Why do some people want INSURANCE companies to cover "pre-existing" conditions?

[Little-Acorn]

Some people seem to have a very strange view of what insurance companies do. They point to the problem of people who have a pre-existing condition, trying to sign up for new insurance, only to find the insurance companies won't pay for the the treatment for that pre-existing condition.

Of course they won't. That's not what insurance companies do. Whoever said they did?

Insurance is a gambling game where you bet on what will happen in the future. You "bet" that you will get sick or injured, and the company "bets" that you won't. If you get sick or injured, the company pays you the stipulated amount (paying for a portion of your medical treatment etc.), and if you don't, you pay them (premiums). The purpose is to shield you from the "shock" of suddenly and unexpectedly getting hit with huge medical bills... which is why you agreed to the contract.

A pre-existing condition cannot be insured against. It's like betting on the outcome of a horse race that's already been run - there is no "chance" involved, and no "unexpectedness" to the outcome (any more).

Insurance companies are in the business of selling security - the assurance that you won't be suddenly bankrupted by huge medical bills, rehab bills etc. in the future. They do it by insuring huge numbers of people and getting them to each pay relatively small amounts (their premiums) each. They and their clients all know that most of them will never incur the huge medical bills they are worried about. But since no one knows which few people WILL incur them, they are all happy to pay the premiums, for the knowledge they won't have to pay the huge amounts if they turn out to be the unlucky ones.

Insurance companies sell safety from FUTURE possible disasters. And that's all they sell. Asking them to cover pre-existing conditions, is like asking a submarine designed to design a supersonic jet - it's got nothing to do with his business or his area of expertise, and he never volunteered to design jets in the first place, for good reason.

If you want to set up some kind of universal pool to pay for pre-existing conditions, fine, go ahead. But why drag insurance companies into it? It's got nothing to do with their areas of expertise, and they never volunteered to do it in the first place - for good reason.

[darin]

It's sorta like asking my car insurance to cover a pre-existing dent... :(

[DragonStryk72]

Some people seem to have a very strange view of what insurance companies do. They point to the problem of people who have a pre-existing condition, trying to sign up for new insurance, only to find the insurance companies won't pay for the the treatment for that pre-existing condition.

Of course they won't. That's not what insurance companies do. Whoever said they did?

Insurance is a gambling game where you bet on what will happen in the future. You "bet" that you will get sick or injured, and the company "bets" that you won't. If you get sick or injured, the company pays you the stipulated amount (paying for a portion of your medical treatment etc.), and if you don't, you pay them (premiums). The purpose is to shield you from the "shock" of suddenly and unexpectedly getting hit with huge medical bills... which is why you agreed to the contract.

A pre-existing condition cannot be insured against. It's like betting on the outcome of a horse race that's already been run - there is no "chance" involved, and no "unexpectedness" to the outcome (any more).

Insurance companies are in the business of selling security - the assurance that you won't be suddenly bankrupted by huge medical bills, rehab bills etc. in the future. They do it by insuring huge numbers of people and getting them to each pay relatively small amounts (their premiums) each. They and their clients all know that most of them will never incur the huge medical bills they are worried about. But since no one knows which few people WILL incur them, they are all happy to pay the premiums, for the knowledge they won't have to pay the huge amounts if they turn out to be the unlucky ones.

Insurance companies sell safety from FUTURE possible disasters. And that's all they sell. Asking them to cover pre-existing conditions, is like asking a submarine designed to design a supersonic jet - it's got nothing to do with his business or his area of expertise, and he never volunteered to design jets in the first place, for good reason.

If you want to set up some kind of universal pool to pay for pre-existing conditions, fine, go ahead. But why drag insurance companies into it? It's got nothing to do with their areas of expertise, and they never volunteered to do it in the first place - for good reason.

That would be fine, LA, but here's the problem: To get treated at almost any hospital in the US, you are required to have insurance, or have a ton of cash just sitting around. Most docs will not work with you without insurance, and the insurance companies wanted it that way. Problem is, that means that since it is necessary to have insurance, it's also necessary that they take more people than they otherwise would.

[darin]

That would be fine, LA, but here's the problem: To get treated at almost any hospital in the US, you are required to have insurance, or have a ton of cash just sitting around. Most docs will not work with you without insurance, and the insurance companies wanted it that way. Problem is, that means that since it is necessary to have insurance, it's also necessary that they take more people than they otherwise would.

