So what is your proposal for the many people (I'm not sure...millions?) who find themselves with such conditions? What if you find yourself with a pre-existing condition?

If you say - pay up because you had cancer...what happens if you can't pay? If you can't get insured and you can't afford the treatment...what exactly are we going to do with that as a society? Would these be something like built in passive market driven death panels? As in - you have access to care, we know you can't pay so you either choose to die quietly or you get the treatment and declare bankruptcy later?

I just don't get the logic - I understand that sick people are going to cost more to treat and conversely more to insure. But if we all say - fuck you I don't want to pay for your problems - well, we're all going to have to put ourselves into our own little individual risk pools and essentially only the healthy folks will end up being able to pay.

In the first place, I acknowledged that it's a real problem. I don't think forcing a health insurance company to pay for it at lower premiums is a realistic or viable solution. Do you?

But if the system works largely as efernand described, I think it's not much of a problem.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

That is not much different than I pay buying plans on the exchange in Washington. I think I am paying $250 a month for my 44 year old wife for a silver plan. I don't remember the exact details, but I believe it has a $3000ish deductible, co-pays for primary and specialists that apply prior to the deductible being met. For my adolescent son, we pay about $200, but for a much better plan, lower deductible and lower out of pocket max. And no, we are not receiving subsidy on either of these.

A pre-existing such as diabetes will lock you out of reasonably priced insurance.

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I have a personality disorder, I don't drink coffee...

That's fucking ridiculous.... the People's Republic of Illinois is significantly higher

you will likely get much worse coverage than you had before Obamacare at about the same price as before Obamacare. And this is what you want? Sounds like a win.

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How does Danny Hart sit down with balls that big?

you will likely get much worse coverage than you had before Obamacare at about the same price as before Obamacare.

Why is that?

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Personal experience.

Our provincial government mandated lower auto insurance. Heres what happened...

The insurance companies obliged. They offered 'low cost' insurance, low cost meant really shitty coverage. But if you wanted to keep the plan you currently had it was now 'premium coverage' and guess what? Your rates went up. It was a fucking joke. And that's exactly what we asked for.

Just be careful what you wish for. The insurance companies will always find a way to screw you.

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How does Danny Hart sit down with balls that big?

The insurance companies will always find a way to screw you.


I hate to be cynical, but so far in life this ^^^ has proved to be true.

...Which goes back to JSA's point ~ they do this by paying the doctors/providers, etc less than they collect from whoever's paying for it (whether employer, gubment, or out-of-pocket). In other words, it's nothing but additional admin BS tacked on above and beyond whatever it costs to treat the patients. How on earth could such a model NOT make things more fucking expensive than they should be?

Collecting premiums and then denying coverage is only the most lopsided case, but at some level it's baked into any for-profit system. That's fine for discretionary purchases like selling smart phones or pizzas which you could simply elect not to buy, but not for health care.

I'll admit there's a bit of hyperbole there, but my experience demonstrates that it's largely true. I know, N=1 and all, but the entire experience was quite shocking. Particularly the issue with the neuroma - it turned out that was due to my hockey skates, and once I got those punched out a bit the problem went away entirely over the course of a year. Total cost about $200 for a single 20-minute office visit and a follow-up phone call or two.

And it's not doctors or medically trained personnel that were making these determinations of pre-existing conditions; it was poorly trained admin staff who'd been trained to look for the flimsiest of excuses to deny coverage.

they do this by paying the doctors/providers, etc less than they collect from whoever's paying for it (whether employer, gubment, or out-of-pocket). In other words, it's nothing but additional admin BS tacked on above and beyond whatever it costs to treat the patients.

That's exactly right, which is why we ought to gut the health "insurance" industry as we know it and return to a system in which they actually provide health insurance, not health coverage. I've said that for years and years.

Every dollar that gets paid to a health insurance company in the present system is a dollar that gets skimmed right of the bat for the insurer's profit. They're a middle man, that's all- they take a cut, but don't actually provide anything inherently useful. If we had a model where individuals paid for their own health care for the vast majority of care, and just had insurance companies to insure against major health costs, we'd have a far saner system.

