TOM TOMORROW: Doctor Hand! ("How Can They Stay in Business if They Have To Insure Sick People?")

[Rilgin]

18. addition to good post

Last edited Mon Nov 4, 2013, 06:47 PM - Edit history (1)

Your last statement about risks is what I would expand on. Insurance works well to spread risks it does not work well to just pay for costs.

Health Insurance as a risk spreader requires the concept of pre-existing conditions or it just becomes a method of having healthy people subsidize the known costs of the people with existing medical conditions. Insurance companies are actually quite good at actuarial predictions of risks. Unknown risks like falling down stairs, strokes, accidents, hearth attacks, cancer with high costs are the real meaning of health insurance. You can add stuff like strep, flu, pneumonia that require doctors visits but are not really costly.

Getting rid of pre-existing conditions makes a system based on insurance a distorted system where you are getting the currently healthy to subsidize the health costs of others with known conditions and costs and then try to make it right with subsidies. Of course the ACA does do other insurance reforms but the essence of the system is using insurance and eliminating pre-existing conditions.

This is why government health care or government single payer is the only system that makes sense because it is theoretically consistent with the decision of a society to make health care a right and just have people with pre-existing conditions have health care directly paid for by government rather than a kludged distorted insurance system.