Pre-Existing Conditions – Who Should Pay

And the debate rages over health care again.  And the left is going to lie again.

I’m seeing many posts decrying the new health are bill being moved through congress.  Gaining special attention is people’s opinions of the concept of pre-exisiting conditions.

Before I go further, it is my position that government has no role in health care, medical care or health insurance.  None.  It’s also my position that insurance companies treat pre-exisiting conditions within the context of actuarial science.  That is, if an individual has a condition prior to obtaining insurance, either the cost of that insurance is higher or the condition isn’t covered.

That being said, the narrative being trotted out by democrats is absolutely false.  Namely that Trumpcare will do away with the requirement that insurance companies must offer a policy to anyone who applies.  If you had a pre-existing condition during Obamacare and were able to obtain a policy, so too will you be able to obtain a policy under Trumpcare.

So, that being said, who SHOULD pay for such pre-existing conditions?  I found a nice article and they explain it this way:

We have a tendency to use “pre-existing conditions” as a euphemism for “expensive health care needs” but the two aren’t quite the same.  If you and I are both healthy today, and both participating in the same insurance plan, the pricing of our insurance should already factor in the probability that one of us will someday face a health problem requiring expensive treatment – and the plan should be able to handle it when we do.  But a sick person without insurance (or looking to change plans) is in a different situation; their need for health treatment is a certain problem rather than a merely possible one, and hence the average expected cost is much higher.  Technically, what they need is not insurance against a possible, unknown problem, but rather help paying for a certain, known problem.

There’s no way around a simple truth: treating an expensive health condition costs (someone) lots of money.  There are four basic approaches that can be taken to this problem.

1)    Leave sick people to face the costs of their own treatment, whether out of pocket or through high-cost insurance, no matter how ruinous those costs become.

2)    Mandate that other, healthier people overpay for the value of their own health insurance, so that sick people can underpay for the value of theirs.

3)    Spread the costs of paying expensive health bills throughout society, for example by having taxpayers pick up the tab.

4)    Require a targeted group to shoulder the costs.

The aspect that I like about this article is that they take no position on the policy.  Only that there are a limited number of options – options that describe who pays.

An important note – if you are someone that already has insurance, are healthy and then gets sick, you will be covered under that policy.  You will be provided the medical care you require and do not have a pre-existing condition.


5 responses to “Pre-Existing Conditions – Who Should Pay

  1. Well, the role of government in health care is not an objective issue – it’s a political one, and the public, limited by the constitution, will decide (and they can even change the Constitution if they want). I think you’re wrong on your view, but hey – that’s America, it’s good we have different views on the proper role of government. I think the question is NOT can people get coverage of pre-existing conditions, but can people continue to have affordable coverage of pre-existing conditions. You again have this left-right fetish where you seem to want to say one said is good and the other side is full of liars and idiots. That’s convenient if one wants to have a reason not to listen to the other side, and I know many on the left who are just as down on the so-called “right,” but in my experience neither side can claim more intelligence or integrity. Talk radio plays that up because it appeals to emotion rather than reason, and that gets listeners. But it’s not reality.

    • I think the question is NOT can people get coverage of pre-existing conditions, but can people continue to have affordable coverage of pre-existing conditions.

      Same question.

      You again have this left-right fetish where you seem to want to say one said is good and the other side is full of liars and idiots.

      The Left is saying that Trumpcare is denying pre-existing conditions. Liars and Iditots.

      The left is saying Trumpcare will kill grannie. Liars and idiots.

      Talk radio plays that up because it appeals to emotion rather than reason, and that gets listeners.

      You would do yourself a favor and turn off talk radio!

  2. No, the left is saying that the ability to get affordable insurance for re-existing conditions is under threat – and it is. But you don’t want to deal with the reality of the issue. You just want to call names, again in this bizarre little left-right two-dimensional world you posit. Rather than get into the details, you maneuver to try to simply dismiss by calling names. Weak thinking. I mean this bizarre claim that “the left says” is a straw man argument. You’re not quoting anyone, you’re making broad claims in your own words. This allows you to ignore reality and fall back into the convenience of thinking a simple ideology can give you the answers. Your dogma does not work.

