November 7, 2018

"Let’s hear it for pre-existing conditions!"

I know what you mean, but...

39 comments:

rehajm said...

She seemed senile at times in the last few months. Not the hopeful-but-not-really-true-RGB kind of senile but the I'm-really-losing-it kind of senile.

Fernandistein said...

Pelosi is a pre-existing condition.

Tommy Duncan said...

Get used to it. Elections have consequences. A senile Speaker of the House is part of the package.

Tommy Duncan said...

BTW, for the third year in a row my Medicare Advantage policy has been cancelled under the rules of the ACA.

AllenS said...

“and the more than 130 million people living with pre-existing medical conditions,” she said

That is a shit load of pre-existing conditions.

On second thought, don't we all have a pre-existing conditions?

Once written, twice... said...

This was the huge loss for conservatives. It is now cemented that government will mandate that insurance companies can not discriminate based on a preexisting condition. That then means we have to have a way to make sure we also have broad insurance pools and everyone is in the system. That is Obama/Romneycare.

Once written, twice... said...

Republicans won’t ever be able to walk this back. It is now a part of our social fabric that those with pre-existing conditions can’t be denied the same coverage as those without. Every Republican running this year stated that.

Once written, twice... said...

Republicans making Obamacare work is now their only option, otherwise it will be an “Medicare for all” system.

MayBee said...

Hahahahhahaha!

Well, Democrats have to come up with a plan. All I know is individual health care plans are really expensive and have crazy high deductibles.

I actually have an issue with the deductible situation. Why does it have to start over on the calendar every year? What if you notice that October is breast cancer awareness month, go get a mammogram, and get diagnosed on Nov 15? You've only got 45 days of treatment to hit your deductible and then start the clock over again. My next big movement is going to be to start the deductible clock on the day of the diagnosis.

Once written, twice... said...

Republicans have been totally dishonest about healthcare in this country. Because of their deceit, they now totally own it. Funny how that worked out.

Hagar said...

Prepaid healthcare for all is not "insurance." Essentially the HMOs become tax collectors for a national healthcare system that is not quite a national healthcare system.
But where are they going to get all the doctors from?

Nonapod said...

The irony here is that thanks to them winning the house, it's pretty much a certainty that absolutely nothing is going to happen on healthcare for the foreseeable future. Good going.

Once written, twice... said...

But with everyone now accepting pre-existing conditions, that means Obamacare now becomes the conservative answer, leaving progressives pressing for single payer.

Once written, twice... said...

If Republicans allow Obamacare to fail they then get single payer.

CWJ said...

Do they really believe that 40% of the American people, man, woman, and child, have pre-existing conditions that would render them uninsurable? No, but that won't stop them from repeating this Big Lie as often as they used to tout the 20% of coeds are sexually assaulted/raped (depending on the version).

Why not just define P-E C down to being born mortal and raise the percentage to 100.

dda6ga dda6ga said...

Ahh the party of colon cancer...

mockturtle said...

But where are they going to get all the doctors from?

Same places they get them now: India and Pakistan.

CWJ said...

"BTW, for the third year in a row my Medicare Advantage policy has been cancelled under the rules of the ACA."

Tommy, I'm sorry for that, but it's no secret why the Federal bureaucracy hates medicare advantage.

Caligula said...

One solution is to cover only those with costly pre-existing conditions with government-subsidized insurance. Or directly with government insurance.

Going totally without medical insurance isn't really an option for those with any significant assets to protect due to the pricing larceny in medical billing that often charges uninsured patients 1000% or more of the prices that insured patients pay. At a minimum, one needs an "it's not insurance" contract that may pay zero benefits but at least provides negotiated prices for drugs and medical services.

And, this medical pricing carnival won't ever end as permitting providers to charge whatever they wish (but requiring them to charge everyone the same price for the same services) can't happen as government can't afford it, because government insists on paying less than everyone else.

Nor can everyone just pay what government pays, because government typically pays just above providers' marginal costs. And although it's always to a business' advantage to accept payments that exceed marginal costs (so long as it can do so without cannibalizing its higher-margin business), a business can't survive if everyone does so as it then has no way to recover its fixed costs.

