Why should govt force insurance co's to take people with pre-existing conditions?

[Little-Acorn]

A headline I saw today, said that Obama officials are warning of "devastating consequences" if the District Court ruling striking down the mandate in Obamacare, is upheld by the Supreme Court. And one of the "devastating consequences" is, that insurance companies will have great difficulty obeying another part of Obamacare: the govt command that they must take applicants who have pre-existing conditions.

A guy has cancer, say, but has no insurance. Maybe he lost his job, or failed to make payments on his old policy and they cancelled him for that reason, or whatever. He applies to a new company, who looks at his medical records and says, "Sorry, but you've got cancer already, and we can't cover something you already have."

It's the thorniest problem people with such conditions face. He can go bankrupt trying to pay for enormously expensive cancer treatments (if he hasn't already), and he might be denied some treatments (but don't all American hospitals have a policy of treating ALL who need treatment whether they can pay or not?). But most people would rather make adequate arrangements to pay for their treatments, whether by insurance or by other means, if they can.

But what is the insurance company for? What was their purpose in starting the company?

Insurance is a gambling game, pure and simple. If you grab 10,000 people off the street (pretty big street), you know that some of them will get sick or injured in the future, and some won't. Some will get severe conditions, others will have relatively mild problems, and a few will even die from their condition. Those events are absolutely certain - they will happen, and everyone knows it.

And the insurance company knows that the costs for the entire groups will be relatively constant. They will have to pay for this many chemotherapy courses, that many appendectomies, That many casts on broken arms, this many stitches, a few heart transplants, and this many funerals. The more people in the group. the more certain the company can be, about the total amount they will eventually pay out. They take the total, add some for profit/operations/etc., divide it by the number of people, and come out with the amount they will charge everybody to pay for it all. And the individual amount comes out fairly reasonably - an amount people would like to pay, for the security of knowing that if bad things happen they will be taken care of without going bankrupt. (Simplified version, but you get the idea)

Those people know that many of them will get only minor illnesses or no illnesses at all. Yet they are still happy to pay, because each one of them knows he cannot predict whether HE will be among the lucky ones. He's not paying for treatment, he's paying for the security of knowing treatment will be there IF he needs it.

The guy with cancer, is in a completely different situation. He's not seeking security "in case" something happens. He's seeking three million dollars, period. Or whatever the costs of his cancer treatments are. And when he goes to an insurance company and they decline, they are essentially telling him, "Sorry, but we're not selling treatment. We're selling security, nothing else. It's the only thing we've ever sold, and we've never intended to sell anything else. But security isn't what you're trying to buy here. Sorry, we can't help you - we're not selling anything you want, and we've never sold it, ever."

The guy with cancer can keep banging on their door and demanding they give him something that will cover his condition, but that won't change the facts. The insurance company is a gambling company betting on future events, not a we-will-pay-for-your-present-problems company, and that's all they have ever been or intended to be.

And government can pass a law forcing them to pay for the guy's present cancer treatments... but that's just forcing them to do something they never intended to do or claimed they would do. Why not pass a law forcing Michael Moore to pay for the guy's treatments instead? Or Bill Gates, or Oprah, or the guy who won last week's Super Lotto? There is no more reason to force those multimillionaires to pay for the guy, than to force an insurance company to do it. Or a car company. Or Apple Computer, or Archer Daniels Midland. Or any other company. Just because insurance companies sell something that looks superficially similar, doesn't mean they should now be coerced into paying for something they never said they would, never contracted with anybody to pay for... any more than Apple or ADM ever did.

Insurance companies do NOT sell medical treatments, or payments for medical treatments. They sell the security of knowing your treatments will be covered... whether you ever wind up needing them or not.

Becausew they sell that security, is NOT a reason to suddenly force them to pay for something completely different. The government might just as well force IBM or Caterpillar Tractor or the Catholic Church to pay for that guy's cancer treatments - it would be EXACTLY the same as forcing the insurance company to do it.

The guy with cancer has a dreadful problem, and one that he never asked for or did anything to deserve. Yet it will make his remaining life miserable, and may well kill him.

But randomly picking some company or isolated group of companies, and forcing them to pay for it, is just as unfair to those companies as the guy's cancer is unfair to him.

Is there a solution to this problem? Not only the life-threatening problem the cancer guy has, but the general problem of people with pre-existing conditions, severe or otherwise.

Assuming there is a solution, is a noble thing, and provides good motivation to people to work hard to find it. But that assumption doesn't mean the solution is easily found... and doesn't even mean there is any solution at all. In the final analysis, there may be NO WAY to solve the problem.

But randomly picking the wrong "solution" - doing something just as unfair to other people who never asked for it or deserved it - is not the way to find the right solution. In fact, it probably makes things even worse. It might even take people off the quest to find the right solution, and so harm far more people with pre-existing conditions.

