Health care – existing condition clause

[narwhalParticipant]

I’m curious to see what you all think about this line of thinking.

For those who may not know. One of the things that the current US healthcare system brought in, or at least made universal, was existing condition clause. This means that a person attempting to buy insurance turned away because of an existing condition. As a consumer, you’d absolutely want this.

From a business perspective though, it makes no sense whatsoever. Medical insurance makes money by betting that you will have lower expenses then your premiums, while the consumer is betting that they will be higher, or at lest even. So you have a pre-existing condition, something that requires regular drugs and office visits, there is no gamble on this. It’s a known factor that your costs will be greater then your premiums.

So in reality, if you have preexisting conditions, or guaranteed costs, a consumer using the pre-existing condition clause is really asking someone else to pay a portion of their medicals bills while contributing nothing to the insurance company or their other customers. You aren’t buying insurance, you are sucking from the system.

With that said, I think there are different cases of pre-existing conditions. If you are medically unable to work, I don’t think you need insurance, you need welfare…and there is absolutely nothing wrong with that. However, if you’re like me with hypertension, it makes more sense for me to pay for maintenance drugs out of my own pocket, while insured based on the risk of unexpected costs.

I think part of the problem with medical insurance is that we don’t call it what it really is. You buy car insurance for what might happen. Guaranteed costs like oil changes and gas are not included. Yet we expected medical insurance to cover costs we know are going to happen.

And, returning back to myself as a an example, I really wish my maintenance drugs were not covered. It would allow me to consider cheaper alternatives, and be more motivated to look for actual solutions to my hypertension then just continually masking symptoms.

Ok. Then do it.

[TattooDaveParticipant 6952]

Anything guaranteed by government is subject to withdrawal at any time. There is never been a law which serves the people that has not been corrupted.

I wish the new Administration well with this problem. The prior problem involved an mit social engineer

I can see their heads have been twisted and fed with worthless foam from the mouth. Bob d

[PistolPeteParticipant 27143]

Try Losartan–works wonders for me. OK AND when I went on disability and stopped working as an attorney—that took 20 points off my blood pressure.

The good news, and I know this from experience, strokes are painless, but if you survive a stroke the aftermath sucks.

I agree about the insurance, it is a gamble for the insured and the insurer. They are gambling you won’t get sick and you are gambling you will. In the end everyone gets sick sooner or later.

[narwhalParticipant]

PistolPete wrote:

Try Losartan–works wonders for me. OK AND when I went on disability and stopped working as an attorney—that took 20 points off my blood pressure.

I am on that and another maintenance drug who’s name is slipping from me. I want to say it’s hyzaar, but I get the names confused. And yes, it does work for me.

When I had my vasectomy back in December, I had to go off of these blood thinners a couple weeks in advance. Going in for the operation, they took my BP first, and surprisingly it was still good. It occurred to me a couple days later that the reason might be because I’ve been taking MSM supplements lately.

And this is exactly the scenario I was talking about. Because my drugs are cheap, because no Dr is going to take me off these drugs without an act of god in order to cover their ass, I find myself unmotivated to really look to see if I can ‘fix’ the problem. Yes, it’s mostly my lazy ass that’s the problem, but changes would certainly help. I should be testing my self daily and see if MSM can really make a difference…but I am not.

Ok. Then do it.

[Faust For ScienceParticipant 22531]

Here is what is going on.

Trump and the republicans what to get rid of obamacare in the way that the least politically damaging to them.

The democrats either want to save obamacare or make sure obamacare is repealed in the most politically damaging way for Trump and the republicans.

Trump and most of the republicans are open to saving two provisions within the obamacare. One is the pre-existing condition clause. The other clause is the family prevision until the “child” is 26 years old. The democrats are against this partial repeal because it will make the republicans look good.

I have read on a couple of forums that the republicans already have a 185 page replacement plan for obamacare.

Now, the press have been spreading rumors that Trump is all over the map on obamacare. This is disinformation.

Trump has kept his card hand close to his chest with him only stating he want to repeal obamacare in the least painful way for the American people, while repealing it would remove the pain for much of the american population, so obamacare has to be repealed one way or another.

[Anonymous 11]

Either Obamacare gets repealed in a controlled manner, or it collapses on its own accord.

One of my nieces is dropping coverage for her entire family this year due to not being able to afford the premium on a simply horrible policy. Basically, it pays nothing while she pays the equivalent on a mortgage for a $200K home. Her internist asked if she were dropping insurance and then quoted his cash rate. I’m thinking a lot of people are dropping coverage this year.

