But that is an extreme.
Uh? Why would anybody with a functional brain carrier insurance other than purchasing it at the door of the hospital if there where not a pre-existing clause of some sort, which somehow relates to your non-insured state and the pre-existing state of the condition in a way that cancels out the benefit of not having paid insurance until now? Beats me!
To argue otherwise is to argue that Term Life Insurance could be profitably sold in a Hospice for a few months premium. Heck, skip the Hospice and sell it along with the casket at the Mortuary for a zero month premium directly to the beneficiary. Not much difference when divided by the $ of the benefit.
theres another whole area where somebody has some abstract "symptom" and is denied coverage based on that, or if they aren't, when a claim is made for an expensive treatment the insurer says "oh we are refusing to pay for that heart bypass surgery because you didnt' tell us you had acid reflux disease". Stuff like that.
As I clearly noted in my edit of that post, yes, the indirection of consumer, insurance co, and care provider builds in a set of related conflicts, even aside from the pre-existing condition issue. Pre-existing condition denial can easily be dealt with by forcing everyone to carry insurance, than forcing all insurance co to offer same level of coverage transportable policies. End of problem. What has no easy solution are the following conflicts:
1) The consumer pays a monthly insurance bill with little control over the premium, but when he/she consumes services, has little motivation to restrict consumption.
2) The Doc has motivation to over prescribe since he makes more $ that way and is the only party really competent to determine what services are needed.
3) The insurance co has motivation to under cover, since they make more $ that way.
4) Neither the consumer nor the Doc has final say if the insurance co. decides not to cover.
What would you think of a system where you paid a monthly "food insurance" bill, then went to the grocery store, where you asked the grocer to fill your cart with whatever he though best for you (he might naturally think high priced was best for you), and then the insurance co rep stood at the till and rejected various of the grocers choices from your cart. Periodically, the insurance co adjusted up your monthly rate based on statistical averaging of their payouts + a profit kicker. That is very roughly the mechanism we accept in the medical field in the USA.
It is a far different system than a consumer directly spending their own dollars on services which they are competent to evaluate the worth or desire of.
You can say in theory that nobody should subsidize some 25 year old woman's healthcare, but in reality all fo this stuff needs to be looked at and made manageable otherwise the system breaks down.
Actually I'm all for looking at all the aspects and trying to clearly make rational choices. I have no problem with admitting that a significant part of the issue is in fact wealth redistribution for some fraction of the populace. Lets just not hide the issue. A significant fraction is also containing services, which in general is dealt with by having a direct link between consumer payment and the service received. A significant fraction is how we share risks in society, when much of the risk is lifestyle related and we are a country of freedom loving individuals. Nobody says it is easy, lets just be honest about it. |
