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to offer specific products to specific people. Anything that forces a private business (insurance companies are private business) to offer a product that they wouldn't otherwise offer is against free market principles.

Thus, forcing insurance companies to offer certain coverage to certain individuals is contrary to the idea of PRIVATE and FOR-PROFIT insurance companies.

Making insurance more expensive for 98% of the population so that it is less expensive for 2% of the population is not good policy (it messes up the pricing mechanism which would otherwise keep price increases in the realm of sanity), and is not consistent with free market principles.

In order to minimize government disruption of the insurance market, it would be better to let private insurance companies function voluntarily for the 98% and then have government deal with the remaining 2% using other means.

If there's one place where the free market does not work, it's health care--the preservation of human life.

Because a free market depends on a pricing mechanism to transmit pricing information to cause supply and demand to balance. But no one can put a price tag on a human life.

The reason why insurance pools work in other areas, notably homeowner's insurance, is that there is an obvious predictable limit on how much the policy needs to pay out on a claim--the replacement cost of the house. If your $300,000 house burns down, you're not going to file a claim for $100,000,000.

But there is no limit on how much money you will spend to save your life, if you have a life-threatening illness. In a sense, the "replacement cost" of your life is INFINITE. Unlike a condemned house, you can't just walk away from it and buy another.

And that's why you can never have a totally "free market" in health care comparable to the free market in homeowner's insurance or the insurance of any nonliving items.

A health insurer can't know in advance how much they will have to pay out in claims to a sick individual, because he will gladly spend whatever it takes to get better--no limit. So it's to the insurer's interest to only have healthy young policyholders who file no claims at all.

That is the minority.

For the vast majority of health issues, there are very clear national averages. If you have a cold, you don't spend 100,000,000 on it. If you have a broken leg, you don't spend 100,000,000 on it. Illnesses each DO have price tags associated with them. There is a whole branch of health insurance-related work that deals with the costs of healthcare per illness, so that the health insurance company can know if a doctor/patient is trying to defraud them.

When you're dealing with unknown illnesses, then yes the price is hard to predict. But for the VAST majority of illnesses that brings someone to the doctor/hospital, the costs are very predictable.

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Dependence is Slavery.

for health care.

Am saying that reform in the direction of free markets would be quite helpful.

Your argument about how "there is no limit on how much money you will spend to save your life" seems to be in favor of free markets. After all, people will be motivated to come up with the money. Similarly, there needs to be some mechanism for limiting the resources that any individual or group can demand be used for their respective benefit.

The costs of health insurances are not replacement costs. Your analogy is flawed. MRI scans do have a price. Surgeons have a price. Medicines have a price. All insurance policies are not based on a "replacement cost" basis. Rather insurance, at its core, is about hedging against future contingencies that would be catastrophic in nature. We buy home insurance because most of us cannot easily self-insure in that way.

The insane healthcare costs are not simply a matter of catastrophic situations. It is the fact that various players in the healthcare industry make up for catastrophic costs by making day-to-day medicine more expensive. Similarily, day-to-day medicine is made more expensive by people making decisions that they do not have to pay for.

We should de-couple employment from health insurance by changing the tax code.

We should allow private insurance to be substantially de-regulated, and allow the free market system to handle the 98-99% of the situations in the most cost effective manner possible.

Government can step in and cover the remaining 1-2% with government insurance (that can be subsidized if desired) by accessing a small amount of the savings that will be generated from a more sane system.

Health Insurance has become a Modern Charity, where the healthy subsidize the sick. The issue isn't with the supposed free-market of insurers. Their preference is already clear, to minimize risks, and reduce risk pools to individual persons.

So, will you support government handouts (a ridiculous idea in the 19th century) for the medically indigent? Because a freed-up insurance industry won't touch them. And a healthy populace will be tired of paying for their bills.

There is a Scandal brewing here, with medical testing for insurance, and I want no part of it.

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Government currently provides insurance options to people who are otherwise uninsurable.

