The Pre-Existing Condition Debate

I hate politics. They use our healthcare system as a chess piece in their game of thrones. I hate health insurance companies. They are the ultimate evil. Add the two together and you have hell on earth. Actually, the biggest lobbying group in this country is health insurers so they are all in bed together. This is why talking about pre-existing conditions sucks.

The old system would charge you more if you had major medical problems. Boooo. But wait. It was still cheaper than the cost of health insurance today.

Sometimes you couldn’t even get coverage if you had a disease in the old days. Booo. But wait. States would have options for uncovered patients in what was a high-risk pool.

Many people with the most common medical problems did have to pay more for insurance in the old system. Booo. But wait, the overwhelming majority of medical problems are from behavioral decisions to smoke, drink, overeat and never exercise.

That leads me to this article in the WSJ. They explain that:

One of the biggest political cons of the past decade is the left’s claim that only ObamaCare could keep these Americans from being deprived of health care. In fact, the law’s regulations and mandates have often resulted in narrow networks and high out-of-pocket costs for patients who most need good and affordable care.

Ok, so let’s not get into left or right here. The above is a charged statement but it doesn’t mean it is false. Narrow networks and high out-of-pocket costs are a reality.

I just want to highlight some other things in the article:

  • a 2018 survey that found more than 90% of National Cancer Institute-designated cancer centers are “out of network for some or all health exchange carriers in their state.” 
  • The survey notes that coverage mandates may have “accelerated the use of narrow networks to control health plan costs” on the exchanges
  • Houston’s MD Anderson Cancer Center doesn’t accept “a single private health insurance plan sold on the individual market in Texas.” Having an insurance card is no comfort to cancer patients shut out from top hospitals and doctors.
  • The Galen Institute’s Brian Blase pointed out last week that the Affordable Care Act is on track to cost taxpayers $1.8 trillion over the next decade, and too much of that goes to pay insurance companies for “healthy enrollees who need massive subsidies to afford the coverage that the ACA made much more expensive.”

I understand this topic is massively controversial. Fine. I don’t need to hear people say Obama was evil or Trump is evil or whatever. The fact is that the only one winning from the ACA are the health insurers and that is not good. They raise their rates every year and more and more people who are forced to pay, for others who don’t have to, are dropping out. Yes, some in this country get their insurance for free but with more people not paying it creates an endless cycle of cost increases.

I am a free-market guy. I am not in favor of socialized medicine. I do not want healthcare to become the DMV or the USPS. Direct Primary Care has proven this can bring prices down massively. It’s time we get rid of the major insurers. It’s time for transparent medical prices. We need a safety net for the very poor but the overwhelming majority should pay something and there should be competition for the cost of medical services and the cost for health insurance.

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