First, this guy's a broker. He sells a PRODUCT and he has to MARKET his product. Using language like "robbing Peter to pay Paul" leads one to believe that by tossing anyone with a pre-existing condition out of the so-called "healthy" pools will dramatically reduce premiums for those healthy folks.
It won't.
I know two actuarial accountants and a number of health care administrators at Blue Cross/Blue Shield of Illinois and also HCSC (Health Care Services Corporation) the holding company for Blue Cross/Blue Shield.
Here's what they all tell me: Pre-Existing conditions aren't an issue for BC/BS.
Why?
Let's assume that the "4% of American's have pre-existing conditions" argument is true.
That means 96% of American's covered by private insurance are "suffering" some form of financial penalty for those that have a pre-existing condition today.
Also not true.
According to the folks I talk to who do the accounting for and manage healthcare plans pre-existing conditions affect premiums for everyone else by pennies to a few bucks per month per policy holder.
What really affects the cost of health care?
Uninsured. No surprise. Those who have no coverage and show up in emergency rooms - the most expensive place to receive health care.
Government regulation. Again, no surprise.
Defensive medicine. Really? Who'd have thunk it! Doctors who have to order every test under the sun to avoid a lawsuit.
Litigation. Here's a shocker, people sue for everything these days! (Article here on FR with a woman in Massachusetts suing Trump for loss of happiness...)
Malpractice Insurance. As a result of all the litigation, malpractice insurance experiences double-digit increases every year for almost every doctor in the country.
And then finally what no one seems to talk about: insurance write-downs which cause doctors, hospitals, etc.. to come back after you and I for the "uncovered" items healthcare insurance mysteriously doesn't pay for.
Are the "chronically ill" or those with pre-existing conditions really the ones driving up the premiums for the "healthy" folks?
Nope. They're not. And when those of you who are complaining the loudest don't see the YUUUUGE drops in your monthly premiums under TrumpCare you're being led to believe are there when everyone who has a pre-existing condition is kicked out of your insurance pool I have just three words for ya:
Told ya so.
Mark this post. It'll be true should TrumpCare ever come to pass.
Insurance rates went up ~50% for 2017 in downstate Illinois. What happened in 2015 - 2016 to justify this increase if it wasn't pre-existing conditions? Chicago gunshot victims? The state not paying the expanded medicaid bills?
No.
First, an insurance broker represents the buyer, NOT "a product" He's an independent agent.
tossing anyone with a pre-existing condition out of the so-called "healthy" pools
Nobody gets "tossed out" unless they stop paying premiums.
Here's what they all tell me: Pre-Existing conditions aren't an issue for BC/BS.
That's part of the propaganda, conflating and equating "preexisting conditions with uninsurable"
Let's assume that the "4% of American's have pre-existing conditions" argument is true.
It's probably more than that, but they're otherwise insurable.
That means 96% of American's covered by private insurance are "suffering" some form of financial penalty for those that have a pre-existing condition today....Also not true.
No, but in a GI state, 99% of them are suffering jacked up premiums due to covering the "uninsurables". (those with guaranteed $100,000+ annual claims)
According to the folks I talk to who do the accounting for and manage healthcare plans pre-existing conditions affect premiums for everyone else by pennies to a few bucks per month per policy holder.
Probably true, but the 1% of "uninsurables" rack up about 50% of the claims...never mind the mere "preexisting conditions". Once again, interchanging the two terms.
You cover the pre-x with a pre-x exclusion policy provision, for a period and otherwise write the client for all other coverages...unless they're truly "uninsurable".
What really affects the cost of health care? Uninsured. No surprise. Those who have no coverage and show up in emergency rooms - the most expensive place to receive health care.
"Free healthcare" This isn't an insurance issue, it's a provider issue. "Cost shifting" is a practice that needs to be banned. Hopefully Dr Price will effect the ban through either rulemaking or legislation.
Government regulation. Again, no surprise.
Socialist practices creeping into public policy have long since damaged or destroyed "free markets" like ObamaCare, HillaryCare, and KennedyCare. Until the ACA, some states survived and were allowed to actually sell real insurance, with full underwriting and no restrictions. Those states had the best coverage and lowest premiums.
Defensive medicine. Really? Who'd have thunk it! Doctors who have to order every test under the sun to avoid a lawsuit.
Litigation...Malpractice Insurance
All under the same heading...."Tort reform"...True, it needs to happen, but it's not an insurance structure issue.
Are the "chronically ill" or those with pre-existing conditions really the ones driving up the premiums for the "healthy" folks?
Probably not much, depends on the nature of the pre-x. But then again, do bad drivers ramp up your car insurance....Hell Yeah!
you're being led to believe are there when everyone who has a pre-existing condition is kicked out of your insurance pool
NOBODY GETS KICKED OUT OF A POOL!
The HRP is only for very ill new-applicant "uninsurables" who are dying, or have very expensive conditions...and finally decided to get insurance, and who will have annual claims in the $100,000 plus range.
I have just three words for ya: Told ya so.
And I have just three words for you:
It worked before.
(that's how insurance works)