Even though it defies the definition of insurance, exemplifies socialism, and is a huge driver of high insurance premiums (as it should be), Republicans are unlikely to brave the political heat required to remove Obamacare’s “guaranteed issue” provision which functionally forces health insurers to cover pre-existing medical conditions.
As it stands today, you can be uninsured, learn you have a disease, buy “insurance”, and saddle the rest of the insured population with your medical costs. It’s like allowing someone to buy car insurance after an accident or homeowners insurance while the roof is on fire. As a business model, it is insane. As public policy it’s only less insane to the degree that you can fool voters into thinking that the costs of the policy are minimal and that insurance companies are evil and deserve whatever happens to them. Sadly, it’s all to easy to fool voters.
So, like all “free” goodies, guaranteed issue popular with voters who see things as free when they’re simply paid for by others.
Yesterday on Fox News, Speaker of the House John Boehner said that the chairmen of relevant House committees are working on a Republican replacement for Obamacare.
My modest suggestion for those congressmen and staffers: In order to avoid the political nightmare of completely undoing the requirement that insurers cover pre-existing conditions — a policy which harms the structure of the industry by encouraging people not to buy insurance until they have a problem — allow insurers a short exclusion period, perhaps between 3 and 6 months, during which they do not have to cover pre-existing conditions. This change should encourage many to buy insurance before they actually need it, broadening the base of the pool of insured people and lowering (or reducing the increases in) insurance premiums and yet maintain the feeling among the public that insurers can’t mistreat customers once they get sick.
The ordinary American gets the idea that buying insurance once you’re already sick isn’t really buying insurance but rather just shifting your costs to others. They’ll go along with this small change, especially if the GOP can credibly explain (perhaps with the use of doctors and other non-politicians and comparisons such as cars and homes) the potentially very large beneficial impact on insurance costs for tens of millions of Americans.
It’s one of the rare issues where the conservative argument can truly use the word “fair” in a way which isn’t simply pandering to those who hope that government will give them a bit of someone else’s money.
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