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I have seen many diaries on this site speaking out against the evils of insurance companies who will not insure people with pre-existing conditions. What I can't figure out, is why people are so surprised at this, and what they think a solution to this would be. Insurance companies exist to make money, and they have elaborate data on how much they have been required to payout to clients with similar conditions. They have mountains of data, so you would have to suspect that if they believe that insuring a particular client would be unprofitable for them, it is. Requiring them to insure the people they have previously denied, at anything under exhorbinant premiums will net out to a loss for them. As an analogy, it would be the same as requiring banks to loan money to anyone asking for it, if the person asking for the loan could prove the money would be used to save or prolong their own life.

I don't see an easy solution for all of this that doesn't effectively move the burden of medical costs from people who are typically healthy, to people who are typically sick. But let's see if anyone on this site can come up with a creative solution, here are my first three tries.

  1. Eliminate private insurance entirely, make all insurance government run, and come up with a system that everyone can agree upon. Alright, this one is a little extreme (and difficult to implement) but under the assertion that healthcare functions as infastructure (which it does to some extent) and as infastructure is something that should be handled by the government like roads and public safety. Since insurance organizations offer a strictly financial service, there is nothing to be gained through innovation, whatever profits that they create must come from the individuals they provide services to (the mechanic functions similarly to a zero-sum game)
  1. Separate the 'catastrophic' portion of insurance from routine medical insurance, and make the catastrophic insurance government funded or require all insurance organizations to take all comers. This accomplishes the benefit that insurance is supposed to provide to consumers in the first place. All other types of insurance (car insurance, fire insurance, home-owners insurance) are structured to provide their owners with support in the event of a catastrophic but unlikely occurance. The benefit to the consumer is the aggregation of risk across a pool of similar applicants. Once the two types of health insurance are separated, health care costs should come down as people with only catastrophic insurance come to see more procedures as optional.
  1. Require insurance organizations to implement FM Global style insurance policies, where they review the health of each client and offer premium reductions based on lifestyle choices (FM Global insures organizations, and they offers reductions in premiums based on equipment upgrades, for example replacing old boliers) This would increase personal health as well as providing a non-financial purpose for insurance organizations. More healthy people would mean more people they could profitably insure.

Alright, that's all I've got. Now it's your turn.

Originally posted to silentbobus on Wed Oct 21, 2009 at 08:41 PM PDT.


Which one of the three proposals do you like the best?

66%10 votes
13%2 votes
6%1 votes
13%2 votes

| 15 votes | Vote | Results

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Comment Preferences

    •  Where have you been? (2+ / 0-)
      Recommended by:
      relentless, Fireshadow

      Almost every diary I've seen that attacks the worthless insurance companies also provide a solution.

      Let's remember that we should care about people even after they're born. - A. Grayson

      by IL JimP on Wed Oct 21, 2009 at 08:47:05 PM PDT

      [ Parent ]

      •  Seriously... great diaries with solutions (1+ / 0-)
        Recommended by:
        IL JimP

        just today!  
        Your solutions are not that well thought out. Sorry.

        "A lie repeated may be accepted as fact, but the truth repeated becomes self evident." -elonifer skyhawk

        by Fireshadow on Wed Oct 21, 2009 at 08:56:36 PM PDT

        [ Parent ]

        •  I assume that is meant for the diarist, (0+ / 0-)

          not me?

          Let's remember that we should care about people even after they're born. - A. Grayson

          by IL JimP on Wed Oct 21, 2009 at 08:58:50 PM PDT

          [ Parent ]

        •  Really? (0+ / 0-)

          Because #1 and #2 are backed up a number of other sites by people who did a lot of research, and I'm condensing their results. #3 is something I came up with on my own that is more whimsical than the other two, but could work if implemented correctly (It already works in the industrial settings that I described)

      •  I would say the plurality of diaries (0+ / 0-)

        Are directed at eliciting an emotional response from the readers. "I can't believe they considered this a pre-existing condition" and so forth. I haven't seen a lot of solutions that would lower cost overall, mainly solutions that would shift the costs around.