So what should we do?

(I mean "we" in the general sense - all the people on this planet, acting independently and cooperatively. Unlike liberals, when I say "we", I don't mean government forcing the rest of us against our wills.)

What should WE do?

For the reasons I have pointed out, forcing insurance companies to accept people with pre-existing condition, isn't the solution. What IS the solution? Is there one at all?

[fj1200]

For the reasons I have pointed out, forcing insurance companies to accept people with pre-existing condition, isn't the solution. What IS the solution? Is there one at all?

Of course government should NOT force insurance companies to take them. People complain about the cost of insurance but then ask the government to force them to do more and more at which point they will again complain.

WE should make insurance as affordable as possible by eliminating the excessive regulations that drive up the cost, let the companies offer cheaper policies that open up the market to those who couldn't afford insurance before, stop telling people that it's not their fault they didn't buy insurance, etc. Let's stop coddling people who might otherwise be able to avoid being out of insurance by telling them that insurance companies have been forced to take them.

I do object to your characterization of insurance as gambling because there are many actuarials that would disagree. But you're right, insurance should be risk management but we've managed to turn it into a health care payment plan; you can't turn the problem around before we correctly identify the issues.

But if your question is what do we do with pre-existings, and after the above items are addressed, then it becomes a matter of having them pay for their own care and beyond that, treating those who cannot afford it as what it is... charity or welfare.

The bottom line is we can't keep driving social mandates on private business and expect to have a well functioning market.

[Missileman]

I'm running down to my insurance agent and taking out a life insurance policy on my great,great,great,great-grandfather...I think they're onto something with this pre-existing condition thing.:laugh2:

[Palin Rider]

But if your question is what do we do with pre-existings, and after the above items are addressed, then it becomes a matter of having them pay for their own care and beyond that, treating those who cannot afford it as what it is... charity or welfare.

Just like tax cuts. :laugh2:

[fj1200]

Just like tax cuts. :laugh2:

When you have nothing substantive to add, it's OK for you not to type; It would save you valuable interweb credits.

[Little-Acorn]

The question remains unanswered:

Why should govt force insurance companies to pay for medical treatments for people with existing conditions? Why not force Home Depot to do it too? And Tower Hobbies, and Clint Eastwood, and Halliburton, and P Diddy?

None of them have ever been involved in the business of taking on obligations to pay for existing conditions. So why is one being forced to do it now, when none of the others are?

Forcing Insurance co's to do it because their regular business "looks sorta like that", is like calling someone a racist because he described a stingy person as "niggardly".

Are Congress and the President so intellectually vapid, that they think they are doing something sensible?

[Palin Rider]

The question remains unanswered:

Why should govt force insurance companies to pay for medical treatments for people with existing conditions? Why not force Home Depot to do it too? And Tower Hobbies, and Clint Eastwood, and Halliburton, and P Diddy?

Here's your answer:

Govt already does force all of the above to pay for medical treatments for people who are unlucky enough to get expensive conditions and who don't have a few million dollars put by. It's called taxes.

[Palin Rider]

When you have nothing substantive to add, it's OK for you not to type; It would save you valuable interweb credits.

If only you practiced what you preach.....

[Little-Acorn]

The question remains unanswered:

Why should govt force insurance companies to pay for medical treatments for people with existing conditions? Why not force Home Depot to do it too? And Tower Hobbies, and Clint Eastwood, and Halliburton, and P Diddy?

None of them have ever been involved in the business of taking on obligations to pay for existing conditions. So why is one being forced to do it now, when none of the others are?

Forcing Insurance co's to do it because their regular business "looks sorta like that", is like calling someone a racist because he described a stingy person as "niggardly".

Are Congress and the President so intellectually vapid, that they think they are doing something sensible?

BTW, it's been well publicized what the inevitable result of forcing co's to accept people with pre-existing conditions, will be.

For most people, the penalty for not signing up to Obamacare, is lower than the premiums they would pay if they did sign up. So, people trying to save money (who isn't trying to save money?) will simply refuse to sign up. They will pay the penalty, month after month, until they get injured or come down with some serious disease. Then they will apply, and the insurance company will have to take them even though their back is already broken or whatever. The company will pay out the $millions needed to cure them, and then after he is cured, the person will drop his insurance and go back to paying the (lower) penalty. Repeat when needed.

Why would people not do this, if they are guaranteed acceptance after they are injured or sick?

[fj1200]

Here's your answer:

Govt already does force all of the above to pay for medical treatments for people who are unlucky enough to get expensive conditions and who don't have a few million dollars put by. It's called taxes.

Being proactive and mitigating risk by buying an insurance policy is luck?

[fj1200]

If only you practiced what you preach.....

