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Not being a doctor, I don't know the details, but this site seems to disagree with you:

Further inquiry, in my mind, would be to determine whether that status ("underweight", "overweight", etc.) is connected to other pre-existing conditions. For example, a careful study of Blade's baby's records would indicate that he has a healthy, young, just somewhat small child. No special risks means that child should be covered under a perfectly normal plan. Similar inquiries into another preemy's records may show neurological damage or muscle problems may indicate the need of substantial therapy in years to come. That's a pre-existing condition. That may mean a more expensive plan (to cover more risks) or actual denial of coverage (if the risks are just too high). A private company should be able to do both within reason.

If the mother had maternity insurance, it covers the pregnancy, and probably natal care as well (such as the NICU). It won't cover the child when they're 2 years old. Some special plans may include an automatic conversion to child coverage after the child is born, but I don't think that's standard. If a company offers such a plan, it should either have any special conditions plainly spelled out, or should cover every child born under that plan regardless of condition. It's part of the risk they take when they offer such a plan.

That's not what we're talking about, though. We're talking about parents trying to get coverage for their 2-year-old child. That's new insurance and any conditions that already exist are 'pre-existing conditions'.

It's not an issue of "good sense" or of control, but of expected risk. When a health insurance company insures me, they're insuring a healthy, active 25-year-old white male, with all the risks typically associated with that. I may go skiing and break my leg, I may get the swine flu and need hospitalization, I may get shot. Pre-existing conditions are known factors that influence that risk. For example, if I were not so healthy, but instead had hemophilia, my insurance would be more expensive, because there are more risks. Same if I had AIDS. If the risks are too high, the company may not want to take them. It's the same thing with children. Preemy babies are commonly associated with a whole slew of other medical problems. Not all preemies will have them, and in such cases where an inquiry can tell the difference, the company probably wants to know (to know how much risk they're taking).

It isn't the government's job to make getting insurance easy. It's the government's job to make getting insurance safe, reliable, and (at the moment) affordable. Basically, where there is good reason for regulation, it should be there, it should be strong, and it should have oversight. Where there isn't a need, introducing regulation is just introducing possibility for things to go wrong or be abused.

In other words, if there's no regulation against insurance companies changing coverage plans without telling people, the insurance companies will abuse the power. That regulation is needed. If there isn't regulation establishing this 'exchange', insurance companies will just have to set up web-sites and offices just like every other company. That regulation isn't needed. If it is put in place, there may be problems with people or companies being denied access to the exchange (it doesn't matter if it's intentional or due to clerical errors, it's a problem that could be avoided), and that's just the beginning.

 

Yes, but that's really early development stuff - it's not still going to be an issue for a toddler.

OK, I think we're talking about two different things. I thought you were contending that a newborn premie, born to parents that have medical insurance could be denied coverage on the basis of premature birth being a pre-existing condition. What I now understand you're saying (I think) is if at a later time you switch insurance companies, that being a premie would be a pre-existing condition to the NEW insurance company. That's a little more reasonable.

I don't know if my plan is typical, but my son was covered automatically for the first 30 days after birth. In that 30 day timeframe you have to add him to your insurance plan and start paying premiums for him as well.

Yeah - I didn't get that from the initial response - I thought you meant all premies had by definition "pre-existing conditions". However, isn't part of the new legislation that you cannot deny coverage on the basis of a pre-existing condition?

One would think that the exchange could accomplish all of those things.

 

It is government's job to protect and promote the general welfare of the people. This was agreed upon by both Hamilton and Washington in their argument for the creation of the national bank, and it is an established, basic function of government since 1789.

It makes no sense to go to war over losing 2000 people to terrorists in the WTC, and then allow 45,000 people a year to die from a lack of basic health services -- on purpose. It would appear that the private sector no longer has the ability, nor the desire to provide basic services that are necessary for the survival of both the lives and economy of the citizens. The general well-being of the nation, and its citizens, do not require any special political mandate.

 

Any medical insurance that automatically extends to a newborn child (i.e. a family plan, or any maternity plans that include such) should, well, extend to the child. I suppose I could see special exclusion clauses for things like high-risk preemy births or other major problems, but they would have to be spelled out very clearly, not tacked on at the back of a 500 page plan in fine print. That also means, of course, that it's in the plan when it's first bought (or most recently updated before the condition is discovered).

 

I'm sure it varies from plan to plan, but I've never seen an employer plan that stops covering you if you get pregnant, or does not cover maternity costs. As you have said, insurance plans are risk tested, and it is reasonable to assume that a married woman in her 30s has the possibility of getting pregnant. I did not get a rate hike when my wife got pregnant, and all of her appointments and tests were covered. My insurance did not increase until my son was actually born (as there was now a 3rd person on the plan). So really, my son was already covered in utero, as my wife was fully covered and he was inside her.