(Businesses have variable costs (that increase as it provides more goods or services) and fixed costs, which it must pay even if it sells nothing. For example, a hospital has fixed costs: it must pay for its facility (capital cost, maintenance, utilities, etc.) and at least a minimum staff at that facility even if it sells nothing. A marginal price is one that covers only variable costs but not any fixed costs.)

Besides, insurers should be required to provide collision insurance on my pre-totaled car! They won't, and how can that be fair??

buwaya said...

Single payer is what the US already effectively has, so much of medical spending being either mandated through employment laws or covered by Medicare and other state systems. The part of medical expenditure that is actually paid for by funding sources that are truly private and not mandated is very small.

The actual gap between "single payer" however defined and that system which already exists is very narrow. In the end it is a silly argument over something that is trivial.

That question of how to pay is really a diversion from your actual problem, the extremely high cost of the American system, vastly expensive in global terms, even compared to other developed countries. This is the result of political meddling and regulatory capture, plus the encroachment of a uniquely interventionist state and legal system.

Really, the US is also unique among developed countries in the greed and effectiveness of the cabal of the private players in the industry and their government counterparts, a classic third world corporatist arrangement, the core of a banana republic. The US is just the wealthiest banana republic ever. The scale of funding is due to overall national wealth, and this produces an illusion of difference vs the usual third world system, but in fact it works exactly the same way.

Much of the wealth behind the Democratic party, and considerable slices of the Republican, come from interests that own this corporatist structure in this industry as in so many others. If anyone is wondering where political money comes from and what it buys, it is this.

buwaya said...

The US in general is an extraordinarily corrupt place, at high levels.
This is masked by the lack of low-level corruption, of the sort that the ordinary person deals with directly.

I think the various international corruption indices are severely flawed. They are not designed to deal with the sophistication of US style corporatism.

One result of this system is a serious misstatement of economic metrics. GDP for instance is likely to be overstated by high medical costs, or high costs of education, or absurdly expensive housing. This does not reflect well-being but inefficiency.

jaydub said...

buwaya, I'm starting to think we don't deserve you here. Maybe it's time for you to go to someplace better and less corrupt.

mockturtle said...

buwaya, I'm starting to think we don't deserve you here. Maybe it's time for you to go to someplace better and less corrupt.

:-)

Hagar said...

The way to get the worst of all possible results is surely what we have done: launch a government mandated NHS without even government management - it is just supposed to get out there and work by itself.

It should be noted that ACA was put together in Harry Reid's back office by insurance industry lobbyists and politicians with no input from the medical care providers.

buwaya said...

We are indeed leaving, when I retire.
And I will keep a lifeline out for the kids, and I am hedged

But the truth will persist in any case.
You have what you have, and you are stuck with it.

Kevin said...

If Republicans allow Obamacare to fail they then get single payer.

If the Dems first plan fails, we must move on to their second.

Right...

Hagar said...

Well, actually, once you sign on to health care being a civil right and justifies government mandated taxation, by whatever name, to pay for it; yes.

jaydub said...

Buwaya, I live in Spain so I know a lot about corruption and hedging, too. But, why are you leaving your kids a lifeline to a corrupt country? Why not take them to the PI? No corruption there.

buwaya said...

I have a lifeline to both.

And more than a little exposure to corruption. I used to do business with the Marcos administration, I am "grandma" here, and I know how to suck eggs.

The advantage of a "little" country is that there is that much less corruption. It may not seem so, because of the low-level bribery of cops and licenses and building permits and real estate titles, etc., but its true.

It may seem strange to think of the Philippines or Spain as not corrupt, they certainly are on those levels. But there is a much lower payoff for corrupt centralized interests.

In both places there are very powerful alternative power sources that mitigate against total control of society.

In Spain for instance there is a system of nationalities and ethnicities, especially among the Basques and Catalans which have been so much in the news, but elsewhere as well much less publicized, which have an identity and community that is defined by resistance to the center, whatever the center may be. There are lots of mediating institutions. In the US this is ceasing to exist, there is a very rapid erosion of all mediating institutions.

In the Philippines central control is fundamentally questionable, as the social consensus desires a degree of chaos, regionalism, and indeed very micro-regionalism. Besides this there are mediating institutions up the ying yang, and the elite are split into mutually hostile camps in a perpetual state of conflict. That is part of the chaos, and a firewall against what is coming in the US.

