RANT: Pre-existing conditions

Friday, March 5, 2010

http://healthinsurance.about.com/od/healthinsurancebasics/a/preexisting_conditions_overview.htm

Pre Existing Conditions – Understanding Exclusions and Creditable Coverage
HIPAA Pre-Existing Condition Protections
By Michael Bihari, MD, About.com Guide
Updated February 08, 2010

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Many Americans have health-related problems that insurance companies define as pre existing conditions. A pre-existing condition is a health problem that existed before you apply for a health insurance policy or enroll in a new health plan.

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An important feature of HIPAA is known as “creditable coverage.”

Creditable coverage is health insurance coverage you had before you enrolled in your new health plan, as long as it was not interrupted by a period of 63 or more days. The amount of time you had “credible” health insurance coverage can be used to offset a pre-existing condition exclusion period in your new health plan.

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Clearly the President and the various Congress Critters don’t understand the concept of “insurance”.

I know it’s a hard concept. But, in a population of people subject to the same RANDOM risk (i.e., meteorite), we can pool our premiums and award them to the “winner”. The Amish help their neighbors. The Mormons have their bishops. The Catholics have Catholic Charities.

We have “insurance partnerships”, like Lloyds of London, that will usually take the other side of any “bet” for the right price. We have “insurance companies” that have “standardized wagers” that they offer to take. That’s Life, Car, Health, and yes even Pet Insurance.

(What confuses us is that we don’t see the aggregation of the risk premium and the “apply – claims – payout” process as really a pass through mechanism. Like “corporate income tax”, only real people pay taxes. So when the “insurance company” has to pay for “pre-existing condition” — like paying off winning lottery tickets purchased after the drawing — it’s really transforming it into pre-paid medical care. Like insuring your car’s oil changes.)

(Let’s examine “insuring” your car’s oil changes. I can go get an oil change for 40$ (Jiffy Lube) to 75$ (Dealer). If an “insurance company” was involved, what would it cost? 500$ You’d have to compensate the insurance salesperson, the clerk to process the claim, and adjuster. And, of course, we have to have lawyers. Maybe 500$ is optimistic. Could be 1,000$. OR two!)

Note: This is NOT buying insurance AFTER the meteorite hits your house. Do you buy the winning lottery ticket after the drawing?

Economics IS truly the dismal science. We’ll always have shortages. But we have been given tools to manage the risks of life.

For car accidents, we have car insurance.

But once again, President Obama demonstrated his lack of economic understanding. Buying car insurance and expecting it to fix “HIS car after an accident. Obviously, he bought LIABILITY insurance; not collision or comprehensive insurance. For a lawyer, at this stage in his career to have such a misunderstanding of insurance is either: stupidity or duplicity. (Dumb or misleading? You choose!)

SO … … …

… … … “pre existing conditions” are buying the lottery ticket after the drawing.

… … … small costs should be out of pocket expenses; insurance is for BIG ones.

… … … health savings accounts with high deductible insurance sounds good.

And, politicians should be sent to “economics class” before they are allowed to vote!

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INTERESTING: Chaos creates order

Friday, March 5, 2010

http://www.economics21.org/commentary/health-care-chaos-and-challenge-chickens-manhattan

Health Care, Chaos, and the Challenge of Chickens in Manhattan
John O’Leary and William D. Eggers | 02/24/2010

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The paradox is that chaos creates order, while control can result in chaos. In an effort to control outcomes, free exchange is curtailed and the essential ordering signals of price and profit are lost—leading to misallocation of resources and outcomes that nobody likes.

Few of us appreciate how mundane chaos really is and how we are essentially surrounded by it.

Consider: Who is in charge of getting the right number of chickens to Manhattan every day? After all, few chickens live there, but a lot of chickens get eaten there. The typical Manhattanite downs about sixty pounds of chicken a year, in every imaginable form, from chicken chow mein to chicken nuggets, from organic chicken to those little cubes that float in your can of chicken soup. Untold thousands of people participate in providing for Manhattan’s ever-changing chicken needs, from truck drivers to restaurant owners, from grocery store managers to Arkansas chicken farmers. Who is in charge? Who makes sure that New York City winds up with the right amount of the right kind of chicken?

The answer is: No one. The chaos of the uncontrolled buying and selling of the market produces an orderly pattern of exchanges that coordinates the activities of independent yet interdependent participants. The result, without any central planning, is an adaptable and ever-changing arrangement that generally meets the needs of Manhattan’s chicken eating public. The government provides certain oversight and context for the market. The U.S. Department of Agriculture watches over chicken farms and the city’s Board of Health licenses and inspects restaurants. Chickens are hauled over public roads and contract disputes between chicken farmers and truckers are resolved in public courts. But when it comes to the essence of the chicken delivery system—how much chicken, of what kind, at what price—it is the invisible workings of supply and demand that align the productive activities of a loose network of thousands of people (and companies) in making sure New Yorkers get their chicken potpie, chicken vindaloo, and extra-spicy buffalo chicken wings.

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Interesting, no central authority using force to “enforce an orderly market”. No “market failures”. Just lots of folks seeking their own best interests as they see them. That’s called “freedom”. If the gooferment didn’t “inspect” chickens — ignore for the moment that this is a farce because they don’t do any “inspecting” — just look into what they really do! — do you think the marketplace wouldn’t figure out how to make chickens safe? Kosher, Halal, WalMart, supermarket guaranties, Consumers Reports or Underwriters’ Laboratory, consumers or buyers talking to each other.

And don’t even get me started on the “roads” argument. No roads in Disney World?

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