Discrimination by Insurers Likely Even With Reform, Experts Say »
Posted By bluetexasvalley 1 month, 3 weeks ago in Political NewsAny health-care overhaul that Congress and President Obama enact is likely to have as its centerpiece a fundamental reform: Insurers would not be allowed to reject individuals or charge them higher premiums based on their medical history.
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bluetexasvalley
I am a 60-plus widow, retired after almost 40 years in the newspaper business. My love of politics was learned, first, from my father, a ...
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bluetexasvalley1 month, 3 weeks ago
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FTA:
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If insurers are prohibited from openly rejecting people with preexisting conditions, they could try to cherry-pick through more subtle means. For example, offering free health club memberships tends to attract people who can use the equipment, says Paul Precht, director of policy at the Medicare Rights Center.
Being uncooperative on insurance claims can chase away the chronically ill. For people who have few medical bills, it is less of a factor, said Karen Pollitz, research professor at the Georgetown University Health Policy Institute.
And to avoid patients with costly, complicated medical conditions, health plans could include in their networks relatively few doctors who specialize in treating those conditions, said Mark V. Pauly, professor of health-care management at the University of Pennsylvania's Wharton School.-
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Natureboy1 month, 3 weeks ago
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"If insurers are prohibited from openly rejecting people with preexisting conditions, they could try to cherry-pick through more subtle means."
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Here's the language going crosswise again.
A pre-existing condition in the language of health insurance is one which existed prior to coverage. Refusing to cover people because of a pre-existing condition is therefore a non-sequitur. Insurance companies refuse to underwrite potential insureds because of their medical history. If they do insure them, claims for treatment arising out of a pre-existing condition may still be denied.
Got it?
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rimbaud1 month, 3 weeks ago
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The insurance companies are betting that an influx of subscribers, mandated, and subsidized, by the government, will offset the added costs of having to take-on, or keep, sick subscribers. They are betting that if coverage is extended to everyone, it will produce a better ratio of well to sick subscribers. Then, they only need to compete with each other over who gets the most well, as opposed to sick, subscribers. Any public option really messes up this marketing scheme.
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EDWARDIII1 month, 3 weeks ago
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If we free insurance companies to write any contract with any individual across state lines limited only by basic laws against fraud, then the best possible coverage for any individual would appear somewhere.
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There will always be conditions that can not be helped by insurance or state-of-the-art medicine or any other thing. The only real help is to release our inventive entrepreneurs to make as much money as they can. Granted that procedures and meds will be expensive as they come on line; the big advantage is that safety and efficacy will be thoroughly tested by the wealthy before prices eventually drop.-
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Beau78901 month, 3 weeks ago
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Releasing "our inventive entrepreneurs to make as much money as they can" is exactly what enables insurers to get rid of high-risk clients.
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And can you explain how enabling insurers to sell across state lines would eliminate the problem outlined in the article? No insurer, whether in state or across the country, wants people who file large claims. -
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bluetexasvalley1 month, 3 weeks ago
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"...the big advantage is that safety and efficacy will be thoroughly tested by the wealthy before prices eventually drop."
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And this is an advantage for whom?
It is certainly not an advantage for the poor and middle-class people who will be dying while waiting for prices to drop. -
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miklkit1 month, 3 weeks ago
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Allowing companies to cross state lines simply means that the biggest companies will get bigger and put the smaller companies out of business. Voila! No competition and they can set the price at any level they please. Ever play monopoly?
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albionperfides1 month, 3 weeks ago
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Oh dear America you are all beholden to the capitalist ethos where individuals seeking healthcare insurance are viewed by the insurance companies as a means of making profit from illness. Far better is the Skandinavian and UK system where people contribute to a health care fund and then when they need treatment it is delivered free at the time of need. I think that your system is corrupt when insurance companies can give politicians thousands of dollars so that these politicians then support the insurance companies. It is really a bribe isn't it?
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Radiofreeeuropa1 month, 3 weeks ago
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It isn't thousands of dollars, it's 1.6 million dollars a day.
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That doesn't include advertisements and web sites masquerading as independent researchers or "grass roots" citizens groups...funded or owned by insurance companies.
Single payer systems work, and they work well for half the cost.
Why we insist on allowing Wall Street and insurance CEOs to double the cost of healthcare while contributing NOTHING to the care...simply a toll paid, a private tax, on you and your doctor is truly insane.
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Radiofreeeuropa1 month, 3 weeks ago
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The "across state lines" solution is largely sought by the insurance industry to escape state regulations. The fact is this friends. Wall street and the insurance industry control this debate. The fact that insurance stocks are surging when they should be considered risky tells all.
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The fact that the best care, highest approval, and least expensive systems are all single payer and single payer is "off the table" before even being discussed should tell you all you need to know. Anyone familiar with how a bill becomes a law knows we really can't know what the final law will look like but I am not betting on any serious change for the better.