Naw - nobody can be denied emergency or other health care. Routine stuff? probably. Not the important stuff.

And - here's the thing...health care is a luxury; not a right. I can't demand to drive a new car, or even a free car, simply based on need.

[Little-Acorn]

To get treated at almost any hospital in the US, you are required to have insurance, or have a ton of cash just sitting around. Most docs will not work with you without insurance

I guess I'll simply ask you to provide ANY evidence you can to back up either of these statements.

[avatar4321]

Because they have pre-existing conditions.

[red states rule]

It's sorta like asking my car insurance to cover a pre-existing dent... :(

Or taking out a homeowners policy the day after it burns to the ground and expecting a payoff

It makes as much sense as Obamacare

[Trigg]

so now anyone who is unfortunate enough to be born with a heart defect or develops some sort of cancer can just die??

That's the argument here??

Pretty heartless isn't it.

As it is most insurance companies can deny coverage for a pre-existing condition for 12 months.

Sorry but compairing car insurance and homeowners insurance to this subject just doesn't work.

[Little-Acorn]

Why do you say that anyone who is unfortunate enough to be born with a heart defect or develops some sort of cancer can just die? Is that the only "solution" you can see?

[fj1200]

so now anyone who is unfortunate enough to be born with a heart defect or develops some sort of cancer can just die??

That's the argument here??

Pretty heartless isn't it.

As it is most insurance companies can deny coverage for a pre-existing condition for 12 months.

Sorry but compairing car insurance and homeowners insurance to this subject just doesn't work.

No. Do the smart thing and have insurance for catastrophic illnesses. Why do you assume no one has insurance?

To the OP and to your issue. Health insurance has little relationship to risk management, read: insurance, any more; it's become a health care payment plan. And this sort of government intervention in the delivery of a private sector product has separated the consumer from the real costs of health care. Ask someone what their HC costs them and they'll quote what comes out of their paycheck, they have NO clue the real cost of their insurance policy.

Comparing health and auto insurance SHOULD be the perfect comparison, the fact that HC has become so polluted by more and more regulations is the reason that the comparison doesn't work.

[DragonStryk72]

I guess I'll simply ask you to provide ANY evidence you can to back up either of these statements.

Um... go to your local hospital, inform them you have no insurance, and that you'd like to see a doctor?

[Abbey Marie]

so now anyone who is unfortunate enough to be born with a heart defect or develops some sort of cancer can just die??

That's the argument here??

Pretty heartless isn't it.

As it is most insurance companies can deny coverage for a pre-existing condition for 12 months.

Sorry but compairing car insurance and homeowners insurance to this subject just doesn't work.

I agree Trigg. Pretty heartless.

So if the parent of a child who has Diabetes loses his job and the accompanying insurance, they are ok with that child not being insured in the future for Diabetes-related needs, such a insulin, dialysis, or even amputation? The parents have to sell their home to try to pay for it all? Yikes.

[DragonStryk72]

Naw - nobody can be denied emergency or other health care. Routine stuff? probably. Not the important stuff.

And - here's the thing...health care is a luxury; not a right. I can't demand to drive a new car, or even a free car, simply based on need.

Okay here's one. You have a congenital heart defect that is being denied by your insurance company as a "pre-existing condition". So you go to the ER. What are the chances you have the money to cover all the expenses incurred there? Without insurance, you've got squat. Right out of the gate, you've got somewhere in the vicinity of a $5000 bill for ER service. That's before you see a doctor, get put in a bed, or get an x-ray. Since you seem insistent on working and earning a living, Medicare and Medicaid want nothing to do with you.

Now, because you already have your insurance through your work, you unfortunately can't sign up for a number of others policies, why? Because there's already insurance offered through your work, even though it doesn't cover the problem you are having. Even if you do get another company to cover you, it will be for exorbitant premiums that will pretty much wreck you financially unless you're pulling six figures a year, and even, you're gonna feel it.

[fj1200]

Okay here's one.

Your sob story is riddled with false premises but the major inconsistency that I see is...

"Government screws up everything.

