[hyteckit]

Well, I just called Blue Cross up yesterday and ask them about their health insurance. The lady ask me if I had any pre-existing conditions. I said not unless you considered acne a pre-existing condition. She said if is a pre-existing condition if you use retin-A or use accutane. Told me I wouldn't qualify for any of their policies and if I applied, I would be denied. She apologized saying she doesn't make the decisions and that the underwriter will denied my application if I have acne and use retin-A.

[andi*pandi]

Well accutane for acne might be considered a frivolous thing, I have to wonder what they'd say about blood pressure medicine, thyroid medicine, or any other medicine for long-term conditions.

[hyteckit]

I don't use Accutane. I'm pretty much against taking any drugs, legal or otherwise. I just use retin-A, a topical acne medication.

Heard Accutane was some powerful and potentially dangerous stuff.

[besson3c]

When does the Obamacare clause that prevents denial based on pre-condition kick in?

[mduell]

So I called Geico about getting an insurance quote for a car I crashed last year, and they say they won't cover the crash!

Originally Posted by besson3c 

When does the Obamacare clause that prevents denial based on pre-condition kick in?

Per wikipedia:

Effective June 21, 2010 - Adults with pre-existing conditions became eligible to join a temporary high-risk pool, which will be superseded by the health care exchange in 2014.

Effective September 23, 2010 - Insurers are prohibited from excluding pre-existing medical conditions (except in grandfathered individual health insurance plans) for children under the age of 19.

Effective by January 1, 2014 - Insurers are prohibited from discriminating against or charging higher rates for any individuals based on pre-existing medical conditions.

[besson3c]

Originally Posted by mduell 

So I called Geico about getting an insurance quote for a car I crashed last year, and they say they won't cover the crash!

Is this supposed to be related in any way to the original poster's situation?

[hyteckit]

Originally Posted by mduell 

So I called Geico about getting an insurance quote for a car I crashed last year, and they say they won't cover the crash!

A better comparison would be:

I have scratches and dings on my car. Now I can't get car insurance through Geico.
I had a flat tire on my car. Now I can't get car insurance through Geico.

[hyteckit]

Originally Posted by besson3c 

When does the Obamacare clause that prevents denial based on pre-condition kick in?

Doesn't seem adults are protected against pre-existing conditions. Just children under the age of 20.

[Athens]

Poor Americans, co-pays, deductibles and pre-existing conditions oh my.

[besson3c]

The next time somebody like Big Mac or the like goes on about Canada's health care system being inferior we should just refer them to this thread.

[Athens]

You know they will just dig up some news story of a unusual event or something that isn't the norm to justify their position, even though the exact same thing can be dug up against them as well.

Oh this lady had to wait 9 months for a operation that should have taken 1 month. Rebuttle oh this man spend 36 hours in a NY ER room waiting and was found dead, prob been dead for 48 hours. and then back and forth at isolated failures in both countries that made the news....

[besson3c]

Originally Posted by Athens 

You know they will just dig up some news story of a unusual event or something that isn't the norm to justify their position, even though the exact same thing can be dug up against them as well.

Oh this lady had to wait 9 months for a operation that should have taken 1 month. Rebuttle oh this man spend 36 hours in a NY ER room waiting and was found dead, prob been dead for 48 hours. and then back and forth at isolated failures in both countries that made the news....

Using American news sources with pretty clear political stances. In the case of Big Mac, right wing news sources, because he seems to have no interest in looking at anything outside of his little wheelhouse.

[subego]

IIRC you're in Cali.

This may be of interest:

Pre-Existing Condition Insurance Plan: California | HealthCare.gov

[hyteckit]

Originally Posted by subego 

IIRC you're in Cali.

This may be of interest:

Pre-Existing Condition Insurance Plan: California | HealthCare.gov

Holy cr*p. Over $400/mo for health insurance just because I have acne?

What BS.

[subego]

That's for someone who's 50.

If you're under 30 it's $164 or less.

http://www.pcip.ca.gov/Publications/...B_Premiums.pdf

[Athens]

Wow

I'll stick to my inferior Canadian Health Care

Monthly Premium: $428 for a 50 year old subscriber in San Francisco
Annual Deductible:
• Medical • $1,500 in-network / $3,000 out-of-network
• Brand Name Prescription Drugs • $500 in-network / $500 out-of network
Annual Out of Pocket Maximum: $2,500 in-network / no maximum out-of-network

Vs

Monthly Premium: $64.00 Anywhere in BC / Any Age
Annual Deductible:
• $0
Co-Pay
• $0

[hyteckit]

Originally Posted by subego 

That's for someone who's 50.

