Why on Earth should Insurance companies have to cover pre-existing conditions?

[AceRothstein]

Surely you don't think facts will get in the way of the lefty loons take on pre-existing conditions do you??

Do you have anything of significance you'd like to add? Some people aren't covered for a variety of reasons such as job loss or divorce. Their pre-existing condition shouldn't be covered when they find a new job or insurance?

which is exactly why healthcare should not be attached to your job.....or your spouse.....or the government.....or the insurance companies (except for major medical)......all of these middlemen just get in the way and increase costs...

each adult should buy individual lifelong reasonable cost healthcare coverage for himself or herself and be covered anywhere he or she lives or works or doesn't work.....starting with pre-tax healthcare accounts would be a great start.....plus buying a low-cost major medical policy to cover a major accident or sickness to prevent bankruptcy....buying off the free market would help to lower the costs of healthcare dramatically....

Well this is a completely different issue and something probably worth opening a new thread to discuss. I don't know if reasonable or low-cost are terms I'd use to describe anything associated with health care.

 

[Quantum Windbag]

If you advocate we in the United States completely abandon the free market model that has worked for over 200 years....

As noted elsewhere on this thread, the health insurance industry had its beginnings in the 1940's. Unless you are in a time warp, I fail to see how this provides "over 200 years" of any kind of experience.

Are you trying to say that there was no health care prior to 1940?

 

[Quantum Windbag]

Some people seem to have a very strange view of what insurance companies do. They point to the problem of people who have a pre-existing condition, trying to sign up for new insurance, only to find the insurance companies won't pay for the the treatment for that pre-existing condition.

Of course they won't. That's not what insurance companies do. Whoever said they did?

Insurance is a gambling game where you bet on what will happen in the future. You "bet" that you will get sick or injured, and the company "bets" that you won't. If you get sick or injured, the company pays you the stipulated amount (paying for a portion of your medical treatment etc.), and if you don't, you pay them (premiums). The purpose is to shield you from the "shock" of suddenly and unexpectedly getting hit with huge medical bills... which is why you agreed to the contract.

A pre-existing condition cannot be insured against. It's like betting on the outcome of a horse race that's already been run - there is no "chance" involved, and no "unexpectedness" to the outcome (any more). Or like trying to get car insurance after wrecking your car.

Insurance companies are in the business of selling security - the assurance that you won't be suddenly bankrupted by huge medical bills, rehab bills etc. in the future. They do it by insuring huge numbers of people and getting them to each pay relatively small amounts (their premiums) each. They and their clients all know that most of them will never incur the huge medical bills they are worried about. But since no one knows which few people WILL incur them, they are all happy to pay the premiums, for the knowledge they won't have to pay the huge amounts if they turn out to be the unlucky ones.

Insurance companies sell safety from FUTURE possible disasters. And that's all they sell. Asking them to cover pre-existing conditions, is like asking a submarine designer to design a supersonic jet - it's got nothing to do with his business or his area of expertise, and he never volunteered to design jets in the first place, for good reason.

If you want to set up some kind of universal pool to pay for pre-existing conditions, fine, go ahead. But why drag insurance companies into it? It's got nothing to do with their areas of expertise, and they never volunteered to do it in the first place - for good reason.

Your comments and questions support the very reason why large corporate insurance companies should not be involved in health care in the first place. Everybody born on the face of this earth will need health care, from the day they are born til the day the die and many in between. It is not a matter of betting against "risk" unless you're a total ******* idiot and believe it should be.

Do you understand the difference between health care and health insurance? Am I going to have to go back to kindergarten to deal with your posts and explain things that have already been explained in detail because you are too ******* lazy to educate yourself before you post?

By the way, keep posting in bold print, it makes you look really intelligent.

 

[AceRothstein]

As noted elsewhere on this thread, the health insurance industry had its beginnings in the 1940's. Unless you are in a time warp, I fail to see how this provides "over 200 years" of any kind of experience.

Are you trying to say that there was no health care prior to 1940?

Do you understand the difference between health care and health insurance? Am I going to have to go back to kindergarten to deal with your posts and explain things that have already been explained in detail because you are too ******* lazy to educate yourself before you post?

Ironic post is ironic.

 

[Quantum Windbag]

If you advocate we in the United States completely abandon the free market model that has worked for over 200 years....

As noted elsewhere on this thread, the health insurance industry had its beginnings in the 1940's. Unless you are in a time warp, I fail to see how this provides "over 200 years" of any kind of experience.

LOL! Yes, American health care in 1813.....Uh-huh.....Two hundred years ago a doctor in America was anybody who wanted to call themselves one.

