Saturday, August 22, 2015

Epidemic of chicanery in GOP health reform plans

Medical underwriting, the medieval practice of requiring the self-employed applying for health insurance to first prove they don't need it, has now been illegal for over 600 days, thanks to Obamacare. There is a special place in Hell reserved for presidential candidates, such as Marco Rubio and Scott Walker, who want to make it legal again.

For those with pre-existing conditions who are rejected by insurance companies, Rubio and Walker propose "high risk pools," a concept that has never worked. Walker hastens to add that those self-employed people who maintain continuous coverage would be exempt from medical underwriting.  But both "next Presidents of the United States of America" likely know they are selling snake oil, because neither proposes creating such a "health status" caste system for those with access to employer-provided insurance or Medicare.

And I can say from personal family experience that the pre-existing condition that kicks you out of the healthy group and into the sick "high risk" group could be as innocuous as teenage acne.

Beyond establishing a caste system based on health status, Rubio and Walker would also allow insurance companies to sell "junk coverage" with restrictions such as annual limits, which guarantee the health insurance stops working at the very moment when you need it most.

Neither medical underwriting nor junk coverage save money in any fundamental sense. Mark my words: the only way dividing the self-employed into a sick group, which goes into a "high risk pool," and a healthy group, which doesn't, can possibly save money is by choking off medical services for the sick. Otherwise the sorting process - time consuming and humiliating unto itself - merely adds costs to a health system which is already by far the world's most expensive. Likewise for junk coverage: it only saves money to the extent sick people get denied treatment.

Both medical underwriting and junk coverage are bereft of economic merit, let alone a moral foundation. Until Republicans get over their infatuation with these reprehensible practices, they deserve nothing but scoldings.

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