If you're under 30 it's $164 or less.

http://www.pcip.ca.gov/Publications/...B_Premiums.pdf

Thanks for the info.

Doesn't look as bad. Good to know I have options.

[Wiskedjak]

Originally Posted by mduell 

So I called Geico about getting an insurance quote for a car I crashed last year, and they say they won't cover the crash!

Did they deny you coverage because you had a cracked windshield?

[subego]

Originally Posted by hyteckit 

Thanks for the info.

Doesn't look as bad. Good to know I have options.

Hope it helps.

Should you decide to apply, you should know it's a lot harder to get an insurance company to decline you in writing than over the phone. I'd recommend calling a private insurance broker and having them do the legwork. It shouldn't be too hard to find one who's willing despite the fact they're not going to earn a commission (just be sure to mention that part up front).

This also wouldn't be a bad idea since the preexisting condition is so minor. They might be able to find an underwriter who can work with that.

[ghporter]

You said you didn't take Accutane for acne, but did you get a prescription for Retin-A? If you have never been formally treated for something, it is NOT a "preexisting condition." Sometimes, talking to insurance people is like talking to the police before your lawyer is present; you can accidentally say the wrong thing, and have a lot of trouble because of it.

Insurance companies' preexisting condition exclusion was originally intended to keep people from burning through benefits under one policy, then buying a new policy from someone else for the same problem-basically to keep individuals from abusing policy benefit limits. But the companies got stupid and applied the blanket rule abusively, particularly by refusing to cover young people who had issues while children (and covered by their parents' insurance) when they reached age 21. Way to give the whole industry a black eye, stupid bean counters!

[hyteckit]

Originally Posted by ghporter 

You said you didn't take Accutane for acne, but did you get a prescription for Retin-A? If you have never been formally treated for something, it is NOT a "preexisting condition." Sometimes, talking to insurance people is like talking to the police before your lawyer is present; you can accidentally say the wrong thing, and have a lot of trouble because of it.

Insurance companies' preexisting condition exclusion was originally intended to keep people from burning through benefits under one policy, then buying a new policy from someone else for the same problem-basically to keep individuals from abusing policy benefit limits. But the companies got stupid and applied the blanket rule abusively, particularly by refusing to cover young people who had issues while children (and covered by their parents' insurance) when they reached age 21. Way to give the whole industry a black eye, stupid bean counters!

I did have a prescription for retina-A. Retin-A isn't that expensive. About $30/mo. I believe you can buy a lesser strength over the counter. I highly doubt $30/mo will blow through any health insurance coverage.

Retin-A dries my skin and makes my skin crack. Shouldn't really be in the sun if you have retin-A applied, but being in CA, I'm pretty much in the sun throughout the year.

I was offered Accutane, which is more expensive. About $300/mo to $400/mo. Being a potentially dangerous drug and too expensive just to get rid of acne, I declined.

Honestly, I just use over the counter benzoyl peroxide 5% now. Much gentler than retin-A.

[ghporter]

Prescription acne medications were overused for quite a while. A lot like any prescription medication when it first finds a new market. Benzoyl peroxide works for the vast majority of people, while the people who it doesn't work for have such severe skin problems that the risks of Accutane are worth trying it. But doctors have problems with bandwagons too...

Within a couple of years, by law, getting health insurance should not be a problem. It's too bad that anyone has to wait for that sort of thing, and especially that anyone has to wait for it to be law. Rule #1 of business is not to tick off your customers. Oh wait-insurance companies forgot their policy holders were customers! DUH!

[Waragainstsleep]

Originally Posted by ghporter 

Oh wait-insurance companies forgot their policy holders were customers! DUH!

I think most insurers in all sectors forgot that about 10 seconds after they opened for business!

[ebuddy]

There are folks so stuck on the idea that someone else handle all their affairs that they're more apt to complain about their situation and how the system is holding them down than put forth the 10 minutes of research necessary to identify the wealth of options available to them.

All for an online argument that only demonstrates the entitlement mentality.

[besson3c]

That was cryptic ebuddy

[Wiskedjak]

Originally Posted by ebuddy 

There are folks so stuck on the idea that someone else handle all their affairs that they're more apt to complain about their situation and how the system is holding them down than put forth the 10 minutes of research necessary to identify the wealth of options available to them.