I love this board. It's like shooting dumbass ducks in a barrel the size of a Budweiser beer can.

Oh boy, a left wing wackamoonbat that thinks the Tea Party is the end of the known universe.

Things were a little more complicated that that even back in 1813. Medical schools have been around for centuries, despite your abysmal ignorance.

 

[Quantum Windbag]

So people who have jobs and some sort of medical condition should not have that condition covered when they find a new job and get insured again? Sounds like a good way to bankrupt people.

Indeed, the number one reason for bankruptcy filings in the U.S.

This lie has been debunked already.

 

[NoTeaPartyPleez]

That's why we need single-payer. Check out the Canadian system. It's a good example.

I have received medical care in Canada. And Mexico. And Chile. And I understand all too well why the World Health Organization ranks us 37th in the world.

 

[Quantum Windbag]

So people who have jobs and some sort of medical condition should not have that condition covered when they find a new job and get insured again? Sounds like a good way to bankrupt people.

No.

They should simply have to provide proof of being insured prior to buying a new policy.

The pre existing condition clause was actually a product of the greed of the consumer. Many would not buy health insurance unless they found they needed it. Such is why dental has the "6 month" clause...you cant use it for 6 months after you get a policy for emergencies such as root canal. Same as hurricane insurance. It does not go into affect for 30 days.

So it is simple....if you have insurance and want to change to another policy, the pre existing clause does not come into play.

Most polices covered preexisting conditions even without prior insurance, you just had to wait a few months to pay into the policy first.

 

[Quantum Windbag]

Some people seem to have a very strange view of what insurance companies do. They point to the problem of people who have a pre-existing condition, trying to sign up for new insurance, only to find the insurance companies won't pay for the the treatment for that pre-existing condition.

Of course they won't. That's not what insurance companies do. Whoever said they did?

I'm not sure where you get your information about the history of the health care insurance industry, but you need to look further.

In the beginning, almost all health insurance was open enrollment, everyone was covered regardless of condition. This was the Kaiser model of the 1940's and the Blue Cross model of the 1950's. Most large groups today, covering perhaps 60% of all insured, have a pre-existing condition clause, but it only excludes coverage for a period of 6 months to two years for that condition. This is typically waived if you are switching plans and demonstrate that you have current coverage for the pre-existing condition. Medicare supplement plans can only deny coverage for pre-existing conditions if you have no current coverage when you apply for Medicare and the denial period is only 90 days.

Last time I looked, the profit margins of health insurance companies were pretty good, so it doesn't appear they will be leaving the market anytime soon.

Tell me honestly that if you ran a health insurance company, you'd provide coverage to someone who already had cancer.

The amount of money you'd pay out in health care costs would completely eclipse the amount you'd make in premiums.

Run a company like that and see how long you stay in business.

I can honestly state that most companies did that before Obama came along.

Next.

 

[NoTeaPartyPleez]

So people who have jobs and some sort of medical condition should not have that condition covered when they find a new job and get insured again? Sounds like a good way to bankrupt people.

Indeed, the number one reason for bankruptcy filings in the U.S.

This lie has been debunked already.

Really? Want to show us the data? And please, provide an impartial source. Not Fox News. Thank you.

 

[ScreamingEagle]

Do you have anything of significance you'd like to add? Some people aren't covered for a variety of reasons such as job loss or divorce. Their pre-existing condition shouldn't be covered when they find a new job or insurance?

which is exactly why healthcare should not be attached to your job.....or your spouse.....or the government.....or the insurance companies (except for major medical)......all of these middlemen just get in the way and increase costs...

each adult should buy individual lifelong reasonable cost healthcare coverage for himself or herself and be covered anywhere he or she lives or works or doesn't work.....starting with pre-tax healthcare accounts would be a great start.....plus buying a low-cost major medical policy to cover a major accident or sickness to prevent bankruptcy....buying off the free market would help to lower the costs of healthcare dramatically....

Well this is a completely different issue and something probably worth opening a new thread to discuss. I don't know if reasonable or low-cost are terms I'd use to describe anything associated with health care.

well it's relevant to the issue of insurance companies covering or not covering pre-existing conditions because it essentially eliminates insurance companies from controlling our healthcare in the first place....

if we pay for everyday healthcare costs from our own HC accounts then we have free choice market healthcare and costs will plummet and you can pay for your healthcare directly.....or if you have a lifelong coverage program they cannot drop you as long as you continue to pay your premiums....and major medical coverage doesn't have anything to do with regular visits to the doctor unless it is a major situation like a car accident or a heart attack....and the insurance company is able to keep your monthly premium low when 'betting' on such incidents...

