> Why is that inherently bad? Should I be able to buy fire insurance on pre-existing embers?
What if someone gets Type 1 diabetes as a child so they can no longer get insurance because of that "pre-existing" condition: if they get cancer for unrelated reasons they should just be saddled with medical debt? Or because of your Type 1 you can't get coverage, and you get t-boned in your car by a drunk driver.
Certainly it sounds 'unfair' that someone who smokes (a personal choice) gets similar cancer coverage for someone who does not smoke. But it also means that if your ((great-)grand-)mother had cancer, and you get it through no fault/choice of your own (i.e. genetics), you can also get coverage. (This latter effects a cousin of mine: her aunt (mom's sister) died of cancer at 37, her mom at 63; so now she's wonder when here number will come up. We're in Canada, so have universal care, but it's still something in her DNA.)
There are many circumstances in which you suffer through no fault of your own, and universal health coverage is present in many societies because it was decided to protect those people—even if it allows some 'free-riding' by others making poor choices.
People make all sorts of crazy decisions to prevent the "wrong" people from getting what they "don't deserve":
Pre-existing conditions also continue to frame healthcare as 'insurance' against a bad thing happening to you, when it should just be a regular service like any other.
You don't need 'insurance' in order to get your vehicle serviced, but that is what the US does with healthcare.
The most it will ever cost me to go from “not having a working car” to “having a working car” is the cost of used car that will reliably get me from point A to point B.
When one of my kids was 4, they had an unexplained seizure. Hospital workup, whole nine yards, never recurred; it was probably a medication reaction. Years later we were denied coverage from all the private insurers over it (more accurately: we were denied any coverage for that child).
Similarly, insurers would as a matter of course exclude from coverage any woman with one of several extremely common conditions, including endometriosis, PCOS, fibroids, and adenomyosis.
Prior to Obamacare, insurers were free to deny coverage wholesale for these conditions. It would have been fucked up to extend coverage but exclude any neurological conditions from my kid, but the actual outcome was worse: they were under the law entitled to withhold any coverage.
If you live long enough, you will have a pre existing condition.
The way it was suppose to work with the original mandate is that everyone had to be insured either through their employee or the exchange. So you couldn’t just buy insurance when you were sick. The Supreme Court struck that down.
If you lost your job, before the ACA, you could not get health insurance outside of working for someone and having group insurance at any cost.
But you do realize that the entire idea of not being able to get insurance because of pre-existing conditions is completely unique to the US?
Costa Rica for instance (where I am right now for a month and half) allows anyone to become a resident as long as you have guaranteed income of around $2000 a month or you deposit $60K into a local bank account and they arrange monthly disbursements and you pay 15% of your stated income to CAJA. Healthcare is both better and more affordable here.
The same is true for Panama. Why can’t the US figure this out?
It interacts badly with insurance being offered as workplace benefit. If you quit or lose your job, you'd lose your health insurance. And any plan you signed up for after that would then treat you as "pre-existing embers" and expect you to pay accordingly. The bundling of health insurance with workplace seems like the healthcare original sin to me.
Obama couldn't change that, so the ACA redesigned the system to work with it. Despite being called insurance, health insurance is no longer really viewed or designed to be any kind of insurance. Instead, it's supposed to be Netflix for healthcare. You pay a flat rate, and then get unlimited healthcare. Obviously, the issue with this is that if you don't need healthcare you can just not sign up for the subscription. So the ACA tried to solve this by requiring everyone to sign up. Once everyone is required to sign up, it's not right to discriminate against preexisting conditions. It may not be an especially good system, but it is coherent.
The US is allergic to taxes. Maybe it's a marketing thing. Benefits paid for by society.
Maybe a department of Return on Investment. See what those taxes pay for. Contrast to buying private versions of the services at the same SLA or better.
It’s more that the US is more like a collection of 50 little countries, and it’s supposed to be hard to accomplish much at a federal level. That separation has eroded a bit in the last 50 years but it’s still very much a part of our political ideology.
it's bad for the person, obviously. The point of society-wide policies is not to maximize economic efficiency; they're supposed to making society a good place to live. Of course if you only look at them under an economic lens they're going to seem bad. Economically the best policy would be to kill all the sick people.
We as a society accept the insurance system as an implementation of "funding healthcare" because market capitalism is supposed to lead to lower prices, fair allocation of scarce resources, and innovation, among other things. That is, the insurance industry is a market solution to a moral problem.
If insurance companies then can wiggle out of covering pre-existing conditions, they're no longer solving the moral problem they were brought into the world to solve, and now we need some other solution to solve the rest of it. Then, whatever that other solution is, it's solving the hard part, so why not extend it to solve the whole thing and cut the insurance middlemen out of the economy entirely? What are they even doing at that point besides extracting a rent?
(This is one answer among many good ones to what is really a bad-faith question—health-insurance is not a lot like fire-insurance at all)
> Why is that inherently bad? Should I be able to buy fire insurance on pre-existing embers?
