mateys,

i have a question fer ye all. this been a question that has bedeviled me ever since the health care debate started, and i can't make no sense 'o it.

lets say yer a lass and ye have a lump in yer breast thats been troublin' ye.

ye lose yer job and with it goes yer insurance, aye?

so ye come into me insurance store and tries to get insurance. i go into me back office and talk to me good friend, Dr. Stephen Edge...
Women Struggle With Breast Cancer Expenses - ABC News

i then go back into me office and just turn ye down flat...its a grim thing, but i don't see what else can be done.

if ye come to me insurance store with a history 'o heart problems...well, open heart surgury costs average $100,000. yarrr! i'd have to turn ye down also.

me question be this, me hearties;

unless i charge ye financially backbreakin' rates, what on earth be the economic model that makes it worth insurin' folks who have pre-existin' conditions?

wouldn't it make more sense, from a business perspective, to not take on these risky folk and make the taxpayers pay for it instead (via medicaid)? the white house be makin' a big to do 'bout insurin' folks with pre-existin' conditions, but i can't see how it be profitable to cover them folks, unless you obliterate them with fearsome premiums.

*waits for an informed answer*

- MeadHallPirate

Good luck with that...

Anyway you know the answer as do I... there isn't one.

*scratches his head*

honestly Tsquare, i do not know the answer. i know 'tis morally right to help them who be ailin' and in desperate need, i just don't see the business reasonin' behind it.

if i were ownin' an insurance company, i'd turn away folks with diabetes, heart problems, hemophelia, asthma....all them kinda things. why on earth would i want to insure them kinda folks? they'd ruin me bottem line.

that answer doesn't feel ethical, but it does seem practical.

yarr?

- MeadHallPirate

I think you've got it. There is absolutely no incentive to cover people with such pre-existing conditions, other than out of the kindness of one's heart. And everyone knows that, despite the fact that they may be people, corporations don't have hearts. Ergo, they don't cover those people.

__________________
"I am certain of nothing but the holiness of the heart's affections and the truth of imagination. What the imagination seizes as beauty must be truth - whether it existed before or not."

-John Keats

The short answer is that insurance companies are businesses. They must make a profit in order to stay in business. They make money by betting you won't get sick and for the most part you don't and they win the bet. But if you are already sick and they have to cover you then it's 100% guaranteed they will loose the bet and any profits. So by forcing an insurance company to cover people with pre-existing conditions is really forcing them to give away their product. How long do you think Wal Mart would stay in business if they gave away all their products? Not long. People seem to forget that health insurance companies are (for profit busineses).

__________________
"To be governed is to be watched, inspected, spied upon, directed, law-driven, numbered, regulated, enrolled, indoctrinated, preached at, controlled, checked, estimated, valued, censured, commanded, by creatures who have neither the right nor the wisdom nor the virtue to do so." John Stossel quoting some guy.

There isn't a person in this country who doesn't have a preexisting condition if you look deeply enough. And I'm talking about the genome.

__________________

but even if you don't " have a heart" they will take a piece of yours anyway and if you do "have heart" that doesn't mean you get choose how much heart they will take....

__________________

"The captain has turned off the `No Dubbing' sign. You are free to speak any language you choose."

Bis interimitur qui suis armis perit...

I'm not sure how informed this answer will be but there is a model which makes this practicable. It's the same one the FEMA uses with property in waterfront areas. Now such properties are very attractive for a variety of reasons, but many are simply unbuildable because of the flooding hazards. Still, in several areas we either already have extensive properties existing or the other attractions, such as resorts, are simply too much.

So FEMA requires flood insurance, which only they as a government agency are allowed to provide, and here's the kicker, they are increasingly either requiring or "encouraging" ALL existing, and especially new, properties to have flood insurance. This includes properties well outside of the hundred year floodplain, the thousand , or the the lifetime of the known universe.

Remember that insurance doesn't eliminate risk, it spreads it. The idea of this model is that if the the risk is spread to enough people then even a very high risk can be subsumed and most everyone won't notice the extra expense.

It's a good model when there is an activity which almost everyone would like to do (ie, own waterfront property, or live) but where the risk is so high as to make the activity uninsurable, if it were to be considered in and of itself. The only real requirement is that EVERYBODY must be in it, even those who don't really run the higher risk AND the number that run the high risk cannot be very large (this is the crucial weakness of FEMA and why they live in terror of a Category 5 storm running right up the East Coast, but it doesn't apply to health insurance unless you have a true pandemic, and that would make health insurance the least of our problems.)

