6 ms·

You point out some of the ridiculous things they cover, which isn't wrong. However, these plans ALSO don't have lifetime benefit caps, are available whether or

You point out some of the ridiculous things they cover, which isn't wrong. However, these plans ALSO don't have lifetime benefit caps, are available whether or not you have pre-existing conditions, and offer (almost always) much better preventive care coverage. I don't think many people realize just how bad the old, cancelled, catastrophic care plans were/are.

rbritton 13y ago
Not all of them were bad. Health insurance varies wildly by state, which is another topic that's being ignored, and we had a reasonable catastrophic plan that covered all preventative care visits with just a small copay.
ams6110 13y ago
There must be some kind of Yogi Berra-ism to describe "how bad" the insurance is that so many people wish they could still buy. Insurance against a condition that already exists is not insurance. Preventive care should not be something you look to insurance to pay for. Do you expect to be insured against your weekly grocery shopping bill? Your utilities? Your rent?
- temporary1312 13y ago
  "Insurance against a condition that already exists is not insurance," but I've twice had coverage for other unrelated conditions (rehab for a broken leg, and treatment for severe pneumonia) denied because I was hospitalized years earlier for a chronic illness having to do with the digestive tract.
  - hsitz 13y ago
    Sounds like you're extending intent of quote to be about "pre-existing conditions". Obamacare requires that health insurance policies cover pre-existing conditions, which is another difference from other types of insurance. The only way this could reasonably be required would be if all individuals are required to always carry insurance, which is what gives rise to the much-debated "individual mandate". All of this makes good sense, in my mind. You don't say why you were denied coverage for broken leg rehab and pneumonia treatment. It seems a stretch for it to have been denied as pre-existing condition, but one of the problems when insurance companies were allowed to deny for pre-existing conditions was that they did often make non-sensical stretches to deny. I think reason for denial in your case was probably for something else, perhaps something like an insurer's "annual cap" on coverage (but not that b/c your previous coverage was years earlier), another thing that now is gone thanks to Obamacare.
    - temporary1312 13y ago
      Yes, I was straight up denied coverage for broken leg rehab and pneumonia coverage for having the intestinal issues, and only through fighting it was it covered. It was not anything other than insurance companies being dickish, hadn't reached the annual cap or anything like that. Other friends of mine with chronic illnesses have had similar issues. Needless to say, I'm looking forward to that provision of obamacare.
- hsitz 13y ago
  "Preventive care should not be something you look to insurance to pay for. Do you expect to be insured against your weekly grocery shopping bill? Your utilities? Your rent?" In fact, Obamacare mandates that much preventive care be provided for free. Health insurance is different from many kinds of insurance, which you hope never to collect on. With healthcare insurance you're very likely to use at least some covered services every year. Preventive care is the kind of care everyone should have every year, and it is the kind of care that best reduces health costs, making it best for patients and for nation as a whole. That's why Obamacare requires that it be covered 100%, even in least expensive bronze plans. This encourages people to get preventive care and prevents bigger expenses for them later on. I'm not knocking Obamacare. Hardly, I'm a proponent of it. It makes sense.