This is a better approach than screwing up the entire system.

I agree that we do not have a free market for healthcare.

We would be better served if we moved in that direction.

Given the upcoming entitlement bomb, conservative government will become impossible if we do not find a way to solve or at least deal with this problem.

(1) Decouple insurance from employment by giving individuals the same tax advantages as companies in buying insurance. This will also increase the number of HSAs, which will help the market function better as well. Competition will get costs down.

(2) De-regulate what is covered and what is not. Allow individuals to buy policies offered in other states. I.e. don't force a 55 year old happily married man to pay for AIDs coverage. This will make insurance more affordable for just about everyone, and it will make people become more involved in their own health care decision making.

(3) Move Medicare and Medicaid to a privatized HSA model (deregulated HCFA). This will increase insurance pools, decrease prices, and increase freedom/choice/control.

These three things would do a lot to improve our system.

I'm not sure how familiar you are with the insurance industry (your comment suggests very little), but Neil is dead on in his assessment of insurance.

Pooled risk is not a concept that precludes a company from having underwriting criteria.

You'd have a point if you weren't misrepresenting why RP is mocked. We go after him for welcoming Nazis and their money in support of him, for spouting off nonsense monetary policy, for being indistinguishable fron UBL when talking about 9/11 and who was to blame, for having a radical pacifist foreign policy, and for being a porker to boot.

We call him a failure for being a lone dissenter while never getting any progress in his direction. He never passes bills, defeats bills through leadership, or gets bills amendedp roperly.

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Well right, in general I agree with all those. That doesn't change the fact that some conservatives seemed to want to use his specific vote against this as some sort of evidence that he is a lunatic, when he was, IMO at least, the only person who voted right. See e.g. http://redstate.com/redhot/streiff/2008/may/02/ron_paul_faux_libertarian

I could, in fact, just be dense and missing the point/humor there.

This bill forces others into paying for them, essentially forcing insurance firms to act as charities.

No, sir, the burden is on those who would act to justify their actions. You can't turn this onto me. I'm ont the one holding up myself and government bureaucrats as having all the answers.

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Do you, somehow, think we'd pay less if insurance was by government mandate?

There are always going to be people in a bad spot. Is it the Government's job to ensure we all have an easy life?

Is it sad? Of course. Do I WANT people to suffer? Of course not.

It is not, however, the job of the government to mandate health insurance coverage.

What do they do? Not sure. Band together and start an insurance company that provides insurance for those who are denied coverage elsewhere.

Why should there be a REQUIREMENT to insure someone?

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Dependence is Slavery.

What of those who already are denied coverage on pre-existing or pre-disposition grounds. I happen to be such a person. Should the government swoop in and force you to pay for my arthritis?

absentee
Also Find Me Here.

Under Socialist Rule, you'd have FREE healthcare!

Well, you have to give up most of your paycheck in taxes, and you'd have total control by the government in most of your life, but isn't freedom and money a small price to pay for FREE HEALTHCARE!

heh.

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Dependence is Slavery.

we as a society have already decided that those without insurance coverage will still recieve a (presumably) reasonable level of medical care. The taxpayer picks up the bill for the poor (Medicaid) and the old (Medicare)and the hospitals (via EMTALA) pick up the tab for the otherwise uninsured. The hospitals then pass the cost on via higher rates to the insurance payors.

My point is just that whatever the fair market principle at play here, it's irrelevant in terms of changing the economics. That ship has already sailed and its never coming back to port.

so that the health care system avails itself to sane pricing mechanisms.

Using public insurance to cover specific individuals for specific conditions (e.g. the pre-existing condition not covered). The Blues already have policies available for this purpose---to cover those who would otherwise be insurable. Segmenting those specific conditions out is more efficient than pooling everything together.

The long term solution to this problem is decoupling health insurance from one's employment. If people weren't force to change insurance when they changed jobs, they could simply preserve their existing insurance if a condition is discovered that would ultimately become a pre-existing condition.

