Pre-existing conditions?

[Sooner5030]

Scenario A: 5030 is currently paying health insurance premiums to ACME Health and has an injury or health problem that requires surgery, rehab and prescription drugs that will cover a 6 month period. 5030 changes jobs after the surgery (pre-completion of rehab and drugs) and also changes to another Health Care plan. His new health care plan denies coverage based on “pre-existing conditions” and he has to pay out of pocket for all services post change of plan.

Scenario B: 5030 doesn’t have health insurance as he is a healthy sonbiatch. But one day he is injured or discovers a health problem that requires surgery, rehab and prescription drugs that will cover a 6 month period. He then quickly joins a health care plan so he can get coverage for his preexisting conditions.

I could support scenario A where either the losing or gaining insurance plan should cover the costs as long as there is no break in coverage.

However if what we are really talking about is folks opting not to pay premiums until they get sick then the entire “pre-existing conditions” thing seems like a sham. You didn’t pay premiums (into the risk pool) but you want that pool to cover your cost.

meh

[texaspokieokie]

that's like buying car insurance after you have a wreck.

doesn't make sense to me.

[OUHOMER]

yep B would be a sham. A: would not be bad, because they will get their premiums after the 6 month cover and healing is over.

Now if it was a cancer they are screwed possibly

[Sooner5030]

As one of the more popular parts of the new Health Care law I wonder why more folks/media have not drilled down the pre-existing conditions portion to splain the details.

[OUHOMER]

I bet the insurance companies get together and figure a way to share the cost of pre-existing conditions.

I also think depending on the condition, the price will be very high for the insured. They have to be covered, but it did not say at what cost.

PLUS IT WILL BE MANDATORY !!!!!!!!!!

[jkjsooner]

Actually this is directly related to the requirement that everyone has health insurance. For obvious reasons congress did not want people to wait until they are sick to get health insurance.

They put in the fee as a disincentive for those who would choose to wait until they're sick. One problem was that the fee was lowered so low that there is still an incentive to wait until you're sick.

Most of these problems with the health care reform were results of compromises. Democrats originally wanted universal healthcare which would have been a whole different ballgame.


As for your first scenario, it's a problem. In fact the change of insurance might not even be your choice. You might be forced to change your job or, quite likely, your job might change their insurance provider. Hell, mine has done so about 4 times.

Also, at some point kids are no longer allowed under their parent's insurance. If they have serious conditions going back to their childhood they're screwed by no fault of themselves or their parents.

Even if the health care reform is completely overturned (and I agree that the preexisting condition part was flawed at best) there still needs to be preexisting condition reform. If someone shows an attempt to remain insured (which can be defined by law) then there should be no preexisting condition rule. You can write the law in a way that is flexible, protects the insured, prevents abuses, and would not result in skyrocketing insurance costs.

[sooner59]

Another thing to add to the scenarios is what my mom had to deal with when she was diagnosed with Lupus was the type of coverage. She had health insurance, but it didn't cover enough to meet her medical needs. Then she had to "medically retire" from her job because it got too bad for her to work. She needed better insurance to cover her needs, but because she had Lupus, most insurance companies either refused to cover her or wanted to charge an outrageous amount of money for premiums that she couldn't afford, especially without a job living on disability. She is covered, but her bills are still crazy.

[hawaii 5-0]

I know an American I grew up with in Oklahoma who is stuck in Ireland. She has ovarian cancer and can't get coverage here in America.

5-0

[SoonerNate]

that's like buying car insurance after you have a wreck.

doesn't make sense to me.

Exactly.

[Serge Ibaka]

It's funny because in our country you're allowed to profit because of other peoples' illnesses and suffering.

Except it's really not that funny, and it kinda sucks.

[picasso]

It's funny because in our country you're allowed to profit because of other peoples' illnesses and suffering.

Except it's really not that funny, and it kinda sucks.

You mean by treating one's illness or covering said care for them? How awful.

[texaspokieokie]

It's funny because in our country you're allowed to profit because of other peoples' illnesses and suffering.

Except it's really not that funny, and it kinda sucks.

if everyone got sick @ once, there'd be no profit.

profit comes from LACK of illnesses.

[Caboose]

It's funny because in our country you're allowed to profit because of other peoples' illnesses and suffering.

Except it's really not that funny, and it kinda sucks.

You mean like doctors and nurses and labs that invest millions upon millions of dollars into researching new treatments, cures, medications, and medical equipment? Yeah, it just sucks that they have a financial incentive to do what they do. We should make it to where they don't profit so they will go do something else and stop wasting society's resources with such silly and selfish sh!t like "medical breakthroughs".