  - hga 13y ago
    "Preventive care is the kind of care everyone should have every year, and it is the kind of care that best reduces health costs...." BZZZT. As I understand it, study after study shows preventive case does not result in cost reductions. E.g. look at the controversial mammogram screening recommendations that came out a while ago. There are many other mechanisms where not immediately obvious things come into play. That's not to say we shouldn't do it, look at the backlash to those mammogram recommendations, which would have killed a friend of mine in her early 40s if she and her doctor had followed them, just that they will overall cost more.
    - hsitz 13y ago
      BZZZT. Preventive care in general is cheapest and study after study shows that it is. That doesn't mean that certain kinds of preventive care might not work. Of course if they don't work then they're not cost effective. But the fact that smart, simple tests to catch diseases or conditions before they've progressed is most cost effective method has been established for a long time. Heck, just having patients get in for an annual physical and quick look over from a doctor is cost-effective form of preventive care. That's why ACA requires it to be covered. I do agree that unwise or poorly designed preventive care, usually in the form of excessive and expensive testing that is poorly chosen and often has too many false positives, is one of the big problems running up medical costs. That does not change the fact that proper preventive care is most cost-effective form of healthcare.
- jasomill 13y ago
  Call it what you will, but health insurance that doesn't cover preventive care and pre-existing conditions would be all but useless to me, personally, due to expensive ($15,000/month, give or take) preventive treatment necessary to properly treat severe hemophilia. With that said, hard cases make bad law, and the argument against immediate coverage of pre-existing conditions — healthy people will rationally choose to remain un- or underinsured, then seek more comprehensive coverage when diagnosed with something that requires expensive treatment — is reasonable. It's also a decent argument for universal health care at a reasonable minimum standard.
hga 13y ago
They also redistribute a LOT of money to the age 50-64 bracket. And the money for the subsidies has to come from somewhere, TANSTAAFL. Also look at the banding system. I don't know about Jayschwa, but __xtrimsky elsewhere in this discussion is one of the "young invincibles" who's buying of very expensive insurance is essential for the economics to work out; well, such as they were before 14 and counting last minute changes.
- gaius 13y ago
  This is exactly how National Insurance works in the UK. It isn't really insurance per se; money coming in is paid straight out again.
rdl 13y ago
My HSA-compatible HDHP which I had from 2010-2013 had no lifetime cap or annual cap, and since I'd had employer coverage before, no exclusion on pre-existing conditions. They actually reduced some benefits (for out of network providers) from 2013 to 2014, and the price went from $81 (2010) to $90 (2011) to $102 (2012) to $120 (2013). HSA Bronze HSA, the nearest equivalent, is $214 from another provider, or $250 from this provider. So I switched to a $41/mo short term plan for 2014.
f3llowtraveler 13y ago
The problem with the new plans is the same as the problem with the old plans: there's no free market. People don't have any "choices" except what's forced onto them in a "market" where everything is all sewn up vertically. The insurance companies are writing the legislation. They were writing it before Obamacare, and they're writing it now. The only difference is, now they are writing more of it.

