One of the most unfair parts of the current health care system is allowing insurance companies to gouge people who have "pre-existing conditions." This rating category allows the insurance companies to deny coverage or put them in costly high-risk pools with high deductibles and limited coverage. It seems the goal of insurance companies is to cover only people who are in good health.
The problem of pre-existing conditions needs to be fixed and it's one of the improvements that The Fresno Bee editorial says should be made in the health care reform package. Click here to read today's editorial on the issue.
Pre-existing conditions can be just about anything, depending on the insurance company. It might include cancer, pneumonia or treatment for stress. Those with these conditions essentially become outcasts in the system. Their crime is they are sick, and they might cost insurance companies money if they go to a doctor.
"It's time to get rid of "pre-existing conditions" in health care insurance rating system" By Jim Boren
And which body of legislators has enough backbone to take on the insurance industry? Because only when they do, can we stop to wallow in hypothesis, and tackle any kind of realistic reforms.
What I'm seeing a lot with this healthcare debate is a lot of "wants" and no one willing to pay for it. There is another reason for the pre-existing condition clause. The person that has never had insurance because they just don't want to pay for it or someone who has paid for low cost podunk insurance because they are cheap, all of a sudden gets an aggressive form of cancer. For that they want top of the line insurance coverage so they get the best care at the least personal cost. So they go to the gold standard of insurance companies, plunk down their $300 bucks for the month and expect $1 million in service to cure them. In essence the insurance company is being penalized for offering a good product. The basic premise of insurance is that you pay into the system so that it is there when you need it. No good insurance company can compete in a world in which the podunk company gets all the premiums and the gold standard gets all the costs.
People have done this and continue to do so when their preexisting condition can be hidden. There is a real world reason why this is not allowed. It is not sustainable. In fact my concern with the entire healthcare reform is that they have done a great job of identifying the problems, there is a wish list a mile long of what the healthcare dream is; however, I have seen nothing to explain how it can be paid for and how it can be sustained. They are wanting more and more out of the insurance companies at less and less cost from insurance and the medical profession. All this while the cost of the amazing technology that is saving previously un-saveable people is at at all time high.
The Constitution never guaranteed a healthcare utopia. All it has ever given us is the right to work hard, prosper and pay for the level of healthcare we are willing to sacrifice for.
I was born with genetic issues that cause clotting causing me to have a stroke at a young age. I have Kaiser now that took care of all that. I just don't want to be denied if for some reason I have to change like if my husbands employer doesnt use them anymore.
Duh: Your point is right on the money. It would be comparable to allowing a person to buy fire insurance after their home has burned to the ground. The only way I could see possibly getting around it is proof of prior insurance if you are forced to change carriers because of employment.
A lot of what Duh says is right on the money, particularly the part about those who have a list of "wants/ needs" a mile long without a legitimate way to pay for it- except, that they view confiscating the incomes of others as legitimate.
I think the "pre-existing" condition issue is one that can be dealt with and resolving this issue would be supported by all sides in the health care reform debate. Perhaps after the demise of Obamacare the country can select a few areas where reform is possible and make improvements at a pace that is acceptable to everyone without turning the whole system upside down.
Why can't we take on the health care issue one bite at a time. I agree the pre existing condition is something that should be fixed. Why don't we just try to fix that one thing before taking on everything else at the same time. Once we get it fixed we can take on competition...letting insurance companies compete in multiple states. We can continue to fix problems one at a time until we have an entire solution. What makes these legislatore think they can fix the whole thing at once?
I used to groom and edit writer's manuscripts for publishing. Mostly for verbosity and redundancy. But plausibility as well; e.g.:
A New England Puritan around 1640 using the term sadism. But "marquis de Sade" 1740-1814. This info is not irrelevant to this post-topic "It's time to get rid of "pre-existing conditions" in health care insurance rating system."
Jackie Krage, what a bummer for nature to encumber you with that clotting condition. I can appreciate you concern about changing insurance and "pre-existing condition". In context with the above, it is my very educated guess that the wordy and callous characterizations presented by "Duh" could be easily interchanged with KT. Typical attitude of those who made their share of the pie toward those who have not. Just hang in there. There is one thing....I personally would never choose Kaiser Permanente of my free will. I am well taken care of by Health Net. Apparently I was not affected by a pre-existing condition clause because my heart condition was not caught from a shared drinking cup. This is not an endorsement but demonstrating that private insurance and national health plans could work together because hubby and I have Medicare B as well.
One of the good reason for nation wide health ins is made by the face that when the only health insurance the poor or unemployment have is the the emergency at any hospital facility
See Jane run.
Duh = Kim Tanksley. Duh.
Economic reality = callous characterization... Gee now we know why our entire economy on the state and federal level is in the toilet. Reality is not sensitive enough. Americans can keep their head buried in the sand and ignore reality and not make any hard practical decisions as long as they like. Until of course even the sand they are hiding in gets sold to pay the piper. American will pay, the debate is only if it is today or tomorrow.