All for an online argument that only demonstrates the entitlement mentality.

How is paying for health insurance an entitlement mentality? Do you have Apple Care? Car insurance?

[mattyb]

I didn't realise that acne was that serious.

[ghporter]

Originally Posted by mattyb 

I didn't realise that acne was that serious.

It isn't, except for a very small minority of people who have really serious problems due to acne, such as aggressive skin infections that cause widespread scarring (not "pock marks" that most of us associate with acne, but major deformities). But since a lot of doctors still push aggressive treatment for even mild acne, it's expensive if the patient wants it to be.

[Wiskedjak]

Originally Posted by mattyb 

I didn't realise that acne was that serious.

I think that's why it's so bizarre that there's a discussion about the entitlement mentality with respect to acne medication.

[hyteckit]

Originally Posted by ebuddy 

There are folks so stuck on the idea that someone else handle all their affairs that they're more apt to complain about their situation and how the system is holding them down than put forth the 10 minutes of research necessary to identify the wealth of options available to them.

All for an online argument that only demonstrates the entitlement mentality.

I'm sorry that my post about my healthcare situation and experience with Blue Cross upsets you. You are right that I haven't exhausted all my options before complaining about Blue Cross. But how is that a sense of entitlement?

I went with Blue Cross first, because that's who I had my policy with. However, my policy has lapsed with them. They sent me a letter saying they have individual healthcare insurance as low as $87/mo. So I decided to call just to find out that I don't qualify for any of their policies because acne is considered a pre-existing condition. I find that to be upsetting and their policy regarding acne to be idiotic.

You don't think I have the right to be upset just because there are possibly other options?
You think posting about my experience and situation with Blue Cross only demonstrates the entitlement mentality?


I think your politics is clouding your mental judgement to the point that you would defend health insurance companies no matter what they do, and will criticizing anyone who would post anything negative about these companies.


According to you, anyone who complaints about their experience with a company without exhausting all their options means they must have a entitlement mentality.

Someone complains about their iPhone ==> Entitlement mentality. Try an android phone.
Someone complains about their AT&T service ==> Entitlement mentality. Try Verizon.
Someone complains about their car insurance ==> Entitlement mentality. Try another car insurance company.
Someone complains about their health insurance ==> Entitlement mentality. Try another health insurance company.


As for the PCIP option that subego mentioned. That option is only available because of Obamacare.

[besson3c]

There is no "wealth of options" ebuddy, as I could have sworn you've acknowledged in the past. That there is is a myth. There are options on paper, but many of them do you no good when hospitals and other health care providers don't recognize these insurers and won't work with them. At least around here the only option that I'm aware of is Anthem Blue Cross Blue Shield.

You've acknowledged the health insurance monopolies and advocating opening up state lines for competition. Has your tune changed?

[besson3c]

There is a certain brilliance to the employer based insurance in terms of preservation of this system, and in terms of employers being able to keep their workers around for longer than they may like, dangling the prospect of losing their health care in their minds.

By preservation of this system I mean keeping employees oblivious to the actual costs of their health care and making them only responsible for copays and deductibles. Perhaps if more Americans knew how much their health care actually cost them and compared this to other countries they would realize that this is absolutely abnormal, and need not stand?

To this day I don't know why there aren't people with metaphoric pitchforks demanding that politicians do more to lower health care costs across the board. How come politicians don't even pay lip service to the idea that maybe people would like to see their costs reduced? Why do people stand for this?

The whole situation is just completely absurd to me. It's bankrupting the country, it's bankrupting some people, yet so many Americans seem to think that this is okay or perhaps worth it.

Many may justify these costs by assuring themselves that it is worth it because of the high quality of care, but this high quality of care is not absolute. Working with my wife's father it was very hard to get various health care providers to work together and share information and records with each other, so with each referral it was sort of like starting from square one in having to explain my wife's dad's situation. How can there be high quality care without caveats when doctors and medical offices are not easily receiving and accessing historical records?

In Canada, is there some system of national digital medical history record keeping? How does this work up there?