Are you in the camp that says "but HC is different"? The only reason HC is different is because of the pressures that have been applied for decades by government intervention in what should be allowed to work as a free market system. If people/things/etc. start to fall through the cracks then a compassionate society can provide aid where necessary but to start from the premise that government needs to impose all of these regulations in order to be fair... Well, then you get what we have which is very good but excessively priced.

[Little-Acorn]

Um... go to your local hospital, inform them you have no insurance, and that you'd like to see a doctor?

So, you can come up with nothing to back up your claims? *I* have to go out and dig up evidence to prove what *you* say?

I enjoy your sense of humor, especially tinged with irony as it is here.

In fact, I have gone to the hospital more than once for problems, and have never been asked about my insurance until after receiving treatment. If I had had no insurance (and at least one of those times I didn't), it would have made no difference to receiving treatment.

I do appreciate your proving yourself wrong so convincingly, though. Even if you needed me to help you do it.

[Trigg]

No. Do the smart thing and have insurance for catastrophic illnesses. Why do you assume no one has insurance?

To the OP and to your issue. Health insurance has little relationship to risk management, read: insurance, any more; it's become a health care payment plan. And this sort of government intervention in the delivery of a private sector product has separated the consumer from the real costs of health care. Ask someone what their HC costs them and they'll quote what comes out of their paycheck, they have NO clue the real cost of their insurance policy.

Comparing health and auto insurance SHOULD be the perfect comparison, the fact that HC has become so polluted by more and more regulations is the reason that the comparison doesn't work.

People loose their jobs and along with that their insurance.

Having to go without insurance for 12 months could be a death sentance for someone with cancer who can't afford their medications and treatment.

[Trigg]

Um... go to your local hospital, inform them you have no insurance, and that you'd like to see a doctor?

Hospitals by law cannot turn anyone away. Plenty of people are referred for routine studies as well, not just ER visits.

Hospitals will set up payment plans.

The problem with denying people with pre-existing conditions comes in when your talking about medications. Diabetes meds, blood pressure meds, anti-rejection meds. those are the things that will kill a person if they have to wait 12 months for their insurance to kick in.

[DragonStryk72]

Hospitals by law cannot turn anyone away. Plenty of people are referred for routine studies as well, not just ER visits.

The ERs won't turn you away, but regular doctor's offices can and do turn people away without insurance.

Hospitals will set up payment plans.

If you can afford the payment plan, and have the credit for it, sure.

The problem with denying people with pre-existing conditions comes in when your talking about medications. Diabetes meds, blood pressure meds, anti-rejection meds. those are the things that will kill a person if they have to wait 12 months for their insurance to kick in.

And that's also the problem with trying to compare it with car or homeowner's insurance. You won't DIE without a car or a house, you can just take the bus, or rent an apartment.

[Trigg]

And that's also the problem with trying to compare it with car or homeowner's insurance. You won't DIE without a car or a house, you can just take the bus, or rent an apartment.

I won't argue with you regarding Dr's offices. I'm not familiar enough with them and I don't feel like digging for info.

Hospitals, on the other hand, can not deny treatment period. No matter the financial situation of the patient.

Hospitals will and do set up payment plans everyday for people who cannot afford their bills.

I've worked in health care for 20 years, I process people's insurance. We see people EVERYDAY who are self pay. I'm not talking ER patients, people with scheduled appointments for MRI, CT, Mammograms routinely come in who are self pay.

[fj1200]

People loose their jobs and along with that their insurance.

Having to go without insurance for 12 months could be a death sentance for someone with cancer who can't afford their medications and treatment.

Why are those two combined? I'll save you the googling, New Deal wage controls. Why can't people buy high deductible insurance? HSA's weren't allowed until the 90's? which meant people could choose the type of insurance that was best for them. Commonality is intervention by government.

[gabosaurus]

Naw - nobody can be denied emergency or other health care. Routine stuff? probably. Not the important stuff.


Wrong again. Unless it is a true emergency situation, private hospitals can refuse to treat you. They will refer you to another hospital. And all those wonderful places that treat cancer and other long term ailments? You either need insurance or a large amount of cash up front.
Public hospitals will treat anyone, but even those can legally switch to "drive by" status, which means you are referred to the next public facility. Especially now that funding for public medical facilities is being cut so drastically.