I'll put up my substantive posts against yours any day. All it takes is for you to respond with something other than quippy one liners followed up by :laugh2:.

[fj1200]

BTW, it's been well publicized what the inevitable result of forcing co's to accept people with pre-existing conditions, will be.

For most people, the penalty for not signing up to Obamacare, is lower than the premiums they would pay if they did sign up. So, people trying to save money (who isn't trying to save money?) will simply refuse to sign up. They will pay the penalty, month after month, until they get injured or come down with some serious disease. Then they will apply, and the insurance company will have to take them even though their back is already broken or whatever. The company will pay out the $millions needed to cure them, and then after he is cured, the person will drop his insurance and go back to paying the (lower) penalty. Repeat when needed.

Why would people not do this, if they are guaranteed acceptance after they are injured or sick?

Yup, it will only further cause people to distance their responsibilities from their actions.

[Palin Rider]

Being proactive and mitigating risk by buying an insurance policy is luck?

Did it ever occur to you, genius, that someone could lose a job and be unable to afford continuing coverage? When they get back on their feet, NO AMOUNT of money will allow them to get a new policy.

[fj1200]

Did it ever occur to you, genius, that someone could lose a job and be unable to afford continuing coverage? When they get back on their feet, NO AMOUNT of money will allow them to get a new policy.

Of course Einstein, some of us are able to look through the seen effects and acknowledge the unseen effects that arise due to continuing piling on of regulations on top of private businesses.

You should expand your horizons a touch... or at least fully read mine and LA's posts before saying, "yeah but..."

[Thunderknuckles]

I don't know what the best solution is. It is problematic.
One thing I do know is that folks with pre-existing conditions or not are entitled to affordable health care. Yes, I said entitled. What kind of country is the US becoming when only the healthy, the wealthy, and the employed get cared for.

What I am posting offends my conservative views but I'll be damned if I didn't see things differently once I got laid off for 2 years and couldn't afford health insurance for my wife and I. Thankfully, there was a lost cost government sponsored program for children of low income families. At least my kids were covered. Luckily my wife and I had no major incidents otherwise we would have been fugged.
While I am employed again, back to a 6 figure income, and have full coverage for my family, I'll never go back to being as discompassionate as I was for people wo did not or could not get health care.

[Nukeman]

I think what most are not realizing is that a number of insurance companies do insure people with "preexisting conditions" they just don't pick it up right away. Every where I have worked and received insurance has a clause that any preexisting will be covered after 1 year of service.. I believe that is the norm.. Some will not cover the condition but everything else Will be covered. So if you have cancer they may not cover your treatment for that but if you break your arm they will cover that..

So this bullshit of they don't insure or won't cover is just that bullshit...

As for "taxes" being charity give me a break. I will let you in on a little secret that isn't that secret. MOST hospitals write off a LOT of bad debt. To give you an example in most years where I work we would write off 1-2 million in bad debt, this year by March alone we had already written off 5 million.. Do the math Einstein and tell me how much they are doing without and are helping people in a bad spot.... Most without mandates from the Fed.....

[Nukeman]

I don't know what the best solution is. It is problematic.
One thing I do know is that folks with pre-existing conditions or not are entitled to affordable health care. Yes, I said entitled. What kind of country is the US becoming when only the healthy, the wealthy, and the employed get cared for.

What I am posting offends my conservative views but I'll be damned if I didn't see things differently once I got laid off for 2 years and couldn't afford health insurance for my wife and I. Thankfully, there was a lost cost government sponsored program for children of low income families. At least my kids were covered. Luckily my wife and I had no major incidents otherwise we would have been fugged.
While I am employed again, back to a 6 figure income, and have full coverage for my family, I'll never go back to being as discompassionate as I was for people wo did not or could not get health care.Show me a hospital that can turn away a ptient regardless fo their ability to pay!?!?!?!? They can't it is the law.... I have many patients that come in with NO ability and NO intentions of ever paying, and that my friend is why YOU pay 7 dollars for a tylenol tablet..... We already have subsidized health care it just isn't out in the open for EVERYONE to see...........

AS for cost if YOU tell your doctor or hospital that your a cash customer and have NO insurance you can take off 30% off the top and sometimes as much as 50% depending on the procedure!!

[Thunderknuckles]

Show me a hospital that can turn away a ptient regardless fo their ability to pay!?!?!?!? They can't it is the law.... I have many patients that come in with NO ability and NO intentions of ever paying, and that my friend is why YOU pay 7 dollars for a tylenol tablet..... We already have subsidized health care it just isn't out in the open for EVERYONE to see...........

