Thursday, September 20, 2012

Insurance and the Affordable Healthcare Act

I feel kind of bad pointing out the missing information to a 12-year old, but since his letter was printed on Huffington Post I felt that some things should be clarified.

First of all, I feel bad that his sister was born with serious medical conditions, it's not something anyone really has any control over. The thing is, when the letter starts pointing out why his family lost coverage it shows the lack of information he has, either because his parents never explained it to him, or his parents (and most people I know for that matter) don't even realize or think about. The thing about using company policies is that you run the risk of losing coverage if you lose your job, thus putting yourself in the situation of having to find another insurance carrier that doesn't want to be put under the additional financial burden of dealing with pre-existing conditions (or didn't before the AHCA, but more on that later).

Companies have been using insurance benefits for years as a way to lure in potential employees, and it has gotten to the point that many people just expect the company they work for to include healthcare benefits as part of their pay (many would actually let you opt out in return for a slightly higher paycheck btw). Most people never even thought of the risk inherent in such a system if they were to lose their job or go find a better one for themselves elsewhere, having to go to a new carrier. What they COULD have done was purchase a private insurance policy. That would have cost them more money true, but it would also have given them the freedom of not feeling chained to a single company in order to retain coverage. Of course, as more and more government regulation got involved it also forced those payments upward to make it harder for individuals to pay for their own plans.

Because of the AHCA requiring insurance companies to cover people even if they have pre-existing conditions people have been watching their insurance premiums go up because the insurance companies now have to cover people for conditions that they have never paid in to have covered. And it's only going to get worse as people opt to not pay for insurance coverage for years until a condition appears or accident occurs since most small businesses do not employ the 50+ people requiring them under the law to provide health insurance. Also, due to the ever increasing coverage costs you're unlikely to see those same small businesses offering coverage for their employees even with the tax breaks they are provided because it still won't cover the majority of the increased cost. The AHCA also includes such stupidity as requiring all females in a household have birth control coverage on the plan, regardless of age or medical condition (pre-pubescent, menopause, etc) which increase costs even more, and it does not make allowances for an individual's religious beliefs.

For anyone wondering why I actually go to a place like HuffPo, it's useful for seeing what false or incomplete information the other side is pushing.


  1. Everyone should certainly have equal access to comprehensive, affordable and quality healthcare regardless of pre-existing conditions, be it physical or mental illness. Quality healthcare is a fundamental right and not just a privilege. Looking forward to 2014 when the Affordable Care Act will fully go into effect!

    Chris from

  2. If you purchase it after discovering you have a condition it is NOT insurance. It is the fault of the individual making the assumption that nothing will go wrong and not purchasing that insurance beforehand, not the responsibility of the insurance company to cover your bad decision. That's about the only benefit of a state-run health program is that it FORCES everyone to pay for insurance rather than making them take the responsibility to do so. And guess what, all those state-run healthcare companies STILL have people coming here to get treated. Most pharmaceuticals are created here, they are just tested in other countries first because of less stringent laws allowing testing and actually marketing the various treatments (yes, our government rules are so screwed they actually prevent new treatments being utilized here within a reasonable amount of time).

    The ability to get insurance individually, or to start your own group that is not company affiliated, has ALWAYS been available, it's just that the majority of people choose not to do so because their company's insurance policy is cheaper. That's the risk people take, whether they realize it or not.

    As far as healthcare for the uninsured, the reason it costs so much in this country is all of the stupid lawsuits we allow against doctors doing their job (having to keep an army of lawyers on call in case something goes wrong is expensive). Even with the informed consent forms (which rarely ever hold up in court) people still sue if anything goes wrong, even though they knew the risks going into the procedure. Add those lawsuits upon the ever increasing cost of making and upkeeping medical equipment (like the increase added in the ACA for medical equipment manufacturers) and you see that the government and frivolous lawsuits are the major cost of our healthcare fees.

    Insurance companies are a BUSINESS, so of course they are in it to make money, and their profit margins definitely drive prices (and natural greed leads them to keep their own army of lawyers to fight having to pay out). If the government increases taxes on them, OF COURSE they are going to increase the cost to their customers, it's the same in EVERY industry in the world. Instead of forcing those companies to increase coverage for people (especially since people with insurance are allowed to determine WHAT they want covered and pay accordingly) the only thing the government should be doing is making sure the insurance companies pay out to people who have been paying in when they discover a condition; Forcing those companies to honor agreements made when the contracts were signed, rather than fighting to payout because the person MAY have known beforehand (now if they have medical documents proving the person knew, and hid the fact, that is a different story).