Skippy Tisdale said...

"My next big movement is going to be to start the deductible clock on the day of the diagnosis."

That makes sense. I had my knee replaced January 2 of this year. I have great insurance, so my total out-of-pocket for the procedure and therapy was$3,500 and that's not so bad. However, I blew it out about five weeks before the surgery, so the emergency room cost and pre-op costs fell within the final weeks of 2017, so I had to pony-up about $2,500 for that calendar year, making the total cost about $6,000 from November 26, 2017 through February 26, 2018. To me, that's kind of a rip-off. It should have just been $3500 for those three months of care.

On the plus side, between March and the end of this year I have been having everything I can think of checked out for free. So...

Big Mike said...
This comment has been removed by the author.
CWJ said...

"My next big movement is going to be to start the deductible clock on the day of the diagnosis."

To which Skippy replied, "That makes sense."

Actually no. It doesn't. Deductibles cover all your expenditures. They are not condition specific. Few, if any, people have potentially covered medical expenses in isolation from one another. I don't think you'd like having to satisfy the deductible all over again should you have a new malady less than a year after the first. Calendar year may be arbitrary, but at least it provides for an administratively feasible reset. I don't even know how one would administer your proposal, and still have something recognizable as a deductible.

Robert Cook said...

'and the more than 130 million people living with pre-existing medical conditions,' she said

"That is a shit load of pre-existing conditions.

"On second thought, don't we all have a pre-existing conditions?"


According to the insurance companies...yes.

Pre-ACA, they used the excuse of "pre-existing conditions" to exclude people from insurance coverage. If you had a cold in junior high that you didn't reveal on your medical history, they would cancel your policy at the first instance of your having to use it for any substantial medical treatment--after taking your premiums for years--on the basis you deceived them as to your medical history.

CWJ said...

"If you had a cold in junior high that you didn't reveal on your medical history, they would cancel your policy at the first instance of your having to use it for any substantial medical treatment--after taking your premiums for years--on the basis you deceived them as to your medical history."

Look. I get it. I know that there is little love for the insurance business, But this is utter bullshit. Robert, I don't know what special animus you have towards the health insurance business, but you do your justifiable credibility. which you've spent years building on this blog, no favors writing nonsense like this.

buwaya said...

"If you had a cold in junior high that you didn't reveal on your medical history, they would cancel your policy at the first instance of your having to use it for any substantial medical treatment--after taking your premiums for years--on the basis you deceived them as to your medical history."

Never happened to me. I had private insurance in the 1990s and I had to disclose high blood pressure, old bouts with malaria, dengue, typhoid, appendicitis. No problem.

CWJ said...

buwaya,

Exactly. And I bet, in fact know, that your premiums would have been higher than "preferred" because of it. My wife's and my premiums were similarly "rated." The point is, if you actually understand underwriting, there are many ways to accommodate people's pre-existing conditions short of denying them coverage. Indeed, beyond "rating," one could have complete coverage except for a specified P-E C, with the exclusion rolling off after a specified time period, usually a year, if no claims were made for such condition. Actually being denied coverage was an extreme step if you were applying for coverage with a company that was selling on any factor OTHER than price.

Ingachuck'stoothlessARM said...

let's hear it for pre-existing conditions

Hip Hip...Replacement !!

Ken Mitchell said...

"Pre-existing conditions" tie into several complicated topics. The root problem is that insurance companies don't want to cover problems for people who couldn't be bothered to buy health insurance back when they were young and healthy.

And I understand that. You need to buy car insurance BEFORE you have the accident. You can't apply for auto insurance after the accident, and if you buy health insurance after you've already had a heart attack, it's going to cost more.

So why can't we buy a health insurance plan when we're young and healthy, and stay with it? That's where health insurance tied to employment screws everything up. If we could divorce health care from employment, we'd be good to go. WITHOUT tying health care to government.

William Chadwick said...

So someone enlighten me: you bought insurance that you knew up front did not cover pre-existing condition--and now you're mad because your insurance doesn't cover a pre-existing condition? And that the taxpayer should make up the difference? Beautiful.