  3. Have to disagree with you on this one in a practical sense for a number of reasons, even if I generally support the ideology of market forces. I should also note that I know the US and Canadian and British systems very well, having direct experience in all three.

    Ideologically yes – if everyone can afford private insurance, then I’m all for government not providing an ounce of healthcare. Such is not reality, however. There is government collusion preventing competition, insurance co’s compete for investor $ on the stock market and have to compete over returns. In the absence of competition and with the presence of collusion underlying premise of the US health care system is not to help customers, it’s almost primarily to help (and attract) investors. I’m sure on that note we can agree that the system needs to change where people being helped first and investors benefitting second is desired rather than the other way around, amd people being about 10th down the list?

    And to some of your points…

    “Or the condition isn’t covered”? This is exactly where the government should step in in a lot of cases. If I get hit by a car that has no insurance and it’s entirely their fault,, the government should step in as it does (in certain places) to provide not only financial coverage but also medical as part of protecting its citizens – and itself for that matter (allows me to get back to work earning money more quickly ((and paying taxes sooner)) and paying taxes longer.

    And the system already accounting for major health issues in premiums? Believable if premiums never went up, but they do and do punitively so the argument is a weak one.

    And the right often evokes the “nobody is ever denied care” excuse. Conveniently parsed, I believe, since they fail to mention that the now very ill and likely not-working person likely has a hefty six figure medical bill that they have to pay that is ready to totally ruin their credit.

    People may argue that instead, I advocate for say a Canadian system. I don”t. To Mr. Erb’s point I say we need to get politics completely out of it. Going one step further, and veering away from the left I also say that we simply need to look at reality and math to solve the problem.

    My proposal:

    1) Everyone pays. Citizens, visa holders, tourists, and even illegals in the United States all pay either $45 a month individually if registered or $95 a visit if you are not. Start paying at 18, pay until 85. Families pay an additional $95/mo, and all families pay. Money is paid to the State but payment gives you temporary access to other states. Tied to driver’s licenses and ofher state-adminsistered services so if you fall behind you’re going to have to catch up by end of the year or no DL, registration, etc. amd further collections if you lapse. Employers can be told to deduct at source. This is the way it already is in Canada and admin-wise it works..

    Private hospitals or clinics have to take triage or GP-related issues but can elect to take on more serious cases at that pay level. Otherwise, state/university hospitals handle it.

    Then we bring in the US insurance co’s, and the system which we don’t have but in my opinion should have in Canada – two tier. If I can afford better care I pay for better care and do not clog up the standard system. I still pay my $45/mo but now I also pay $500/mo for the best care possible. And, since that plan doesn’t have to cover my pre-exist or my catastrophic, more room for profit and unique product/service package. Competition over state lines and no collusion w State politicians.

    Jobs are created, the health care horror stories go down. Responsibility falls primarily back on the employee rather than the employer for health care and now companies can use better health care options to attract canditates. (Including electing to pay basic and supplemental premiums). People no longer go bankrupt over health, and taxpayers no longer get stuck with a very over-inflated bill when it finally gets to the taxpayer as they do now.

    That’s the system I hope for as both a Canadian and US resident. Both need to be fixed and both the ideologies and politics on both sides have held both back from being fixed for a long time. We can argue over ideology forever – in the meantime people aren’t getting care and that’s totally wrong. And Americans against single-payer? Look st Texas right now if you’re self-employed. Blue Cross/Blue Shield and that’s it – no clear answers on services when you call in, improper billing, zero customer support. That’s “American”? Hardly.

    P.s. I recently had a family member die as a result of the failings of BOTH systems, so this is also where I am coming from.

    Thanks for reading.


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