To decouple health insurance from employment, we need to go in the direction of free markets.

Is that pretty much everyone in the country who is employed with a job that has totally sweet health insurance would see the move to decouple health insurance from employment as an attempt at the government taking away one of their major benefits.

Here's the sweeping generalization:

There are two types of people who have totally sweet health insurance.

1) Public Service Types. You know, teachers, cops, TSA Employees, that sort of thing. 100% Democrats who aren't afraid to call their union representative and you *KNOW* the union rep has at least two senators on speed dial and goodness knows how many congressmen.

2) Employed White Collar Workers. Accountants, Middle-to-Upper level Managers, that sort of thing. 95% of them are 100% Republicans who aren't afraid to call their Congressman/Senators and point out that they donated the max last year and is moving to socialized medicine really in the best interest of the country?

Man is free at the moment he wishes to be. --Voltaire

at the least the folks in #2 should understand that companies will have every incentive to increase their comp as employees take direct control and responsibility for their "totally sweet health insurance coverage". Such folks can also come to understand that control means they can even pursue "totally sweeter than sweet" coverage if they want.

#1 is harder. These union groups never support Republicans in any case. This is were we need to spend time and energy educating the public.

Let's say that my employer pays, I dunno, $230/week for my health care leaving me to pay $20/week for some totally sweet insurance.

The company sits me down and tells me that I have to get my own coverage henceforth but they'll give me the *ENTIRETY* of that $230 a week that they used to give to the health care company for me to do whatever I want with it.

Hurray! I'm making an extra $1000/month! That's a $12000/year raise! Then, of course, when I go out and look for insurance that is comparable to what I used to get... I find that I have to pay around $1000/month for it. Moreover, I have to spend time thinking about it. I have to deal with hassle of shopping around for a better deal.

And, irrational as it is, I'm going to think that, before the government got involved, I was "only" paying $20/week for really sweet insurance and I didn't have to think about it.

Man is free at the moment he wishes to be. --Voltaire

while others will welcome the opportunity to get a cheaper policy that is not loaded with coverage that they will never use. Moreover, if people are allowed to implement HSA options at their choice, many will appreciate the value in bargain shopping if they can keep the savings tax free for a rainey day.

If someone were to take the time to realize all the different coverage requirements that are highlighly unlikely to ever be invoked, people will appreciate the ability to chose less expensive coverage that is more targetted to their individual concerns.

In summary: the argument you give above applies to virtually everything in the economic sphere and means that socialism is inevitable unless we can explain why socialism is bad.

I think people understand that people keeping bad jobs to keep good insurance is a bad situation that needs to be remedied.

There are different 'levels' of insurance coverage in terms of deductables and copays....

but how about an illness inventory?

pay ALOT less, but certain illnesses are not covered.

No history, ever, of illness X in your family? Why pay for coverage for it?

Yes, it'd be dangerous if you happen to get an odd illness, but the money you could save, especially for the young married couple trying to make that house payment, could be vital.

Case in point: I'm a single straight male christian. Why do I need coverage for STDs? Yet my insurance covers treatment.

I'd trade treatment of tourette syndrome for treatment of STDs.

have a core: broken bones, cancer, heart disease, common cold/flu, etc.

and additional charges for other diseases, based on cost of treatment and chance of getting it.

I get gout, but I don't have osteoperosis. Yet my insurance covers both.

Just a random brainstorm that may NOT be a great idea, but is put up there anyway. heh.

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Dependence is Slavery.

I am against assistance that distorts the entire private insurance industry. Market/pricing distortions are what cause healthcare to be so darn expensive. We need to unleash the free market to get a rational pricing mechanism in place.

Markets should be allowed to properly function and serve the 98%-99% that would benefit.

I have no objection to assistance to the remaining 1-2% using other means.

FYI--if we went closer to a market driven system (decoupled employment from health insurance) you could change jobs without impacting insurance. That has to be the long term solution.

