Would you want health insurance that excludes maternity coverage?

[CreekDog]

if it meant that at some point, coverage for heart disease could be excluded?

if it meant that at some point, coverage related to cancer could be excluded?

if it meant that a disabled adult could have coverage for their condition excluded from coverage?

the problem with "opting out" of the group that helps insure people for things you can't get, is that other people can opt out of the things you can get and insurance "coverage" falls apart and becomes a myth.

be careful what you ask for.

[onehandle]

1. I want health insurance that excludes heart treatments for Dick Cheney.

That would bring the overall rates down for decent people.

[kairos12]

6. I did this by excluding grave robbing on my insurance

[Scuba]

2. No man should be required to pay for maternity care ...

... assuming he can prove he wasn't born.

[CBGLuthier]

3. My wife and I can have heart problems, cancer or become disabled

We will not ourselves be needing maternity services again in this lifetime. I would have no problem with our insurance being cognizant of this totally true and undeniable fact.

[badtoworse]

4. +1

[CreekDog]

11. you literally are screwing yourself over, and you don't even know it

being grouped with those who have maternity coverage keeps your rates for things older people tend to get lower (cancer, heart disease, etc.).

if you actually get what you want, you'll be uninsurable.

you just don't get it and no matter how hard we try to explain how insurance works, you still prefer your ignorance (which harms your chances at health insurance, raises your chances of having excluded preexisting conditions, losing the coverage completely or having it be unaffordable).

when will you stop just posting things that make you feel good, but actually hurt your chances at health care?

when will you learn?

[badtoworse]

25. Do you have any numbers?

I haven't seen any comparisons between the "junk" polices and what is available through the exchanges. Perhaps you are right, but what I've seen posted here about the Bronze plans doesn't look all that great (very high deductibles).

[pnwmom]

5. But the only basis for denying maternity coverage would also open the door

to denying coverage for heart problems or cancer.

EVERYONE is susceptible to SOME health issue or other. That is the true and undeniable fact.

From now on, people's current, past, or predicted future health -- including genetically related conditions -- won't bar them from coverage or increase their premiums.

You might have genes that increase your risk for (or even have a history) of some type of cancer. Because of the ACA, you can't be denied coverage.

Human beings with XX chromosomes are at risk for foreign cells growing in one of their organs; a situation that requires medical care. Those human beings also can't be denied coverage.

You and your wife are not as different from young fertile women as you think. Stuff happens to our bodies that requires medical attention, and our health is the result of how our particular physiology combines with choices we make.

If an insurance company can deny coverage for cells growing in a woman's uterus, they can deny coverage for cells growing in your prostate. It's the same thing.

[MANative]

7. My husband and I are well past childbearing years...

and I have no objection to having this coverage on our policy. As an up-thread post said, if you've been born, you were probably the beneficiary of some prenatal care. Prenatal care helps to prevent disease and ensure healthy birth for both the child and the mother. Apart from the relatively rare percentage of people who chose a sperm donor, a male was involved in the conception.

I don't know whether I'll develop some other condition or disease in the future, and I certainly won't be getting prostate cancer or need Viagra. Those are both covered in nearly every policy that's not junk insurance. It's risk. Same as you pay for your house insurance, your car insurance, your renter's insurance.

[Puzzledtraveller]

8. +2

[CreekDog]

13. ignorance is bliss

but keep posting some pipe dream where you expect the young to help lower the cost of your insurance.

while you tell young females to do without.

wait til that comes back to bite you.

[CreekDog]

10. Again, you fail to understand that the option costs you more than it saves you...

you fail to understand the concept of group insurance.

so say you opt yourself out of the group that covers maternity coverage for young women.

you've excluded yourself from being subsidized by their premiums.

and then of course, then can opt themselves out of the group you are in:

then can be covered for problems they don't have yet (cancer, heart disease) and those problems people in the group have, are excluded as preexisting conditions...so your heart problems, cancer are no longer covered.

see how awesome it is to be able to opt out of being grouped with young women's maternity coverage!

look at the freedom you have to make yourself uninsurable. you're so smart, how did you figure out how to poke yourself in the eye like that?

[Skittles]

28. and they fail to understand everyone has a vested interest in healthy babies

yes indeed

[CreekDog]

30. Tell me about it, and yet I haven't even been able to address that because...

they can't even see that if they want to only think of what benefits them the most as individuals, it involves covering other people's care, but I can't even get them to see that.

wtf.

[Skittles]

34. you seem to be bewildered by selfish people, CreekDog

they're everywhere and I have news for you - their numbers are growing

[CreekDog]

35. :(

yes, of course, but you know what?

i'm selfish. i'm really selfish.

but saying that you want your health insurance to cover everything you need, but want someone else's insurance to not cover everything they need --that's beyond selfish. i couldn't even ask for that with a straight face.

