrong with it in principle. If you and I belong to the same insurance group your premiums help pay my claims. Do you want to buy me a new house because I did a bunch of re-wiring myself and didn't pay attention to codes and my house burned down because I'm a crummy electrician and took all kinds of short cuts?

**Epaphras** · 11-09-2009, 09:48 AM

Quote:

Originally Posted by jthomas1600

And while this practice also gets abused there is nothing wrong with it in principle. If you and I belong to the same insurance group your premiums help pay my claims. Do you want to buy me a new house because I did a bunch of re-wiring myself and didn't pay attention to codes and my house burned down because I'm a crummy electrician and took all kinds of short cuts?

I get what you're saying, don't get me wrong.

If an applicant knowingly withholds or puts false information on the application for insurance, and the company proceeds under false pretenses, and then you get denied a claim for something you didn't disclose at the time, then yeah, I have no problem with the insurance company doing that, in principle.

BUT, in the example of health insurance, if you know you have a condition or a history of something that no insurer will touch, what is your recourse? You either lie to get coverage, or you go without. That's why I believe in a public option. If every taxpayer pays just a little bit, it will cover that tiny portion of the risk pool that is a 99.9% risk for expensive treatment.

I also don't like how it's up to them to decide that you lied on your application and therefore don't need to cover you. If you don't cross every T and dot every I on the application, they can nail you with that later. If you forgot to mention you had one asthma attack once, they can deny anything that they decide is related to that as a pre-existing condition. That is bullying, unfair, and unprofessional. If this bill stops that, I'm happy with it.

Bryan · 11-09-2009, 09:59 AM

Quote:

Originally Posted by jthomas1600

The people I'm talking about are the ones who choose not to have insurance through their 20s and 30s because they're healthy and then go to to the Dr. and find out they might have cancer or some such ailment so they want to rush out and buy health insurance.

hence the reason we should make basic health insurance a requirement by law.

jthomas1600 · 11-09-2009, 10:12 AM

Quote:

Originally Posted by Bryan

hence the reason we should make basic health insurance a requirement by law.

So that when people get sick it doesn't cost the rest of us extra money? Correct? Then we should out law cigarettes, Twinkies, bacon, unprotected sex,....where does the government oversight end? Some times people make decisions and then just need to live with the consequences.

**Epaphras** · 11-09-2009, 10:54 AM

Quote:

Originally Posted by jthomas1600

So that when people get sick it doesn't cost the rest of us extra money? Correct? Then we should out law cigarettes, Twinkies, bacon, unprotected sex,....where does the government oversight end? Some times people make decisions and then just need to live with the consequences.

Are you saying that people who don't choose to buy health insurance either need to not procure medical treatment if they are sick, or if they do, that they pay for it entirely out of their own pocket, up front or in installments? Should we make medical bills "un-bankrupt-able" (as student loans currently are) for such people?

I understand your sentiment but how would this actually look? How would we ensure that uninsured sick or broken people either refuse treatment or the hospital or doctor gets paid?

jthomas1600 · 11-09-2009, 11:24 AM

Quote:

Originally Posted by Epaphras

Are you saying that people who don't choose to buy health insurance either need to not procure medical treatment if they are sick, or if they do, that they pay for it entirely out of their own pocket, up front or in installments? Should we make medical bills "un-bankrupt-able" (as student loans currently are) for such people?

I understand your sentiment but how would this actually look? How would we ensure that uninsured sick or broken people either refuse treatment or the hospital or doctor gets paid?

Hence the need for health care reform. I think everyone agrees on that. I think we just disagree on the means to the end. I do think if you choose not to purchase health care you should pay out of pocket when you get sick. How do we make this possible? Do we make federally backed low interest long term loans available? That might be one idea. Maybe an alternative to the government health insurance that's being talked about now, we just have "catastrophic" coverage available. So if you choose not to buy your own insurance and then break your leg skateboarding that's on you, but if you get cancer the government would pay a portions so as not to bankrupt you or put the burden on the doctors or hospital to try and cover the cost.

Those or sort of off the cuff ideas, not really sure if they're feasible or make any sense.

