Can you buy car replacement insurance after you total your car?
Nope. But cars aren't human lives, and some conditions exist from birth. So following that model, anyone whose parents didn't have the foresight to have health insurance is probably out of luck?
Government problem. What exactly do you think is stopping your government from taking care of such a luckless infant? Any infant whose birth is covered by insurance should also be covered by that insurance.
You could faithfully carry a health plan for 20 years, then get laid off and now your heart condition will only be covered if you pay a high premium - if at all.
Ahh.. yes, and why is your insurance though your employer in the first place? Government manipulation. They deliberately set the tax code to give companies buying insurance bigger deductions than individuals. That means your insurance is not going to be portable. They easily could have incentivized the opposite.
So why didn't they? Lot's of reasons, but a big one (on the good intentions side) is that they wanted to put large companies (rather than individuals) opposite insurance companies at the negotiating table. That did result in sweetheart deals for large companies. Unfortunately it left out the little guys and the private companies.
Easy fix? Not really. You could minimize some of the problems by requiring that any insurance plan offered to a corporation be offered on a mandatory basis to the public on the same terms. But that doesn't fix the pricing problem that the government created.
If you work for corporate, you're better off because they lump you in with other employees. If you are self-employed - not so much.
Sort of. They could lump the whole world into a giant pool and the logic on pooling would still function, but they don't - why not? Cause they can stick the small guys with worse deals, and the pre-existing problem would overwhelm the best plans.
I do agree also that costs for the people who could get healthcare would likely drop with the unraveling of legislation over the past 40 years. If nothing else, you would immediately have oversupply with all the people being turned away. I'm just not sure that's the world I'd like to live in where a homeless guy can't get treated for an emergency at an ER because he has no ability to pay.
Yeah, no. We wouldn't unwind every law regardless of utility, we'd just be looking to unwind those that broke the efficiency incentives. Access to emergency rooms regardless of ability to pay was never about efficiency, it was about public policy, and it was funded by the government.
Similarly, I've got little issue, and think it's a good idea to fund super conditions that involved years or decades of enormous costs directly from a government pool. Of course that means their will be rationing and less than optimal treatments involved (the same as every socialist system today) but it will mean that healthcare and insurance costs for 95% of the populace are affordable.
Our medical system is far too big and feeds far too many people for it to just start turning away business. In fact, if your fear was realistic, it'll almost certainly be proof that the market would immediately issue a massive price correction. Are hospitals really going to go out of business when there are sick people with money? No.
And it's not like they'd really be getting much less. They currently send a bill for $20k on a knee surgery and get a co-pay of say $150 from you, and a payment of $1200 from your insurance. Why's the bill $20k if they are willing to and profitable doing it at $1350? Tons of things like that.
You may be right that hospitals and insurance companies shouldn't be "back door forced" to solve a government problem. I just learned that ERs actually get paid back for their charity/bad debt by way of raising medicare/medicaid rates. There's certainly an obfuscated process there, and elsewhere.
There's a lot wrong with what you just said. Medicare/medicaid rates are the lowest reimbursements out there. Hospitals that have choices almost always try to find ways to reduce their medicare/medicaid patient loads. Heck doctors where I'm from won't even take those patients, well at least the ones that are rated as "good" won't.
You ever wonder why your doctor won't talk to you about a new issue at an appointment for something else? They don't get paid if they do. The bureacracy pays them based on volume of discrete events, not on quality of outcome, or happiness of patient.