[ebuddy]

Invariably it seems, whenever an anecdote is presented to demonstrate the absurdity of the insurance market, the example turns out to be more absurd and without fail missing a great deal of information. For example, was our OP denied health insurance outright or was it just the preferred plans he was calling after? Would they have offered a provision of waiver for a condition already being treated with a topical ointment, over-the-counter? After all, many of the systems held up for comparison to the US system (usually accompanying the anecdotes) do not readily offer or require dental care yet denial of acne coverage is supposed to be absurd? Yet, it is the health insurers that are absurd and greedy. I don't know, I think we're the absurd and greedy ones sometimes.

Insurance companies know you are more aware of your expenses than they are. There's a reason acne is at issue here. A health insurer doesn't want to assume risk for skin complexion any more than they will shape your cuticles or address the bags under your eyes. ghporter offered some excellent information on how to address insurance companies with a little panache yet the OP was supposed to be a valid indictment against the health insurance industry when BCBS has pre-existing condition polices in California as well as others. We've come to expect too much and we've created this monster.

[ebuddy]

Originally Posted by besson3c 

There is no "wealth of options" ebuddy, as I could have sworn you've acknowledged in the past. That there is is a myth. There are options on paper, but many of them do you no good when hospitals and other health care providers don't recognize these insurers and won't work with them. At least around here the only option that I'm aware of is Anthem Blue Cross Blue Shield.

Oh, there could certainly be more options, but too often we're expecting the perfect play to drop right into our laps when sometimes it takes a little legwork and research. For example, An insurer must be licensed to conduct business in your state and that license must be rated to ensure "recognition". I've not heard of a clinic or provider "not recognizing" licensed insurers in your state. I'd also be willing to bet Anthem Blue Cross Blue Shield is not the only option available to you. I just don't buy it. In fact the last time someone mentioned their lack of options as being self-employed (may have been you), I did about 5 minutes of legwork on line for their state and found 5 other insurers.

You've acknowledged the health insurance monopolies and advocating opening up state lines for competition. Has your tune changed?

No as these are things that would make the industry more competitive. I'm still very much in favor of more options, but what's most absurd about the health care industry right now is not the fact that acne isn't covered, but the fact that consumers will not perform any legwork. They will not save for their own care, they will not search their options exhaustively, they do not shop their own care, and too often are not even taking care of themselves.

Some insurers will cover some things, other insurers will cover other things. Most will cover most things, but shopping may always be necessary. The seafood restaurant is not absurd because they don't have gyros on their menu.

[finboy]

Originally Posted by besson3c 

To this day I don't know why there aren't people with metaphoric pitchforks demanding that politicians do more to lower health care costs across the board. How come politicians don't even pay lip service to the idea that maybe people would like to see their costs reduced? Why do people stand for this?

And how does government lower healthcare costs?

By doing it better? Nope
By innovating and doing it differently? Nope
By rationing? Yep [FYI rationing = death panels for those of you keeping up at home]

Government only provides the means of coersion to mandate "lower costs" which means lower benefits to some so that others can have marginal benefits. A full government system allows for rationing.

Don't blame the Canadians for loving their system - after a few generations even wild sheep will take to a pen.

On the other hand, government involvement in the system (Medicare) contributes to the rising cost by overregulating and taking consumer decisions out of play. As a subsidy, Medicare (and Medicaid too), drives up the cost of health care, by definition.

My favorite part is how the state pays for braces these days. Nice. That's a pretty big example of how the system screws one bunch of folks to shift wealth to others.

[besson3c]

Wow. I don't even know where to begin.

How does government lower healthcare costs? Well, how do employers lower health care costs compared to what it would cost to buy a plan on your own without a large employer?

How else? How about adjusting FDA standards to permit more generic drugs and thus market competition? How about encouraging preventative care with various economic incentives and helping to enact policies that make access to preventative type treatments more affordable? How about working with states to digitize records to help reduce administrative overhead? How about revising medical malpractice laws? I'm not advocating for any particular balance or solution here, but to say that the government can't be a part of lowering health care costs is just dumb.

Maybe you should demonstrate a little less ignorance before asserting that Canadians are sheep, especially since you are in no position to be prideful with the American alternative when it comes to scalability and accessibility. Regardless, even without the comment about Canada, you need to lose the blinders and tunnel vision.