Yes, Jim that would seem the most fair way to compromise. I agree that would be a good answer.
I tore my back up working for Ironworkers local 155 Fresno , ca. If it were not for my SS disability I would not be able to get health care on my back.The gov run health care I have has saved my butt. The Ins and employers need to protect there worker not abuse them like my Union and Government did, I had to sue them to get what I EARNED not what I want for free.The union will not let me have the best care money can buy because of money and poor policy. If my union will do this to me what would a non union company do to its employees to save a buck.I hear a lot of complaining from people that do not or have not been hurt by this system I have and you are wrong. The insurance company only cares about dollars not you .If you are defending them your a bigger fool than I thought.
Dana, I don't know anyone yet on this blog who is defending insurance companies and their unfair practices. However, there is an economic reality as to how capitalism works. I also have been treated unfairly by an insurance company to the point that I almost lost everything I owned. That does not preclude me from observing abuses by some regarding preexisting conditions. Jim characterized it perfectly, what some people do is "comparable to allowing a person to buy fire insurance after their home has burned to the ground." When that is allowed the concept of insurance is not fiscally sustainable to the point that they fail and no one gets insurance. This country is chanting "we want", "we want" but to give us everything we want we get closer to socialized medicine then everyone chants "socialism, socialism, we want a free economy." The reality is that capitalism requires compromise. We need ideas like Jim's in which there is a level of compromise so that there is optimum benefit to the most people. That is not foolish, that is practical reality and whatever the solution, it will not be the best for everyone. That is the reality of how capitalism works. Utopia is a mythical construct.
Denying people for preexisting conditions is not at all like the fire insurance example noted several times in this blog. Why? Because when you health insurance is attached to your employer and you (a) get laid off, or (b) want to CHOOSE another job, or (c) want to start YOUR own BUSINESS, or (d) want to move to another state, or (e) are too sick to work and have to leave your job, or (f) your employer goes out of business, or (g) you want to go back to school full-time, or (h) well... I could keep going with many examples, but I think you get the point. The problem is, that once you have a preexisting condition... even though you were happily paying into the health insurance system through your employer... you are a slave to this employer and all of the FREEDOMS mentioned above are no longer options to you. So please do not compair home-owners insurance (fire insurance) to the our broken health care system.
"...you are a slave to this employer and all of the FREEDOMS mentioned above are no longer options to you. So please do not compair..." Excuse me but do you mean slave as in slavery? If that is your standard for what constitutes being a slave, you will really enjoy government healthcare. I had a friend in England who's sister was born with a moderate to serious foot deformity. I was there for two years, she was in her early twenties waiting for corrective surgery.
Yes Athena, those are all problems of pre-existing conditions. That is the reality of a health system based on capitalism and also a reality of the response of insurance companies to those many who scam the system. You mention the social aspects to the issue but there is also the financial aspect. It is just as real. An insurance company has to be financially sound or it will fail; then there is no coverage for anyone. All I was saying is the issue is not so cut and dried. People can't just say I want, I want and ignore the how.
As for your slavery. A person is only a slave to their choices. All of those things you mention are still free for you to choose. A pre-existing condition may require you pay more for insurance; some companies do allow pre-existing conditions if you pay more. You may have to pay in full out of your own pocket. You may choose to wait, sue for an exception in coverage, etc. Or you may choose to stay where you are. It is your choice. No one said choices are easy or you get everything you want. You get what you choose to work toward. There is no law that says a business has to offer insurance; it is an incentive to entice employees. No insurance company is required to insure anyone. Insurance is a capitalistic enterprise. Nothing in the Constitution say you have a right to healthcare.
Athena, I believe the Constitution of the United States of America indirectly makes provisions for your health care.
"We the people of the United States, in order to form a more perfect Union, establish JUSTICE insure domestic tranquility, provide for the common defense, PROMOTE THE GENERAL WELFARE,and secure the blessings of liberty to ourselves and our posterity, do ordain and establish this Constitution for the United States of America."
To tell those who cannot afford health care, that's just too bad, or that an insurance company can tell you wether or not you can be insured because of pre-existing condition may be legal, but it is not justice. That an insurance company can condemn you to be un-insured or underinsured because of pre-existing condition may be very legal, maybe very capitalistic, but is not just and it is not humane. There is a commading moral reason that throughout history there are so many religious health care facilities. And I don't mean a hospital for profit with the name of some saint.
I did not quite understand the "slave" thing.
I think that physicians should list their service in the waiting room. Office visit $50.00 and let families pay as they go. Why are we paying the insurance and again at the doctors office. For the price of insurance, then just do as you would in a grocery store.
I know that a specialist may see you for less than 15 minutes and charge 400-500 dollars. If patients knew the cost, they could shop around.
Why should anyone be punished because they were born with an illness that can not be cured.
In the old days, medicine that could be purchased without a prescription cost 10 a vial. Now that same vial is 100 dollars a vial and you need a prescription. Without that prescription a person would die.
Congress should ask the people what they want.