But you know how it is, you have all these infantilized citizens ought there who can't be trusted not to spend all their money on hookers and blow, and if we don't provide free health coverage, they'll die, and so will all their poor children. Think of the children.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

Wait til rural hhospitals dry up and blow away....

This has always been at the core of many of my more socialist-sounding arguments. People are stupid. We can pretend that it's not a problem, or that it's their problem, or that somehow simply providing access to choices addresses it. But the level of stupidity out there is such that people truly left to their own devices will find a way to screw up YOUR life if we don't all decide to help 'em out. I'm exaggerating but I've grown more and more disillusioned with humanity as I grow older. I'm a CPA. Our entire society is based on evaluating pretty much everything in a common currency - money. Guess what my experience is with people's understanding of money? This, amazingly, includes almost everyone right up until junior financial professionals. That's why when I see those clickbait articles on Yahoo! ("75% of Americans have nothing saved for retirement!" or "2 out of 3 can't handle an emergency of just $400") I just nod in agreement.

Most people can't properly evaluate different options for their cellphone provider. Why do we think they can shop for "healthcare (coverage/insurance)"? Unless your a medical professional you can't really evaluate different options for treatment. Similarly, unless you have a significantly above average understanding of financial matters and insurance specifically, you have no fucking clue what you're looking at in terms of coverage.

Well, your candor is refreshing.

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"People think it must be fun to be a super genius, but they don't realize how hard it is to put up with all the idiots in the world."

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Civilize the mind, but make savage the body.

- Chinese proverb

I guess I could explain to you what I mean by that sentence but I suspect you'd actually understand it anyway if you read it. So my conclusion is that you're just trying to be a dick. Happy Friday!

The truth is you can't repeal ACA and it be completely gone the next day. It will take several years to unwind all of the details.


But "repeal & replace", sounds really good in a sound-bite and when Trump was blustering and blundering his way around the press conference this week.

He makes everything sound like the sky is falling! Obamacare is "Terrible" and the "Worst ever" and so on speaking in extreme, extremes as Trump is wont to do.

But the hard, complicated and messy part is what Trump doesn't talk about - what do they have to replace it. What is the plan?

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Steve Fleck @stevefleck | Blog

Exact same 'plan' they had the last time the GOP controlled the presidency and both chambers of congress ~ i.e., not a damn thing. If you have the $$, you're free to choose whatever flavor of insurance coverage you like; if you can't afford it, tough shit. We've seen this movie before...

If I recall, we had to pass the ACA before we could read it, why the double standard now? Can't the R's pass a new ACA and then we can find out what the replacement is?

Sure. They will just have to live with the consequences of that action like the democrats did from theirs.

Does that sound like a good plan to you?

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Kevin

http://kevinmetcalfe.dreamhosters.com
My Strava

What a funny thread, full of angst over something that is almost completely unknown. We do know a couple of things; the pubs have had several plans put forth over the last few years, and I have not read that any one of them did not cover pre-existing conditions. It's been widely reported that a couple of the most popular things from ACA will be kept.
I'd imagine pubs are in what are now "real" discussions, with a back and forth as to what will actually be in "the plan". Not much out so far, but one thing I did not like hearing floated is a tax on employer provided plans to help generate revenue. I'd expect pubs to end up with a better plan than ACA, hopefully much better, partially because they've had ACA to learn from (as well as break down walls that had limited govt in some areas).

I'm confused :( So if you and your wife are "perfectly healthy" what was your preexisting condition?

I gave more detail in a subsequent post - search on "neuroma".

Initial drafts of ACA were going to remove the tax-exempt status of employer-provided plans. That foundered largely due to labor unions, who argued that many of their contracts are negotiated for several years, and that suddenly taxing negotiated benefits would be unfair.

From a purely selfish standpoint, I'm worried about this too, since I have a very expensive employer-provided plan.

I do think it would be a good idea (in the long run) to make employer-provided health benefits taxable. But it's got to be done gradually and predictably so that employers and the labor market can adjust in a predictable tax environment.