[hyteckit]

Originally Posted by ebuddy 

Invariably it seems, whenever an anecdote is presented to demonstrate the absurdity of the insurance market, the example turns out to be more absurd and without fail missing a great deal of information. For example, was our OP denied health insurance outright or was it just the preferred plans he was calling after? Would they have offered a provision of waiver for a condition already being treated with a topical ointment, over-the-counter? After all, many of the systems held up for comparison to the US system (usually accompanying the anecdotes) do not readily offer or require dental care yet denial of acne coverage is supposed to be absurd? Yet, it is the health insurers that are absurd and greedy. I don't know, I think we're the absurd and greedy ones sometimes.

Guess you didn't bother to read the OP.

"Told me I wouldn't qualify for any of their policies and if I applied, I would be denied."

I call to see what options are available.

Was told I wouldn't qualify for any of their policies. None, zip, nada. Was denied health insurance through Blue Cross outright. As in can't qualify for anything offered by Blue Cross.

What part don't you understand?

Originally Posted by ebuddy 

Insurance companies know you are more aware of your expenses than they are. There's a reason acne is at issue here. A health insurer doesn't want to assume risk for skin complexion any more than they will shape your cuticles or address the bags under your eyes. ghporter offered some excellent information on how to address insurance companies with a little panache yet the OP was supposed to be a valid indictment against the health insurance industry when BCBS has pre-existing condition polices in California as well as others. We've come to expect too much and we've created this monster.

My acne treatment is $30/mo. That's less than $400/yr. So I do find it absurd that I would be denied health insurance just because of that. Their deductibles are at least $3,500/yr.

You would think if a health insurer doesn't want to assume risk for skin complexion any more than they will shape your cuticles or address the bags under your eyes, they wouldn't cover it under their health insurance policy.

Common sense right? Yet you seem to think we are the absurd ones and not the health insurance companies?


Did you read what ghporter wrote? He finds the health insurance company's policy on acne to be absurd as well.

Originally Posted by ghporter

Insurance companies' preexisting condition exclusion was originally intended to keep people from burning through benefits under one policy, then buying a new policy from someone else for the same problem-basically to keep individuals from abusing policy benefit limits. But the companies got stupid and applied the blanket rule abusively, particularly by refusing to cover young people who had issues while children (and covered by their parents' insurance) when they reached age 21. Way to give the whole industry a black eye, stupid bean counters!

[besson3c]

Originally Posted by ebuddy 

Oh, there could certainly be more options, but too often we're expecting the perfect play to drop right into our laps when sometimes it takes a little legwork and research. For example, An insurer must be licensed to conduct business in your state and that license must be rated to ensure "recognition". I've not heard of a clinic or provider "not recognizing" licensed insurers in your state. I'd also be willing to bet Anthem Blue Cross Blue Shield is not the only option available to you. I just don't buy it. In fact the last time someone mentioned their lack of options as being self-employed (may have been you), I did about 5 minutes of legwork on line for their state and found 5 other insurers.

You haven't heard of insurance providers that are "out of network"? The problem is, how do you find out which insurance providers are considered in network by the hospitals? Not all hospitals publicize this information, nor is what they publicize guaranteed to be up-to-date.

From the Wikipedia page on health care (http://en.wikipedia.org/wiki/Health_...nited_States):

Individuals with private or government insurance are limited to medical facilities which accept the particular type of medical insurance they carry. Visits to facilities outside the insurance program's "network" are usually either not covered or the patient must bear more of the cost. Hospitals negotiate with insurance programs to set reimbursement rates; some rates for government insurance programs are set by law. The sum paid to a doctor for a service rendered to an insured patient is generally less than that paid "out of pocket" by an uninsured patient. In return for this discount, the insurance company includes the doctor as part of their "network", which means more patients are eligible for lowest-cost treatment there. The negotiated rate may not cover the cost of the service, but providers (hospitals and doctors) can refuse to accept a given type of insurance, including Medicare and Medicaid. Low reimbursement rates have generated complaints from providers, and some patients with government insurance have difficulty finding nearby providers for certain types of medical services.

I'm sorry, but anybody who can defend this, particularly the bolded part given the difficulty/impossibility of determining this in advance (not to mention, what about areas where there is only one hospital close by?), needs to get a brain (I'm not saying that this is you, ebuddy). This is horseshit and part of why what we have now really blows. Besides, who wants to start doing all of this research right after you've been hit by a car and need immediate ER care?

Some insurers will cover some things, other insurers will cover other things. Most will cover most things, but shopping may always be necessary. The seafood restaurant is not absurd because they don't have gyros on their menu.

