No individual mandate?

[LivingAlmostLarge]

Okay i've always wondered something about the individual mandate. Obamacare started in 90s as republican idea against socialized medicine. So individual responsibility.

But now to repeal obamacare they need to repeal individual mandate. And I get why to bring prices down so healthy individuals can opt out of medical insurance. It's why insurance is expensive is it's not spread out across the population.

But my question is when you repeal the individual mandate and people choose to not have insurance, what happens if something happens to them and they need it? How do you insure someone after they need it?

What happens if you develop something chronic? How do insurance companies cover someone with the condition?

Also the biggest tax breaks the employer provided health insurance tax free. But do you actually think employers would give employees more salary if they didn't provide insurance?

Wouldn't it make sense to decouple insurance with employment to have a fully free market health insurance system? Then we could determine if we could make obamacare work? Or if not an individual mandate then we'd really see how the market works if people aren't covered by medicare, tricare, or employer provided coverage?

[Thrif-t]

Wouldn't it make sense to decouple insurance with employment to have a fully free market health insurance system? Then we could determine if we could make obamacare work? Or if not an individual mandate then we'd really see how the market works if people aren't covered by medicare, tricare, or employer provided coverage?

Yep I agree with you and I have great health insurance thru my DH's work, but this isn't going to work unless EVERYONE pays into it. I really thought that we would move away from businesses providing health insurance when all this started, now I'm not so sure what they're trying to do??

Obviously some more tweaking needs to be done to help more people,as now it seems we've shifted the burden from poor people to the middle class, so we are no further ahead.

[disneysteve]

LAL, you are trying to use logic and rational thought to approach a problem that is political and involves insurance companies. Those things are mutually exclusive. The politicians and insurance companies don't give a damn what makes sense or what helps the most people. All they care about is what gets them votes and makes them the most money.

Insurance definitely shouldn't be tied to employment. Many people are stuck in dead end jobs because they need the coverage. Many people can't retire when they'd like to because they need the coverage. Many people lose their insurance when they lose their job for any reason.

Insurance should be universal. Everyone should be covered from the day they are born until the day they die. Anything short of that is unacceptable. Our current system is a disgrace.

[msomnipotent]

They simply DO NOT cover anything when you need it, if they have their way with healthcare. They want to bring back pre-existing conditions and a lifetime max. I take care of myself. I take my meds. I go for my appointments. I exercise and try to eat right. I still have RA and congenital defects, which made me uninsurable when they allowed pre-existing conditions. True story... I worked in healthcare for almost 11 years. Calling insurance companies all day to verify coverage was my main job for several years, so I developed a relationship with several people from several companies. When I called them to get individual coverage when we lost ours (the start up just decided to stop paying premiums and not tell anyone), they suddenly didn't know me. American Family actually hung up on me mid sentence, because I wasn't a money maker for them. My friend from Cigna was helpful and told me how to get in the state's high risk pool, but that was more expensive than self-insuring. We had to though, because losing coverage meant that they never had to insure us again. That is what we are looking at again, and I am in total disbelief.

Just so people do not assume this is a political rant, I am middle of the road with no political ties. I think this would be much simpler and more affordable if every politician was forced to have the same coverage as the worst plan offered. Suddenly, the plan wouldn't suck anymore!

[creditcardfree]

I find insurance to be part of the problem. Insurance decides what is even covered in the first place. There are many good health practitioners and treatments that aren't even covered by insurance. One example is thermography. Less invasive, earlier detection, but not covered or considered 'acceptable' thus insurance companies don't pay. So even if it was universal there is still a third party deciding what you can have done to your body that they will cover.

Health is complicated. Insurance is complicated. Politics is complicated. Thus no easy solution that will satisfy all.

[disneysteve]

Insurance decides what is even covered in the first place. There are many good health practitioners and treatments that aren't even covered by insurance. One example is thermography.

Lord knows I'm no fan of insurance companies but I have to defend them on this one. They don't decide what is approved; the FDA does. A medication, treatment, device, or procedure has to prove it is safe and effective in order to gain approval. Most alternative things simply can't. Thermography is a good example.

If a woman goes for breast thermography and it comes back positive, she needs a mammogram because of the high false positive rate. If it comes back negative, she also needs a mammogram because of the high false negative rate. It isn't dependable enough to serve as adequate screening. So if you're going to get a mammogram either way, what was the point of the thermography? Why would or should any insurance company pay for a useless test?

ETA: Thermography is FDA-approved but only to be used in conjunction with mammography, not as a screening tool on its own. So you need to have both done. I can understand insurers only covering the better of the two tests.

[disneysteve]

I take care of myself. I take my meds. I go for my appointments. I exercise and try to eat right. I still have RA and congenital defects, which made me uninsurable when they allowed pre-existing conditions.

This is something that so many people ignore. Yes, it is absolutely true that a lot of health problems are self-induced. People are their own worst enemies. If everyone stopped smoking, stopped drinking in excess, ate a healthy diet, and exercised regularly, a lot of health issues wouldn't exist.