Another market-based reform would be to allow your family to pay for health care expenses out of pre-tax dollars. That would address the issues with about 50% of the remaining 1-2%.

The question is not one of compassion. My cousin has Down Syndrome as well, and is not able to function beyond that of a toddler. I have ALOT of compassion.

Why, though, do you feel that it is the job of the government to require health insurance companies to cover things?

Where are they to stop in this regulation? At what line do you suggest the government draw, and upon what do you base that drawn line?

While healthcare costs are indeed VERY high (much of it due to crazy amounts of malpractice insurance, and also many doctors not wanting to actually SEE patients and getting paid quite a bit in 'On call' fees even if they do not see anyone), why is government regulation of health insurance a good answer?

You want to become self-employed, get a license to deal in health insurance and start a company that specifically covers such genetic-based issues. Make it an affordable option to the other insurance companies.

If you say that it wouldn't work because it'd be too expensive and your company would go bankrupt, maybe that would be a clue as to why the existing health insurance companies do not cover it.

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Dependence is Slavery.

The origin of the word "compassion" is literally to "suffer with". There are cases where it is appropriate for us to share a burden with the less fortunate, particularly in those areas where we are arguing is that the moral high ground is to impose those burdens on people in the first place (i.e., we are against abortion).

Listen, in the vast, vast majority of cases where government regulation or interference is involved, I'm right there with you on the conservative positions. Get the government out of the business and encourage free markets and private charities to fill in the holes. However, this is one area where I emphatically disagree.

For some of the reasons that sinz52 has pointed out in other places here, I agree that a purely free market system doesn't work with health care. Nor is this an area where private charity can easily fill the gap. The necessity for open heart surgery within the first few months of a Down Syndrome child's life is fairly common. Do you have any idea how expensive that is? Your average church, no matter how compassionate or generous its members are, simply doesn't have the financial resources among its membership (unless they are extremely wealthy) to pay those kinds of medical costs.

Nor does it make sense to talk about allowing the free market to work, as if insurance companies will simply charge more to those with bad genetic test results. Did you read what I wrote above? All insurers, who have the option of denying coverage, do so. Completely. They didn't give us the option of paying more, they simply denied coverage. Not partial coverage -- any coverage. The only insurance we can get is that which the federal government mandates be provided, i.e., group insurance or government insurance.

There is no financial metric by which any private insurer could be convinced to willingly insure children with Down Syndrome. As Neil stated above, insurance is a gamble. The odds are, by insuring those with Down Syndrome, a private insurer will lose that gamble, unless those people are rolled in with and essentially paid for by everyone else. Only the most extremely wealthy people in our country could afford to pay the kind of premiums that an insurance company would be required to charge in order to make the gamble pay off.

So your options for coverage are either forcing private insurers to group the genetically "bad" in with everyone else, or having the government pay for them (or have a significant portion of them die off, which kind of defeats the purpose of opposing abortion). Which would you rather have trying to come up with the best solutions for caring for these people, private insurance companies who are thinking about their profit margin or the government, spending your money? Think maybe forcing private companies to do this isn't the worst of all solutions, perhaps?

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You missed over the biggest of my points:

Start a health insurance company that DOES cover those things that the others won't.

You, then, have an instant niche market.

Why do you think a private entity would fail where the government would succeed?

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Dependence is Slavery.

You're suggesting that someone should start an insurance company only for high risk cases? That kind of defeats the purpose of "insurance is a gamble", doesn't it? As has been pointed out elsewhere, health insurance is not like flood insurance. The highest potential cost is not simply a measurable quantity like the sum total of the values of the homes of all the insured. The costs are prohibitively high. There is no conceivable way that only the participants in a "high risk only" health insurance company could cover the costs of caring for the insured. That would be essentially the same as asking each of the involved families to pay for everything out of pocket themselves.