At the very least it should be a legal requirement to disclose all of this information in advance and make it easy to find. Not only this, but the last time my wife went to a hospital she was sent a number of separate bills for different treatments she received. How are people supposed to keep track of what specific treatments will be covered within a given hospital when you don't even know what treatments you'll need before you arrive?

This is crap, plain and simple.

[besson3c]

The out-of-network thing...

I probably wouldn't mind it as much if it were handled sort of like what happens when you roam on AT&T or Verizon or something, where you are given a clear message saying "okay, you are roaming, it will cost $x/minute" in making this abundantly clear to the customer and providing a clear pricing structure. WIth roaming you still get the service you are paying for too, it is just slightly more expensive.

To flat out refuse any reimbursement after not providing the customer with the proper means to make a researched and informed decision, or to not help support emergency type procedures at all where there was literally no opportunity to do this research, or to deny claims for no apparent rhyme and reason is borderline criminal.

This is like paying a huge premium for an airbag for your car, only to find out that when you need it it doesn't deploy because the manner in which you were struck was not supported by this particular airbag while not making it clear what the caveats of this very expensive airbag were, while the airbag of a competitor who doesn't even make airbags for your car would have helped, but only to allow you to escape with one cracked rib rather than three.

I.e. it sucks.

[Chongo]

Unless I missed it, the OP does not mention if they currently have medical insurance.
I've had to switch medical plans twice in the last five years and did not have any issues with preexisting condition clauses. I was with Cigna since I was a teen (on mom's plan), and continued with them when I started at Motorola/Freescale(21). Five years ago (after 30+ years with Cigna) Freescale dropped Cigna because of rate increases and we went with Healthnet. Two years ago they dropped Healthnet for the same reason and we left with Freescale's self insured health plan administered by Aetna. I had stent placed six years ago, my wife was diagnosed type 2 four years ago. When asked about preexisting condition clauses we were told that as long as it was under treatment by a doctor they did not apply.

[hyteckit]

Originally Posted by Chongo 

Unless I missed it, the OP does not mention if they currently have medical insurance.
I've had to switch medical plans twice in the last five years and did not have any issues with preexisting condition clauses. I was with Cigna since I was a teen (on mom's plan), and continued with them when I started at Motorola/Freescale(21). Five years ago (after 30+ years with Cigna) Freescale dropped Cigna because of rate increases and we went with Healthnet. Two years ago they dropped Healthnet for the same reason and we left with Freescale's self insured health plan administered by Aetna. I had stent placed six years ago, my wife was diagnosed type 2 four years ago. When asked about preexisting condition clauses we were told that as long as it was under treatment by a doctor they did not apply.

I had Blue Cross under a group policy. Since I am currently self employed and without any health insurance, I'm applying for an individual health insurance plan. The health insurance company can denied you health insurance if you have acne, hemorrhoids, or toe fungus as a pre-existing condition if you are apply for an individual health insurance plan. However, those pre-existing conditions won't disqualify you from getting group health insurance.

Sounds like you have a group policy through your company, so many of the pre-existing conditions don't apply to you.

[finboy]

Originally Posted by besson3c 

1. How about adjusting FDA standards to permit more generic drugs and thus market competition?
   
2. How about encouraging preventative care with various economic incentives and helping to enact policies that make access to preventative type treatments more affordable?
   
3. How about working with states to digitize records to help reduce administrative overhead?
   
4. How about revising medical malpractice laws?

Except for the last one, you'll have a hard time demonstrating that any of these actually exist. Additionally, why should the government ever have to do something that markets can obviously do themselves?

Encouraging generic drugs? How, exactly? Generics are inevitable once patents expire. If anything the govt. has gotten in the way of generics more than it's ever helped in the past. Why did FDA standards have to be "adjusted"? Because of crony capitalism with the big drug companies. Duh.

I'm not sure what role govt. has played in preventative care, other than *perhaps* funding research to demonstrate its efficacy. Regulations *requiring* insurance companies to provide preventive care have actually led to fewer policies or other limitations. Again, govt. telling us how it should be doesn't really work in this case, either. Insurance companies that have adopted preventative coverage willingly have found it to be successful in some cases, less so in others. Big Gov doesn't have a role in that.

Digitizing records? Sure. I can't wait to see how that's been made more efficient by govt. intervention - the current coding systems are a nightmare, and Medicare/Medicaid is some of the worst you'll ever see. That system is a Tom Daschle pipe dream. But it has the distinct advantage of centralizing all of our individual medical records in case we need to be penalized for poor health choices down the road.

