I don't like the entire concept of "pre-existing conditions". It goes against the entire concept of caring for sick people.
We are all people. We all get sick sometimes. Sicknesses can last a long time, or a short time. Sick people need help. Help the sick people. Pay what you can (a reasonable amount) into a common pool and take what you need (only as much as you need)
> I don't like the entire concept of "pre-existing conditions".
If you have an elective health insurance system where people choose whether or not and when to participate, it implies this restriction.
Say you have private health insurance companies but don't allow them to prohibit members based on pre-existing conditions. Everyone will simply not get health insurance to avoid paying the premiums until the day they need it. That would make health insurance companies completely unviable financially.
This is why Obamacare both eliminated the pre-existing condition restriction and mandated people get health coverage. You can't have one without the other or you get the free-rider problem.
This is another reason why healthcare should just be universal. It doesn't work at all like an actual efficient market product.
Would a wait limit, like with hurricane insurance, help to mitigate this problem? You can't wait until the NWS declares a Category 4 storm is barreling towards you to buy coverage. I mean you can, but the coverage doesn't kick in until 30 days later.
Or turn it around and make it equally burdensome to both insurer and patient. If you acquire a malady while insured by a particular company, all medical expenses that are tied to that diagnosis must be forevermore paid by that insurer, even after the policy lapses, is cancelled, or the patient switches insurers.
If that sounds unfair to an insurer, that's great--now they know how we feel about it.
Insurers want to deny pre-existing conditions because they don't want to add already-sick people to their risk pool. They wouldn't have to, if the previous insurer was still on the hook for that diagnosis. But they'd never agree to that, because it exposes them to some of the same insolvency risk due to medical bankruptcy that some patients have to face.
Surely "what you can" should be relative to both your income and your need. We'd need to supervise the system to make sure people aren't taking advantage or else the whole system goes broke.
> into a common pool
We could also invest the money in the pool to make some extra cash and reduce what people need to pay in, we'd have to have an organization do that too.
> (only as much as you need)
How can we know what people need? We'd have to charge a token amount for office visits and medication so that people aren't frivolous with their medical visits, while perhaps guaranteeing an out of pocket limit in case of extreme illness. We'd also need some kind of system to verify that people are only taking what they need.
We probably have different ideas of "paying what you can". How do you judge whether someone is only paying what they can, or they are taking advantage? Not a rhetorical question.
One way is like we do today -- highly-paid positions often come with high-quality insurance, which is (ime) fairly expensive and low-paid positions have less expensive insurance that is a bit worse (all this on average, I'm sure there are outliers).
We are in different pools today but I don't see how that's meaningfully different than everyone being in one pool if the individual pools are large enough and you can't discriminate the population of the pools.
There are cases where it’s hard to tell if someone is truly paying what they can, but there are also cases where it’s easy: when it costs more than they can pay. Health insurance trivially fails the “paying what you can” criterion for sufficiently poor people.
We are all people. We all get sick sometimes. Sicknesses can last a long time, or a short time. Sick people need help. Help the sick people. Pay what you can (a reasonable amount) into a common pool and take what you need (only as much as you need)