4 ms·

Was this ever a real problem, before or now after the individual mandate?

_jal 5y ago
"Empirical evidence of adverse selection is mixed. Several studies investigating correlations between risk and insurance purchase have failed to show the predicted positive correlation for life insurance, auto insurance, and health insurance. On the other hand, "positive" test results for adverse selection have been reported in health insurance, long-term care insurance, and annuity markets." https://en.wikipedia.org/wiki/Adverse_selection https://en.wikipedia.org/wiki/Adverse_selection
BurningFrog 5y ago
Before Obamacare adverse selection was managed by the "preexisting condition" system. Much like how you can't sign up for fire insurance when your house is already burning, you couldn't get insurance only after you need care. Obamacare did away with "preexisting condition", and the mandate was meant to replace it. With nothing at all acting as a backstop, AFAIK, I assume this is now baked into the ever exploding "cost disease" of US health care.
- anamax 5y ago
  > Obamacare did away with "preexisting condition", and the mandate was meant to replace it. The Obamacare "fix" already existed in several states. You believe that such a policy has certain consequence - can you identify those states by looking for that consequence? Note that pretty much every state had "if you keep your care, you can change providers", so the problem was only for folks who dropped coverage and then wanted back in. If you have a relevant condition, dropping coverage seems like an odd thing to do.
  - LorenPechtel 5y ago
    Some states had high risk pools. Limited coverage, limited access, high premiums.
    - anamax 5y ago
      I was unclear. While some states did have high-risk pools, other states had "can't turn down" rules much like Obamacare. Can you identify the "can't turn down" states by looking for the predicted health outcomes of such a policy?
      - LorenPechtel 5y ago
        In one sense we were a can't-turn-down state. No limit on the premium, though, and note the response I received from an insurance application. The can't-turn-down option wasn't meaningful.
- actually_a_dog 5y ago
  That's some serious twisting of words to claim that straight up denying people health insurance is "managing" anything.
  - BurningFrog 5y ago
    No, it's just using words. You can describe things without stating an opinion about the things!
    - actually_a_dog 5y ago
      No, sorry. Implying that adverse selection is "managed" by excluding people from having health insurance implies that the system actually works. Since large numbers of people are, by definition, excluded from having health insurance under such a system, it de facto does *not* work. This is not an opinion; it's a fact. A system that, by design, fails those who need it the most in order to syphon money off from those who need it the least is a failure.
      - BurningFrog 5y ago
        You seem really confused about the English language.
LorenPechtel 5y ago
It used to be that if you had health issues you simply couldn't buy insurance, period. My former employer failed in the housing collapse, trying to get private "Please feel free to reapply when you have a diagnosis." I'd love to have even a real diagnosis, but I do not expect I ever will.

_jal 5y ago

"Empirical evidence of adverse selection is mixed. Several studies investigating correlations between risk and insurance purchase have failed to show the predicted positive correlation for life insurance, auto insurance, and health insurance. On the other hand, "positive" test results for adverse selection have been reported in health insurance, long-term care insurance, and annuity markets." https://en.wikipedia.org/wiki/Adverse_selection https://en.wikipedia.org/wiki/Adverse_selection

BurningFrog 5y ago

Before Obamacare adverse selection was managed by the "preexisting condition" system. Much like how you can't sign up for fire insurance when your house is already burning, you couldn't get insurance only after you need care. Obamacare did away with "preexisting condition", and the mandate was meant to replace it. With nothing at all acting as a backstop, AFAIK, I assume this is now baked into the ever exploding "cost disease" of US health care.

anamax 5y ago
> Obamacare did away with "preexisting condition", and the mandate was meant to replace it. The Obamacare "fix" already existed in several states. You believe that such a policy has certain consequence - can you identify those states by looking for that consequence? Note that pretty much every state had "if you keep your care, you can change providers", so the problem was only for folks who dropped coverage and then wanted back in. If you have a relevant condition, dropping coverage seems like an odd thing to do.
- LorenPechtel 5y ago
  Some states had high risk pools. Limited coverage, limited access, high premiums.
  - anamax 5y ago
    I was unclear. While some states did have high-risk pools, other states had "can't turn down" rules much like Obamacare. Can you identify the "can't turn down" states by looking for the predicted health outcomes of such a policy?
    - LorenPechtel 5y ago
      In one sense we were a can't-turn-down state. No limit on the premium, though, and note the response I received from an insurance application. The can't-turn-down option wasn't meaningful.
actually_a_dog 5y ago
That's some serious twisting of words to claim that straight up denying people health insurance is "managing" anything.
- BurningFrog 5y ago
  No, it's just using words. You can describe things without stating an opinion about the things!
  - actually_a_dog 5y ago
    No, sorry. Implying that adverse selection is "managed" by excluding people from having health insurance implies that the system actually works. Since large numbers of people are, by definition, excluded from having health insurance under such a system, it de facto does *not* work. This is not an opinion; it's a fact. A system that, by design, fails those who need it the most in order to syphon money off from those who need it the least is a failure.
    - BurningFrog 5y ago
      You seem really confused about the English language.

LorenPechtel 5y ago

It used to be that if you had health issues you simply couldn't buy insurance, period. My former employer failed in the housing collapse, trying to get private "Please feel free to reapply when you have a diagnosis." I'd love to have even a real diagnosis, but I do not expect I ever will.