Tort reform has been extremely effective (witness Texas), but that's clearly a case of government limiting the abuse of the legal system by attorneys at the expense of ignorant juries.

The other stuff: not so clear cut.

BUT you managed to hit all the partisan Leftie health care talking points, so you get a cookie for effort. That is if the government dietician will allow you to have it.

[ebuddy]

Originally Posted by hyteckit 

Guess you didn't bother to read the OP.

"Told me I wouldn't qualify for any of their policies and if I applied, I would be denied."

I call to see what options are available.

Was told I wouldn't qualify for any of their policies. None, zip, nada. Was denied health insurance through Blue Cross outright. As in can't qualify for anything offered by Blue Cross.

What part don't you understand?

The part where your policy "lapsed". By law you have 60 days to maintain your insurance through COBRA which extends you for another 18 months. You have to pay the full premium to do it and I don't blame you for opting not to, but... what can I say, you should have? To be clear, I don't mean this to be cold and wouldn't wish the experience on anyone. I'm also not trying to marginalize acne, but we're talking about health insurance and the point is, acne came up. Believe it or not, while your usage of insurance for acne treatment may have been nominal, it can be a very pricey business for a health insurer if nothing more than its increasing prevalence, severity, and longevity. For what it's worth to you, I'm sincerely pleased to know that your best option for treatment is available over-the-counter. I can tell you that if you're being denied the money you're worth to them, mathematically, there are reasons I don't see as absurd. I frequently rail on what I believe are the root causes of the problem and could not defend the system that creates such a distorted marketplace.

In the interest of introspect, I meant to give credit to subego on how to deal with insurers. He also offered a link for PCIP, but that likely meant more to you than me. Of course, ghporter made excellent points as well and was very diplomatic as always. I disagree with him on what has driven insurers to "blanket" denials, but he nailed the problem IMO.

Common sense right? Yet you seem to think we are the absurd ones and not the health insurance companies?

I think the marketplace is distorted severely by a system that in many ways reflects us, yes.

Did you read what ghporter wrote? He finds the health insurance company's policy on acne to be absurd as well.

I get the impression his views grant some absurdity for all parties. He's the nicest of gents. I'm Serious.

[andi*pandi]

So acne has an over the counter treatment and doesn't seem a serious condition. What if it was for some other pre-existing mild condition? Blood pressure, diabetes, thyroid? All require daily medication, is it ok to get denied for these?

[besson3c]

Originally Posted by finboy 

Except for the last one, you'll have a hard time demonstrating that any of these actually exist. Additionally, why should the government ever have to do something that markets can obviously do themselves?

Encouraging generic drugs? How, exactly? Generics are inevitable once patents expire. If anything the govt. has gotten in the way of generics more than it's ever helped in the past. Why did FDA standards have to be "adjusted"? Because of crony capitalism with the big drug companies. Duh.

I misspoke on the generic drugs. It's the price controls that result in the same prescription drugs being the most expensive in the US compared to any other country:

Prescription drug prices in the United States are the highest in the world. "The prices Americans pay for prescription drugs, which are far higher than those paid by citizens of any other developed country, help explain why the pharmaceutical industry is — and has been for years — the most profitable of all businesses in the U.S. In the annual Fortune 500 survey, the pharmaceutical industry topped the list of the most profitable industries, with a return of 17% on revenue."[1] National expenditures on pharmaceuticals accounted for 12.9% of total health care costs, compared to an OECD average of 17.7% (2003 figures).[2] The high price of prescription drugs is one of the major areas of discussion in the U.S. health care reform debate.

Prices of brand name drugs in the United States are significantly higher than in Canada, India, the UK and other countries, nearly all of which have price controls. Prices for generic drugs tend to be higher in Canada. The price differential for brand-name drugs between the U.S. and Canada has led Americans to purchase more than US$1 billion in drugs per year from Canadian pharmacies.[5]

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I'm not sure what role govt. has played in preventative care, other than *perhaps* funding research to demonstrate its efficacy. Regulations *requiring* insurance companies to provide preventive care have actually led to fewer policies or other limitations. Again, govt. telling us how it should be doesn't really work in this case, either. Insurance companies that have adopted preventative coverage willingly have found it to be successful in some cases, less so in others. Big Gov doesn't have a role in that.

