What @alahmnat said. cough pinto cough
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I don’t know that we should be singling out particular things to point out that they count as pre-existing conditions, because as far as the health insurance companies operated pre-Obamacare, anything could be a pre-existing condition used to retroactively deny you insurance, even if it never impacted your health-care needs. Ever had a yeast infection? Yep, pre-existing condition. Stubbed your fucking toe? Pre-existing condition, probably. Cried during a sad movie? Shit, why not - the insurance companies could pretty much act with impunity.
I dunno - when did the concept of regulation first arise?
If you honestly think that’s what the Republican bill does, you are really, really not paying attention to what’s in it.
No. Just, no. As people have pointed out, health insurance in the US works in a fundamentally different way than any other form of insurance because, among other things, the industry has warped conditions making it fundamentally unaffordable to purchase healthcare without it (unless you’re a billionaire). So stop with the analogies - they don’t actually work, but instead actually obscure the relevant issues. Which is maybe your intention, in which case really stop it.
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The reason people are getting upset about the reduction in regulation is because the party interested in and currently 100% capable of making those reductions into law is not even remotely interested in focusing on the costs of health care and why it is so expensive. Republicans want to take away the handful of consumer protections in the insurance market that the ACA instituted (and which the individual mandate helps support financially by ensuring that healthy people are paying into the pool), with absolutely no guarantee that they’ll ever get around to doing anything to institute better replacements by addressing the health care industry directly. It’s putting the cart before the horse, and then not even bothering to buy the horse in the first place. People - mostly poor, sick, and elderly people - will lose coverage, and thus access to care. Some will be just fine if that happens. A lot of people won’t.
Notably, Republicans are also completely opposed to the concept of a government-backed single-payer system which has been proven to be effective in dozens of other countries, and which would eliminate the ridiculous profit motive behind our current insurance-backed health care system.
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Haven’t you heard, government services are bad, everything should be privatized, this is just the same. 
[quote=“Chuck_Steel, post:61, topic:104164, full:true”]That’s kind of my whole point. People are getting upset about the reduction in regulation on the health insurance companies when instead we should be focusing on the costs of health care and why it is so expensive.
[/quote]
It’s not just the cost. It’s who’s paying too. Even if the costs were driven to near 0, but not 0, we would still have the issue about what to do when you run out of money and don’t even have “near 0” left to pay. At that point, we’re back at either backstopping and paying or kicking you to the curb to die.
So, where we end up is that we need some institution to provide that backstop. For people to pay into that institution somehow. And that institution, in it’s own best interests then, will work on how to drive the cost down.
Taxes vs premiums, government vs insurance companies, it’s the same logical system.
Pick one, taxes fund a government system that pays and backstops. Everyone pays their taxes and gets the coverage. Or, premiums fund insurance companies that provide the backstop, everyone get’s the coverage. The backstop entity works to drive down costs. End user costs are some flatter level of funding the backstop. Since, it’s almost impossible for the end user to comparison shop in any meaningful way that causes competition of providers to drive costs down.
Where we get into trouble is when we screw around with the backstop entity. One group wants the government to backstop, one group wants insurance companies (current status quo), one group doesn’t want any backstop but also doesn’t want to kick people to the curb (not possible), one group doesn’t want any backstop and is perfectly happy to kick people to the curb.
The first group wants single payer, but has never been able to get it. The second group got what they wanted, disappointed the first group. The third group thinks the first group got “just enough or to much” with the current plan, doesn’t want what we have, and thinks “magic” allows us to simultaneously remove any backstop entity but still provide a backstop, because they don’t really want to be heartless. The fourth group is hiding among the third group, because they really are heartless but know it’s a hard position to take.
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I didn’t start the analogy, I was actually pointing out that it wasn’t good in the first place.
Yeah I did try to joke a little there only because I didn’t want it to be too dark and start crying.
The primary difference between single public payer and private insurance is the profit motive. Discussing the issue as if the two are interchangeable seems disingenuous at best. It should be obvious that the profit motive of private insurers runs contrary to providing compassionate and reasonably priced healthcare. To suggest the problem with our healthcare system is rooted in screwing around with the backstop entity is to imagine that the healthcare crisis began with the ACA.
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Bonus round: in the midst of a claim, your insurer declares bankruptcy. They admit that they are responsible for paying the claim, but it will have to be at some nebulous future date because… bankruptcy proceedings. The hospital offers you a choice between a payment plan and having Collections called on you. You’re stuck paying the hospital $$ per month (in addition to $$ per month in premiums to your NEW insurance provider) until the magical day on which your bankrupt insurer will somehow manifest the money out of its asshole (currently occupied by its collective head) to reimburse you, never mind that they no longer have the incentive of the hospital’s lawyers nipping at their heels to pay up and you have no realistic legal weight to make them do so.
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Not at all. If your insurer declares bankruptcy, the insured should insist the healthcare provider seek restitution from the insurer through the bankruptcy courts. Once you have paid your patient portion of the bill and the insurer has accepted the claim, your involvement in the payment portion of the interaction is at an end. That is the standard and accepted practice.
That would be ideal, but is not the real-life case in this actual situation because of a combination of bureaucratic technicalities (the claim was improperly entered, rejected, requested to be re-entered properly, and the declaration of bankruptcy occurred during that intermediate limbo period before the properly-entered claim was accepted, so it’s more like… everyone involved knows the insurer should be paying, but they technically have not said so in a legally-binding manner that would lift the financial burden of responsibility from us, hence my firm belief that no, we will never see any of this money ever again), exhaustion with dealing with said bureaucracy on both hospital and insurer ends, and (thankfully) financial ability to absorb the monthly hit for the time being so the choice to do so rather than go insane with stress over fighting a losing legal battle while fielding calls from debt collectors is a viable one.