The reason the government and large insurance companies, with a large base of healthy contributers, can succeed where a "niche" company would fail is precisely because they can spread the cost of a few high cost individuals over a large number of mostly healthy individuals, thereby reducing the cost for everyone to manageable amounts.

The most likely outcome of allowing insurance companies to exclude all "high risk" applicants will be that the government will have to step in and become the high risk insurer. I still argue that private companies are more likely to come up with better solutions for efficient health care than the government will. Unless you make all high risk people dependent on charity, (and I don't think the people of this country would tolerate the resulting deaths and suffering for long) you will end up paying for high risk individuals, either through your insurance premiums or through your taxes. Only when you pay for it through your taxes, you can count on adding a lot extra to pay for the government bureaucracy and inefficiency as well.

As to your last question, I'm not the one arguing that a private entity would fail (except for your "high risk only" private entity); indeed today's group insurers, who are already required to provide coverage for those with pre-existing conditions who have had continuous coverage, are succeeding just fine, thank you. Yes, I also agree that today's insurance premiums are way too high, but I think there are plenty of better ways of solving this problem, mostly involving free market ideas to improve both the quality and cost of care in this country, than throwing those with genetic proclivities towards health problems out the door.
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"'You come of the Lord Adam and the Lady Eve,' said Aslan. 'And that is both honour enough to erect the head of the poorest beggar, and shame enough to bow the shoulders of the greatest emperor on earth. Be content.'" -- C.S. Lewis' "Prince Caspian"

I agree with you that currently, they cannot. This is because the government receives 20-40% of our income while churches and charities receive <10%. If those figures were switched, then our churches and charities would certainly be able to afford helping to pay for hospital bills.

Insurance companies, including government healthcare insurance, are able to pay for these things so easily compared to churches and charities because they receive so much more money. We should be moving our resources toward institutions like churches and charities and away from the government.

Of course no insurer would insure me for brain cancer if I already had brain cancer. If I have brain cancer and cannot afford the treatments, I should not be looking to insurance companies, government or otherwise. I should be able to look to charities and churches for help with reasonable expectation that they can afford to. Sadly, this is not the case because 1) our resources and money are sapped by the government, and 2) people are selfish, and 3) people have gotten used to not donating to charities and churches and simply letting big government replace our neighbors and friends.

I don't expect anyone in your situation to swear off government or any other help you can get at this point. But we live in sad times when you're forced to go to the Washington government for help instead of your friends and neighbors in your churches and charities.

I live in Charlottesville, VA. Do you live nearby?

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Small is beautiful.

I live in Charlottesville, VA. Do you live nearby?

No, I'm afraid not. We're stuck, for the moment, out here in the People's Republic of California.

I want to address some of your other points in more detail, but have to run out the door now. I'll try to get back to you later.
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"'You come of the Lord Adam and the Lady Eve,' said Aslan. 'And that is both honour enough to erect the head of the poorest beggar, and shame enough to bow the shoulders of the greatest emperor on earth. Be content.'" -- C.S. Lewis' "Prince Caspian"

regarding the perverse incentive that would be created to abort babies that prescreen for any potential health issues.

Why stop with abortion pre-birth? From there you've even created a financial incentive to sterilization. If someone has a genetic condition that's inheritable, you're better off mandating that he not have any kids, because you don't want kids born with conditions who will also cost society a lot of money.

That's part of what I was driving at in my other posts: A totally free market in health care, combined with a rigorous policy of genetic screening, leads you toward eugenics--improving the genetic fitness of the race. You're not doing it for racist reasons like the Nazis, but for purely financial reasons. But you are still doing it.

That's the equivalent of what happened with other insurance fields. Automobile insurance companies lobbied for better cars--more safety features and more antitheft devices. Because it was in their interest to improve the car to lower claims.

Now you'll have health insurance companies lobbying for genetically healthier people. So you logically get to eugenics--improving the race.

And at some point, you've deviated from our Declaration of Independence's claims on human equality before God.

That cannot be our sole excuse for letting government control health insurance.