Government has a role in determining what Medicare/Medicaid will cover, therefore it has a role in what preventative care is offered. Local and state governments can certainly have a role in providing flu shots, cancer screenings, etc.

Digitizing records? Sure. I can't wait to see how that's been made more efficient by govt. intervention - the current coding systems are a nightmare, and Medicare/Medicaid is some of the worst you'll ever see. That system is a Tom Daschle pipe dream. But it has the distinct advantage of centralizing all of our individual medical records in case we need to be penalized for poor health choices down the road.

I'll never understand this whole Republican attitude of discrediting an idea based on this notion that nothing can ever get better than what it has been or is now.

Government is corrupt and ineffective, therefore it should not exist? How about, let's make government work with the services it does provide? How about, if digital records are a possibility and will lower administrative costs, let's look into this? If the government can manage social security checks for so many years, why is it a given that it couldn't help oversee digital records? I'm not even talking about the government themselves being responsible for these records, maybe each state brings in a private contractor, but the federal government can help coordinate these efforts by setting standards and coordinating efforts with the goal being that no matter what state you travel to, doctors can bring up vital medical information about you, without major privacy concerns.

Your party seems all about faith and emotion these days - these knee jerk reactions that government just sucks and needs to stop providing services based on this weird quasi-religious dogma, without ever examining value and doing a cost/benefit analysis. And, anybody that wants to actually assess this stuff is a communist? Or wait, socialist... I can never keep track.

BUT you managed to hit all the partisan Leftie health care talking points, so you get a cookie for effort. That is if the government dietician will allow you to have it.

It has been lovely talking to you. Yes, I have been aggressive with you, but you were the one that veered the conversation this way by calling Canadians sheep based on your aforementioned knee jerky quasi religious dogma, so **** you.

[Wiskedjak]

Originally Posted by ebuddy 

For example, was our OP denied health insurance outright or was it just the preferred plans he was calling after?

I believe the OP clarified this a few hours prior to your post:

Originally Posted by hyteckit 

I went with Blue Cross first, because that's who I had my policy with. However, my policy has lapsed with them. They sent me a letter saying they have individual healthcare insurance as low as $87/mo. So I decided to call just to find out that I don't qualify for any of their policies because acne is considered a pre-existing condition. I find that to be upsetting and their policy regarding acne to be idiotic.

[Athens]

Originally Posted by besson3c 

In Canada, is there some system of national digital medical history record keeping? How does this work up there?

Every province has its own separate independent medical system. The pharma-nets are linked together to avoid accidental overdoses, at least with BC and Alberta, I don't know if that is national.

I know BC has digital medical history record keeping. I can't say for others but I assume most of them do now.

[Athens]

Originally Posted by finboy 

And how does government lower healthcare costs?

By doing it better? Nope
By innovating and doing it differently? Nope
By rationing? Yep [FYI rationing = death panels for those of you keeping up at home]

Government only provides the means of coersion to mandate "lower costs" which means lower benefits to some so that others can have marginal benefits. A full government system allows for rationing.

Don't blame the Canadians for loving their system - after a few generations even wild sheep will take to a pen.

On the other hand, government involvement in the system (Medicare) contributes to the rising cost by overregulating and taking consumer decisions out of play. As a subsidy, Medicare (and Medicaid too), drives up the cost of health care, by definition.

My favorite part is how the state pays for braces these days. Nice. That's a pretty big example of how the system screws one bunch of folks to shift wealth to others.

What is this rationing stuff about, death panels about?

[Athens]

Originally Posted by finboy 

Tort reform has been extremely effective (witness Texas), but that's clearly a case of government limiting the abuse of the legal system by attorneys at the expense of ignorant

Watch the documentary called "Hot Coffee", your tune on Tort reform will change. The only abuse of the legal system that occurred was the marketing of such a idea to allow for tort reform.

[ebuddy]

Originally Posted by andi*pandi 

So acne has an over the counter treatment and doesn't seem a serious condition. What if it was for some other pre-existing mild condition? Blood pressure, diabetes, thyroid? All require daily medication, is it ok to get denied for these?

Absolutely not, but the more insureds seeking medical attention for acne, the less insurers have available for the more serious conditions like those you mention above. It's not apologetics, it's just the way of things. I've yet to hear how happy the most vocal complainants would be as self-employeds earning the avg profit margin of a health insurer. All I'm sayin' is hate the game, not the playa.