A band-aid with no antiseptic perhaps, and we will be charged heftily for it, like the $100.00 Tylenol pills on your hospital bill. -
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EDWARDIII1 month, 3 weeks ago
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"Across State Lines" helps the insurance consumer and creates a healthier--not a richer-- insurance industry. Insurance companies invest your premiums at a profit to the company making it possible to buy more health care than the insured person could afford on his own. Regulations that require policies to insure all sorts of unusual things-- breast implants, in-vitro fertilization and the like-- hurt everyone but the poor most of all. The poor invariably pay the greatest price for government over-regulation.
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The rich have the resources to adapt and the ultimate adaptation is to quit fighting the government and join it. History has shown that the greediest, most corrupt and brutal find their way into government as soon as it reaches a critical proportion of the economy. Once there they become answerable to no one.
The code of silence seen in police departments becomes universal in the police state. The police don't always wear blue. Sometimes they wear suits and work for the SEC or the FDA or POTUS. -
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EDWARDIII1 month, 3 weeks ago
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When there is a single system, and make no mistake--that is what the left aims for-- then our most self-serving ruthless citizens will compete for the high positions and milk health care like an oriental satrap. In a free enterprise system pure greed can not succeed like it can in government.
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Greed under capitalism must be balanced by service or it will be uncovered by competition. Greed will not cease to exist in a socialist or any other system. Under socialism, however, it will thrive as in no other.
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fritz10211 month, 3 weeks ago
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It may be time to step on their *uts once and for all.No one that i know is against fair Profit but what the Ins people have done in the last 20 years is a Crime against humanity and it should be dealt with on that level.And if they don,t like it Hey pack your bags find another nation you can screw into the Ground.
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EDWARDIII1 month, 3 weeks ago
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When you over-regulate an industry you drive out honest profit and replace it with scheming. You drive out those who created health care in the beginning. You drive out the widows and orphans and coal miners and make it necessary to replace them with lawyers and specialists in gaming the system. In exchange you get a false sense of security because you trust the government---- YOU TRUST THE GOVERNMENT---- to make life fair.
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OncejesterwasI1 month, 3 weeks ago
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I would like to say "to heck with all of the insurance companies" and just have the money my employer pays BCBS which I could then place into a private medical savings account.
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As the CEO of my own insurance company I would be gaurantied 100% coverage for any medical expense for me and my family once the funds accumulate.
But I can't do that when the federal government keeps stepping in to make things all better for me. ...Oh,yay.-
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Natureboy1 month, 3 weeks ago
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And what do you do when your wonderful medical savings account has $100,000 in it but your doctor tells you that you need $250,000 for that heart surgery or you are dead in a month?
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Kiss wifey and the kids goodbye, and transfer the $100,000 into their college fund because it ain't gonna keep you alive.
It may not happen. But if it does, you're dead. And that's why people came up with the idea of using insurance to share risk.
And what kind of deal would you get from your local hospital, when you contact them as head of your "insurance company" and demand to negotiate based on your one covered life? You think you have muscle like CIGNA? You will be paying 100 percent, boyo, every last dime of their billed charges.
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Natureboy1 month, 3 weeks ago
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Articles like this make my ass itch.
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Reporters should be more familiar with their subject matter.
First of all, there is a distinction between refusing to cover people based on their medical history and denying payment for claims arising from pre-existing conditions, as I commented above.
Second, the issue of declining to underwrite an applicant based on medical history typically only arises with individual, non-group plans, the sort which are issued to the self-employed, or small business owners. The vast majority of us who are insured through an employer don't have this issue, as it is the group, not the individual, which is subject to the underwriting process.
A corrollary of this is that the issue of declination of coverage for past medical history is 100% an artifact of our employer-based, patchwork insurance system. If we had cradle-to-grave single-payor coverage, there would be no such problem. -
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Jeboba1 month, 3 weeks ago
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It matters not what rules are written to try to control the insurance industry. They are crooks. They will find ways around them. The ONLY way to solve our health care crisis in this country it to put the bastards out of business and have universal single payer healthcare! PERIOD!
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lloydm651 month, 3 weeks ago
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Do I understand that someone in their sixties,or seventies who decided not to carry medical coverage,now needs a triple bypass will be able to purchase coverage for a few months without a penalty,and then drop it until a new crisis comes along.I wonder if this would work with an extended warranty.No need to take it when offered,just wait until something breaks then demand it
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jonnyrttn1 month, 3 weeks ago
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Beau7890 you call me out then i cant get a reply through.Am i blocked? Thats the problem with you libs you run you'r mouth about whatever but cant take the other sides opinion. You think you'r argument is always the right one.I can admit when im wrong but then im an adult.
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Beau78901 month, 3 weeks ago
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What are you talking about? What comments have you made that you'd like a response to? I've replied to every one of your replies to me, including this one.
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I don't block people, unless they send me endless private messages or spam me with links to websites wanting me to buy things.
I'll believe you're an adult when you start sticking to the topic, using logic and reason, and when you stop posting like an eighth-grader.
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jaern1 month, 3 weeks ago
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We won't get health care reform. Money that went to bail out the banks should have gone to health care and the banks should have failed. Republicans will be pleased. They won't have decent coverage but by golly, their insurance companies will be richer!
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