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To: isthisnickcool

What do you call a pre existing condition on the scenario below which is very real:

An individual goes to work full time at age 22 after completing 4 years of college. He works for three different companies during his career. During that time he had employer health care coverage to which he contributed. Economic theory would suggest the employer paid portion of the health care insurance coverage was part of his compensation.

At age 51 he is stricken with cancer while still employed. After a lengthy treatment, the cancer goes into remission but there is the potential for it to occur again at a later date. His endocrine system is damaged due to the cancer and he must take drugs daily for the rest of his life.

At age 55 the company executes a downsizing and he is involuntarily terminated. He immediately starts an aggressive job search and begins paying 100% of his health insurance coverage under Cobra. He is unsuccessful in finding full time employment but is able to find part time consulting work with two companies at a much lower income level with no benefits. After 18 months the Cobra insurance expires. He cannot find a private insurer to cover him and his family due to the preexisting condition even with an expensive high deductible policy.

Here is a person who has participated in the US health insurance system and paid into the system for 30 years. He has also been a taxpayer his entire working career, even now when he is working part time doing what he can in this tough economy. Since has worked for multiple employers he has been covered by multiple insurance companies, so he has no long standing relationship with any one insurance company. His preexisting condition occurred while he was a paying participant in the system. He is willing to continue paying for insurance, even at a high cost, but is being denied coverage due to preexisting conditions. What is your answer for this person?

1) Tough luck. That’s the way it is. Have a good life if you can. In this case the “market” fails to cover a few people and you just happen to be one.
2) A government mandate insurance companies cover citizens with preexisting conditions (i.e. the 2014 Obamacare requirement).
3) A high risk pool with extremely high premiums, deductibles and copays for people with preexisting conditions. If this is your choice, who should administer it - private companies, the states, the federal government? If you choose private companies and they don’t provide the pool, what do you do then? If someone has paid into the system for years, why should that person necessarily pay a higher cost for insurance?
4) Another idea?

We have a situation today where average middle class people who pay into the system for years can end up with a preexisting condition that prevents them from getting insurance. These people pay taxes and vote. If the conservative answer is “too bad the market doesn’t provide you insurance, tough luck” then Democrats pick up at least one additional voter and perhaps many given that most individuals have extended families and friends.

Do you have an answer other than “too bad”?


23 posted on 01/14/2013 8:47:25 AM PST by Soul of the South
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To: Soul of the South
Your scenario describes almost exactly my situation. Right now my wife and I are struggling to pay $1200/month for our COBRA continuation coverage while I try to get a full-time job (which in my field and age group is almost impossible right now given the number of cheap recent graduates in my area).

We lived in Germany for a while about twenty years ago, where our health insurance coverage (including dental) was about $50.00 a month.

The German system, by the way, is not a 'benefits' or welfare system-- it is an actuarial based national insurance system. It works for the following reasons:

1) as I said, it's based on real actuarial calculations of the country's population and probable health care costs

2) there are almost no malpractice lawsuits-- to sue a doctor you first have to have a determination of medical malpractice by a medical review board and then there's a table of compensation limiting the maximum compensation depending on the injury. If the lawyer asks for more money than is awarded, the amount is reduced by double the difference.

3) Everybody pays: the employed and employers split the insurance cost and the government pays for the unemployed/disabled/retired (the German pension system is actuarial also, not like SS), etc.

4) Every year a panel of physicians, government officials and insurance companies haggle over reimbursement rates and adjust the insurance premiums as needed.

Their system works and ours is a nightmare where you never know if a trip to the hospital will leave you bankrupt, and Obamacare has just taken the worst elements of our system and multiplied them.

We should just pay the Germans to run our system for us.

28 posted on 01/14/2013 9:14:48 AM PST by pierrem15 (Claudius: "Let all the poisons that lurk in the mud hatch out.")
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To: Soul of the South

I have a pre-existing condition.

I cannot get insurance.

I have had to pay 100 percent out of pocket for my healthcare needs since day one.

My answer to this individual is, “welcome to the crowd”.

Also - not an Omugabe voter and holding me hostage with a sob story, ain’t going to change me.


30 posted on 01/14/2013 9:18:28 AM PST by JCBreckenridge (Texas is a state of mind - Steinbeck)
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To: Soul of the South
Do you have an answer other than “too bad”?

I have several answers:

1) It is not my problem just as it is not my problem if the person does not have a car or a new Rolex for that matter if they want one. It is though my option to help them if I choose to. FYI, I have done that in the past. Even once for an employee who had cancer of the cervix. We not only made sure that they had insurance we also paid them for a year while they were going through things and did not work. By the way, it never once came to mind that we should require that someone else, including the government be forced to pay for things.

2) The market can handle these high risks but if it cannot then indeed it is "too bad". Harsh? Maybe, but this is not or used to not be a socialist country. Forcing any third party, including insurance companies, to be forced to pay for the person in the situation you describe is theft. Period.

3) If someone has paid in to the system and that system was constructed as some kind of health savings plan then they should see some of that money back. But if they paid premiums for all those years in to a pool that covered events that were insured then the person paid for what they got. Thinking that the person is "owed" something after paying in money for years is just wrong headed. Insurance is designed to cover the loses, that is for sure, but that is not what it is for. It is for covering the "risks". Anyone that uses the "hey I paid in to it" does not understand what insurance really is. The federal government and Congress is a good example of this. They don't understand insurance. They think it should be sensible to sell fire insurance after the house has started to burn. This is actually the scenerio you are describing. I suggest you take a look at "federal flood insurance" too. It ain't insurance but that is a topic I do not want to get in to here. Too long.

So basically my answer is that your scenerio while sad is not my problem unless I choose to make it mine. Under no circumstances should I be required to make it my personal problem.

The notion that Democrats pick up another voter as you assert is likely accurate. But that does not make it right nor does it make the theft of money out of my pocket to pay for the plight of someone else, no matter how sad, right.

Recently, I had a parent who has been retired for many years find that as they put it they were "outliving their money". Did I think of a way to get the government to pay them more? Nope. Did I ask the government to come up with a way to take money from others to help them? Nope. My solution was simple, I figured out a way to pay them myself. And the problem was solved. But here is what pisses me off about your sad sack story here. When people in the situation you describe sell their votes to the government and in return the government STEALS from me that means that they have just dug in to the same pocket that I use to pay for my parents in their golden years. It steals from the same pocket that I used to help my employee with cancer. It steals from the same pocket I use to help others whenever I can. So my reponse is not only "too bad" I add "how dare you" in addition to that!

38 posted on 01/14/2013 10:51:05 AM PST by isthisnickcool (Sharia? No thanks!)
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