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“Covering pre-existing conditions is a ‘feel good’ measure”

Exactly. Since voters love free things and are easily scared, they’re all for it. Republicans, being whores, will give it to them. Nevermind its fundamental stupidity.

Demagogues, due to “poverty in the midst of plenty” horror stories of unfortunates who lost coverage through no fault of their own, currently have credence on the issue. They can convince people that there but for the grace of God go them without insurance. However, NO ONE will long have insurance if this passes. Why? Because it’s like forcing bicycle manufacturers to suddenly start producing aircraft carriers. That’s simply not what insurance is.

Democrats know this. It’s the whole point: they want private insurance to collapse. If we fall into that trap we deserve socialism. For there’s another answer, too good and obvious for any politician to see. Sever insurance from employment. BAM!, problem solved.

There are two factors to the pre-existing conditions that don’t match well the analogy of the car.

Using the analogy of the car accident. OK, so you had an accident, and you didn’t have insurance, so you pay for the accident yourself.

But you realise now how foolish it was, so you go to buy insurance. What if nobody will sell you insurance because of your accident? OK, they might legitimately feel you are a risk for accidents, so maybe they should charge more like they would if you had been a policy-holder and had an accident. But what if they simply wouldn’t cover you at all?

Or what if they decided not to cover the car you had the accident in, because they are afraid that since the car was repaired, it might be more prone to accidents now, and cost more if it gets in another accident?

The point is, a person who for example is diagnosed with diabetes often can’t get health insurance at all. Not just because they don’t want to cover diabetes, but because the fact that you have diabetes may make you a higher risk for all sorts of other illnesses. There’s also the problem that in most states, you couldn’t WRITE a policy that excluded a major illness, because the laws require a basic coverage set. So the insurance companies sometimes have no choice but to reject you.

A reasonable “pre-existing condition” law would allow a company to exclude the pre-existing condition, but also require coverage for all items not directly related to an EXISTING medical ailment. Yes, that would drive up costs slightly for everybody, but it would still meet the definition of “insurance” because those increased risks are only a small possibility, so it’s a “risk pool”.

On the second matter, suppose you have a heart attack. OK, so you want to buy insurance, and the insurance company certainly doesn’t want to pay for the open heart surgery you are about to go through. But, what if the law required that they cover you for any FUTURE heart attacks, once you are deemed medically “repaired” from the existing heart attack?

Again, yes you are a higher risk, and in fact might well have recurring and known expenses because of your heart condition. But that small additional burden to the insurance company isn’t as serious as making them cover hundreds of thousands of dollars of known necessary treatment.

So you might narrowly tailor the “pre-existing condition” law to put some minor burdens on insurance companies as a cost of doing business, without upsetting the apple cart, and keeping in place incentives to buy insurance before you need it, as the initial costs of illness will be a severe “punishment” for not having insurance.

We could even allow the insurance companies to charge additional fees to pre-existing condition applications, to be phased out over a period of time; kind of a “tax” to pay back the higher costs of insuring the pre-existing condition, but eventually letting the people off.

You could then establish risk pools for the actual costs of pre-existing conditions that don’t fall into this new ‘insurance’ regimen, and that could be funded with a retroactive tax charged to people who USE the fund, over a period of years, in proportion to how much money they got out of the fund.

So the fund would work somewhat as a loan, but would also be a government handout, but one that was not “free” and invoked some burden based on ability to pay, and thus still providing incentive for people to buy insurnace ahead of time.

We need some form of pre-existing condition coverage, BECAUSE there is NOT the political will to let people die on the sidewalk in front of a hospital for lack of payment. If you are going to force care-givers to provide care without payment, you have already acceeded to others paying for care, and it’s best to do that in a way that is well-controlled, well-defined, and applies pressure to the users of the system to choose to insure themselves or pay the penalty.

The problem is, we will never allow the “penalty” to be death from illness that we can cure, or even lifetime debilitation. I don’t even think a majority of CONSERVATIVES would choose that form of punishment.

Pre-existing condition insurance makes no sense, but it’s also wildly popular. You can explain to people why it has to be regulated and taxed and not given away for free, but you won’t get support for repeal of Obamacare if people think they will be back to the old ways of not being able to buy insurance because they have some illness already.