Problem: No denail for pre-existing conditons doesn't work without mandates

[Jersey Devil]

Maybe I am wrong but there are plenty of people who will always try to game the system no matter how fair it is. But if you ban insurance companies totally from excluding people with pre-existing conditions and you do not have a mandate to buy health insurance, then what is to prevent people from simply not buying health insurance until they come down with some type of catastrophic illness or medical condition?

So you are in pretty good shape, see your doctor for an exam and every now and then for treatment, maybe lay $500-$1,000 out of pocket per year on average for medical care without insurance so you don't buy it. So then you get cancer. No problem, just go online and sign up for the insurance. Then when you heal (hopefully) you drop the coverage again. No problem doing this unless there is an emergency, but you'll take your chances on that. You could even wait until your doctor hospitalizes you and sign up for insurance on the hospital's computer in their patient intake area before getting a bed and they'd have to cover you. Send the spouse right over to deliver the first payment to make sure.

So where am I full of shit here?

[treestar]

1. Makes sense

I didn't like the mandates at first either. It is the natural American knee-jerk reaction. Then thinking about it, one can see that everyone has to pay into it. It's just geared to their ability to pay. And that is why the right wing hates it.

[T Wolf]

2. The scenario you describe IS a problem. And another reason why universal, single-payer,

tax-funded system is the only way to fix a corrupt and ineffective (for the patient) system.

Fucking around with a half-assed (or less) plan like this only creates a more fucked-up system.

[Vincardog]

8. Bingo this scenario is the reason for Universal Single Payer. TAX everyone and stop the deadbeats

[Jersey Devil]

10. Agree about single payer but don't agree with an all or nothing approach

Right now you, me and everyone else paying health insurance premiums pay for the uninsured when they need treatment and it is not just the poor we are paying for. There are lots of people who can afford insurance but don't get it for various reasons, like single people who don't own homes and are not afraid if they lose their bets and have to file for bankruptcy. How much does that cost the rest of us who do pay premiums? I don't know but I am willing to bet my premiums would be at least s smidge lower if I didn't have to pay for them.

Should anyone be forced to pay higher premiums so that someone without insurance can drive a $45,000 SUV or have 3 big screen TVs in their home?

Don't get me wrong. I am plenty willing to chip in for those who are truly needy, but I know that right now there are people gaming the system and these same people will do the exact thing I described if there are no mandates.

[Larkspur]

3. Except that heath ins companies can drop you for "fraud"

and they get to name it. The health ins companies will still find ways to drop you. In California a law was passed to forbid recissions, but the health ins cos still do it because California was outgunned in the courts by them. Also, there is a plank in the bill regarding health risks. Being old, overweight, and having other pre-existing conditions will allow the health ins cos to charge 3 times the lowest premium, so that means you could pay more than 8% of your gross income in premiums.

the bill also doesn't do much to define what health ins cos should cover. they could and most likely will sell lots of junk plans and if you want more coverage it will cost you more money.

[Jersey Devil]

11. No need to lie about pre-existing conditions

Fraud would not apply. As I understand it you can apply for and get health insurance even if you have a condition like cancel when you apply and you tell them about it.

[ima_sinnic]

35. but what if you forget about that case of athlete's foot you had in 1982?

seriously, they can claim fraud and drop you, is the way I understand it.

[ima_sinnic]

36. in addition, at the age of 63, I cannot remember every sngle ailment I sought treatment for

for example, I do remember having a urinary tract infection in about 1975. I remember going to a clinic or emergency room to get an antibiotic, somewhere near Boston because I lived in Brookline. But I'll be damned if I remember any specifics about it, like the exact year or who treated it. And that is a case I remember. What about other illnesses and symptoms I have simply forgotten about? Will I be accused of fraud because there's some detail in my medical history I forgot about?

[dflprincess]

4. They may offer a person "coverage"

but they will still find ways to avoid paying claims. There are all sorts of games the insurance companies play because they know most people won't make more than a token protest over a claim denial.

[Tailormyst]

5. Yet another reason why we need single payer universal healthcare

We are paying people billion to transfer money from us to the doctors. It is insane and counter productive.

[Jersey Devil]

13. apples and oranges

Single payer is a pipe dream right now.

[ROakes1019]

6. no denail

Is "no denail" sort of a crucifixion without nails?

[PBS Poll-435]

7. No Denail/No Amnety 2012!!

[phleshdef]

9. Right. You can't afford to cover everyone without a wealth generating mandate to make it possible.

Most of us would prefer the creation of a public pool with a tax mandate instead of a private pool with a purchasing mandate, but if the end result truly means everyone gets adequate coverage, then thats progress and I could care less how it was achieved. Thats TRUE progressivism, putting the goal of moving from point A onto point B ahead of ideological blabbering.

[Hello_Kitty]

15. Well I do care how it is acheived

A progressive tax on everyone would be fair. This mandate to buy private insurance is unconstitutional, unfair, and regressive as shit. And don't hand me bullshit about subsidies. A helluva lot of middle and working class Americans are going to get little or no subsidies.

