Pregnancy + domestic violence = pre-existing conditions?

[Amelia]

If it's true that some health insurers count pregnancy, C-sections and domestic violence as pre-existing conditions (this sounds unbelievable!), why are people (including women) voting against health reform? It makes no sense.

SEN. PATTY MURRAY (D), WASHINGTON: ...What I believe is that, if you are a citizen of the United States of America, you should have the ability to buy health- care insurance. You shouldn't be denied health-care coverage because you're a victim of domestic violence or you are a woman who have had a C-section or a pregnancy. I mean, these are pre-existing conditions. Surely in this country, we should provide some protections to all Americans, and women in particular.
http://transcripts.cnn.com/TRANSCRIP...06/cnr.05.html

ANGIE HOLAN, POLITIFACT.COM: ...Well, pre-existing conditions are pretty much any illness that someone may have when they have to switch insurance. We looked into this on the issue of pregnancy. Sometimes pregnancy is a pre-existing condition. Now, I should say if you have insurance through a large employer and you're moving to another employer, usually there's no problem. The problem is when you go into what's called the individual market. And you have to buy insurance on your own. Then these pre-existing conditions can exclude you from coverage. The new legislation proposes to say that they can't do this, that they must accept everyone regardless of preconditions.
http://transcripts.cnn.com/TRANSCRIP...22/cnr.07.html

[UltraShy]

I heard about the C-section thing on the news last night. The reasoning is that women who've had one are more likely to have another baby via C-section, which will cost the insurance company a pile of money. Is this discriminatory? I guess, but then discrimination isn't new to insurance and it doesn't apply only to woman.

Consider the following:

-A 55-year-old man is going to pay considerably more for life insurance than a 55-year-old woman. Why? Because he's statistically more likely to die sooner than she will.

-Health insurance rates for women are higher earlier in life, but that changes around 50 (menopause) where men are now the higher health risk.

-Auto insurance. Teen boys are charged higher rates than teen girls. Why? Because statistically teen boys on average drive even worse than teen girls, doing crazy things like personally checking what's the top speed on the family car. All teens are charged more than I am, because they figure after 20 years of driving I'm going to drive much better than someone who's been driving for a month. The charging of males more for auto insurance continues well into adulthood. They even charge young males more if they are not married.

The issue with pre-existing conditions is that some people would game the system if coverage for pre-existing conditions was not excluded for a certain period of time (like 9 months in the case of pregnancy). For example, one might magically decide they desire insurance right after peeing on a stick indicates she's pregnant. She immediately buys insurance and then decides she doesn't needs to waste money on insurance premiums as soon as she's had the baby and has fully recovered. Please don't consider me sexist for using a female in the example. Obviously, men can just as easily figure out how to game such a system by buying insurance only when he's feeling sick and then dropping it as soon as he recovers.

One problem with making insurance companies take everyone is that it does lead to higher rates. People who were previously either priced out of the individual insurance market or denied coverage outright due to conditions they had will now be getting the same rates as everyone else. Clearly rates will rise if you toss in AIDS patients along with people who are as healthy as could be. Problem: the higher rates that result will further encourage those who are young & healthy to avoid insurance coverage (something plenty already do to save money).

The only way I see to avoid this problem is to make everyone buy insurance. Of course, the concept of being forced to buy health insurance isn't compatible with the concept of freedom.

Just some thoughts of mine.

[BlueBamboo]

I don't think there are too many people who are against the idea of "health care reform", it's the specific kind of reform being discussed that they are against. I personally agree with only parts of the government's current reform ideas... considering that they don't have any money at the moment (printing more doesn't count), I think they should be focusing on things that don't actually cost them any money - for instance creating a law that all insurance companies are required to extend coverage to continuously insured people regardless of pre-existing conditions. I could be wrong but I think some states have laws like this, actually. And group coverage already works this way.

This would mean that I can't be denied insurance with a new company for, say, having some kind health problem that'll eventually require surgery to fix (because they don't want to pay for it), but I can't pick up health insurance out of the blue, get the surgery, and then drop it again either (because I don't want to pay when I'm not 'using' it).

