But there are more sick people that are his age. Are you saying there should be no permitted age rating in ACA?
I thought this nailed it perfectly:
Before ACA, the individual health insurance industry existed for people that health care.
Pre-existing conditions and Underwritten exclusions basically make up a huge % of the total cost. Excluding them is ridiculous.
Not really… Caesar was providing zero charity. I would interpret it to mean “don’t refuse to pay your taxes” not “work to ensure that we have higher taxes that pay for a lot of social programs”.
He was for individuals being charitable, certainly. He never advocated for governments to be.
I’m saying that the burden of covering the sick and uninsured should have been spread around better.
No, you’re going back to underwriting. Which is not related. Unless I’m totally confused by your definition of “underwriting”.
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The Dems have been wanting that for a long time. They had to work with what could get through.
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Again, you could get insurance with pre-existing conditions. You just couldn’t decide to go uninsured until you had a pre-existing condition, which is what a lot of people did.
When you buy a new car insurance policy, will it cover repairs for the accident you had a week before you bought the policy?
When you buy homeowners insurance, will it cover rebuilding your house that burned to the ground a week before you bought the policy?
Can you buy a life insurance policy on your grandmother who is already dead?
None of these are equivalent to developing a life-long condition. If you have a chronic condition, and get hospitalized, you can’t just go “rebuild” your body in a place that won’t burn down next year. It’s going to catch on fire every year, and you can’t do squat about it.
Also, none of these are like health care, where you can simply live without it.
Also, none of these are similarly expensive. Poor people literally can’t afford their conditions, and yet don’t let them suffer and die.
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Well, you’re right in that I’m probably not being very clear, so I will try to clarify.
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It is wrong to classify underwritten policies pre-Obamacare as being insurance only for people who don’t need heath care as YankeeTripper asserted.
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Actuaries on here are happily accepting underwritten health insurance for themselves while making out people like my Dad to be bad for preferring underwriting.
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If we’re making a decision that society should help out the sick and uninsured population then we should all be sharing in that burden, not placing the burden solely on a tiny percentage of the population that doesn’t include us and then self-righteously declare that the subset who doesn’t like that arrangement are somehow bad. Like if I decided that we should be doing more to help Ukraine and therefore everyone with a GoA screen name ending in the letters “ar” should send $5,000 to the Ukrainian war effort… you might have something to say about that. That’s essentially what happened with Obamacare.
What are you referring to here? If you’re referring to my large group health care plan, because underwriting 5,000 people, who can’t be excluded, is not even vaguely the same thing as underwriting 1 person.
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I’m not being self-righteous about his burden.
I’m being self-righteous about the logic behind sharing burdens, which I do also.
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If you develop a lifelong condition and you have insurance then your insurance covers it (subject to cost-sharing, of course).
I agree that people have a greater need for healthcare than a car, for example, although losing one’s home can be pretty financially devastating for most people if you don’t have it insured.
That said, with homeowners insurance mortgage lenders effectively had a mandate, so you didn’t see so many completely uninsured homeowners once home mortgages became the norm.
That is one of the many teachings of Christ that modern Republicans love to ignore.
I look forward to reading the very un-Christlike justification as to why this does not apply today.
You also have more choice in a home. You can choose a safe, cheap home. With health, you can be making $25k/year and randomly develop a condition that costs $50k/year.
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Of course people can be excluded. Probably 3,000 of those 5,000 are required to have been healthy enough to get a job at your employer. And another large subset were healthy enough to get married at some point. Not everyone is. And probably nearly everyone at your employer has some sort of medical insurance so there is cost-sharing going on.
You benefit from that underwriting and cost-sharing, whether you are aware of it or not.
But a lot of people who didn’t have group coverage were waiting to buy insurance until they developed a serious condition. So the folks on the exchanges were hugely more likely to have serious conditions than the folks on your group plan. Because the folks who had no health conditions and low assets just wouldn’t get health insurance at all.
Not to the same extent that the individual market folks are. Obamacare makes that expressly illegal.
Yeah, this just isn’t obvious at all to me. I’ll come back to you later in the week.
While it still applies, there is a degree of difference today since we are Caesar in a democratic republic. There is also the balance between caritas and “If any one will not work, let him not eat.” I think this provides room for discussion about how to best provide for those who can’t for themselves while not doing so for those who could but refuse to.
So do you just want underwriting for ACA, and widening the bands so the highest premium is 10x the lowest or something? And, if so, do subsidies come up so that poor old folks aren’t going to see a $2,500 premium?
No, I think the cost of covering the uninsured with pre-existing conditions should be shared between the group and individual markets. Not just the subsidies to help low-income folks pay the premiums, but the differences in premiums.
Remember Member X in Iowa? My recollection is that every single insurer pulled out of the individual market in Iowa in order to guarantee that they would not be stuck paying Member X’s claims. Obviously the individual market in a low-ish population state like Iowa was nowhere close to large enough to cost-share those claims.
If those costs were spread beyond Iowa’s borders and to more than just the individual market that wouldn’t have happened.