AS for cost if YOU tell your doctor or hospital that your a cash customer and have NO insurance you can take off 30% off the top and sometimes as much as 50% depending on the procedure!!
There's the problem isn't it. Cost. Again, I don't know what the solution is but the system we have in place right now is not sustainable. Forget that Cash Customer stuff when your unemployed or have a pre-existing condition. You're already broke and have folks coming after you 6 ways from sunday because you're already heavily in debt just to stay afloat and stay alive.

[Palin Rider]

Of course Einstein, some of us are able to look through the seen effects and acknowledge the unseen effects that arise due to continuing piling on of regulations on top of private businesses.
Obviously you and LA aren't among them.

[Nukeman]

There's the problem isn't it. Cost. Again, I don't know what the solution is but the system we have in place right now is not sustainable. Forget that Cash Customer stuff when your unemployed or have a pre-existing condition. You're already broke and have folks coming after you 6 ways from Sunday because you're already heavily in debt just to stay afloat and stay alive.

More legislation is not the answer. If you look at the history of health care cost you will see a correlation with the reimbursement rates of Medicaid/Medicare and the steep rise in cost.

The number for last year were Medicaid were $0.04 cents on the dollar of billable goods that means for every dollar they were billed we received 4 cents. Medicare was a little better and that was $0.22 cents on the dollar. There is a direct correlation between the what is payed and how much things cost. example with the current Medicare rate if the hospital needs $2,00000 for a test we have to bill $8,000.00 to get what we NEED to operate. The person who is a cash paying customer is the only one that sees a full priced bill. Think of it as paying sticker at the car lot.....

Ohh lets not forget when CMS ( canter for nMedicaid/Medicare services)they dropped reimbursement and make it retro for 2 years so YOU owe them money on all those test you performed.. Great being the government isn't it???!?!?!? You get to make the rules than bitch at those that have to follow them!!?!?!?!

[fj1200]

Obviously you and LA aren't among them.

It's hard to argue with the, "I know you are but what am I?" trump card. Does your mom know your using the interwebs?

[logroller]

Lots of great post here, a few...not so great.
I must admit, I am a little confused on the subject. I have been w/o insurance and with it. I can tell you, from a wellness perspective, insurance is fine, w/o its more complicated. I recognize the risks of gov't intervention, but, to a lesser degree, the collective bargaining pursued by insurers behaves similarly. I recently went into a doctor's office, knowing I have strep throat, signed a paper promising to pay for services which they, the office staff, had little to no idea of the costs I would incur; they run me through the gamut of tests and presto-- I have exactly what I said I had! Thanks, I needed a $10 prescription and receive a $190 dollar statement, discounted for insurance -$90, copay -$10, insurance paid -$58; amount due $32. Oh yeah, I paid $7 for the prescription, insurance paid $3. Explain to me how this battery of financial calculations is necessary for the treatment of a relatively simple illness. Medicine is a unique service, there is no substitute; and with the powerhouse lobbyists of PhRMA, insurance companies and the AMA conspiring to preserve their profits resulting from such inefficiencies, who can intervene ?
Has medicine become monopolized by corporate investors?
I'm rarely a cynic but, in this case, it appears the entire system is rittled by collusive profiteering; seeking to increase profit, instead of general health; as curing ailments generates far less marginal profit than treating them.

[fj1200]

Medicine is a unique service, there is no substitute; and with the powerhouse lobbyists of PhRMA, insurance companies and the AMA conspiring to preserve their profits resulting from such inefficiencies, who can intervene ?

We can start by doing the opposite of what is being tried, less and less intervention instead of more and more.

[PostmodernProphet]

the worker's compensation system in most states have already found a solution to this problem....

when it became obvious that partially disabled persons were finding it difficult to return to work because employers' insurers were not willing to take the risk of a permanent disability (such as back injury patients who had recovered), they solved the problem by creating a second injury fund.....all insurers paid a portion of their premiums into a fund that covered these people....thus, it didn't matter which insurer had the primary liability since they all shared equally in the risk of a secondary liability.....

it would be simple enough to do the same.....if X% of patients incur Y% of payouts, then all insurers contribute Y% of their premiums into a fund that covers all the X% patients......then it doesn't matter which company insures the X% patient because they all share equally in the costs of caring for him......

[Little-Acorn]

it would be simple enough to do the same.....if X% of patients incur Y% of payouts, then all insurers contribute Y% of their premiums into a fund that covers all the X% patients......then it doesn't matter which company insures the X% patient because they all share equally in the costs of caring for him......

If you are suggesting that this be done for people with preexisting conditions, then why do you confine the contributors to only insurance companies? As I said above, paying for preexisting conditions has NEVER been what insurance companies did, intended to do, or announced they would do.

Instead of having only insurers contribute (BTW, if this is being forced on them by government, then "contributing" isn't the right word for it), why not have ALL companies contribute, and all private individuals?

