No. If you exclude preexisting conditions, how do you prevent the case where someone decides to buy insurance the day after they're diagnosed with cancer?
You do that by requiring everyone to have insurance when they're well to help cover those that are sick. That's the mandate. If you try to separate them, the system collapses under the weight of even more cost.
I've heard a republican idea that would instead allow insurance companies to charge a large fee for lapses in coverage, which would be nearly equivalent to requiring coverage except people would be hit with a big fee when signing up.
Medicare already does this. If you go uninsured and then try to enroll (at a time when you're eligible, of course), there's a penalty you're required to pay.
I didn't say it was a good plan, just one I heard suggested. I'm in the opinion that the US should just combine to have one giant risk pool, and include everyone in it (aka single payer)
The irony of that is that in the pre-ACA days, if you did get cancer (or were diagnosed early on-set), in theory, you could go get a job with group healthcare and even with a known diagnosis, you would receive that policy and could immediately receive benefits under that employer group health plan.
Thats easy, actually. If you suffer cancer it should be the company that you are active with at the time who are responsible for paying for your treatment for that, even if you are no longer with them.
You weight until you have cancer to sign up? Well then you have to pay for the cancer treatment, but if you break your leg tomorrow, the insurance company has to pay.
Again previous conditions are not an issue, because they won't cost the next insurance company anything. If you get diagnosed with, say, aids and need treatment for the rest of your life, then it should be the company you were with at the time of your illness that has to paid, even if you are no longer with them.
Couple this with payment in cash for treatment, so that you can shop for the best/cheapest/whatever doctor (just as you would with car work), a mandatory disclosure of prizes and untangle health insurance from your employer and the system should be much more manageable.
"You weight until you have cancer to sign up? Well then you have to pay for the cancer treatment"
Unless you're rich, you either die from lack of treatment, or declare bankruptcy and let the rest of us pay for your treatment. Neither option is particularly good for any of us.
This is one of the more ironic parts - obviously, few people choose death. They choose to massively delay going to the doctor, driving up total cost by skipping preventative care, and then bankruptcy when they finally do.
That bankruptcy is not a magic free moment - it simply means someone else pays. Depending on the case, this might be the state through medicare/medicaid, it might be the health care provider, or it might be third party creditors.
Eventually, though, those defaults are all factored into operating costs of hospitals, the government, banks and so on - meaning you and I pay for them.
So, in the old system, we were all forced to pay for health coverage, whether we liked it or not. In the new system, we're all forced to pay for health coverage, whether we like it or not. ACA is explicit and, with extreme certainty, cheaper, since it expands preventative care on a systemic level.
But, of course, since people didn't realize they were paying for it previously, they now throw fits because the cost is made explicit.
Right on. We've had some form of universal coverage at least since the Emergency Medical Treatment and Active Labor Act was passed in 1986. Unless someone wants to roll that back, then it's just a matter of how you want the universal coverage to be structured, not whether you want it to exist.
But, as with many things, the politics around this issue is all about feels over reals.
We've had some form of universal coverage at least since the Emergency Medical Treatment and Active Labor Act was passed in 1986
Which, of course, is the most expensive way to go. You have people who can't pay visiting the emergency room for an ear infection or the flu. And that cost gets passed on to everyone else, which is why that single Tylenol tablet in your hospital room costs $10.
Among other things, you are relying on no insurance companies ever closing in the future. What happens if they go bankrupt? The government has to bail them out?
That plan won't work because people constantly change insurance companies and there are too many conditions that are life long.
Most people develop many pre-existing conditions as they get older. By the time you're 70 you'll have 5 different insurance companies all treating different conditions that you developed at various times in your life.
Not to mention what happens when companies go out of business. This plan isn't workable at all.
You do that by requiring everyone to have insurance when they're well to help cover those that are sick. That's the mandate. If you try to separate them, the system collapses under the weight of even more cost.