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That would be the fault of the healthcare provider. Has nothing to do with you. Your best bet would have been to insist they go through the courts like everyone else. They accepted your insurance, did not receive a denial of coverage, and took your co-pay. Unfortunately it sounds like you were bullied in to accepting responsibility where you had none.
Edit to add: don’t forget, you never have to speak to a debt collector. You have the right to insist on only working with the original debt holder. If they sell your debt, that’s their mistake.
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Logically, at it’s root for how the system at a high level functions, it is the same, from the perspective of how services are funded and paid for.
I completely agree, at a detail level, not the same at all. In fact, I would argue that all the regulation applied to Insurance companies in general is trying to force the company actions to more align with how we want them to behave along with providing consumer protections that are at direct odds with a for profit company.
It’s along the same lines that’s in the news lately about running the government more like a business. Then, pointing out all the ways that government goals are different than business goals and how the two don’t work the same.
We all assume, a single payer system would have a goal of providing care first, and worry about its operating budget second. It can’t completely ignore it, but there’s not the same shareholder, quarterly earnings, and profit growth things to worry about.
We all assume (and are probably right), that an insurance company goal is to make money first and provide care second, possibly a very distant second.
So, while a government, or perhaps a non profit organization would be happy to just break even on operating expense and care vs funding. A for profit also wants to add in a profit amount as an additional expense.
That’s back to the privatization of government services argument. Which mostly resolves around a private institution being able to drive it’s costs down lower than a government institution while also having the extra expense of making a profit. With regulation forcing them to meet a certain level of service. Otherwise, its simple for a private group to have lower costs than government, just do less.
Back to healthcare, things like mandatory coverage, no preexisting conditions, no lifetime caps, are all ways of saying they can’t reduce services.
If the math says these should be equal:
Premium = Heath Service Costs + Overhead
For government, the premium comes from taxes. The overhead is the budget for everything needed to run the agency, and Health Care Costs are what they pay out to providers.
For a private company, it’s the same math (sort of). The private company breaks that Overhead down into 2 buckets.
Premium = Heath Service Costs + (Overhead + Profit)
The first is still everything needed to run the company, the second is profits beyond that.
Our assumptions say a government system is happy to have the 2 sides be the same. While a private company wants to transfer as much of the right side into the profit part of overhead and always wants that number to go up. You can do that by getting more premium, reducing what you pay out for services, or reducing other expense, or doing all 3.
Still doesn’t change the basic decision. First you have to agree on if you’re kicking people to the curb to die. Once you decide you’re not, might as well decide how to pay for that. Otherwise you’re just being delusional. Or, maybe you’re totally fine with kicking people to the curb. (Not YOU you, but someone.)
My current feeling is that we’ve got some politicians who would gladly kick people to the curb, and some that are delusional and think we will not but that we’ll also not pay for it at all. The kickers are hiding with the delusional to avoid being called out as death panels.
At every town hall, someone should be asking their representative if they want to kick people to the curb. If they say “no”, the follow-up is to ask what entity pays for it when we don’t. If they say “yes”, put it on campaign posters: “XXX wants YOU to DIE!”. Then, ask the replacement the same questions.
Hold them to a real answer about the entity, not some side stepping non answer.
Hell, everyone should ask themselves this question.
Bullet fragments are known to be strong infectious agents. I thought the early optimism might have been misplaced. Sure hope he doesn’t become septic as well as antibiotic resistant in the process, or is it the other way around. MRSA is ugly stuff; it contributed to my father’s premature death.
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I’ve had MRSA 3 times, and yes, without some luck, it will kill you.
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Depends upon the company and the plan. I called ahead to make sure my plan covered a second opinion from an ortho. Of course, I was told. Then they tried to weasel their way out of it. I had to call them multiple times and expend a lot of time and effort, which did result in the claim finally being paid. However, most people give up, which is what the insurers count on.
Uh, no. Most insurance companies have forced arbitration. And that’s if you’re physically able to go through arbitration.
You’re correct that health insurance companies are taking a risk. They’re gambling and hoping that the healthy outweigh the costs of the unhealthy. But, as @Mindysan33 stated above
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I was about to suggest marksmanship training for everyone, but this works too.
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“I need healthcare.”
“Sorry Sir, you have a pre-existing condition.”
“But…but what’s that?”
“You voted Republican, Sir.”
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I expect there will be an exception for white people shot by black people, though it will only affect a minority of cases.
I believe it is not the bullets so much as the clothing fibres they drag in with them.
When Heydrich was assassinated, he appeared to be recovering and then died of an infection. At the time there were various suspicions including poisoning. But a more probable explanation seems to be that he was penetrated by a very small piece of shrapnel that had passed through the horsehair upholstery of his car, and the infection came from bacteria in the horsehair.
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You’d be really surprised (hopefully) how many animals we see that get shot. I’ve lost count personally.
People are dicks.
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Precisely. You’re someone that could be sick or dying and at the same time drowning in debt from medical bills. Just hire a lawyer (since they are free) and take those damn insurance companies to task. (Provided of course your contract doesn’t require forced arbitration.)
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