Allstate has never been in the business of paying for preexisting conditions, no have they ever claimed to be. Neither has Wal-Mart, Boeing, Home Depot, or H&R Block. Neither have I personally, or you, or Bill Gates or Barbara Streisand. So why should only Allstate be hit up for these "contributions" to pay for pre-existing conditions? They are no more "insuring" the person with the condition, than Bank of America is "insuring" the guy who sticks a gun in the face of a teller and grabs thousands of dollars and runs away.

See my point here? Forcing only insurance companies to pay for pre-existing conditions, is like forcing only Ford to pay for acccident damage to all cars regardless of make, while letting Chevy, Toyota etc. get off. Neither Ford, Chevy, Toyota or any of the other carmakers EVER promised to pay for accident damage to ANY car. Making only Ford do it, and for eveyone, makes even less sense than making all carmakers do it - or all companies of all descriptions.

Forcing any carmaker to pay for accident damage is a strange and nonsensical thing to do - they've never been in that business, nor claimed to be. Forcing only one (or just a few) carmakers to pay for the damage to all cars, is even weirder. If you're going to force ANYONE who's not responsible, to pay anyway, how can you justify doing that to only an isolated group? Isn't the only possible fair way, to spread these costs among ALL the people and groups who aren't responsible?

The government should not force insurers to pay for people's pre-existing conditions. If they are going to force anyone to pay for them (and that's a separate question of its own), they should force everybody to pay. That's State Farm, Sears, Geico, Halliburton, Fisher-Price, Baskin-Robbins, George Soros, the MGM Grand at Las Vegas, Rush Limbaugh, Cher, you, and me.

Forcing insurance companies to do it, is the silliest and most unfair possible way to go. Naturally, that's the way government is choosing.

[PostmodernProphet]

Instead of having only insurers contribute (BTW, if this is being forced on them by government, then "contributing" isn't the right word for it), why not have ALL companies contribute, and all private individuals?

????....because only insurance companies would be required to pay someone's medical bills?.....employers don't.....if they provided insurance to their employees it is likely they do it through an insurance company.....

the point is, under the plan I propose there is no reason for a company to kick out someone who incurs an expensive illness.....thus, there are no people out looking for insurance that covers pre-existing illnesses.....and, no reason to have laws regarding the same......

[fj1200]

????....because only insurance companies would be required to pay someone's medical bills?.....employers don't.....if they provided insurance to their employees it is likely they do it through an insurance company.....

the point is, under the plan I propose there is no reason for a company to kick out someone who incurs an expensive illness.....thus, there are no people out looking for insurance that covers pre-existing illnesses.....and, no reason to have laws regarding the same......

Sounds like your describing reinsurance where a secondary insurer picks up the higher level risk. That may be a good idea but it doesn't necessarily cover pre-existing conditions. You are still requiring the insurance industry to pick up the tab for a group of people who have not been insured for whatever reason and then seek it out after illness. I think that is LA's issue, they are being held to task to pay the medical bills when they were not in a position to accept premiums and make actuarial risk calculations.

[fj1200]

Instead of having only insurers contribute (BTW, if this is being forced on them by government, then "contributing" isn't the right word for it), why not have ALL companies contribute, and all private individuals?

...

The government should not force insurers to pay for people's pre-existing conditions. If they are going to force anyone to pay for them (and that's a separate question of its own), they should force everybody to pay...

Careful, that's starting to sound like the government/public option. ;)

[Little-Acorn]

Careful, that's starting to sound like the government/public option. ;)

Sure does. That's why I wasn't supporting it, but merely pointing out that if you want to extort money from one group (whether it's "for a good cause" or not), to be fair you should extort it from all groups.

[PostmodernProphet]

Sounds like your describing reinsurance where a secondary insurer picks up the higher level risk. That may be a good idea but it doesn't necessarily cover pre-existing conditions. You are still requiring the insurance industry to pick up the tab for a group of people who have not been insured for whatever reason and then seek it out after illness. I think that is LA's issue, they are being held to task to pay the medical bills when they were not in a position to accept premiums and make actuarial risk calculations.

generally, pre-existing conditions become an issue when a previous insurer has dumped a client due to an expensive illness or when someone loses a job and employer provided insurance and is unable to find another company that will take on the risk......that is the scenario I am addressing......

[fj1200]

generally, pre-existing conditions become an issue when a previous insurer has dumped a client due to an expensive illness or when someone loses a job and employer provided insurance and is unable to find another company that will take on the risk......that is the scenario I am addressing......

Sure, but forcing an insurance company to accept pre-existing conditions is an inducement to NOT be insured, be careful what you wish for. Insurance companies need to be held to account for "dumping" clients and hopefully they are; Was that part of "reform"? And someone losing their job is also an issue but forcing rules on insurance companies is not the way to do it.

