Expectation of coverage...without premiums?

I try not to pick apart the NYT op-eds, as they are not supposed to be well researched arguments. But the below makes a case against current healthcare reform plans, while trying to argue for them.

http://www.nytimes.com/2012/04/05/opinion/down-th…

The author's sister was tragically disabled in an auto accident. Now she is receiving health coverage from the state.

The author laments the limited nature of these programs, and hopes that exchanges will come into existence so that her sister will be able to buy covergage. But, how is it realistic to have "insurance" that you only buy after the accident? This is the basis of the argument against Obama's reforms...it creates an unreal moral hazard.

While I hate to create another health insurance thread, what do you all think of the financial impact of Obamacare? Ignoring constitutionality, role of government, etc. can this bill be realistically implemented?

Comments (7)

 
Apr 5, 2012 - 9:59am

Angus Macgyver:
I have no idea how this shit works. Question: What's stopping insurers from charging $100,000 in premiums a year for people with pre-existing conditions, if those conditions make it very likely that someone will need fat insurance payouts?

Exactly. How are you supposed to force an insurer to give coverage to someone who just learned they have Leukemia? How do you price that, where the economics make senses for either party?
 
Apr 5, 2012 - 10:34am

This is part of the larger problem of people confusing health "insurance" with health "care". People who suddenly learn they have a debilitating illness are uninsurable. Once you know with decent certainty that medical costs are going to be huge, it's not "insurance" agaisnt anything anymore. There is no market solution for these cases. I think this is a big part of the reason that lots of people advocate a mandate - get peple into risk pool immediately so they don't run into these situations. You can argue about the constitutionality of the mandate (I think it's pretty clearly unconstitutional) but it does make more economic sense (was origionally proposed by the Heritage Foundtion, I think) than ther alternatives.

 
Apr 5, 2012 - 11:30am

I agree with Booth in this case. While I usually hawk libertarian ideas, healthcare needs to be realigned with reality. You can argue moral hazard and whatnot, but there is one simple truth - we are not ever going to let people die as a result of denying care. There will always be chronically sick people - and they will be provided some level of treatment. Those expenses are dipersed throughout the system in one form or another whether it's in the case of higher premiums, or passed on directly to the healthcare provider/tax payer. The system we have now has so many broken pieces. Everyone needs to be assigned to a pool one way or the other - we are being bled dry. Most of the boomer's and the older generation don't give a fuck and keep the status quo because they basically have free healthcare in the form of Medicare. We need high deductible insurance and HSAs.

 
Apr 5, 2012 - 11:47am

Agree with both of the above. I could stomach a single payer system if there were also tax credits available for those who elect pay for private insurance / care. But yes, unless you plan on turning people away at the hospital door you should probably get everyone paying.

I just cant believe that Obama, a constitutional law professor, championed a bill of such dubious constitutionality. The regulatory power compel a private individual to engage in commerce did not exist before this bill was passed (especially b/c they are buying a private good). The individual mandate should have been enforced as a tax where precedent regarding medicare and medicaid would take over. This would allow the court to stay in familiar territory without worrying about unintentionally laying the foundation for unlimited federal power in the future. That being said, I don't see how you can call it a tax without offering a public option.

Hard issue for me b/c I hate giving the government power. Unfortunately it seems like a single payer is the most economically viable solution. It just needs to be enacted in a legal way.

 
Apr 5, 2012 - 3:16pm
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