Friday, November 20, 2009

Health Care Question

So I keep hearing this particular point being raised about Health Care Reform regarding pre-existing conditions. Some people don't think you should be turned downed by insurance companies because of a pre-existing condition. I don't understand this. Sure, it would be nice to be able to have the cost of every ailment taken care of. But in the arena of insurance, this concept of pre-existing conditions makes no sense.

It is my understanding that the purpose of insurance is to be financially protected, or covered, in the case of a catastrophic illness or injury. The idea being that such can be financially challenging and, perhaps, able to bankrupt. The insurance companies make their money when such things don't happen. They collect premiums paid in regular intervals with the hope that they'll never have to pay a claim. At the same time, though most people hope to never have to endure a catastrophic illness or injury, they pay the premiums so as not to have to save up millions of dollars just to protect themselves. It's a nice arrangement and we should be grateful that there exist entities that will risk their money to pay for our medical problems.

Auto and homeowner insurance works the same way. You are actually paying for repairs or replacements that may or may not ever be necessary. Repairs or replacements that would be financially difficult to make without massive savings available.

But no insurance company will insure a home that's on fire or a car that is totalled from having crashed. So whence comes the expectation that an insurance company must cover a new client with a pre-existing condition?

Don't get me wrong. I feel for anyone who finds himself in such a position: a victim of a serious or chronic disease, loses his job and with it, his insurance, seeks coverage elsewhere and no one will take him, or they'll cover everything but that which is related to the illness from which he suffers. But is that really the insurance company's problem?

Put yourself in they're position. Consider the car scenario if it helps to understand: someone comes to you for coverage on his car. You go outside and see that it's on fire. Are you a jerk for telling the guy to push off? I think the customer's a jerk for expecting a total stranger to come across with bucks just because he came knocking and asking for it. It's really unconscionable.

Does no one prepare for the unexpected? Is no one responsible anymore for their own troubles? Must we impose upon each other when we should be thinking in terms of never being a burden on others? I would hope that everyone who still has a job is thinking in those terms right now. It's too late for those who have already lost their job. We're taught not to store up treasures for ourselves, yet, should we act as if we are impervious to nasty turns of events?

Of course, from the insurance industry standpoint, losing the job does not have to mean losing the insurance. The ex-employee should merely take over the share paid by the employer, thus maintaining the coverage he had when he got sick. There's really no need to bump him off the group plan. If he never lost the job, the insurance provider would be paying anyway. The insured would simply maintain the policy as long as necessary. The insurer, it seems to me, is still liable for the coverage since that was the point of the insured buying the policy in the first place.


Jim said...

Well, let's start with your first theme: pre-existing conditions. The biggest complaint about insurance companies is that they will take your money for years and then when you have a major health care issue, they refuse to cover you because they find that you had a totally unrelated "pre-existing condition". You read about this occurring all the time.

Think about your car insurance. Suppose you lost control of your car on a wet, icy road and hit a tree. Totaled your car. Then your insurance company says, "Sorry, your rear bumper has a dent in it from before this accident so we're not going to pay for your totaled car."

How would that work for you?

Next, "losing the job does not have to mean losing the insurance." Huh?

"The ex-employee should merely take over the share paid by the employer, thus maintaining the coverage he had when he got sick."

Paying for it with what?

Marshall Art said...

"You read about this occurring all the time."

Actually I don't. I do read about people like YOU saying it happens all the time. I don't believe you could provide too many examples like what you claim happens all the time. What I hear regarding pre-existing conditions are those who lose their job and the insurance that goes along with it, then try to purchase coverage elsewhere and are denied completely or taken on with the provision that all things related to their pre-existing condition will NOT be covered. I think what you describe is totally lawsuit city and hardly typical at all.

Your auto example is stupid. Sorry, but it's true.

"Next, "losing the job does not have to mean losing the insurance." Huh?"

By this I meant that despite what is now the case, losing the job does not have to mean one need lose his place within the group. Think about it. What difference does it make to the insurer that you've lost your job, particularly if you continue to pay your share and with it, the ex-employer's share? The insurer is still getting the premium payment without interruption. So this is what I think SHOULD be happening and if it did, there'd be less bitching about the system.

"Paying for it with what?"

With funds the former employee saved throughout his time with the company for just such an scenario. What? You mean most people don't save for a rainy day? Well, why the hell didn't they and why is that the insurance company's problem? Are you saying that buying a home, a new car, a flat screen hi-def TV, a bass boat, having kids, getting a dog, etc, etc, etc, is more important that providing for the unexpected? That's a freely made choice, Jim. With choosing comes the consequences of the choice made. Those consequences are on the chooser, bad as well as good, not on some third party like the insurance company, the employer, the gov't, or one's fellow man.

Keep in mind. I lost my job and the insurance that went with it. We've found a company that provides coverage we can accept at a price we can afford. We didn't deal with COBRA or no insurance as the only options and went looking until we found something. We pay for it, as well as other obligations with funds from the wife's job, my unemployment compensation and the money we've set aside for just such an occasion. So I'm not speaking as one who doesn't know.

Mark said...

Pre-existing conditions notwithstanding, the biggest problem with the government health care is the fact that the plan is to force us to pay for it, whether we want to pay for it or not. Whether we want health insurance or not. Whether we prefer an alternative or not.

And now, government tells us we will have to have their government health insurance or face heavy fines, and/or jail if we don't.

Is this democracy? Is this Liberty? Is this freedom?

Remember this: If they succeed in taking away our freedom to decide for ourselves on health care, they will continue to take away other freedoms, and continue and continue until we have no freedoms left at all.

And then the blind Liberal followers of the Marxist-in-Chief (like Jim) will suddenly find themselves in a gulag wondering how it came to this.

Randy said...

Actually, pre-existing conditions ARE covered. If you can show "Certificate of Credible Coverage" when you change companies, the new company will cover pre-existing conditions with NO waiting period.

As for Jim's auto example, insurance companies DO care about pre-existing conditions. My son's car was totaled after a rear-end accident (not hard to total a car whose value is < $3,000). The appraiser deducted $$ because of damage caused BEFORE the crash.

Craig said...

Not only that but the auto insurance analogy fails on another level as well. Most (if not all) states require all motorists to carry Liability insurance. This is required to protect OTHERS not the purchaser of the insurance. There are other levels of coverage available which will pay for the damage to your vehicle in you want to pay for those coverages. These are not mandated by the state.

The closest analogy between the two, (and it is still not a good comparison) would be if the govt. required everyone to have some sort of catastrophic care insurance, and then people could go from there.

Shockingly this is one of the "non" solutions that conservatives "haven't" proposed.