Concerns are being raised far and wide about the validity of patching the BROKEN insurance model using a $2.90 a year/person Band Aid. The high risk pool approach - (which was also the model for the election-winning and discussion-diverting "public option")
Many advocates for people with serious illnesses are concerned about the six month "waiting period", and indeed, studies have shown that for people with serious illness, that first six months is by far the most expensive. However, it will save the government a LOT of money asking people to spend their own money themselves while remaining uninsured during that six month waiting, (although some use the term "dying") period.
From "
Democrats' Plan to Help 'Uninsurables' Questioned:Advocates for cancer patients decry waiting period; budget for high-risk pool seen as low"
The average Canadian saves around a quarter million dollars over the average American in health care costs over their lifetime
Flash! Insurers Refusing
to include family's adult children with pre-existing conditions in policies, they interpret law's wording only to extend coverage for adult children already on parents policies.
"Wait a second. Read the fine print. You may have to be uninsured for six months to qualify.
"If you are a cancer patient and have cancer now, you can't wait six months to go into a plan because your condition can go from bad to death," said Stephen Finan, a policy expert with the American Cancer Society Cancer Action Network. He called the waiting period in the Senate bill "unacceptable."
Many have also worried that given the tendency of high risk pools to need substantial subsidies, the funding allocated, $2.90 a year per American- is low.
"Now there are concerns about the design of the high-risk pools. Besides the six-month wait, there's a more fundamental issue -- whether $5 billion set aside for the three-year program is enough. The money would be used to help people in poor health pay premiums."
Its clear that many here do not understand what high risk pools are and what they are NOT. Many are also confusing PREMIUM subsidies with the subsidies required to keep the entire risk pool SOLVENT. Hopefully the below can clarify this distinction.
In my opinion, high risk pools are primarily a method of preserving the appearance of fairness and choice in a system so obscenely inefficient and expensive that it should have been scrapped decades ago.
One doesn't have to look long before the LIES being used to varnish over this fact become obvious!
This is taken from What is a Risk Pool (naschip.org) (I've added the word "individual" and several other annotations to make it clear that high risk pools are individual insurance policies, for purposes of price comparison)
If I were you, I would save the original version of the document to disk to refer to, when you see people speculating about high risk pools. The ugly reality is that as long as we keep the present insurance system, they will not be able to help many people or the cost would become prohibitive enough to require dipping in to the military budget, a BIG NO NO! This is why its obvious to many that we really need the savings of single payer! NOW, before GATS is triggered, making public healthcare impossible!
What is a Risk Pool?
Health insurance risk pools are special programs created by state legislatures to provide a safety net for the "medically uninsurable" population. These are people who have been denied health insurance coverage because of a pre-existing health condition, or who can only access private coverage that is restricted or has extremely high rates.
- Each of the state risk pool-type programs is different. Generally, the programs operate as a state-created nonprofit Association overseen by a board of directors made up of industry, consumer and state insurance department representatives. The board contracts with an established insurance company to collect premiums and pay claims and administer the program on a day-to-day basis. Insurance benefits vary, but risk pools typically offer benefits that are comparable to basic private market plans -- 80/20 major medical and outpatient coverage, a choice of deductible and co-payments. Maximum lifetime benefits vary by state from as low as $350,000 to $2 million.
- Generally, there are no exclusions. However, risk pools do have waiting periods (if you miss a payment by one day, for example, you can be made to pay but not receive coverage for six months) for coverage of pre-existing conditions to make sure individuals pay for continual coverage and the program can operate financially sound. Without waiting periods, the concern is that too many people could forego paying for insurance until they had a high cost claim, and the programs could not function financially. However, under the federal portability legislation, people who have had continuous coverage in the group market, not broken by more than 63 days, can access coverage in risk pools without any waiting periods.
- Risk pool insurance generally costs more than regular individual insurance, but the premiums are capped by law in each state to protect the individual from exorbitant costs. The caps range from as low as 125 percent of the average for comparable private coverage in some states, up to 200 percent of the average or more in other states. Most states offer coverage at less than 150 percent of the average.
- All state risk pools inherently lose money and need to be subsidized. While the individuals in risk pools pay somewhat higher premiums, roughly 50 percent of overall operating costs need to be subsidized. Subsidy mechanisms also vary from state to state -- some states assess all insurance carriers, HMO's and other insurance providers; others provide an appropriation from state general tax revenue; some states share funding of loss subsidies with the insurance industry using an assessment of insurance carriers and providing them a tax credit for the assessment, or other states have a special funding source, such as a tobacco tax, or a hospital or health care provider surcharge.
- It is important to note that risk pools are not created expressly to serve the indigent or poor who cannot afford health insurance. (at approximately 150% to 200% one and a half to two times the cost of the market rate for individual coverage at similar actuarial value) Risk pools are designed to serve (barring additional premium subsidies, usually fairly well to do) people who would not otherwise have the right to purchase health insurance protection. The indigent can access coverage through state medical assistance, Medicaid or similar programs. However, some state risk pools do have a (premium) subsidy for lower income, medically uninsurable people. (But they are being buried with need, because only around one fifth of American wage earners can still afford to buy health insurance at market rates, maintaining this scarcity. The real reason for the pools is to preserve the intolerable waste and injustice- and to keep the private insurance companies profitable and dominant)
For information about your state, see "States That Have Risk Pools" or contact your state insurance department.
The average Canadian saves around a quarter million dollars over the average American in health care costs over their lifetime