That would be fine, LA, but here's the problem: To get treated at almost any hospital in the US, you are required to have insurance, or have a ton of cash just sitting around. Most docs will not work with you without insurance, and the insurance companies wanted it that way. Problem is, that means that since it is necessary to have insurance, it's also necessary that they take more people than they otherwise would.

DS is totally right. Let's suppose you switch jobs, or your employer switches health care providers. Anyone with any type of pre-existing conditions (most adults have at least one) is either screwed, or faces a huge increase.
Anyone who has gone to a public health care facility know how health care companies and affiliated hospitals screw you. My sister got a set of X-rays in a public clinic for $48. When my husband got the exact same set of X-rays, the hospital charged his insurance company $230.
Health care providers are rackets on par with organized crime or drug cartels.

[red states rule]

Wrong again. Unless it is a true emergency situation, private hospitals can refuse to treat you. They will refer you to another hospital. And all those wonderful places that treat cancer and other long term ailments? You either need insurance or a large amount of cash up front.
Public hospitals will treat anyone, but even those can legally switch to "drive by" status, which means you are referred to the next public facility. Especially now that funding for public medical facilities is being cut so drastically.




DS is totally right. Let's suppose you switch jobs, or your employer switches health care providers. Anyone with any type of pre-existing conditions (most adults have at least one) is either screwed, or faces a huge increase.
Anyone who has gone to a public health care facility know how health care companies and affiliated hospitals screw you. My sister got a set of X-rays in a public clinic for $48. When my husband got the exact same set of X-rays, the hospital charged his insurance company $230.
Health care providers are rackets on par with organized crime or drug cartels.

Yea Gabby, health ins companies make a 3% profit - what an outrage.

http://money.usnews.com/money/blogs/flowchart/2009/08/25/why-health-insurers-make-lousy-villains

and as much as 30% or employers will STOP offering ins coverage to their employees if Obamacre becomes the law of the land due to the addditional cost they would have to pay

So what if a majority of voters still want Obamacare repealed? Libs like you still think the government will take care of better then private ins companies.

Liberals are out to do for the health care industry what they did to the housing industry by demanding health care be a "right"

[Trigg]

Wrong again. Unless it is a true emergency situation, private hospitals can refuse to treat you. They will refer you to another hospital. And all those wonderful places that treat cancer and other long term ailments? You either need insurance or a large amount of cash up front.
Public hospitals will treat anyone, but even those can legally switch to "drive by" status, which means you are referred to the next public facility. Especially now that funding for public medical facilities is being cut so drastically.




DS is totally right. Let's suppose you switch jobs, or your employer switches health care providers. Anyone with any type of pre-existing conditions (most adults have at least one) is either screwed, or faces a huge increase.
Anyone who has gone to a public health care facility know how health care companies and affiliated hospitals screw you. My sister got a set of X-rays in a public clinic for $48. When my husband got the exact same set of X-rays, the hospital charged his insurance company $230.
Health care providers are rackets on par with organized crime or drug cartels.

hospitals are loosing money hand over fist in this economy. They have to see Medicare and Medicade patients and their reimbursement rate is shamefully low. This is only going to get worse when the gov. links patient satisfaction with reimbursement rates.

The hospitals charge more to insurance companies to try to make up the difference.

[DragonStryk72]

Yea Gabby, health ins companies make a 3% profit - what an outrage.

http://money.usnews.com/money/blogs/flowchart/2009/08/25/why-health-insurers-make-lousy-villains

and as much as 30% or employers will STOP offering ins coverage to their employees if Obamacre becomes the law of the land due to the addditional cost they would have to pay

So what if a majority of voters still want Obamacare repealed? Libs like you still think the government will take care of better then private ins companies.

Liberals are out to do for the health care industry what they did to the housing industry by demanding health care be a "right"

Well, this is sort of what I'm saying: You can't make health insurance as vital to Life as the insurance companies made it, then start denying everyone who has pre-existing conditions (read: Anything you may have been born with, but didn't know about til later, btw). However, FORCING people to buy health insurance is also wrong. this is the basic problem of Obamacare: There was solid legislation in it, but then they mired it in utter crap.

[fj1200]

... health insurance as vital to Life as the insurance companies made it...

Check your premise. Insurance companies supply a service in the market determined by massive regulations and employer based demand; the latter based on other regulations.