[Little-Acorn]

generally, pre-existing conditions become an issue when a previous insurer has dumped a client due to an expensive illness or when someone loses a job and employer provided insurance and is unable to find another company that will take on the risk......that is the scenario I am addressing......

Very true. It's the reason I opened this thread. It's a very thorny problem.

But, remind me again why government must become involved with this???

[red states rule]

The main reason Dems want to force insurance companies to cover pre existing conditions is to increase the cost of coverage; thereby making the government plan more price atttractive

Unike the provate sector, the government plan need not worry about turning a profit. After awahile Obama thinks the governemnt will be the only place anyone can get coverage then the door is wide open for more governemnt control over your life

Which is what they wanted in the first place

We are seeing companies and unions drop coverage due to the increased cost of Obamacare, and it is only the beginning

The new Congress needs to pass the repeal of Obamacare every week until obama caves and signs it. Like he did on taxes, Obama knows HIS job is on the line now

[PostmodernProphet]

Sure, but forcing an insurance company to accept pre-existing conditions is an inducement to NOT be insured, be careful what you wish for. Insurance companies need to be held to account for "dumping" clients and hopefully they are; Was that part of "reform"? And someone losing their job is also an issue but forcing rules on insurance companies is not the way to do it.

but you're turning the national debate into something it's not......

[PostmodernProphet]

Very true. It's the reason I opened this thread. It's a very thorny problem.

But, remind me again why government must become involved with this???

because it's a function of government to resolve thorny problems?......

[fj1200]

Like he did on taxes, Obama knows HIS job is on the line now

I think BO would rather be a one-termer than repeal his own legacy.

[fj1200]

but you're turning the national debate into something it's not......

How so? Because those are exactly the types of things that were put into reform.


because it's a function of government to resolve thorny problems?......

What if they're creating/exacerbating the thorny problem to begin with? Oops, answered my own question, that is a function of government.

[Nukeman]

Once again I want to point out that MOST insurance companies will treat a preexisting condition after certain time has elapsed. Usually this is one year from date of service and if your switching jobs it can be immediate if you continued to have coverage..

Everyone here is trying to reinvent the wheel when there are already guideline in place for this. Unfortunately they are sometime expensive (not as expensive as not having coverage).

There is room for much improvement but a lot has to do with your choices in the pas and ho you have managed YOUR health care!!!

Here is a little about "preexisting conditions"

http://www.investopedia.com/articles/pf/09/covering-medical-costs.asp#12926843484772&close



Pre-Existing ConditionA pre-existing condition is a medical condition that existed prior to the date the patient signed up with a health insurance provider. Most insurance companies use one of two definitions to identify such conditions. Under the "objective standard" definition, a pre-existing condition is any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan. Under the broader, "prudent person" definition, a pre-existing condition is anything for which symptoms were present and a prudent person would have sought treatment. Pre-existing conditions can include serious illnesses, such as cancer, less serious conditions, such as a broken leg, and even prescription drugs. Notably, pregnancy is a pre-existing condition that will be treated regardless of prior treatment.

While the definitions are fairly easy to understand when you know which one will be applied to your circumstances, it gets more complicated after you factor in the additional rules regarding coverage. Navigating through the bureaucracy begins with an understanding of the Health Insurance Portability And Accountability Act (HIPAA), which provides limited protection for consumers enrolled in group healthcare plans with regard to healthcare coverage and pre-existing conditions. (For more insight, read Fighting The High Costs Of Healthcare.)

Consider the following three scenarios:

Scenario 1: Changing JobsThe first involves changing jobs. If you were covered under your prior employer's healthcare plan and take a job with a new employer, your new employer's health insurance plan can impose a six-month "look back" period. During that time, you must have had "creditable coverage" with no breaks in excess of 63 days in order to get immediate treatment for a pre-existing condition. Creditable coverage includes group healthcare plans, private medical insurance, COBRA coverage, Medicare or Medicaid.

Calculations of creditable coverage are used to determine whether immediate treatment of pre-existing conditions will be available and how long patients must wait if they are not immediately eligible. If, for example, you worked for your prior employer for 15 months and had continuous healthcare coverage and then moved immediately to the new employer, you would be given credit for 15 months of prior coverage. Any pre-existing conditions would be eligible for immediate treatment.

If, on the other hand, you worked for the prior employer for 15 months, had healthcare coverage for 11 months and then stopped coverage for three months before resuming it for one month, only the last month of coverage would be creditable because the break in coverage was longer than 63 days. Under this scenario, the new employer's healthcare coverage could refuse treatment for pre-existing conditions for a period of 11 months. Some employers further complicate the issue by breaking down healthcare coverage into five additional categories: mental health, substance abuse, prescription drugs, dental and vision. Each category of care is then subject to the six-month look-back period.