I don’t even know what kind of goal seeking they are using to claim more people have coverage. Everyone I know who had no insurance prior to the ACA still has no insurance. Everyone I know who has insurance pays way more for far, far less. The one guy I know who partook of Obamacare got burned to the tune of $15K. It’s not self-employed friendly at all.

[Sky-OParticipant 18936]

Obamacare (Affordable Care Act) resulted in only 20 million more people in the US having coverage that previously did not have health insurance.

But the problem is, they are all subsidized in order to have it.

And the plans they have are plans they cannot actually afford. The kind with $12k annual deductibles.

With the average income of someone in the US being $26,580 a year (before taxes) – Anyone that has a serious medical problem within a calendar year and has to pay a $12k deductible related to care, is out half of their annual income for that year.

It’s not insurance. It’s a scheme to ensure economic slavery.

[narwhalParticipant]

Really, they should stop calling it medical insurance. It’s not really insurance anymore.

About a month ago, my daughter had to spend 2 nights in the hospital because of leg pain she was having that could have been something serious. It turned out not to be serious, at least so far since I have yet to hear a diagnosis. However, the bill came in at over $10k. ‘Insurance’ is paying for the majority of it, but it makes me wonder…

How much is the actual cost and how much is the insurance company actually paying?

How much is inflated in order to cover costs of those who cannot pay?

How much is inefficiency in the hospital administration due to lack of actual free market capitalism?

Of the tests she had done, which would we have not have done (like x-rays) if we were told costs upfront and had to pay specifically for the test?

I am lucky in that I’ve always had relatively good insurance. I understand that there is a element of humanity that compels us to pay for others medical expenses. However, there is also an element of humanity that says that you should not demand others pay for your own medical expenses when you refuse to do so yourself.

Ok. Then do it.

[BeerParticipant 11832]

Our entire system is butt f~~~ed. I had a dog a while back that was messed up and needed some x-rays. I think it was like 60 buck a shot. Fair enough since it took the time of a vet and an assistant, probably a rather expensive machine, plus overhead…I don’t expect stuff like that to be free. A couple years later I messed up my foot and had to get an x-ray to see if I broke anything more than a couple toes, and it was 500 dollars for one x-ray.

Basically the same x-ray machine, and it only required a doctors assistant vs the two people it took for my dog as one had to hold her while the other worked the machine. Why such a huge difference? Why are medicines so ridiculously priced here compared to every other country in the world? If drug companies are selling to Canada for half price, they can obviously sell drugs for half price and still make money, otherwise they’d be telling other countries here is the price take it or leave it. I’m all for companies making profits…but we currently pretty much have a handful of large pharm companies that pay the government off so they can legally price gouge, then turn around and buy up all the competition.

Its just a total f~~~ing all the way around that care is so expensive that everyone thinks you HAVE to have insurance, then when insurance gets expensive because care is expensive…everyone cries about the cost of insurance. Idiot democrats come along and try to reform healthcare by reforming insurance…which does NOTHING when the cost of care/drugs is still insane. What I really wish the government would do for “healthcare reform” is to actually try to do some s~~~ to bring the cost of care down. Pre-existing conditions wouldn’t be such a huge deal if we weren’t getting gouged on the price of care and drugs. I really like the idea that high deductible plans and HSA’s become the norm. If I’m just going in for a quick doctors visit to get some antibiotics or something simple why can’t I just pay a fair price and be on my way with no insurance involved?

For most of my life I had a “cadillilac policy” that cost roughly 10-14k a year. I used maybe 2-3k worth of healthcare during that 13 year period I had that insurance. I paid in over 150k into the system, used 2-3k, and now have nothing to show for it. I since switched to a high deductible/HSA combo…my premiums are like 600 bucks a year + whatever my employer pays…I’m not really sure to be honest but I know its not even close to my last policy. They also put 500 a year into my HSA. After 2 years I went to the doctors once and just swiped my card for like a 90 dollar bill, and still have over 6k sitting in my HSA for future use. If I just had this plan all along I’d probably have about 75k sitting in an HSA. My deductible is 5k…which seems like a lot for most people to pay out of pocket before insurance kicking in…but after all those healthy years I’d have enough in my HSA already to pay up to my deductible for the next 15 years even if I stopped adding to it.

Basically our current bloated insurance system forces young and healthy people to pay way more than they should be to subsidize everyone else. If you happen to be young or someone that actually eats well, exercises, and takes care of yourself, you get f~~~ed. You pay money into a black hole that you will never recover. If you go the high deductible/HSA route you have insurance so if you get in a car wreck or get cancer or something expensive you are covered…but you get to throw money into an HSA to cover your future expenses rather than throw it into a bottomless pit.