The fact is there are too many incentives, financial or otherwise, to dehumanize to let that be an excuse. Children are expensive. There is a financial incentive, as well as personal selfishness, to not have children at all. So should the government force people to have children?

Yes, genetic screening DOES create more of an incentive to dehumanize people based on their genes. But citizens must resist the temptation to dehumanize by remembering what it means to be human, and then counting the costs and deciding that they will choose to take the financial hit for the sake of loving their neighbor.

It's not the government's place to save us from ourselves. The government may certainly outlaw eugenics because that is immoral and unjust in and of itself, but we ought to be careful when making policies that prevent people from the possibility of doing evil.

There are other ways. People must be willing to give to charities and churches for specifically congenital defects.

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Small is beautiful.

.

And just how to you intend to force these charities to fund health care for all the people that regular insurers won't touch? And suppose that the donors don't want their donations to go for those purposes? And how to you plan to match people to their charitable donor, and what are the criteria by which people would qualify for charitable coverage?

Sorry, I don't logically see how you intend to force voluntary behavior without involving the heavy hand of government.

That is, unless want to revive "Queen for a Day" for people in need of health care, complete with audience partipation over the internet (to give a more modern air), as the free-enterprise alternative?

And Rightly So!

Yes, if charities and churches don't step up to the plate, people will die. Just like people die in wars, from diseases, lightning strikes, etc. etc.

What is your point? That churches and charities must step up to the plate is a moral assertion, not a legal mandate. I'm not a fan of coercion of charity.

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Small is beautiful.

Taxes are forcing.

WHen people have more money, they donate more. That's how it actually works, historically.

As for 'forcing' charities to help those in need. They, uh, kind of already do and with more money flowing in, they could help more people.

Charities, with the possible exception of the United Way, have a MUCH lower overhead than ANY government program.

Having the government do something that a charity is already trying to do is a monumental waste of money.

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Dependence is Slavery.

and PUBLIC insurance.

Leave the private insurance system alone to cover the vast majority of people and the most economic prices.

Government can step in (as it currently does) to insure the rest WITHOUT screwing up the private insurance market.

This is the same model we use in other necessities.

Food.
Energy.
Housing.

The government provides assistance in all three of the areas listed above, but does so in a way that does less damage to the pricing mechanisms of the free market.

Does government artificially lower the prices of all homes because some people would otherwise be homeless? No.

Does government artificially lower the prices of all energy because some people would otherwise not be able to affort heat? No

Does government artificially lower the priceses of all food? No.

While all three of the markets listed above have their issues, they each function better than healthcare does.

and not farm subsidies, which truly are a disaster and help keep the third world poor and hungry so that we are perptually asked to send in aid

This article is a polite way of saying that you're perfectly happy with the idea of insurers denying coverage (or jacking up premiums into the stratosphere) to people with pre-existing conditions. A genetic condition is a pre-existing condition.

Or, perhaps, that it isn't the job of the government to mandate coverage?

I can't think of a surer way for the GOP to lose elections, then to advocate such a thing to the American electorate. Everybody with a pre-existing condition, everybody with a child with a pre-existing condition, will vote against you. That includes me, by the way.

Do you support Socialized Medicine? That's where your line of thinking leads. Government regulation leads to government ownership.

There's a tendency among some conservatives (not me) to just wave around "Free markets!" like some mantra--but without ever explaining how a free market can work for something like health care: What is the price tag on preserving human life, what does the pricing mechanism look like, what does the supply-demand curve look like, etc.

Why do you think that government mandated coverage or government controlled coverage will have a lower price tag? When has the government been a WISE steward of our money and resources?

Go hang out at an overcrowded VA hospital/clinic and think about all of healthcare being like that.

If you've ever had a serious illness, you know that the LEAST important thing on your mind is the cost of the treatment. By far the MOST important thing on your mind is the EFFECTIVENESS of the treatment. Money is no object, if the alternative is your death, or a life wracked with pain and discomfort.