Originally Posted by UltraShy

The only way I see to avoid this problem is to make everyone buy insurance. Of course, the concept of being forced to buy health insurance isn't compatible with the concept of freedom.

Curious... does this mean you're for or against the idea?

I am for it based on the idea that you not having health insurance can (and most likely will) have negative affects on other people, and while you may be at perfect liberty to screw your own life over it's not fair that other people get dragged into it. Rather like being required to have auto insurance in case your bad driving causes you to damage somebody else's car in addition to your own. But I think that's a discussion for another thread...

[UltraShy]

Originally Posted by BlueBamboo

Curious... does this mean you're for or against the idea?

I intentionally made only factual statements and avoided taking a stand one way or the other because I don't know what to say. Group insurance works because a big company doesn't suffer from adverse selection as exists in the individual market. If you work for XYZ company you get insurance from them and you pay the same whether you're the healthiest person around or if you have AIDS and need to consume $20,000 worth of pills each year just to stay alive. Group insurance works because everyone in the company is part of it. Individual insurance doesn't work, in part, because those who are sick are the ones most likely to want it, while the healthy say the hell with paying outrageous premiums.

I could accept the concept of being required to buy insurance if I could buy insurance on my terms. I'd want a high-deductible policy (like $10,000) to keep costs down. I don't need nor want what has effectively become pre-paid medical care when one gets ridiculously low deductibles like $250. Insurance is to protect one from disaster, not fully expected medical expenses.

Originally Posted by BlueBamboo

I am for it based on the idea that you not having health insurance can (and most likely will) have negative affects on other people, and while you may be at perfect liberty to screw your own life over it's not fair that other people get dragged into it. Rather like being required to have auto insurance in case your bad driving causes you to damage somebody else's car in addition to your own. But I think that's a discussion for another thread...

Could you please clarify your above statement. I bolded the part I found unclear. Does "you" specifically refer to me or to the population in general? My medical bills would have to top $1M before I'd have burned through enough money to qualify for Medicaid, so I don't present much of a risk to the general population.

As a side note, if anybody hits you with a car, you'd best hope they are as insured as me with liability coverage of $2M. As for the $6,000 car I drive, well, I'll be out $6,000 if I total it.

[BlueBamboo]

Could you please clarify your above statement. I bolded the part I found unclear. Does "you" specifically refer to me or to the population in general? My medical bills would have to top $1M before I'd have burned through enough money to qualify for Medicaid, so I don't present much of a risk to the general population.

I meant a general "you", mostly people who insist that they shouldn't have to buy medical insurance if they don't want it because it only affects them (which is not true). Sorry for the confusion.

I actually think the whole idea of employer-sponsored group insurance should be done away with... I don't see why an employer should be responsible for selecting and directly paying for employee's health plans, I don't see why employees should be subject to their employer's whims in such (for instance I too would like a high-deductible plan but my employer does not offer one), and I don't see why people across the country with the exact same age, level of health, and so on, should pay more or less for exactly the same coverage based solely on how many other people work at their company. It makes more sense to me to put everybody on individual plans, with every customer at one insurance company lumped into one big risk pool. This is one of the big pros I always hear about for having a single government-run insurance, but I don't see why it can't be applied to private insurances as well.

[slaughter in the vatican]

The insurance companies make me sick. I've seen how they treat people. It's disgusting.

And now they're going to do whatever they can to stop reform. Large, multinational corporations control the government.

It's scary in a way too real kind of way.

[UltraShy]

Originally Posted by BlueBamboo

I actually think the whole idea of employer-sponsored group insurance should be done away with...

I fully agree. Linking health insurance and employment is a stupid idea that should have died long ago. As I understand it, it's a creation of long ago during a time when wages were frozen by the government and to effectively increase pay to workers they tossed in goodies like health insurance instead of cash.

