Comment by dragontamer | Hacker News Reader

Comment by dragontamer | Hacker News Reader

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> Yes, people do lose their insurance constantly when they switch jobs...and then immediately sign onto their new plan.

Lets say you payed for insurance, but were healthy for the 90s. So ~10-years of paying insurance. Around 2005, you are diagnosed with Diabetes, so your insurance pays for your care.

Around 2007, the recession happens and you lose your job. You immediately find a new job, but you need to get new insurance. Diabetes is now a "pre-existing condition", so your insurance no longer covers your condition.

Its important to recognize that changing health-plans is a regular event, that shouldn't punish people with chronic conditions. Diabetes is lifelong, once you get it, you live with it for the rest of your life. Insurance companies don't want to pay for that kind of issue. With all talk about "Repeal and Replace", its important to recognize the tradeoff.

As long as "pre-existing conditions" are banned in the USA, I don't think its a big deal to lose employer sponsored health care (at least, compared to pre-Obamacare). We should build a world where it is easy to lose (and regain) health coverage... compared to the pre-Obamacare world where it was a big risk to lose coverage. Hopefully laws of the future make it easier to switch health care plans without problems.

If you find a new job and you’re eligible under group insurance, the insurance company can’t deny a claim under pre-existing conditions. This was true before the ACA. What the ACA changed was that insurance companies couldn’t exclude treatment based on preexisting conditions if you go on the open market.

Pre-ACA group plans could deny preexisting conditions for a time period equal to the time that you were uninsured.

When I switched job I would get a letter from previous insurance company stating the dates that I was insured. Once I actually had to provide that to the new company.

It seems like we are both partially correct. They could deny you for up to a year for a pre-existing condition prior to the ACA.

https://twocents.lifehacker.com/you-could-be-denied-pre-exis...

That’s been ameliorated somewhat by ACA and is the only reason I think it’s an improvement even though my premiums have gone up. There’s all sorts of pre-existing conditions, and healthcare with the threat of retroactive recision if they feel your application was incomplete ought to feel insecure to just about anyone.

Somewhat, but people with insurance are still the largest group of people with medical bankruptcies.

I don't mean that it's affordable, I just mean that the reason isn't a pre-existing condition exclusion. For insurance for myself I'm paying $484.71 a month and there's a $5850 deductible, after which it probably only covers some percentage of it, until a maximum out of pocket is reached (this information isn't viewable in my account online and is probably in some mail that I've thrown out). Certainly not affordable.

A pre-existing condition exclusion means that you're on your own for expenses arising from your pre-existing condition, or if you didn't report it when you applied for your health insurance, that you could have your health insurance retroactively cancelled, and have to pay back any money you received. It's really bad, but since some healthcare expenses seem to have more than tripled in the last 10 years, it's often worse today. I'd much rather pay 100% of $800 than 50% of $3000.

Insurance is expensive in this country because medical care is expensive.

Medical care is expensive for a variety of reasons: nurse shortage, high-cost of training doctors, poor market conditions (opaque pricing that almost no layperson understands), cultural emphasis on fighting to the end rather than dying with dignity.

The cultural part probably won't change, we just have to accept that USA's culture (aka: "Full Code") is going to naturally result in more expensive health care. Its far more expensive to try to live than to accept death. Maybe someone out there will fight the cultural battle, but I don't see any political advantage in doing so.

Other issues can be worked on. Doctors aren't necessary for all care: nurses are sufficient for most cases. Lowering the cost of becoming a doctor likely would help too: if doctors had less medical bills, they might charge less for their services. (They HAVE to charge a lot to pay off those $200k+ to $300k+ student loans).

Medicine / Drugs is getting political... because changes to drug laws necessarily becomes a patent dispute. Should we allow drugs from India to become FDA-tested and imported? Or should we keep them banned for patent-law issues?

There's research issues: FDA is purely a placebo test. There's almost no comparative research going on at the federal level (Obamacare started up a comparative research group, but that group needs more funding and probably should also research on the PRICE of medical solutions. For whatever reason, research of prices is illegal). FDA is a very, very rigorous placebo test, but that's all it is. If a new drug comes out that's better than a placebo (but worse than standard treatment), it will pass the FDA. This means that doctors still have to research which drugs are most effective for their patients on their own.

Doctors can't trust insurance companies when they pay for research: insurance companies are looking for the cheapest solution. Drug companies are obviously biased, and may not conduct fair comparative trials. And unfortunately, those are the two major groups which sponsors research in the USA.

The problem with covering pre-existing conditions at all times is that you need to make insurance mandatory, due to the adver selection problem.

If insurance is optional, then only people that know they are sick or will get sick will dominate the insurance, making it more expensive, and pushing the healthy-low risk out.

Its a well known economics problem that has no silver bullet.

What is crazy to me is that insurance is involved in paying primary care doctors. That is a terrible application of health insurance, and have full faith on high deductible plans bringing sanity back into this.

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