rbritton 13y ago

Not all of them were bad. Health insurance varies wildly by state, which is another topic that's being ignored, and we had a reasonable catastrophic plan that covered all preventative care visits with just a small copay.

ams6110 13y ago

There must be some kind of Yogi Berra-ism to describe "how bad" the insurance is that so many people wish they could still buy. Insurance against a condition that already exists is not insurance. Preventive care should not be something you look to insurance to pay for. Do you expect to be insured against your weekly grocery shopping bill? Your utilities? Your rent?

temporary1312 13y ago
"Insurance against a condition that already exists is not insurance," but I've twice had coverage for other unrelated conditions (rehab for a broken leg, and treatment for severe pneumonia) denied because I was hospitalized years earlier for a chronic illness having to do with the digestive tract.
- hsitz 13y ago
  Sounds like you're extending intent of quote to be about "pre-existing conditions". Obamacare requires that health insurance policies cover pre-existing conditions, which is another difference from other types of insurance. The only way this could reasonably be required would be if all individuals are required to always carry insurance, which is what gives rise to the much-debated "individual mandate". All of this makes good sense, in my mind. You don't say why you were denied coverage for broken leg rehab and pneumonia treatment. It seems a stretch for it to have been denied as pre-existing condition, but one of the problems when insurance companies were allowed to deny for pre-existing conditions was that they did often make non-sensical stretches to deny. I think reason for denial in your case was probably for something else, perhaps something like an insurer's "annual cap" on coverage (but not that b/c your previous coverage was years earlier), another thing that now is gone thanks to Obamacare.
  - temporary1312 13y ago
    Yes, I was straight up denied coverage for broken leg rehab and pneumonia coverage for having the intestinal issues, and only through fighting it was it covered. It was not anything other than insurance companies being dickish, hadn't reached the annual cap or anything like that. Other friends of mine with chronic illnesses have had similar issues. Needless to say, I'm looking forward to that provision of obamacare.
hsitz 13y ago
"Preventive care should not be something you look to insurance to pay for. Do you expect to be insured against your weekly grocery shopping bill? Your utilities? Your rent?" In fact, Obamacare mandates that much preventive care be provided for free. Health insurance is different from many kinds of insurance, which you hope never to collect on. With healthcare insurance you're very likely to use at least some covered services every year. Preventive care is the kind of care everyone should have every year, and it is the kind of care that best reduces health costs, making it best for patients and for nation as a whole. That's why Obamacare requires that it be covered 100%, even in least expensive bronze plans. This encourages people to get preventive care and prevents bigger expenses for them later on. I'm not knocking Obamacare. Hardly, I'm a proponent of it. It makes sense.
- hga 13y ago
  "Preventive care is the kind of care everyone should have every year, and it is the kind of care that best reduces health costs...." BZZZT. As I understand it, study after study shows preventive case does not result in cost reductions. E.g. look at the controversial mammogram screening recommendations that came out a while ago. There are many other mechanisms where not immediately obvious things come into play. That's not to say we shouldn't do it, look at the backlash to those mammogram recommendations, which would have killed a friend of mine in her early 40s if she and her doctor had followed them, just that they will overall cost more.
  - hsitz 13y ago
    BZZZT. Preventive care in general is cheapest and study after study shows that it is. That doesn't mean that certain kinds of preventive care might not work. Of course if they don't work then they're not cost effective. But the fact that smart, simple tests to catch diseases or conditions before they've progressed is most cost effective method has been established for a long time. Heck, just having patients get in for an annual physical and quick look over from a doctor is cost-effective form of preventive care. That's why ACA requires it to be covered. I do agree that unwise or poorly designed preventive care, usually in the form of excessive and expensive testing that is poorly chosen and often has too many false positives, is one of the big problems running up medical costs. That does not change the fact that proper preventive care is most cost-effective form of healthcare.
jasomill 13y ago
Call it what you will, but health insurance that doesn't cover preventive care and pre-existing conditions would be all but useless to me, personally, due to expensive ($15,000/month, give or take) preventive treatment necessary to properly treat severe hemophilia. With that said, hard cases make bad law, and the argument against immediate coverage of pre-existing conditions — healthy people will rationally choose to remain un- or underinsured, then seek more comprehensive coverage when diagnosed with something that requires expensive treatment — is reasonable. It's also a decent argument for universal health care at a reasonable minimum standard.

hga 13y ago

They also redistribute a LOT of money to the age 50-64 bracket. And the money for the subsidies has to come from somewhere, TANSTAAFL. Also look at the banding system. I don't know about Jayschwa, but __xtrimsky elsewhere in this discussion is one of the "young invincibles" who's buying of very expensive insurance is essential for the economics to work out; well, such as they were before 14 and counting last minute changes.

gaius 13y ago
This is exactly how National Insurance works in the UK. It isn't really insurance per se; money coming in is paid straight out again.

rdl 13y ago

My HSA-compatible HDHP which I had from 2010-2013 had no lifetime cap or annual cap, and since I'd had employer coverage before, no exclusion on pre-existing conditions. They actually reduced some benefits (for out of network providers) from 2013 to 2014, and the price went from $81 (2010) to $90 (2011) to $102 (2012) to $120 (2013). HSA Bronze HSA, the nearest equivalent, is $214 from another provider, or $250 from this provider. So I switched to a $41/mo short term plan for 2014.

f3llowtraveler 13y ago

The problem with the new plans is the same as the problem with the old plans: there's no free market. People don't have any "choices" except what's forced onto them in a "market" where everything is all sewn up vertically. The insurance companies are writing the legislation. They were writing it before Obamacare, and they're writing it now. The only difference is, now they are writing more of it.