Practically Speaking
Kyle and her husband moved to Brookfield in 1986. She became active in local politics and started blogging in 2004. Her focus is primarily on local issues but often includes state and national topics, too. Kyle looks at things from the taxpayers' perspective in a creative, yet down to earth way, addressing them from a practical point of view.
Pre-existing conditions: Could any insurance company stay solvent this way?
One of the many things Obamacare Health Care reform promises to correct is eliminating the pre-existing condition exclusion from private health insurance policies. As I understand it, Obamacare will force all insurance companies to cover pre-existing conditions without increasing their premiums. (Page 18, lines 4 - 23 of the Baucus Senate Finance Committee bill, a pdf of all 1,502 pages of the bill.)
Another Obamacare mandate is that all Americans must carry health insurance whether they want it or not. If they do not obtain health insurance, they will be fined or taxed, initially at a rate of $200 during the year 2014 phase in period, on up to $750 in year 2017. (Page 197, lines 2 -6 of the bill)
So during the year 2014 phase-in period, some people might be tempted to not enroll in any health insurance plan. After all, under Obamacare rules, if they get sick, they just pay the $200 fine and then they can get health insurance.
How on earth could any insurance company offer that kind of coverage?
Let's just look at homeowners insurance. Wouldn't you like to eliminate your yearly premiums and not worry about a tree falling on your home or worse yet, a catastrophic total loss due to fire? If homeowners insurance followed Obamacare rules, all you would have to do is pay that $200 tax/fine and then get full coverage!
What about auto insurance? Don't bother to insure your cars, just drive uninsured. Get in an accident? Just pay the fine and get your car repaired and your insurance company will pay for damages and liability. Or, drive like a maniac, rack up accidents and tickets without worry you will be dropped or charged more.
Nice, eh?
Obviously, doing business that way, no insurance company could remain solvent for long, without raising it's premiums drastically. Yet, that is pretty much how Obamacare Health Care reform is set up in it's present state.
Maybe that is the whole idea?
Only government can offer coverage like that without solvency worries. (The government just increases taxes, fees and the deficit to cover losses.)
Unlike driving recklessly, sometimes we get sick through no fault of our own. So how do health insurance companies handle pre-existing conditions?
Stay tuned for the next installment: About those pre-existing conditions.
Links:
Brookfield7, Fairly Conservative, BetterBrookfield, Vicki McKenna, Jay Weber, The Right View Wisconsin, Randy Melchert, Mark Levin, The Heritage Foundation, CNS News, Breitbart BigGovernment
14 COMMENTS
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When someone else is paying the bill, the consumer tends to be less frugal in making their selection of product. Another example would be per diem allowances. Who is going to spend more on lunch? The person paying out of pocket or the person with a per diem allowance?
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My apologies for some of the wording in my previous post. I did not mean to imply that insurance costs are the sole reason for high medical costs. Obviously, there are other factors at work there. - DC
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Where does the extra $100 go after this root canal? Does it go directly to the endodontist? Then I can understand why she would not want reform. It's just another reason to get rid of INSURANCE COMPANIES and enact HEALTH CARE. Why would you or anyone want things to stay the same if the very businesses you are fighting to keep are the reason for our high medical costs?
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CarpieD, you are missing the point. When the consumer is able, or must shop price, prices stay lower. When the consumer has no idea how much things cost, and it is covered, prices rise. Insurance separated the purchaser from the price tag.
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I never mentioned excessive profits, only that people were getting rich off not denying claims and coverage. Nor did I say a govt law mandated employer-provided HEALTH insurance. Workers comp, unemployment ins, etc. are examples of the gov't doing well for employees that emploers would never do on their own.
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CarpieD, Obamacare is not health care reform, it's just a way to take over the health insurance industry. Those excessive profits you talk about amount to around 6% most years, 3% this year. Health care facilities profits are up around 28% yet they are not dealt with in health care reform like insurance providers.
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Jeeziz cripes...