 

[Quantum Windbag]

Of why we shouldn't have single payer? Because, the last time I checked, Canada was moving allowing private insurance, not that you are going to let facts influence your delusional thinking.

Um, no Canada is NOT moving toward the clusterfuck that is our health care system. My Canadian friends are HORRIFIED at our system. BTW, you can buy private insurance in England as well as France and the Scandinavian countries. In fact, I believe you can buy it in any country. But we know you think only the wealthy should be able to afford to go to the doctor.

You have friends in Canada that hate the idea of getting in to see a doctor the same day, getting emergency surgery withing hours, and not being forced to wait for a bed to open up to get into the hospital?

Why don't I believe you?

 

[Quantum Windbag]

When Obama first mentioned his plan to mandate insurance companies cover pre-existing conditions I said to my wife " that is theft. It's impossible."

But it also creates a situation that makes talk of governmental "death panels" nothing more than a cruel joke. If the insurance companies can't handle it, then the only solution is single-payer.

Come back and tell me that in 50 years if we keep going the direction Obama wants.

 

[thereisnospoon]

True.

Medicare is a successful, well-run program, for example.

Conservative opposition to a single payer system is predicated solely on this myth.

OH what a dumb ******* statement...
WHAT city do you live in?
I will bet you $1,000 that the largest hospital in your city Overcharges Medicare easily 300% maybe 6,000% and because idiots like have no clue how medicare works!

For example I have access to all the Medicare payments made to 6,000 hospitals and I can tell you for a FACT in this example over 6,000% overcharge to Medicare by the hospital!

In 2009 the University Community Hospital in Tampa sent Medicare 2,110 claims for CAT scan no contrast.
Each claim averaged: $2,635 which is what was billed by the hospital to Medicare...
But the hospital's ACTUAL COSTS to perform the CAT SCAN was $43 a mark up 6,127.91%

6,127% MARKUP over costs! THIS IS REAL money being spent by Medicare and ALL because total idiots like you have NO clue specifically to a law passed in 1986 called EMTALA.
If you were smart enough you'd look it up but you aren't so here it is!!!
"In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) that if a hospital takes
Medicare,they have to regardless of an individual's ability to pay provide stabilizing treatment for patients..."

So this is why hospitals charge sometimes 6,000% above costs! Because idiots didn't think EMTALA through... just as they haven't thought Obamacare through!

You are so full of shit your eyeballs are brown.

No CT Scan is $43. First, it's an incredibly expensive piece of equipment. It's takes a lot of power to operate and a highly trained technician to maintain and in a room where the temperature and humidity are regulated.

If there is a "myth" about health care, it's the health care companies. CEO's making tens of millions for what? And how do they make it? By skimming policies and running death panels. They are "middle men". They are where the cost goes. How many policies need to be skimmed to pay for one CEO salary?

Sick for Profit - Insurance CEOs

Aetna CEO
Ronald A. Williams
2007 Compensation
$23 million
2008 Compensation (Forbes)
$24,300,112
Total Value of Unexercised Options (Forbes)
$194,496,797
Williams is in the top
ten of Forbes'
"$100 Million CEO Club."

5 pages to get to the real reason why parasites and slugs want Obamacare..Class warfare..
Dino, you dumb ****. When a person working in an industry tells you the facts, you then out of hand dismiss them with a lead in to an unrelated matter, it is YOU who end up looking full of shit.
The fact is, many things dispensed by medical professionals and medical facilities have very low costs. It is necessary for the provider to bill in such large amounts because the write off can be as much as 50% or even 75%. The write off is defined as the difference between what the provider charges vs what the insurer pays the provider. So, if the provider bills $1 and the provider pays the provider 40 cents, the write off is 60%. That's pretty typical.

 

[Quantum Windbag]

As noted elsewhere on this thread, the health insurance industry had its beginnings in the 1940's. Unless you are in a time warp, I fail to see how this provides "over 200 years" of any kind of experience.

Are you trying to say that there was no health care prior to 1940?

Do you understand the difference between health care and health insurance? Am I going to have to go back to kindergarten to deal with your posts and explain things that have already been explained in detail because you are too ******* lazy to educate yourself before you post?

Ironic post is ironic.

I was asking a pertinent question, even if you are too stupid to get it. People paid for health care before the health insurance industry came into being. Personally, I think we should more away from using insurance to cover most health care expenses, something that did not happen until the brilliant idiots in the government decided to freeze wages and **** up the free market.