[Skittles]

37. part of it is the consequences of people feeling more and more squeezed

they tend to blame the wrong culprit though

[Arugula Latte]

14. So then why should a young healthy person pay for your geriatric stuff?

[CreekDog]

31. They probably think if they don't cover maternity, and younger folk don't cover his stuff,he'll save

you and I know the opposite will happen if young people don't subsidize care for older folks by enrolling --of course, this will generally be to their benefit when they get older as they'll get rewarded in the same way and be on the receiving end.

this is one of those times where selflessness is in one's own best interest.

if everyone just covers what they need, then it's no longer insurance and everybody is basically covering the cost of their own care.

[Sgent]

17. It is to a point

Although they must "cover" it, insurance companies are allowed to charge different premiums to those over 49. Presumably, the cost of maternity is figured to be 0 by the insurance companies for those over 49.

[geek tragedy]

20. By your logic, you should be put into the "too old to have children" pool

whereas young healthies (<40) would be put into a different pool, with each pool having to pay for their respective costs (young people bear all the costs of maternity care, older people bear all of the costs of cancer and heart disease treatment).

Care to take that deal?

[lumberjack_jeff]

9. It's the wrong question.

If everything boils down to self-interest, then of course I don't want to pay for maternity coverage, or contraceptive coverage, or domestic violence counseling or STD screening or any of the things that the ACA provides to women but not men.

The question is; "Does that make any sense from a 50,000 foot policy view?"

It does not. It's important to society that mothers and babies get adequate prenatal and postnatal care. It's not about "fairness". If it were about fairness (defined as only have to pay for one's own stuff) then insurance itself is unfair and indefensible. In that dystopian world, each individual would be responsible for the cost of their own birth and all subsequent care.

That's one of the main reasons that the "I shouldn't have to pay for Viagra pills!!" argument is stupid. We really don't want to go there. We're all supposed to be in the same boat.

[CreekDog]

16. Jeff, when you and I agree, people should take notice. I ask the question to show its folly

it makes no sense to be able to exclude conditions you don't have because others can exclude conditions you do.

then suddenly we are all just gambling, buying coverage for what we don't have, paying 100% of costs for what we do or what we are prone to.

such a system, largely what we've had in the individual market already, just falls apart as a useful means of providing access to health care.

[lumberjack_jeff]

23. My problem with the ACA

My problem isn't about eliminating gender as a rating criteria, and developing a standardized set of coverage. Both generally good things despite the fact that it shifts costs onto men.

My problem is that unlike for women, ACA does nothing explicitly to promote men's health. Men die younger of every preventable cause, and live 5 years less partly because 30% less is spent on men's care. Substance abuse treatment, workplace safety counseling, violence intervention, Prostate cancer testing and contraception should all be free for men, and an office of Men's health should be created to help guide policy in that regard - and we should all bear the cost increase that this implies.

That's "fair".

[elfin]

12. If those fertile whippersnappers contribute to my geezer issues in their premiums

And eventually to my end of life care, who am I to deny them?

Ala carte in cable would be great, not so much for health care. No ala carte even broached for taxes -- but wouldn't that be fun?

[csziggy]

15. I'm happy to subsidize maternity care so wanted babies can be healthy

And their mothers can get the necessary care.

I've been incapable of having children since I was 25 and never wanted children, but I want those children who are born to be healthy, to be fed, and to get education, even if it costs me more in health care and taxes. Providing for all children makes our country stronger and better and makes it a better place for me to live, so this is not just altruistic.

[Joel thakkar]

46. You are very kind

Thank you!

[justanaverageguy]

18. I'm perfectly comfortable with your scenario providing

i can cancel the policy and go buy one that does cover what I need it to cover.

[CreekDog]

24. how much would a policy cost that covers old guys getting cancer or heart disease?

one that doesn't include young men or young women paying in?

do you really think you could afford that?

also, what insurance company is going to sell you such coverage?

keep dreaming, it must be a nice dream.

[RebelOne]

19. Well, I am on Medicare,

which does not have maternity coverage. I doubt any woman over 65 will be requiring it.

[Savannahmann]

21. Opting out

Opting out means you go down the cafeteria plan, and opt out of things you personally don't want covered. Like auto insurance you can, or may not choose towing coverage, rental car coverage, or content theft coverage. Your argument is that if you have liability, you must have ever asinine rider attached to the policy because if you don't, nobody will.

You mention Maternity Coverage. My wife will never be pregnant. Ever. As part of a group plan, that would be irrelevant as the group is calculated for those who have and those who have no chance of that need. But as an individual plan, it should be my choice, like rental car coverage in case my car is totaled, to choose or do without. It may mean that those who choose to get towing coverage may have to pay more, and I may come out of pocket possibly to the extent of nearly bankrupting myself if I choose to go without said towing coverage. But insurance is a personal matter, one in which we make choices based upon several factors.