[BeerParticipant 11832]

Just another little add…I’d really f~~~ing love to see health insurance companies be run more like car insurance companies. You get a lot of speeding tickets or a DUI on your record…guess what…pay more for insurance because you are high risk. Well…if you are obese, a smoker, or have a legal record for illegal drug or abuse of prescription drugs…you should have to pay more for insurance because you are high risk.

The whole pre-existing thing is kind of a unique situation because I really feel bad for people who are born with or develop conditions that are out of their control and I’d hate to get f~~~ed over if I was in that situation…but when your condition is 100% preventable and caused by your own laziness and/or bad choices I don’t see why I have to pay for it. Like smokers for example…if you can afford cigarettes year after year…awesome…you should be able to afford to pay more for healthcare as well…and if you can’t well maybe you need to rethink your priorities.

My job already kind of does this, which is pretty sweet. We can voluntarily go for a health screening every year, and if we do and meet certain criteria, they give us a 500 dollar discount on our insurance for the year. In reality though I think its more like they just charge obese people more to keep the costs down for all for next year, but hey, I’m all for it.

[narwhalParticipant]

Beer wrote:

Our entire system is butt f~~~ed. I had a dog a while back that was messed up and needed some x-rays. I think it was like 60 buck a shot. Fair enough since it took the time of a vet and an assistant, probably a rather expensive machine, plus overhead…I don’t expect stuff like that to be free. A couple years later I messed up my foot and had to get an x-ray to see if I broke anything more than a couple toes, and it was 500 dollars for one x-ray.

I can think of a few reasons for the contrast. First, because with the dog, you are told the cost upfront. Second, because it’s your dog (and not you or a dependent), opting not to get the x-ray is a legitimate choice. Third, there is no insurance involved. You are not covering the costs of someone else who can’t/won’t pay.
Fourth, the potential for a malpractice suit is much lower for your dog then it is for you.

Beer wrote:

Just another little add…I’d really f~~~ing love to see health insurance companies be run more like car insurance companies. You get a lot of speeding tickets or a DUI on your record…guess what…pay more for insurance because you are high risk. Well…if you are obese, a smoker, or have a legal record for illegal drug or abuse of prescription drugs…you should have to pay more for insurance because you are high risk.

I agree with this. I have a high blood pressure and therefore have maintenance drugs. I don’t think insurance should cover this, because there is no risk involved…it’s a guaranteed expense. It’s the equivalent of getting an oil change…which car insurance doesn’t cover.

To add to this, why do I need to go to a Dr’s office to renew prescriptions? I’ve been on these drugs for 20 years now, and the diagnosis has never changed. I’ve switched doctor’s several times, and all the new Dr ever does is verify I am already on it and renew. It’s a waste of everyone’s time. Why not allow people on non-addictive maintenance drugs to sign some sort of waiver and self medicate if they want to?

I also usually get a yearly blood drawn. The damn report tells me when I am in normal range on everything they test, so why do I need to see a Dr to tell me that or draw the blood? I can go have a pint drawn at the blood bank with no Dr present, why is this different?

I think the devil’s in the details with medical costs. I don’t see costs getting down to where the need to be with one big move. Looking at the entire process and cutting out useless inefficiencies is the way to go.

Ok. Then do it.

[BeerParticipant 11832]

narwhal wrote:

I can think of a few reasons for the contrast.

Sad thing is I think a half dozen random guys on a MGTOW forum could come to agreement on the framework for a healthcare reform law that would actually reduce the cost of care across the board rather than just be a wealth redistribution scheme…yet congress can’t get any of it done. Hopefully this changes going forward as the democrats obviously had no interest in anything other than taxing half of us to give more handouts to the rest in order to buy more votes in the future…and they’re already in full on fear mongering mode in alignment with the media talking s~~~ about what any future Republican healthcare reform will look like. If we roll with the status quo or a double down on Obamacare the healthcare bubble will simply further inflate til in pops…I just hope the current trend can be reversed before that happens.

[narwhalParticipant]

Beer wrote:

Sad thing is I think a half dozen random guys on a MGTOW forum could come to agreement on the framework for a healthcare reform law that would actually reduce the cost of care across the board rather than just be a wealth redistribution scheme…yet congress can’t get any of it done

Because congress has two other higher priorities. Satisfying their financial backers and placating the voters. Those two plus logical healthcare are not compatible.

Ok. Then do it.

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