In other words, the very thing you are complaining about came about because the government you support did something.

 

[healthmyths]

True.

Medicare is a successful, well-run program, for example.

Conservative opposition to a single payer system is predicated solely on this myth.

OH what a dumb ******* statement...
WHAT city do you live in?
I will bet you $1,000 that the largest hospital in your city Overcharges Medicare easily 300% maybe 6,000% and because idiots like have no clue how medicare works!

For example I have access to all the Medicare payments made to 6,000 hospitals and I can tell you for a FACT in this example over 6,000% overcharge to Medicare by the hospital!

In 2009 the University Community Hospital in Tampa sent Medicare 2,110 claims for CAT scan no contrast.
Each claim averaged: $2,635 which is what was billed by the hospital to Medicare...
But the hospital's ACTUAL COSTS to perform the CAT SCAN was $43 a mark up 6,127.91%

6,127% MARKUP over costs! THIS IS REAL money being spent by Medicare and ALL because total idiots like you have NO clue specifically to a law passed in 1986 called EMTALA.
If you were smart enough you'd look it up but you aren't so here it is!!!
"In 1986, Congress enacted the Emergency Medical Treatment & Labor Act (EMTALA) that if a hospital takes
Medicare,they have to regardless of an individual's ability to pay provide stabilizing treatment for patients..."

So this is why hospitals charge sometimes 6,000% above costs! Because idiots didn't think EMTALA through... just as they haven't thought Obamacare through!

You are so full of shit your eyeballs are brown.

No CT Scan is $43. First, it's an incredibly expensive piece of equipment. It's takes a lot of power to operate and a highly trained technician to maintain and in a room where the temperature and humidity are regulated.

If there is a "myth" about health care, it's the health care companies. CEO's making tens of millions for what? And how do they make it? By skimming policies and running death panels. They are "middle men". They are where the cost goes. How many policies need to be skimmed to pay for one CEO salary?

Sick for Profit - Insurance CEOs

Aetna CEO
Ronald A. Williams
2007 Compensation
$23 million
2008 Compensation (Forbes)
$24,300,112
Total Value of Unexercised Options (Forbes)
$194,496,797
Williams is in the top
ten of Forbes'
"$100 Million CEO Club."

YOU said "No CT Scan is $43. First, it's an incredibly expensive piece of equipment. It's takes a lot of power to operate and a highly trained technician to maintain and in a room where the temperature and humidity are regulated."


IDIOT HERE is the table that I got that information from:

Look at this screen shot from the report I have for
Florida Hospital Tampa
3100 East Fletcher Avenue
Tampa, FL 33613
Telephone Number: (813) 971-6000
Hospital Website: www.elevatinghealthcare.org/locatio...
CMS Certification Number: 100173

What you are looking at in the below colored row is the CT without Contrast
The above hospital was paid on 1,362 claims by Medicare an average of $3,463!
Medicare KNOWS the hospital's average cost to perform the service is $57!
So if the costs the hospital reports is $57.. all that expensive equipment etc....per claim
and dividing $3,463 the hospital was paid on average by Medicare by the average of $57 cost.. 6,075%!!!!!

YOU tell me differently OK.. This information comes from this source:
Medicare OPPS claims data are for calendar year ending 12/31/2011.



Profile Definitions and Methodology

Outpatient Utilization Statistics by APC


All information in this report is taken from the Medicare Hospital OPPS Identifiable Data Set which is updated annually by CMS based on the service year (i.e. calendar year). The file includes hospital outpatient billing data for 100% of all Medicare fee-for-service claims for outpatient services provided during the twelve months ending December 31. The report is consistent with CMS Data Release policies.

Information is reported for the twenty Ambulatory Payment Classifications (APCs) representing the highest Medicare payment to the hospital. APCs are defined by the procedures performed according to definitions published by CMS for the corresponding service year.
A list of APCs is provided for reference.
Note that the Number of Patient Claims may be less than the Units of Service provided (i.e. one claim may include multiple units of service for a procedure).
Average Charges are based on both covered and non-covered charges for all accommodations and services (related to the revenue code) for a billing period before reduction for the deductible and coinsurance amounts and before an adjustment for the cost of services provided.
Average Costs are based on charges adjusted to cost using the hospital's specific cost center cost-to-charge ratio.

DO YOU KNOW UNDERSTAND how stupid,complicated,convoluted, DESTRUCTIVE Obamacare is IF right NOW Medicare agrees to a 6,000% Markup!!!

 

[NoTeaPartyPleez]

So people who have jobs and some sort of medical condition should not have that condition covered when they find a new job and get insured again? Sounds like a good way to bankrupt people.

