Is coverage for preexisting conditions welfare?

[coboardhead]

My problem with the current system is that one can play by all of the rules...paying tens of thousands in premiums or seeking employment with health insurance coverage and suddenly find themselves on the open market with a pre-existing condition. This seems unfair. Feuser asks if this is welfare for providing coverage for this person out of the larger pool, of which they were a contributing member. I don't believe it is.

Personally, I DO have a problem with someone, who has never had health insurance suddenly getting insurance when needed. This is why I believe in the insurance mandate. Require everyone to join the pool.

Currently, if you are poor, you get that treatment for that pancreatic cancer. If you do not have insurance (by your fault or not), and have assets, you will be treated and you will be bankrupted...then you get the Medicaid. Ultimately, the government, other enrollees, or the medical industry will pay. It is a shell game.

It is about time we looked at the entire health care system as a shared responsibility and a shared risk. If we do not, the current system of "each man for himself" will fail as costs continue to spiral out of control.

Do I think that the ACA is perfect. Not by a long shot. I believe the insurance reforms are necessary, but long term cost savings will not be maximized without short term funding to rebuild the medical delivery model.

I will again state this...you cannot reform the health care system by only looking at the way it is financed.

[mac]

It appears that our brief hiatus from the daily news feed by the Koch brothers has come to a jarring end. Mrgybe is back, and now claims:\

[keycocker]

Gasoline is sold like every other thing on earth. They raise the price until consumption drops off,then lower it a level that folks are willing to pay.
Notice that a barrel of oil can go down and up over a wide range,while gas price steadily creeps up?
If this is true wouldnt there be giant profits for the oil companies?
Not long ago the oil giants made the largest profit of any company in human history.

[techno900]

coboardhead,

Well said, I think you defined the issue very well. However the Obama care solution just doesn't appeal to me. There is some logic behind the ACA, but in my mind, the mandate goes way too far for me to buy into.

I don't have a solution, but something will come along sooner than later that will be a compromise (assuming the Supreme Court shoots down the ACA). If not we certainly will find out if the ACA was a good plan.

It's easy to say that health care should be the government's responsibility, but for years and years, I have heard many more horror stories than positive stories from people living in those countries where government mandated programs exist. In my opinion, the majority will be sacrificing quality and timely care, plus rationing, to the benefit of the minority (those without insurance, but not on medicaid).

It seems like the solution should address the segment of the population that are having problems, not the entire country. Easier said than done.

[coboardhead]

Techno

Feuser's original post was in regards to the question of existing conditions and the lack of a method to deal fairly with this issue. It is worth noting that this situation is a problem for about 20% of the healthcare system. Those that either do not have insurance or are forced to purchase insurance on the open market. Although any of us, as NickB stated, could become part of that population at any time.

The majority of folks in this country have insurance thru the govt or employers (approximately 80%). The biggest problem for this group, and because of this group, is that cost increases are unsustainable. Because costs are increasing, more folks will become part of the minority discussed above as employers drop coverage. The anti "Obamacare" folks will claim this is because of the ACA, but it has been a trend prior to the inception of the plan.

The Republicans have tried to limit Medicare and Medicaid reimbursements to providers in the past in an attempt to stem this growth to no avail. Wrong approach, IMO. The result has been cost shifting and some rationing.

The ACA has elements, such as insurance exchanges, to allow a greater level of participation in the insurance pool, which should help reduce the cost shifting and provide small businesses methods to insure employees and proprietors. That's the good stuff in the plan.

However, the cost containment methods in the ACA will not be realized without some real reform in the delivery of medical care. The plan calls for a merit based payment system. Great idea, right? Well, not so good if you are treating a sicker population. Providers may begin to cherry pick "well" patients. In addition, the plan tries to implement these cost savings using Medicare payments as the carrot. The reaction will be for providers to refuse new Medicare patients.

Small providers will, largely, be incapable of the record keeping and accounting required to fulfill the goal of a merit based system. So, the ACA will promote the demise of the small practice. This is already a trend (pre ACA)...small primary care practices are failing due to low Medicare reimbursements and high overhead.

This is not, necessarily, a bad thing. While I believe the quality of care delivered in this model is good, the costs are, quite simply, too high.

Large clinics will contract to serve all the needs of a patient population. I feel these clinics should be privately run with strict guidelines for care and cost containment. This is why I support the ACA. The other option, really, is government run clinics.

Where the ACA fails is in the nuts and bolts of the implementation of the cost saving strategies. Docs are, generally, poor business folks. (would you want your's reading a med-journal or the wsj?) They will need help with setting up these practice systems to provide services to sicker, poorer and older populations.

[keycocker]

I am with techno on this.
The thing that makes Ocare special is that the framework was written by Bush GOP,then giant lobbyist money came forward and the writers of the legislation were required by the Party to vote against it.
Nothing better will come along in a gov. like Bush which was controlled by lobbyists. Ocare is likely as close as we will ever get and a clear sign that the Dem President is refusing at least some lobbyist money.

[DanWeiss]

[pueno]

[techno900]

coboardhead said:

[coboardhead]

Techno wrote