It's NOT a good model for many other things, such as owning a business. There you want to actually only encourage a very few so it makes sense for insurance cos to have high requirements and not protect businesses that have "pre-existing conditions" (bad managment, poor location etc)

It's not a good idea to do that with people. A goverment that permits business structures to simply say "Die" to even a small segment of their population is headed for serious trouble.

__________________
Alizee Jacotay, the reason god invented hips

IT'S ON YOUTUBE, IT MUST BE TRUE

No one should be refused health insurance pre-exisiting conditions or not. What should happen is the person should be given a standard rate like anyone else and the gap or any balance should be picked up by the govt.

Funny you dont want to pay for what could give a longer life, improved health and at the same time have no problems with the millions spent every years locking up and caring for criminals in prison many of which will never be released!

So, people with preexisting conditions are just SOL?

__________________
It's a small world, unless you gotta walk home.

Democrats are sexy. Who ever heard of a nice piece of elephant?

Sometimes...

Sometimes, like me... you just pay more. For my blood pressure for example.

And my obesity... and my case of terminal ugly.

Expensive all...

I can understand paying more. I'm talking about when they're denied outright and I think that's what MHP is talking about too.

__________________
It's a small world, unless you gotta walk home.

Democrats are sexy. Who ever heard of a nice piece of elephant?

One of the issues that results from having a health insurance system that is tied to employment is that people may lose their ability to change jobs due to pre-existing conditions for which they would lose coverage if they changed jobs. It is even worse when the separation is non voluntary and for no fault of the employee. (i.e. employer bankruptcy)

If pre-existing conditions were considered insurable then this issue would disappear and the job market could function more efficiently, people would change jobs freely without taking health coverage into consideration.

Also if it was universal that pre-existing conditions would be covered then overall every coverage of a pre-existing condition covered would also result in coverage being lapsed for that with another insurer. Since insurance works on overall averages then it should more or less balance out for any individual insurer.

You may have provisions that new coverage cannot exceed previous coverage or had to have been insured previously but with a reasonable time limit on the pre-existing condition coverage (say one year or so) then it should work.

__________________
I always find it strange that only reasonable people agree with me.

It's just a back door scheme to single payer when the insurance companies go the way of AIG.

We have to separate the revenue streams for the infrastructure, supplies, and labor. Replace Medicaid/care on the state and federal levels with public hospitals, and make the patients pay for the one use supplies and the doctors time. Insurance exists only for catastrophic illness, working exactly like life insurance, if not replacing it.

__________________
January 21, 2013: The End of an ERROR.

"Only a virtuous people are capable of freedom. As nations become more corrupt and vicious, they have more need of masters."
"When the people find that they can vote themselves money, that will herald the end of the republic."
"The Constitution only gives people the right to pursue happiness. You have to catch it yourself."
---Benjamin Franklin

Well, me hearty, 'cept for those of us that will be killed by jealous husbands or meteorites or the like, the vast majority of us will get sick and die, sooner or later, half the money spent on health care is spent on the first two weeks and the last two weeks of life.
So fer most of us, we'll be running up a tidy tab sooner or later.
Now when you have a situation where there is something that may cost a great deal that may happen or may not happen, but it's relatively rare that it happens, then insurance is a great idea. But if it's something that happens to most everyone, then the government can do a much better job at administering the program.
Socializing the cost of something that almost everyone benefits from makes sense.
Which is why the founding fathers socialized the cost of the military, and the Post Office, and the roads and canals. Which is why Social Security is such a marvelously successful program, and the envy of all those countries that have been foolish enough to "privatize" their pension plans.
Socializing medical costs, really socializing the costs, eliminates nearly 30% of the actual cost of medical insurance. There is no need for underwriting, or sales commissions, or massive CEO salaries, or individual premium billing.
And almost everyone is going to run up some massive health care bills sooner or later, so socializing the cost makes sense.

__________________
“ The subjects of every state ought to contribute towards the support of the government, as nearly as possible, in proportion to their respective abilities; that is, in proportion to the revenue which they respectively enjoy under the protection of the state.”

Adam Smith , The Wealth of Nations 1776

"We have always known that heedless self-interest was bad morals; we know now that it is bad economics"
FDR's second Inaugural Address