EDIT: Nice new gem

 

Your right Aldeth, usually the 1st baby in a household will change the plan from a Employee & Spouse plan and costs to a Family plan & costs. Any new babies from there are usually covered as part of the family plan. I never saw an increase for each new babay born in a family.

 

That's true - once you're on the family plan, it's the same costs regardless of whether you have one kid or 10.

 

Typically, you are covered and are free from abuse in an employer based plan, since the insurance companies mostly administer the plans. It's the private plans that the insurance companies screw their clients on.

That's your specific plan, Aldeth. With our plan, each additional kid is $95.00 per month.

 

Wow, I have never seen a plan add on for additional kids after the 1st. Whatta gip! I hope your not eating extra cost, Chandos. I'm not sure if you have kids, but that would suck the big one if you did.

 

I have three kids, Blades: Two girls and one boy, and yes we pay for them out of pocket every month. We pay about $500.00 a month for coverage for the five of us.

 

Rebranding the Public Option

It seems like the House is rebranding the public option. It's the same damn thing as it was before, but now they are referring to it as "Medicare Plan E", where the "E" stands for everybody. This is a really good move. The term "public option" has been drug through the mud so much at this point, that the mere mention of the term caused many Republicans to tune the speaker out.

Medicare Plan E is likely to have a much more popular reception, as the majority of people who currently have Medicare are satisfied with it. It would have made so much sense if the Dems had started with this talking point - if they had just started the health care reform push with the slogan "Medicare for Everybody". They wouldn't have had to put up with tea baggers accusing them of being socialist, communist, nazis, and setting up death panels to killl grandma. Public perception is a very important thing, and because pretty much everyone has an idea of what Medicare is (but few people knew what a public option would entail) the silliest of the charges never would have been brought up. For example, people know Medicare doesn't have death panels out to kill grandma.

Also, if they had framed the debate around Medicare from the beginning, it would have been difficult for Republicans to come out really hard against it without sounding anti-Medicare. Moreover, there are already Blue Dogs in the House that are now throwing their support behind the plan, even though nothing of substance besides the name has changed. We will see if the Senate follows the House's lead in this.

Apparently, a rose by any other name is not still a rose. I guess if rebranding was necessary to get this done, so be it. But it is aggravating that people are so stupid.

Here's a news link from Countdown. (Warning: Countdown is definitely liberal and pro-public option. If you're a conservative it may well piss you off.)

 

It's what they should have done from the start: make a PO an expansion of Medicare.

None of that will change, regardless of what Obama does.

Where did I leave my violin?

 

It would seem that it's time to bring this thread back to life, espeically since we are so close to making the insurance companies that much richer:

http://www.theonion.com/content/news/congress_deadlocked_over_how_to

 

Fivethirtyeight is covering this as well. Three of the first four articles are on health care in the link, although I must warn that Nate gets a bit colorful in his language today, including referring to Joe Lieberman as a prick - I went with that example as that would pass the word filter. Anyway, Nate Silver argues that the public option was not ever a realistic goal, and that the Democrats never had more than 58 in favor of it.

This bill is not nearly as good as it could have been, and I am somewhat disappointed in the final product. However, with the alternative being maintaining the status quo, it's a least a little better than nothing.

I also agree with Nate that the Blue Dogs weren't negotiating in bad faith - quite to the contrary they never changed their position at all on the public option. From 538:

The main concern I have is does this bill do enough? One example listed said that the typical family of four earning $54,000 per year would have to spend a little over $13,000 for health care premiums, co-pays and other out of pocket costs every year, which is simply unaffordable to most on that salary. The bill, if it passes as is, will subsidize the cost down to about $6,000 for that family. My question is this: Is $6,000 still in excess of what a family of four making $54,000 per year can afford to pay?

 

That works out to $500/month. That isn't too bad as I'm currently paying $552/month. Of course, my employer is kicking in the rest of the premium. I wonder who will be kicking in the rest of this average guys premium?

 

My family of 4 is covered through my wife's employer. She is payed bi-weekly, costing us $149 a paycheck. $298 a month on 10 months and $447 for the 2 months that the extra checks land in. Her employer covers the rest. We made over a 100K last year. I certainly don't want reform that would drive our costs up because we make X dollars more than say average Joe family.

 

This is a sad statement, primarily because that's not the only alternative. If you don't like this bill, fight it and make sure the next one is better. And I promise you, if this one doesn't pass, there will be a next one. Settling for second best is going to cause more problems than solutions in the long run.

 

Usually true, yes, but alas democracy is all about crappy compromises.

 

When? In another 15 years? The last time we tried (and failed) to reform the health care system was Clinton's first term.

NOG, we never settle for second best. Settling for second best would require shooting for second best, and there are too many entrenched interests to ever allow for something like that.