Another Problem With Community Rating














  1. Joshua Vanderberg:

    Rather a brilliant idea on the part of the hospitals I think. Pay maybe $12k/year max for insurance for your high cost patients, and the insurance company then picks up $100k+ of expenses/year, if not more. There might even be a way to get around the "anti-kickback" policy.

    Couldn't hospitals pool their money into a regional or national non-profit that's designed to buy insurance for high cost uninsured? Then there'd be no direct kick-back, but hospitals on average would see the the number of high cost uninsureds decrease significantly.

  2. DensityDuck:

    But that's the thing--they *expected* stuff like this to happen. This is what "we have to pass the bill to find out what's in it" means. They knew right from the get-go that there would be weird situations and unexpected outcomes and what they probably thought of as "gray areas". Unfortunately, since they don't actually know what trying to comply with government regulations is like, they assumed that all of these situations were the result of dumbass insurance company people, and that all we needed was a good dose of Smart Government Thinking to set us right.

  3. Morlock Publishing:

    Ayn Rand's signature work work was crisp on the movie screen, a bit drawn out on the page, and hellaciously boring in real life.

  4. rst1317:

    Good points. Not to be a pain and the rear and split hairs but these situations aren't weird. Most if not all of them could've been better anticipated. Some actions will always have some negative side effects that are worth living with. I suspect that you and others have eluded to, the problem is that they never even went skin deep on this stuff and just assumed all side effects worth it ( aka the end justifies the means ).

  5. rst1317:

    Have we seen anything like this in states that already had mandates requiring insurers take on applicants regardless of prior conditions? Or maybe some hospitals in states with a state-ran fallback plan like MN and CO have done something like this? A lot of states have a fall-back plan people can buy if they're rejected for insurance due to pre-existing conditions.

  6. J Calvert:

    I can see the actuaries and underwriters going pale and getting the shakes just hearing about this idea. If you think the exchange policies were expensive now, just wait until every schizophrenic, alcoholic, frequent flier homeless dude is part of your risk pool.

  7. irandom419:

    I believe that hospitals could continue someone's cobra insurance before. I'm all in favor of hospitals signing people up for medicaid without their consent, although it is a real world example of a zero sum game.