[phleshdef]

16. Unfair, fine, think that. Unconstitutional? No, not even close. Thats ignorant.

[Jersey Devil]

17. Some of this stuff is lifted directly from right wingers like Orrin Hatch

Here's where they're getting this stuff from:

http://hatch.senate.gov/public/index.cfm?FuseAction=PressReleases.Detail&PressRelease_id=8028d1d2-1b78-be3e-e01f-efc1c9ea2128&IsTextOnly=1

[Hello_Kitty]

18. If you're going to call me a right winger, I get to call you a DLC sellout.

And frankly, I thinks that's worse.

[phleshdef]

20. Frankly, I'm just gonna call you someone who has no idea what they are talking about.

Back up what you said about the constitutionality of the mandate. That should be rich.

[Jersey Devil]

28. That too

I don't understand the constitutional argument he is trying to make.

So what's the difference between using the general welfare clause of a state constitution to make people buy auto insurance and using the general welfare clause of the US Constitution to make people buy health insurance? Beats me too.

Someone tried to argue yesterday that the difference is that you affect other people whon you have a car accident but you don't when you get sick. I think that clearly demonstrates a total lack of understanding of the problem.

[phleshdef]

29. If you don't want the mandate then don't expect emergency room treatment, EVER.

Thats what I have to say to people that say not having health insurance fof some sort, offered through public or private means, doesn't effect others.

[girl gone mad]

31. Really? You get to control who doctors and hospitals treat?

Just because you think everyone should be forced to hand over their money to a useless, crooked middle man?

Stay classy, pal.

Unfortunately for you, I'm absolutely certain doctors and hospitals will still be willing to take cash customers.

[phleshdef]

33. Wow, you totally missed the context of that comment.

Read what I was responding to before running your mouth.

[girl gone mad]

30. You don't need be a douchebag.

This type of mandate is unprecedented and there is certainly room for debate.

Not every constitutional scholar agrees on the topic, though most believe a Supreme Court challenge would be tough.

http://www.politico.com/news/stories/1009/28463.html

[Jersey Devil]

23. Well let's see: You make the same arguments as Orrin Hatch

That doesn't necessarily make you a right winger but I think it does make you the victim of right wing propaganda and it strives to achieve the same result.

[girl gone mad]

32. Accusing posters of being "right wingers" is a violation of policy here.

As soon as you start making this stupid assertion, you've already lost the debate, anyhow.

[Jersey Devil]

38. I did not do that. Perhaps you have a guilty consicence?

Hey look, I never called you anything except to suggest that you were buying into a right wing argument that, imo, is pure poppycock.

I am getting DU etiquette lessons from someone who just called another poster a "douchebag"? :rofl:

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=433x85428#85737

[Warren Stupidity]

12. I knew it! Gummint De-nailing Panels!

Damned gummint snuck this in just like The Good Sarah tole us. Now everytime you get sick they rip out a finger nail.

Fuck!

[yourout]

14. I would have if they had threatened them with the loss of their Anti-trust exemption.

[Clear Blue Sky]

19. Makes sense.

I'll hold off in buying fire insurance for my house until it's actually on fire.

[Armstead]

21. There are peoel who abuse any system -- That should not be the basis of the system though

First off, most people without insurance SIMPLY CAN'T AFFORD IT. They are not trying to "game" the system. They would prefer to have insurance. However, when the other basics are factored in, their income simply cannot include the adsded burden of overpriced insurance. The money just is not there.

Yes, without mandates there would be people who deliberately wait until they get sick to buy insurance.

HOWEVER there are also people who scam the Social Security Disability program, engage in Medicare fraud and inappropriatly collece Unemployment Compensation.

Does that mean we should not have Medicare or those other systems?

There are ways around the problems that you are referring to.

[tinrobot]

37. The stock market is nothing but people gaming the system.

If people realize they can game the system, they will, rich and poor alike.

If we're going the route of private insurance, then mandates are needed. I'm not a fan of private insurance, but if this is the direction we're being sent, then everyone needs to buy in or it won't work.

Don't forget, for those who can't afford it, the plan will provide subsidies up to 400% of poverty. Again, not a fan of giving tax money to private insurance companies, but if this is the direction, then hopefully the subsidies will make it affordable to all.

[OHdem10]

22. Is it true that this part of the Bill only goes into effect immediately

for SCHIP Kids???

This does not go into effect for the rest of us until 2014.

This has been out there the past couple of days.

[Jersey Devil]

25. That is my understanding as well - 4 years for mandated to go into effect

and by then problems will crop up that they will have to address with further legislation.

The bill before the Senate is only the beginning.

[Democrats_win]

24. It sounds better if you say it backwards: Mandates don't work without no denial for pre-existing...

conditions. It's obviously true. It just goes to show you it's all in the spin.

Oh, and don't forget, its truer than the forward phrase!

[Jersey Devil]

26. ?mmh Then we'd have the ouq sutats

You're need your Captain Video Secret Decoder Ring for this.

[NYC_SKP]

27. Makes sense. nt

[grantcart]

34. lol

http://www.democraticunderground.com/discuss/duboard.php?az=show_mesg&forum=433&topic_id=85131&mesg_id=85772