What if someone gets Type 1 diabetes as a child so they can no longer get insurance because of that "pre-existing" condition: if they get cancer for unrelated reasons they should just be saddled with medical debt? Or because of your Type 1 you can't get coverage, and you get t-boned in your car by a drunk driver.
Certainly it sounds 'unfair' that someone who smokes (a personal choice) gets similar cancer coverage for someone who does not smoke. But it also means that if your ((great-)grand-)mother had cancer, and you get it through no fault/choice of your own (i.e. genetics), you can also get coverage. (This latter effects a cousin of mine: her aunt (mom's sister) died of cancer at 37, her mom at 63; so now she's wonder when here number will come up. We're in Canada, so have universal care, but it's still something in her DNA.)
There are many circumstances in which you suffer through no fault of your own, and universal health coverage is present in many societies because it was decided to protect those people—even if it allows some 'free-riding' by others making poor choices.
People make all sorts of crazy decisions to prevent the "wrong" people from getting what they "don't deserve":
* https://en.wikipedia.org/wiki/Dying_of_Whiteness
Pre-existing conditions also continue to frame healthcare as 'insurance' against a bad thing happening to you, when it should just be a regular service like any other.
You don't need 'insurance' in order to get your vehicle serviced, but that is what the US does with healthcare.
The most it will ever cost me to go from “not having a working car” to “having a working car” is the cost of used car that will reliably get me from point A to point B.
I can’t say the same about health care
When one of my kids was 4, they had an unexplained seizure. Hospital workup, whole nine yards, never recurred; it was probably a medication reaction. Years later we were denied coverage from all the private insurers over it (more accurately: we were denied any coverage for that child).
Similarly, insurers would as a matter of course exclude from coverage any woman with one of several extremely common conditions, including endometriosis, PCOS, fibroids, and adenomyosis.
Prior to Obamacare, insurers were free to deny coverage wholesale for these conditions. It would have been fucked up to extend coverage but exclude any neurological conditions from my kid, but the actual outcome was worse: they were under the law entitled to withhold any coverage.
If you live long enough, you will have a pre existing condition.
The way it was suppose to work with the original mandate is that everyone had to be insured either through their employee or the exchange. So you couldn’t just buy insurance when you were sick. The Supreme Court struck that down.
If you lost your job, before the ACA, you could not get health insurance outside of working for someone and having group insurance at any cost.
But you do realize that the entire idea of not being able to get insurance because of pre-existing conditions is completely unique to the US?
Costa Rica for instance (where I am right now for a month and half) allows anyone to become a resident as long as you have guaranteed income of around $2000 a month or you deposit $60K into a local bank account and they arrange monthly disbursements and you pay 15% of your stated income to CAJA. Healthcare is both better and more affordable here.
The same is true for Panama. Why can’t the US figure this out?
>If you lost your job, before the ACA, you could not get health insurance outside of working for someone and having group insurance at any cost.
This is a flat out lie. You absolutely could buy health insurance without being at a company.
Not if you had a pre-existing condition - the entire point of this thread.
It interacts badly with insurance being offered as workplace benefit. If you quit or lose your job, you'd lose your health insurance. And any plan you signed up for after that would then treat you as "pre-existing embers" and expect you to pay accordingly. The bundling of health insurance with workplace seems like the healthcare original sin to me.
Obama couldn't change that, so the ACA redesigned the system to work with it. Despite being called insurance, health insurance is no longer really viewed or designed to be any kind of insurance. Instead, it's supposed to be Netflix for healthcare. You pay a flat rate, and then get unlimited healthcare. Obviously, the issue with this is that if you don't need healthcare you can just not sign up for the subscription. So the ACA tried to solve this by requiring everyone to sign up. Once everyone is required to sign up, it's not right to discriminate against preexisting conditions. It may not be an especially good system, but it is coherent.
The US is allergic to taxes. Maybe it's a marketing thing. Benefits paid for by society.
Maybe a department of Return on Investment. See what those taxes pay for. Contrast to buying private versions of the services at the same SLA or better.
It’s more that the US is more like a collection of 50 little countries, and it’s supposed to be hard to accomplish much at a federal level. That separation has eroded a bit in the last 50 years but it’s still very much a part of our political ideology.
it's bad for the person, obviously. The point of society-wide policies is not to maximize economic efficiency; they're supposed to making society a good place to live. Of course if you only look at them under an economic lens they're going to seem bad. Economically the best policy would be to kill all the sick people.
We as a society accept the insurance system as an implementation of "funding healthcare" because market capitalism is supposed to lead to lower prices, fair allocation of scarce resources, and innovation, among other things. That is, the insurance industry is a market solution to a moral problem.
If insurance companies then can wiggle out of covering pre-existing conditions, they're no longer solving the moral problem they were brought into the world to solve, and now we need some other solution to solve the rest of it. Then, whatever that other solution is, it's solving the hard part, so why not extend it to solve the whole thing and cut the insurance middlemen out of the economy entirely? What are they even doing at that point besides extracting a rent?
(This is one answer among many good ones to what is really a bad-faith question—health-insurance is not a lot like fire-insurance at all)
Because people aren’t objects.