I have fibromyalgia and Tourette Syndrome. I DO live in regular pain and neither of those are covered by my insurance. I don't want the government to mandate coverage just so that I don't have to pay as much. Would I like for it all to be free? Of course. But the costs of 'free' healthcare or mandated insurance are too high.

I was in that situation, some 15 years ago. The doctor prescribed a state-of-the-art (and very expensive) treatment that he said offered the surest hope of a quick cure. It would never have occurred to me to say "Give me something cheaper instead." All I wanted at that moment, was to get better. Cost be damned.

I'm also diabetic. I've had my doctor change my medication so that rather than paying 200 bucks a month, I could pay 4. I could have complained about the 200 buck a month medication, but I found something cheaper. Not everyone can do that, and it isn't the government's job to make everything cheap.

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Dependence is Slavery.

Not only are firms prohibited from denying coverage or even adjusting premiums,t hey are further barred from requesting, purchasing, or requiring any genetic screening at all.

That's anti-science, anti-market, pro-higher costs right there. Its only rational purpose is to bring us closer to Canadian style socialism.

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right now, your insurance premiums are inflated for the costs of the uninsured that hospitals absorb and pass on to the their paying customers. Genetic screening to create more uninsured won't have a net impact on premiums if hospitals are still treating the uninsured population and passing the costs along to the folks who do pay the bills (the insurance companies).

From a purely principled perspective, their may be free market merits to argue. But in terms of impacting costs, I doubt it would end up saving "healthy" people anything meaningful as long as hospitals are still passing along the costs of treating the uninsured.

If you really want to make a difference with insurance costs, you should focus on repealing EMTALA, but that's a heck of a mountain to climb.

You're ignoring something. People who get screened and learn they have a condition will be more likely to buy full service insurance than those who didn't know.

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They are getting full treatment now, and many if not most of them have insurance. What we are missing out on is the early treatment that may save costs in the long run by early treatment or disease prevention.

I don't have any family history of genetic diseases, but if I did I wouldn't get tested because I want to be able to shop around for insurance without that particular ball and chain.

If I did have family history, I might just resign myself to always working for a place that provided group coverage and get tested anyway, but that is a distortion of the market all by itself.

I meant what I said and I said what I meant. An elephant's faithful 100 percent.

is the reality that if insurance companies can use genetic screening data to make coverage decisions, they will either make coverage prohibitively expensive or more likely refuse to give any level of coverage.

Elizabeth went into great detail on this point above, and there's no need for me to rehash what she wrote.

Maybe I'm misunderstanding you, but insurance company knowledge of genetic screening of a health issue makes it far less likely that someone with said genetic screening results would be able to get insurance, not more likely.

That's dishonest. You misunderstand what insurance is, obviously.

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I wasn't following your post (currently #41) above. If I've got it now, you are concerned that someone will get a genetic screening test done, find out the are more likely to get a disease in the future, and therefore obtain insurance, when they otherwise wouldn't have obtained insurance without the knowledge from that test, and that's not fair to the insurance providers.

I thought you were suggesting that the genetic testing, done at the behest of the insurance companies, would make it more likely for someone to get full insurance coverage, which had me a bit confused.

But if I now understand you correctly, I still don't think it would make any meaningful difference with the cost of individual premiums given the way the system currently works. For the simple reason that those of us paying for insurance now are effectively paying all the non-Medicare and -Medicaid healthcare costs in the US. Private pay is pretty neglible. The cost of paying for the uninsured is baked into the rates that hospitals negotiate with insurance companies. So if you kick the genetic prescreeners out of the insurance pool, the hospitals are still required by law to provide emergency related care for uninsured and are therefore will still be incurring the costs of caring for those genetic prescreeners now added to the rest of the uninsured population and they will just pass it along to the insurance companies at higher rates, which in turn will be passed along to those of us who pay the insurance premiums.

