Pre-existing conditions and medical care

This is Joseph.

We have talked a few times about the issues with medical insurance.  We live in a world where, unfortunately, we all age and decay.  Over time, we all acquire conditions.  It is also the case, in a world where insurance is linked to both employment and the ability to pay, gaps in insurance may occur and/or insurance providers may change.

This makes the question of pre-existing conditions a thorny one.  Since the rules against excluding care based on them are under legal assault, there is a new bill to protect them.  Unfortunately it doesn't do a great job.

From Michael Hiltzik

The measure says that no insurer may reject an insurance applicant based on his or her medical condition or history. But it’s got a loophole that even the dimmest insurance company could drive a hearse through: It doesn’t require that the insurer provide for treatment of the applicant’s preexisting condition.

That makes the bill’s guaranteed access to insurance “something of a mirage,” says Larry Levitt, senior vice president of the Kaiser Family Foundation. Levitt observed on Twitter that “So-called ‘pre-existing condition exclusions’ were common in individual market insurance policies before the ACA, and are also typical in current short-term policies.” At best, they can impose waiting periods for treatment of those conditions; at worst, they exclude coverage permanently.

As medical costs rise in the United States, it becomes impossible to self insure against a pre-existing condition at any likely level of total income.  So this matters a lot.

If we want to make private insurance work, there has to be a way for people to get coverage for these conditions, unless we want to completely rethink the cost and licensing structure of American medicine (can we outsource medical care to India using robots and teleconferences?).

It is a big deal not to make this mistake.