Palisades, on 27 January 2012 - 01:26 PM, said:
^ If you have pre-existing conditions, you often can't get health insurance by yourself. Your only hope is to get it through your employer's group plan -- if your employer offers it. Federal law prohibits employers that offer health insurance from excluding employees based on health.
What solution would you propose for people with pre-existing conditions? ACA takes the route of requiring health insurers to accept individuals with pre-existing conditions and then imposes a mandate to keep people from waiting until they have a health problem to buy the insurance. I have reservations about the specific implementation of ACA, but it addresses a pervasive problem.
Insurance is a bet.
You bet you are going to get sick, and the insurance company consults their actuarial data, computes the odds, and sets the line and bets you are not going to get sick.
If you are more likely to get sick, making the bet is more expensive for you.
Once we depart from that model, what we have is not "insurance" against a risk in the classic sense.
Just like with taxes and tax shelters, people now have a choice to make with their health care expenses.
The Canadian system, as it has been explained to me, requires the payment for the national level insurance, and if you have not paid for years, you either pay for the procedures performed, or pay the back premiums.
People will do whichever is cheaper.
Same will happen here. When the fines are less than either the insurance cost, or the procedure cost, people will pay the lesser amount.
Now what does that do to the overall cost of medicine?
We have required by law that emergency medicine be performed, that insurance companies "cover" people who are already sick, and individuals and companies can use the fines as a "health insurance shelter" but still get treated as if they are fully covered.
What to do about those with pre-existing conditions?
I don't see why the federal government should be involved at all.
I understand that health problems are a bad enough problem, and money problems makes it worse. But I don't have the notion that government should be in the business of solving our personal problems.
Put differently, it isn't much different for the government to bail out GM, Wall Street, or millions of voters with large medical bills.
Whenever the government subsidizes something, prices rise.
It happened with housing, it happened with education, and it has been happening with health care for a few decades.