So whatever costs are saved by kicking out the prescreeners, those with insurance ultimately get the bill for anyway when the hospitals bake the now higher uninsured costs they have to absorb into the rates they negotiate with the insurers.

That's the main point I've been trying to make- not wrt when it is or isn't ethical for someone to obtain insurance.

The arguments for this is that those denied coverage are getting the care anyway and we are paying for it AND that those who are denied coverage can't get treatments because it is too expensive.

Which is it?

And why do YOU oppose starting a health insurance company that specifically covers such things? Why require a government mandate? This IS still a free country in which one can start a company.

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Dependence is Slavery.

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"If we want to take this party back, and I think we can someday, let’s get to work." – Barry Goldwater

Imagine a small child with (nasty disease).

There is always one more test.
One more treatment.
One more specialist.
One more prescription.
One more therapy.
One more last-ditch attempt.

Is there *ANY* point at which it would be okay for the insurance company to say "you know what, we won't pay for one more X"?

If there is not, I think that this answers your question as to why these insurance companies aren't springing up out of the ground in response to the demand.

Man is free at the moment he wishes to be. --Voltaire

Also kind of my point.

If it is 'too expensive' for the PRIVATE sector to insure such issues, why would a government mandate or government control be a viable solution?

It seems, to this layman anyway, that such a mandate would be a REQUIREMENT to do poor business and would lead to the demise of the insurance companies. It seems, to this layman anyway, that such control by the government, which would HAVE to replace the bankrupted insurance companies, woud only lead to the demise and bankruptcy of the federal government (which is already over 9 trillion dollars in the hole.)

I don't see how the public sector, or a mandated private sector, is supposed to be a forced answer.

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Dependence is Slavery.

"What? Are you saying that the insurance companies can just stop covering the child? Do you want the child to die? You are the exact caricature of Republicans that the Democrats paint. It's more important for a shareholder to get 7 cents per share than 6 cents than it is to give medical treatment to a *CHILD*."

Man is free at the moment he wishes to be. --Voltaire

BECAUSE I care about children and the sick, I want to insure that the government doesn't, by mandate, bankrupt insurance companies by setting a stage where they can mandate new things for insurance to cover.

I value children and the sick so much that I don't want healthcare to turn into the DMV.

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Dependence is Slavery.

When we pass insurance regulations, we are not anti-free market. We are recognizing that some industries must be regulated (and I work in banking...I know regulation). Sometimes our legislators go too far (forcing coverage for acupunture) but I happen to think that they should not be allowed to use genetic screening.

YMMV.

I meant what I said and I said what I meant. An elephant's faithful 100 percent.

Since when it is the government's job to tell a health insurance company what illnesses it is required to cover?

We're not talking about an insurance company not covering something they previously said they would. These are issues that they openly say they do not cover. If it were the former, you would have a point, and I'd agree with you.

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Dependence is Slavery.

Not to be too flip about it, but when insurance companies started calling pregnancy a pre-existing condition and denied all coverage for it. That was the final straw that told me that sooner or later they would keep denying things until they figured out how to maximize profits which meant that lots of sick people were going to be screwed over and over again. I was in favor or some regulation from there on out.

We must let the People's Commissars decide what will and will not be paid for with the People's Money.

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"If we want to take this party back, and I think we can someday, let’s get to work." – Barry Goldwater

what is the point of an insurance company insuring against a pregnancy when somebody is already pregnant?

So then why don't I go out and get a homeowner's policy for my house after it burns down? Pretty good racket there - pony up about $1500, get $180,000 back as soon as the adjuster comes out and sees the damage.

Unfair. Unbalanced. Unmedicated. -- IMAO

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"If we want to take this party back, and I think we can someday, let’s get to work." – Barry Goldwater

You said what I wanted to say. But you said it much better.

I meant what I said and I said what I meant. An elephant's faithful 100 percent.

Science fiction dystopias are coming to pass in my lifetime. Scary.

And Rightly So!