JerryLove · 11-09-2009, 04:57 PM

Quote:

Originally Posted by jthomas1600

Hence the need for health care reform. I think everyone agrees on that. I think we just disagree on the means to the end. I do think if you choose not to purchase health care you should pay out of pocket when you get sick. How do we make this possible? Do we make federally backed low interest long term loans available? That might be one idea. Maybe an alternative to the government health insurance that's being talked about now, we just have "catastrophic" coverage available. So if you choose not to buy your own insurance and then break your leg skateboarding that's on you, but if you get cancer the government would pay a portions so as not to bankrupt you or put the burden on the doctors or hospital to try and cover the cost.

So you would prevent the burden of people who opted out pulling the system down by not paying for the cheapest of their injuries, but paying for the most expensive? It should be obvious why that won't work.

Similarly: half our healthcare costs are in the last 6 months of life, so a loan to get paid back won't work either.

So. You either completely fail to cover people, meaning people die of poverty (and huge bankruptsy problems exist).
Or you unfairly make people who paid into coverage pay for those with none (meaning zero incentive for anyone to opt in).;
Or you mandate everyone get coverage.

Our current system is a mashup of the first two.

jthomas1600 · 11-09-2009, 06:05 PM

Jerry, it's not just "refusing to cover" the cheapest of their injuries or illnesses...it's expecting THEM to pay for it. What's wrong with that?

JerryLove · 11-09-2009, 06:12 PM

Quote:

Originally Posted by jthomas1600

Jerry, it's not just "refusing to cover" the cheapest of their injuries or illnesses...it's expecting THEM to pay for it. What's wrong with that?

That they lack the funds to do so? And when they don't, who pays for it then?

You get cancer tomorrow and need a quarter-million or more in treatment. Now what?

RubberChipmunk · 11-09-2009, 06:43 PM

Quote:

Originally Posted by JerryLove

That they lack the funds to do so? And when they don't, who pays for it then?

And why should I have to pay for it? Why should you? You are going to have a hard time convincing me to feel ethically or morally obligated to pay for someone who can't afford it themselves. Am I saying that I wouldn't? No. If my best friend couldn't afford his hospital visit and I had the money to help him out, then of course I would help him out, or at least try and raise money to do it. I'm saying that I don't feel as though I am or should be obligated to do this, that it is and should be my choice.

I'm not trying to sound like an ass by saying this, but Jerry (to use you as an example, this isn't specific to you, its to anyone), if you got a life threatening illness tomorrow, didn't have coverage, and couldn't afford the necessary treatments, it wouldn't directly affect my life. Upon hearing about it, I would certainly feel sympathetic to the situation. But I wouldn't feel bad about not paying my money for you to get treatment. You're not me, you're not part of my family, and I don't know you through anywhere but here. The most you and I have in common is that the city you live in is 20 minutes away from where my girlfriend lives and we both post on CGR. What happens to you doesn't affect me in any way. Knowing this, for the sake of argument, convince me why I should be forced to give my money to you so you can be treated.

JerryLove · 11-09-2009, 06:56 PM

Quote:

Originally Posted by Jëssȋca

And why should I have to pay for it? Why should you? You are going to have a hard time convincing me to feel ethically or morally obligated to pay for someone who can't afford it themselves. Am I saying that I wouldn't? No. If my best friend couldn't afford his hospital visit and I had the money to help him out, then of course I would help him out, or at least try and raise money to do it. I'm saying that I don't feel as though I am or should be obligated to do this, that it is and should be my choice.

So what happens tomorrow when you cannot afford what you need to continue living?

I mean: if you are just saying "let those who cannot afford care die", that's fine. Just say it.

Quote:

I'm not trying to sound like an ass by saying this, but Jerry (to use you as an example, this isn't specific to you, its to anyone), if you got a life threatening illness tomorrow, didn't have coverage, and couldn't afford the necessary treatments, it wouldn't directly affect my life. Upon hearing about it, I would certainly feel sympathetic to the situation. But I wouldn't feel bad about not paying my money for you to get treatment. You're not me, you're not part of my family, and I don't know you through anywhere but here. The most you and I have in common is that the city you live in is 20 minutes away from where my girlfriend lives and we both post on CGR. What happens to you doesn't affect me in any way. Knowing this, for the sake of argument, convince me why I should be forced to give my money to you so you can be treated.

That requires a common frame of reference.

But "because you don't want to die when you get sick" would seem to be the most compelling selfish reason.