If you have not had healthcare coverage in the past 12 months, your new employer's healthcare plan can refuse treatment for pre-existing conditions for up to one year. If you do not enroll in the new plan as soon as you are eligible to do so, late enrollment can extend the delay in coverage to 18 months.

Scenario 2: Purchasing Private Healthcare InsuranceIn the second scenario, if you had employer-sponsored healthcare coverage and wanted to purchase private healthcare insurance, HIPAA guarantees that the new insurer will cover pre-existing conditions provided you have had continuous healthcare coverage with no breaks longer than 63 days during the past 18 months. (For more on private insurance, read Buying Private Health Insurance.)

Scenario 3: Switching Insurance ProvidersUnder the third scenario, if you had an insurance plan that you purchased on your own that is not affiliated with your employer, you may have trouble finding coverage for a pre-existing treatment if you wish to switch insurance providers. Private insurance may be able look back into your medical records and decline to cover you even if the condition that you had was treated many years ago. Keep in mind that insurers make a profit when their customers don't get sick, so taking on a risky customer is not in their best financial interests. With this in mind, if you are currently being treated for a medical condition or had a serious condition in the past, finding a new insurer may be a real challenge.

[Little-Acorn]

because it's a function of government to resolve thorny problems?......

I just checked both the Constitution and the Declaration of Independence, and I couldn't find any passage that said it was the government's job to generally solve problems, thorny or otherwise. Instead, it's the people's job to do that. You know, it's their problems, their lives, etc... why should government get involved in something clearly outside its purview?

There was one passage in the Declaration, BTW, that DID outline what the "funcion of government". Goes something like, "...all men are endowed with certain inalienable rights... to protect these rights, governments are instituted among men....."

That's right. The function of government (that means, the reason it exists) is to protect our rights. Period. Not to solve our problems, not to provide us health care, not to measure our toilets or tell us what handrails our walkways should have or what light bulbs to use.

I can't find a single right government is protecting, by forcing insurance companies to pay for something they never promised to pay for, never intended to pay for, never advertised they'd pay for.

But in fact, the Declaration does address such things. It further says, "...whenever any form of government becomes destructive to these ends (protecting our rights), it is the right of the people to alter or abolish it....".

In fact, when the govt forces people to do things it's not allowed to force, it is being destructive to one of the "ends" - that is, it is destroying our freedom instead of protecting it. And you can see what our duty is when it does that.

Solving problems is not the government's job. That's the people's job instead - people who cannot force one another to do something unless the other agrees.

Keep that in mind when you try to announce that it's the government's job to do something. Is that something, a protection of our rights? If not, it's hardly government's duty to do it. In fact, it's government's duty to avoid doing it.

The Declaration is the first law ever passed in the United States of America. And it has never been repealed. It's still in force, with all the power of law. Including those inconvenient passages that tell us what government's job is... and isn't.

They're not just a good idea. They're the law.

[Kathianne]

I don't think we are at the ends of our rope. However, I've come to the conclusion that we've veered way too far towards 'direct democracy' in dangerous ways. We need to get back to the real representative democracy that was originally called for, with good reasons.

[red states rule]

If only you practiced what you preach.....

Can't you go somewhere else and annoy some family member, friend, or poisonous reptile?

[red states rule]

I think BO would rather be a one-termer than repeal his own legacy.

With the new Republican majority coming in, Obama may be able to do both

Bottom one is, Republicans ran on repealing Obamacare. Polls shows a amjority of voters want it repealed

Now it is time for Republicans to belly up to the bar and pass the bill to repeal Obamacare every week. Put Obama and libs on defense. Make them publicly defend the bill, Make them justify 3 to 4 years of tax increases before the bills "benefits" kick in. Make them defend higher ins rates. Make them defend employers and unions cutting back of coverage

That is one way to make 2012 election turn out better then 2010 mid-term election

[red states rule]

I just checked both the Constitution and the Declaration of Independence, and I couldn't find any passage that said it was the government's job to generally solve problems, thorny or otherwise. Instead, it's the people's job to do that. You know, it's their problems, their lives, etc... why should government get involved in something clearly outside its purview?

There was one passage in the Declaration, BTW, that DID outline what the "funcion of government". Goes something like, "...all men are endowed with certain inalienable rights... to protect these rights, governments are instituted among men....."

That's right. The function of government (that means, the reason it exists) is to protect our rights. Period. Not to solve our problems, not to provide us health care, not to measure our toilets or tell us what handrails our walkways should have or what light bulbs to use.

I can't find a single right government is protecting, by forcing insurance companies to pay for something they never promised to pay for, never intended to pay for, never advertised they'd pay for.