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By the way, you guys won. You can pass anything you want. Republicans aren't standing between you and your government healthcare program. When it goes south there will be absolutely no doubt about how this got started; who gave us rationing and substandard care. But this should curtail the influx of foreigners coming to the US for the beat care.
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If you think a federal takeover means you won't be denied service you are dreaming. Maybe you will feel better when the excuse is not "BS" but rather a simple "you aren't worth the cost". My goodness, so many people looking for a government handout. And so trusting, too. Like I said, we all have an opinion. I just don't want to hear any whining when you can't get what you want. If I'm wrong about this being a disaster for healthcare and our economy I will freely admit my mistake. Once again, we'll all see in a few years so the discussions we have now are purely academic.
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Think of all the aspiring doctors who will change their career paths now that the government will force them to deny services to people in need based on what some "czar" has to say. Perhaps they'll give up being compassionate caregivers and just become Wall Street republicans.
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Load more comments View all comments Back to topKyle Prast - Nov 01, 2009 4:09 PM - Report Abuse
Whether the payer is the insurance company or the government, they both separate the consumer from shopping price. I would like health care insurance reform to address incentives for shopping price or using less services like my longterm care insurance plan does, but that is a whole different subject.
CarpieD - Oct 30, 2009 1:39 PM - Report Abuse
CarpieD - Oct 30, 2009 1:36 PM - Report Abuse
The body shop is, to me, a bad analogy. I have had several cars need body work after accidents. Most of them were worked out between the insurance companies and my body shop before I even saw a claim form. (None of which were my fault. Honest.)
Currently, if I pay for ANY insurance, I expect things to be covered and paid for. But that is not always the case. When everyone has access to the same HEALTH CARE, no matter their respective conditions, we will be a better nation.
Kyle Prast - Oct 30, 2009 10:56 AM - Report Abuse
Example: If my car insurance company covers body work, will I shop for the cheapest shop or go with anyone I want regardless of price? If the body shops know that my insurance company is paying the bill, will they make it the leanest profit margin or go for a more plush margin?
Another example: A root canal paid for by insurance cost $100 more than the same procedure privately paid for.
CarpieD - Oct 30, 2009 9:32 AM - Report Abuse
Other countries have national HEALTH CARE plans, not insurance.
You said: "If there was no such thing as health insurance today, I doubt prices would be as high as they are." A perfect reason to eliminate it and provide HEALTH CARE, not insurance.
Kyle Prast - Oct 28, 2009 6:51 PM - Report Abuse
I grew up without health insurance. My family paid for surgeries and the few doctor visits we needed out of pocket. If there was no such thing as health insurance today, I doubt prices would be as high as they are.
What government enacted law is there calling for employer provided health insurance?
CarpieD - Oct 28, 2009 3:47 PM - Report Abuse
Not everyone is looking for a government "handout." Most are looking for affordable coverage that will not exclude them for some reason other than to make more and more money for shareholders. What is so difficult to understand?
I will argue that republicans ARE standing in the way. If they weren't, this would have been done long ago, bipartisanship be damned. The whole strategy has been to stall so that fearmongering can take over. "Death panels", "rationing", "doctors leaving their practices"; nothing but false red herrings tossed about by the likes of Limbaugh, O'Reilly and Beck, (constantly repeated here and elsewhere) with very little correction from the true republican leadership.
Many of us have the foresight to look beyond the naysayers and see some true good come from all of this. A history lesson: most employer-provided insurance would never have come about if not for the government enacting laws calling for it.
It's can't ALWAYS be about money.
chkursix - Oct 28, 2009 1:12 PM - Report Abuse
chkursix - Oct 28, 2009 12:57 PM - Report Abuse
CarpieD - Oct 28, 2009 12:36 PM - Report Abuse
For the party of "no" to suggest that some people deserve better health care than others, in many cases, is no different than deciding who lives or dies. Who's the real "czar" in this case.
We all pay for health care now, whether it's through high taxes or high premiums. In any case it's legalized gambling (or at worse, extortion.) At least if the feds take it we know that we won't be denied services for some BS excuse.
I think I see Dick actually saying that people deserve to be treated the same no matter what their situation.