IMO the Subsidy should have covered the basic catastrophic care coverage with doctor visits covered with a minimal (not $60) copay. So at least people would have free insurance for accidents, surgeries, and major unexpected events. After that add the others with a few dollars for this, and that. Then the argument from the Rethugs would have been it was wrong, and we would have come out pretty good overall. We would have had in effect single payer. But instead we went for full coverage with all the riders insurance mandated by the Government, and now are trying to sell the people on how much they'll save if their Monet is ever stolen from their trunk thanks to the content theft coverage.

[leftyohiolib]

22. no but why are those my only choices

why not one that excludes maternity for older people and excludes prostate exams for younger people. maternity for younger groups and osteoperosis for older etc.

[CreekDog]

27. because if you don't insure things other people get, they don't insure things that you will get

you both end up paying the full cost of your own care.

which you probably can't afford. it's a basic principle of insurance.

think about it:

1 out of 100 people get cancer, if all 100 of them pay for insurance that covers cancer, the one person is paying 1/100th the cost of that care because it's divided among 100 people. if the 99 that don't have it, or aren't expecting to get it, opt out, the 100th person pays the full cost.

but here's the thing...all those women of child bearing age, they have little to no chance of getting heart disease in the near term. so say you are in a group policy with them that covers their maternity costs, their costs are divided amongst all of you in the group and lots of you don't have that cost, so it's relatively small.

but they pay for you if you have heart disease, that's more costly than pregnancy. so every young woman who is covered by the group coverage you have, helps pay for care that you get that she likely will never need.

if you want to opt out of her cheaper care for maternity, then she can opt out of the stuff that older folks like you get, and you'll get stuck for the entire amount --can you afford that?

or maybe she just won't sign up for the insurance at all, making you and your peer age group coverage VERY VERY expensive, because the young and healthy aren't paying into it and offsetting your higher costs.

but hey, if you think that saves you money, you're just wrong but you just refuse to learn that.

[rickford66]

26. Size matters

Large risk pool = low premiums. Small risk pool = higher premiums. That's why a single payer system would have the lowest premiums possible. I'd love to have all the young child bearing women and their young sperm doners in my Medicare pool.

[mike_c]

29. divide and conquer!

eom

[CreekDog]

32. that's the exact problem and it's frustrating.

[kcr]

38. I think it might be the biggest barrier to single payer

Too many people don't understand how insurance works. The concept of pooling risk is simply too complicated.

[Demo_Chris]

42. I don't think so. The funding for any working single payer system would be progressive...

In many ways, be the opposite of this. With the ACA we are forcing society's poorest group -- the young -- to fund the healthcare needs of comparatively more affluent Americans. The system ONLY works because young people are not expected to use as much as they kick in and will be unable to afford actual care regardless.

Socialized medicine is different. Everyone kicks in according to their ability, and there is no question in anyone's mind that they will get care if they need it. There's no confusion, no fuss, and everyone gets something for their money. They get CARE as needed, something that under the ACA is reserved for the wealthy.

[kcr]

43. If I could wave the magic wand that made all the conservatives

disappear so we could get single payer? Believe me, I would. Until then, we have to deal with insurance. ANd it won't work if unless we group everyone in. And if we kill ACA? We don't get single payer.

[Munificence]

33. I dont' mind the

male species paying for maternity care in their healthcare coverage as long as if his coverage can kick in and cover his partners expenses once hers goes over the limit or cover it all if hers is not as good as a plan for maternity coverage.

Say a 25 year old man gets a female pregnant and they are not married then if her healthcare coverage exceeds the cost or runs out or only covers a percentage then his should be able to kick in. If her deductible is higher/lesser plan then they should be able to choose to use his as the primary if they so choose.

I mean if they are gonna pay for it they should be able to use it for a spouse or for the babies momma.


For any old coots who don't like the idea then maybe we should stop paying for your viagra.

[Demo_Chris]

36. Health Insurance + Healthcare costs more than Healthcare alone...

So why in the hell are we playing this game?

[lonestarnot]

39. Whut?

[Demo_Chris]

40. It costs our nation more money...

In terms of overall national expenditures, it costs more money to purchase health insurance AND healthcare than it costs to simply pay for healthcare alone and be done with it.

[TheKentuckian]

41. What you have is the irreconcilable failure of attempting to make

what by law is an individual responsibly funded by after tax dollars into a social safety net.

There are literally folks pretending that their increased premiums are chipping in for someone less fortunate when that isn't actually the case at all since that less fortunate person is being subsidized out of the general fund and is quite possibly in another pool as well.

[Tanuki]

44. People who think this should be a permissible exclusion

should stop and think about the rapid advances in DNA testing and whether they would want to have jacked up premiums for conditions their profile predicts they "might" develop at some point in the future.

[Orsino]

45. An insurer in the habit of excluding anything...

...will be doing so for profit, and will therefore try to exclude everything. They will have entire departments devoted to the work of denying coverage.

Why would we want any such behavior at all in the way of preserving our lives?