Who should pay for pre-existing conditions?

A friend of mine, whose name I will keep anonymous wrote the following satire about what to do about how to pay for people’s pre-existing conditions.  But when it comes right down to it, he basically described high risk pool insurance in a nutshell.  Pre-Obamacare, we had Cover Colorado, the high risk pool in Colorado.  It was funded by a small fee that every insured person in the State paid on their insurance bill.  If you think about it, any group can be “taxed” to fund high risk.  In Colorado, it was a hidden fee that every insured person had to pay.  It can be done, and it can work, with agreement from the people of the community.  I believe that all states should have high risk pools, but to keep things fair, there should still be waiting period penalties for those who choose to have a coverage gap longer than a specified amount of time.  As an alternative to high risk pools, we could implement health status insurance, for those who are worried about developing a health condition while employed who loses insurance due to job loss; health status insurance is simple way to solve the problem of portability:

“I have an idea for how to handle people with pre-existing conditions. First, we need to understand what insurance is, and what a pre-existing condition is. Insurance, by definition, is a system whereby people insure against the risk of something happening. Some people will have unforeseen expensive conditions develop, so a large group of people pays premiums proportional to their risk, and then the insurance company pays for the expensive conditions out of those premiums. Pre-existing conditions are conditions that exist before somebody buys insurance.

So what does it mean to make an insurance company pay for somebody’s pre-existing condition? It means that some company is doing business selling insurance policies to people who want to mitigate their future risk. Then along comes somebody who is not a customer of the insurance company, and has, for example, a severely damaged knee, wanting a knee replacement. The insurance company is then forced to pay the cost of this person who is not their customer, which might amount to $60,000. Perhaps the person with the bad knee has to pay a “premium” of a few hundred dollars, maybe even a thousand dollars, one time, in exchange for the $60,000 payment of the insurance company. After getting the knee replacement, the person can then cancel the “policy” and walk away from the insurance company, and never pay them anything again. That is, unless something else expensive comes along, in which case he can just make the insurance company pay his cost again and cancel again.

So what we are talking about is making some company pay the high costs of people who are not their customers. Clearly, these people need something to be done for them. They can’t afford to pay these high costs. In order to be compassionate, we need to force some other group of people to pay for them. It really doesn’t matter who (as long as it is not doctors). Who wants their own group to have to pay for them? I propose that we make hockey team owners pay for other people’s pre-existing conditions. Why not? If we are going to make some group of people pay for the medical fees of people who are not their customers, then why should it be insurance companies? Why not hockey team owners? In Idaho Falls, the hotel owners have to pay a special tax to pay for a hockey rink, which is called an events center. I believe that sort of thing has happened in plenty of other cities. I figure what goes around, comes around. Hockey team owners make hoteliers pay for their stadia, so we can make them pay for other people’s pre-existing medical conditions.

If you are opposed to this, then you must be uncompassionate. Either that, or you have a different idea about who you want to force to pay for people who are not their customers. What group of people do you think it should be? I think most people would pick a group to which they do not belong. Remember – not doctors. Let’s start a national movement to make the hockey team owners pay for pre-existing conditions. After all, we can’t just let these people suffer and die. Have some compassion, for crying out loud!”

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