But in fact, the Declaration does address such things. It further says, "...whenever any form of government becomes destructive to these ends (protecting our rights), it is the right of the people to alter or abolish it....".

In fact, when the govt forces people to do things it's not allowed to force, it is being destructive to one of the "ends" - that is, it is destroying our freedom instead of protecting it. And you can see what our duty is when it does that.

Solving problems is not the government's job. That's the people's job instead - people who cannot force one another to do something unless the other agrees.

Keep that in mind when you try to announce that it's the government's job to do something. Is that something, a protection of our rights? If not, it's hardly government's duty to do it. In fact, it's government's duty to avoid doing it.

The Declaration is the first law ever passed in the United States of America. And it has never been repealed. It's still in force, with all the power of law. Including those inconvenient passages that tell us what government's job is... and isn't.

They're not just a good idea. They're the law.

You will find it in the same section where abortion, hate crimes, and Affirmative action are all constitutional rights

[fj1200]

With the new Republican majority coming in, Obama may be able to do both

Bottom one is, Republicans ran on repealing Obamacare. Polls shows a amjority of voters want it repealed

Now it is time for Republicans to belly up to the bar and pass the bill to repeal Obamacare every week. Put Obama and libs on defense. Make them publicly defend the bill, Make them justify 3 to 4 years of tax increases before the bills "benefits" kick in. Make them defend higher ins rates. Make them defend employers and unions cutting back of coverage

That is one way to make 2012 election turn out better then 2010 mid-term election

He would never sign it and it won't get through the Senate either so it'll never even get to his desk. The House could do it but it will just sit there... They can start to chip away at it, defund it, minimize it with other reforms but outright repeal isn't going to happen.

But yes, I do think they need to keep pointing out how destructive it is and why but they need to make substantive changes not charge at windmills.

[red states rule]

He would never sign it and it won't get through the Senate either so it'll never even get to his desk. The House could do it but it will just sit there... They can start to chip away at it, defund it, minimize it with other reforms but outright repeal isn't going to happen.

But yes, I do think they need to keep pointing out how destructive it is and why but they need to make substantive changes not charge at windmills.

Who knows if the repeal of Oba,avare could get out of the Senate? I believe there are about 20 Dem Senate seats up in 2012

Looks how many Dems broke rans beofre the 2010 election and supported keeping the current tax rates

Look how many yesterday voted against the Dream Act

If enough pressure is applied, there may some Dems who could support the repeal of Obamacare if they see their jobs are on the line

[PostmodernProphet]

Solving problems is not the government's job. That's the people's job instead - people who cannot force one another to do something unless the other agrees.


ah, but we're talking about "thorny" problems....I expect by definition, that would be the type of problem an individual cannot solve.....

[fj1200]

ah, but we're talking about "thorny" problems....I expect by definition, that would be the type of problem an individual cannot solve.....

No, usually it's the type of problem that the markets could solve if left to their devices. And in the case of health care it's a problem that the government has exacerbated, if not created.

[Little-Acorn]

ah, but we're talking about "thorny" problems....I expect by definition, that would be the type of problem an individual cannot solve.....

"Thorny" simply means "especially difficult".

As I said, the difficulty of a problem, is not what gives government the authority to step in. Only if the problem violates people's rights, does govenment have the moral authority to start issuing punishments and restrictions (the only thing any government can do).

And even if this is the case, they'll gave to check the Constitution to see if they have the legal authority as well... or else they still must stay out of it.

[trobinett]

Little-Acorn posts:
forcing insurance companies to accept people with pre-existing condition, isn't the solution. What IS the solution? Is there one at all?

Don't think there is a solution, other than government ran hospitals, and clinics.

I don't have medical insurance, haven't had it for better than 20 years, been lucky, that I haven't been a sickly person. Just waiting till I can
sign up for Medicare.:cheers2::dance::poke:

[Missileman]

Little-Acorn posts:

Don't think there is a solution, other than government ran hospitals, and clinics.

I don't have medical insurance, haven't had it for better than 20 years, been lucky, that I haven't been a sickly person. Just waiting till I can
sign up for Medicare.:cheers2::dance::poke:

Like it or not, it's going to boil down to an economic decision. We are all going to die. Do we impose financial suffering on everyone to extend the lives of a few for a few months?

[trobinett]

Like it or not, it's going to boil down to an economic decision. We are all going to die. Do we impose financial suffering on everyone to extend the lives of a few for a few months?

My "knee jerk" reaction is NO, we DON'T impose financial suffering on the many to prolong the lives of a few, but as you just pointed out, we ALL are going to die, just saying.........:dunno:

[PostmodernProphet]

Like it or not, it's going to boil down to an economic decision. We are all going to die. Do we impose financial suffering on everyone to extend the lives of a few for a few months?

ah, now that the bill has passed you decide there ought to be death panels?......