But a lot of health problems aren't the individual's fault at all. Pre-existing condition clauses punish everyone regardless of the cause of the condition. My wife is a cancer survivor. She didn't get cancer from smoking or drinking or being obese or occupational chemical exposure. She was 4 years old when she was diagnosed. I'm pretty sure she led a perfectly normal existence for those first 4 years of her life. Her cancer wasn't her fault. But even today, 50 years later, she has to give details of her cancer diagnosis and treatment and current status when she is doing any sort of insurance paperwork. If the insurers had their way, I'm sure they'd refuse to cover her because 5 decades ago she had cancer.

[creditcardfree]

Lord knows I'm no fan of insurance companies but I have to defend them on this one. They don't decide what is approved; the FDA does. A medication, treatment, device, or procedure has to prove it is safe and effective in order to gain approval. Most alternative things simply can't. Thermography is a good example.

If a woman goes for breast thermography and it comes back positive, she needs a mammogram because of the high false positive rate. If it comes back negative, she also needs a mammogram because of the high false negative rate. It isn't dependable enough to serve as adequate screening. So if you're going to get a mammogram either way, what was the point of the thermography? Why would or should any insurance company pay for a useless test?

ETA: Thermography is FDA-approved but only to be used in conjunction with mammography, not as a screening tool on its own. So you need to have both done. I can understand insurers only covering the better of the two tests.

OK...our government FDA...who is subject to lobbying by the pharmaceutical
and insurance companies, both of which are in business to make money. Wouldn't a business who sees a potential therapy to be a threat to their business want to deny a service? Seems logical to me. They only answer to their shareholders in the end, not the customers. Thus they lobby the FDA to deny approval of known and proven treatments.

There are known cancer treatments in other countries that our FDA does not approve. Why? Maybe because we would actually cure something that is making businesses money in this country. I find that unethical. I will go to another country and pay out of pocket for those treatments if it ever comes to it.

Subjecting breasts to radiation and pounds of pressure is not the better of the tests. Look at the high false positive rates of mammograms. They are not better. My next step would not be to get a mammogram. I would seek out functional medicine doctors that would provide intensive nutrition evaluation and treatment, and possible hypothermia (which would have to be in another country) People have reversed cancer this way and it is not rare.

It's my body my choice. I will always do my own research before subjecting my body to any treatment. I will not blindly trust the FDA or any other individual for doing that for me.

No mammography for me. It's outdated and the science is ahead of current practices. Women want better. Women deserve better. We want safer ways to detect and treat breast cancer.

[disneysteve]

There are known cancer treatments in other countries that our FDA does not approve. Why? Maybe because we would actually cure something that is making businesses money in this country.

Sorry, I am not a conspiracy theorist.

If you think a cure for cancer wouldn't make businesses hundreds of billions of dollars, I don't even know what to say to that.

I will point out that cancer deaths have been steadily declining in the US for the past couple of decades as early detection and treatments have improved. If the conspiracy was true, that wouldn't be the case.

Look at something like liver cancer. One of the leading causes of liver cancer is Hepatitis C, a previously incurable disease - but not any more. Today, we have medication that is curing 98% of cases of Hep C. That will translate to far fewer cases, and deaths, due to liver cancer. And guess what, the companies that make those meds are earning a fortune selling them. So the cockamamie idea that there's no money to be made curing cancer is ludicrous. But I know facts never have any effect on the beliefs of the conspiracy folks.

[TexasHusker]

LAL, you are trying to use logic and rational thought to approach a problem that is political and involves insurance companies. Those things are mutually exclusive. The politicians and insurance companies don't give a damn what makes sense or what helps the most people. All they care about is what gets them votes and makes them the most money.

Insurance definitely shouldn't be tied to employment. Many people are stuck in dead end jobs because they need the coverage. Many people can't retire when they'd like to because they need the coverage. Many people lose their insurance when they lose their job for any reason.

Insurance should be universal. Everyone should be covered from the day they are born until the day they die. Anything short of that is unacceptable. Our current system is a disgrace.

Should we also all be guaranteed housing, transportation, clothing, food, and a college education?

[TexasHusker]

I find insurance to be part of the problem. Insurance decides what is even covered in the first place. There are many good health practitioners and treatments that aren't even covered by insurance. One example is thermography. Less invasive, earlier detection, but not covered or considered 'acceptable' thus insurance companies don't pay. So even if it was universal there is still a third party deciding what you can have done to your body that they will cover.

Health is complicated. Insurance is complicated. Politics is complicated. Thus no easy solution that will satisfy all.

Insurance companies are generally for-profit entities. They make money only when they take in more than they pay out. Kind of like other businesses.

Everyone blames the insurance companies, but lets the hosoiitals have a free pass. My wife spent ONE NIGHT in the hospital last year and the bill was over $80,000. I don't blame the insurance company for balking. Although they finally paid.

We don't have an insurance problem. We have a rape-and-pillage problem.