Obviously, there is no logic whatsoever in having health insurance & work linked. It's as stupid as linking auto insurance to your employer, but we've gotten so used to employers providing health coverage that we no longer notice how exceedingly stupid it is.

The market for individual insurance policies is tiny because the vast majority either get their insurance from an employer, spouse's employer, the government (Medicare & Medicaid) or have no insurance at all.

I'd love to see a large & robust market for individual policies, but it's never going to happen as long as employers are the ones expected to provide insurance. I'd love to see a free market where huge pools of millions of individuals get to buy the insurance they actually want. If somebody wants high premiums for a dinky $100 deductible, great for them. If I'd rather have a $10,000 deductible and a vastly lower premium since they'd pay out zero in claims most years then I could have what I want (I think there is only one year out of my 36-year-life that could have topped $10K adjusted for inflation to 2009 dollars).

[millenniumman75]

subtle

[TiMeZuP]

Originally Posted by UltraShy

I'd love to see a large & robust market for individual policies,).

If that were the case....I wonder if we would be even having this debate on health care right now. If people had to buy individual health insurance plans just like car insurance, I wonder where health care would have gone......

No one likes insurance. But REALISTICLY now, is anyone really that dissatified with there car insurance policy? I have been in the past. Since I've been able to shop around, I been able to get better auto policy at a lower rate.

I like what obama is doing I really do.

But it would have been nice to see employers not providing health care and have EVERYONE buy there own individual policy. You'd really start to see some competition in the health care insurance market.

The current platform is no better or worse then what the government is going to provide.

[UltraShy]

Originally Posted by slaughter in the vatican

Large, multinational corporations control the government.

Unlike the utopian reverse where huge govenment controls everything. Works so well in Cuba & North Korea.

[Kelly]

Originally Posted by UltraShy

Unlike the utopian reverse where huge govenment controls everything. Works so well in Cuba & North Korea.

Clearly, we can have either one or the other.

Have a nice day,
Kelly

[UltraShy]

Originally Posted by Kelly

Clearly, we can have either one or the other.

Have a nice day,
Kelly

Kelly, the reason we have huge corporations buying political influence is because there is so much of it to be purchased. We have a huge government that regulates seemingly every aspect of life in one way or another. I'd advocate a much smaller government that simply isn't worth buying.

I know you're not accusing me of this, but for the benefit of others: I very strongly oppose corporations having undue influence over government. Government should not be for sale to the highest bidder and just like most people I'm disgusted by how huge corporations make huge donations to BOTH parties. They don't play favorites, as they want to buy favors regardless which side wins.

[Amelia]

Originally Posted by UltraShy

I very strongly oppose corporations having undue influence over government.

Didn't Obama say that he was going to do away with this?

[slaughter in the vatican]

So are you actually saying that we should have no regulation of the insurance and banking industry? What about Wall Street? How well do you think that would work? How well has that worked in the past?

It's not just that corporations are "donating to both parties", they actually write the law. No, I mean they literally have their lawyers write the legislation and give it to congress to have it passed. This small group of extremely wealthy people--who were not elected to any public office, have more power then congressmen and senators.

Wealthy US corporations have also overthrown democratically elected leaders in Central and South American countries. Have even worked with the CIA to assassinate some of these people; to jail, torture, and kill students, labor unionists, and other dissenters. Sadly, this kind of thing has also happened right here in America.

Whether it's oil companies paying off the EPA to hide data and derail climate change regulation, or large pharmaceutical companies paying FDA scientists to allow doctors to give children and the elderly dangerous, debilitating drugs...I guess it comes down to a "right to kill" kind of issue.

If you have money and power, should you be able to do whatever you want? Do we actually have rights anymore? Why do we keep electing politicians when almost all of them are bought and paid for? Can you really call it democracy anymore?

[UltraShy]

Originally Posted by Amelia

Didn't Obama say that he was going to do away with this?

I don't know, but like all other successful politicians he made a ton of promises that he could never deliver on. I'm not suggesting any others could perform magic and make good on all the pie in the sky promises that are made during a political campaign either.