No.

They should simply have to provide proof of being insured prior to buying a new policy.

The pre existing condition clause was actually a product of the greed of the consumer. Many would not buy health insurance unless they found they needed it. Such is why dental has the "6 month" clause...you cant use it for 6 months after you get a policy for emergencies such as root canal. Same as hurricane insurance. It does not go into affect for 30 days.

So it is simple....if you have insurance and want to change to another policy, the pre existing clause does not come into play.

Most polices covered preexisting conditions even without prior insurance, you just had to wait a few months to pay into the policy first.

Tell that to someone who discovers a suspicious lump on their body, or has bleeding in places where there should be no blood. Tell them they have to ******* wait to see a doctor so an insurance company can make money off of them. People who buy into their healthcare relying on corporate bottom lines and a board of directors are total idiots.

 

[Quantum Windbag]

That's why we need single-payer. Check out the Canadian system. It's a good example.

I have received medical care in Canada. And Mexico. And Chile. And I understand all too well why the World Health Organization ranks us 37th in the world.

Because you are just as stupid as they are?

The simple fact that any rational look at the health care system in those country ranks it as one of the best in the world. The US reports a lot of data that other countries do not report, including infant mortality rates that include premature babies that live for less than 30 minutes.

 

[thereisnospoon]

Some people seem to have a very strange view of what insurance companies do. They point to the problem of people who have a pre-existing condition, trying to sign up for new insurance, only to find the insurance companies won't pay for the the treatment for that pre-existing condition.

Of course they won't. That's not what insurance companies do. Whoever said they did?

Insurance is a gambling game where you bet on what will happen in the future. You "bet" that you will get sick or injured, and the company "bets" that you won't. If you get sick or injured, the company pays you the stipulated amount (paying for a portion of your medical treatment etc.), and if you don't, you pay them (premiums). The purpose is to shield you from the "shock" of suddenly and unexpectedly getting hit with huge medical bills... which is why you agreed to the contract.

A pre-existing condition cannot be insured against. It's like betting on the outcome of a horse race that's already been run - there is no "chance" involved, and no "unexpectedness" to the outcome (any more). Or like trying to get car insurance after wrecking your car.

Insurance companies are in the business of selling security - the assurance that you won't be suddenly bankrupted by huge medical bills, rehab bills etc. in the future. They do it by insuring huge numbers of people and getting them to each pay relatively small amounts (their premiums) each. They and their clients all know that most of them will never incur the huge medical bills they are worried about. But since no one knows which few people WILL incur them, they are all happy to pay the premiums, for the knowledge they won't have to pay the huge amounts if they turn out to be the unlucky ones.

Insurance companies sell safety from FUTURE possible disasters. And that's all they sell. Asking them to cover pre-existing conditions, is like asking a submarine designer to design a supersonic jet - it's got nothing to do with his business or his area of expertise, and he never volunteered to design jets in the first place, for good reason.

If you want to set up some kind of universal pool to pay for pre-existing conditions, fine, go ahead. But why drag insurance companies into it? It's got nothing to do with their areas of expertise, and they never volunteered to do it in the first place - for good reason.

Your comments and questions support the very reason why large corporate insurance companies should not be involved in health care in the first place. Everybody born on the face of this earth will need health care, from the day they are born til the day the die and many in between. It is not a matter of betting against "risk" unless you're a total ******* idiot and believe it should be.

Absolutely correct. Here is your other option. To seek medical care, bring cash, check or credit card.
No one is telling you that you must...uh oh....Well at least until 1/1/2014 ....buy and use health insurance.

 

[ScreamingEagle]

No.

They should simply have to provide proof of being insured prior to buying a new policy.

The pre existing condition clause was actually a product of the greed of the consumer. Many would not buy health insurance unless they found they needed it. Such is why dental has the "6 month" clause...you cant use it for 6 months after you get a policy for emergencies such as root canal. Same as hurricane insurance. It does not go into affect for 30 days.

So it is simple....if you have insurance and want to change to another policy, the pre existing clause does not come into play.

Most polices covered preexisting conditions even without prior insurance, you just had to wait a few months to pay into the policy first.

Tell that to someone who discovers a suspicious lump on their body, or has bleeding in places where there should be no blood. Tell them they have to ******* wait to see a doctor so an insurance company can make money off of them. People who buy into their healthcare relying on corporate bottom lines and a board of directors are total idiots.

but you're willing to change your healthcare from corporate control to government control......?

there is a third way.....YOU control your healthcare....