  •  Health insurance was NOT a for-profit (3+ / 0-)
    business until the Nixon Administration passed the legislation that created HMOs and their profit-driven stock structure. Insurance as a "profit growth business" is as ridiculous as having an electric company as one .... like Enron. If insurance companies REALLY did what they are in theory supposed to do, the "profits" they are racking up now would have gone to the rightful claimants who own their policies. The same thing happened along the Gulf Coast after Katrina -- legitimate claims were rejected by the flimsiest and bald-faced of lies. And what happened? In the year of Katrina and various other disasters, insurance companies made RECORD PROFITS. Insurance isn't a guarantee, it's a racket to take your money and give you nothing.

    "There is no radical change without blood spent"

    by fourthcornerman on Wed Oct 21, 2009 at 09:04:13 PM PDT

  •  Were you surprised by the poll results? (0+ / 0-)

    I like option 2 and is similar to what I have.  High deductible plan with an HSA.  Until I meet that deductible, I'm paying.  It makes me very aware of the cost of everything associated with my healthcare.  Once people are disconnected from the cost of their healthcare there is a tendency to overuse.

    Republics decline into democracies and democracies degenerate into despotisms.

    by uhswhut on Wed Oct 21, 2009 at 10:29:15 PM PDT

  •  Option 2 sounds good until you realize (2+ / 0-)
    Recommended by:
    churchylafemme, Alexandra Lynch

    that often, avoiding catastrophic outcomes (such as cancer, diabetes, etc.) requires on-going, preventive care that these policies don't pay for.

    Also, I suspect that funding on-going necessary after-care following a catastrophic event or illness would be problematical in Option 2.

    I agree with you about the reasons for-profit health insurance doesn't work. Eventually, the profit motive will have to be removed from health care. No one should get rich on another's misery. Earn a living taking care of sick people(even a ridiculously exorbitant one as some docs do), yes. Get rich off denying care, no, never.

    'Fair and balanced.' The Republicans take a lie and balance it with a truth, and sometimes they leave out the truth. -MinistryOfTruth

    by Late Boomer on Wed Oct 21, 2009 at 11:09:47 PM PDT

  •  Lifestyle choices aren't always choices. (1+ / 0-)
    Recommended by:

    That's code for being fat and smoking.

    On the one hand, yes, I have control over what I put in my mouth. I don't eat all that much. My problem is that I don't exercise. The reason I do not exercise is that I have unrepaired dislocations and misalignments in my foot, and ruptured ligaments and torn tendons in my ankle. Fix that, make me able to afford the medications I'm supposed to be on, and I'll drop eighty pounds. It's simple.

    I'd be working on it now with non-weight-bearing exercise, but I can't afford a gym membership.  

    Many poor people smoke. This is why. If you are working a service job, say, as a dishwasher in a kitchen, you can say while business is slow, "Can I go have a smoke break?" And your immediate supervisor will be "Yeah, go ahead." The smoker gets to go through a relaxing mini-ritual, ingest a calming drug, breathe fresh air, look at the sky, and just relax for a few minutes.

    The guy who doesn't smoke can't go stand out on the back stoop, do a little calming meditation, breathe fresh air, look at the sky, and just relax for five minutes. "If you've got time to lean, you've got time to clean," says someone to him when he so much as leans on the counter.

    So in the short term, smoking is a positive strategy for many people.

  •  Insurance companies should have to put (0+ / 0-)

    back a certain percentage of their income for years when there are catastrophes like an epidemic for health insurance.

    Insurance started being ridiculous when Reagan was in office and they decided they needed to make a huge profit each year.  A prescription I was paying $5 for went to $130.  

    I know Nixon thought that health care was going to bring this country down financially.  I didn't think he did anything about it though....that may have been because he resigned.

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